State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China.
National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100084, China; Centre for Clinical and Epidemiologic Research, Beijing an Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, China.
Environ Pollut. 2024 Dec 1;362:124991. doi: 10.1016/j.envpol.2024.124991. Epub 2024 Sep 18.
In recent years, the precision of exposure assessment methods has been rapidly improved and more widely adopted in epidemiological studies. However, such methodological advancement has introduced additional heterogeneity among studies. The precision of exposure assessment has become a potential confounding factors in meta-analyses, whose impacts on effect calculation remain unclear. To explore, we conducted a meta-analysis to integrate the long- and short-term exposure effects of PM, NO, and O on all-cause, cardiovascular, and respiratory mortality in the Chinese population. Literature was identified through Web of Science, PubMed, Scopus, and China National Knowledge Infrastructure before August 28, 2023. Sub-group analyses were performed to quantify the impact of exposure assessment precisions and pollution levels on the estimated risk. Studies achieving merely city-level resolution and population exposure are classified as using traditional assessment methods, while those achieving sub-kilometer simulations and individual exposure are considered finer assessment methods. Using finer assessment methods, the RR (under 10 μg/m increment, with 95% confidence intervals) for long-term NO exposure to all-cause mortality was 1.13 (1.05-1.23), significantly higher (p-value = 0.01) than the traditional assessment result of 1.02 (1.00-1.03). Similar trends were observed for long-term PM and short-term NO exposure. A decrease in short-term PM levels led to an increase in the RR for all-cause and cardiovascular mortality, from 1.0035 (1.0016-1.0053) and 1.0051 (1.0021-1.0081) to 1.0055 (1.0035-1.0075) and 1.0086 (1.0061-1.0111), with weak between-group significance (p-value = 0.13 and 0.09), respectively. Based on the quantitative analysis and literature information, we summarized four key factors influencing exposure assessment precision under a conceptualized framework: pollution simulation resolution, subject granularity, micro-environment classification, and pollution levels. Our meta-analysis highlighted the urgency to improve pollution simulation resolution, and we provide insights for researchers, policy-makers and the public. By integrating the most up-to-date epidemiological research, our study has the potential to provide systematic evidence and motivation for environmental management.
近年来,暴露评估方法的精确性得到了快速提高,并在流行病学研究中得到了更广泛的应用。然而,这种方法学的进步给研究之间带来了更多的异质性。暴露评估的精确性已经成为荟萃分析中的一个潜在混杂因素,但其对效应计算的影响尚不清楚。为了探索这一问题,我们进行了一项荟萃分析,以整合 PM、NO 和 O 对中国人群全因、心血管和呼吸死亡的长期和短期暴露效应。文献通过 Web of Science、PubMed、Scopus 和中国国家知识基础设施于 2023 年 8 月 28 日之前进行了检索。进行了亚组分析,以量化暴露评估精度和污染水平对估计风险的影响。仅达到城市水平分辨率和人群暴露的研究被归类为使用传统评估方法,而达到亚公里模拟和个体暴露的研究被认为是更精细的评估方法。使用更精细的评估方法,长期 NO 暴露与全因死亡率的 RR(每增加 10μg/m,95%置信区间)为 1.13(1.05-1.23),显著高于传统评估结果 1.02(1.00-1.03)(p 值=0.01)。长期 PM 和短期 NO 暴露也呈现出类似的趋势。短期 PM 水平的降低导致全因和心血管死亡率的 RR 增加,从 1.0035(1.0016-1.0053)和 1.0051(1.0021-1.0081)增加到 1.0055(1.0035-1.0075)和 1.0086(1.0061-1.0111),组间差异具有统计学意义(p 值=0.13 和 0.09)。基于定量分析和文献信息,我们在一个概念化框架下总结了影响暴露评估精度的四个关键因素:污染模拟分辨率、研究对象粒度、微观环境分类和污染水平。我们的荟萃分析强调了提高污染模拟分辨率的紧迫性,并为研究人员、政策制定者和公众提供了参考。通过整合最新的流行病学研究,我们的研究有可能为环境管理提供系统的证据和动力。