Peng Minjin, Li Yachen, Wu Jing, Zeng Yi, Yao Yao, Zhang Yunquan
Department of Outpatient, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China.
Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
Int J Hyg Environ Health. 2025 Jan;263:114472. doi: 10.1016/j.ijheh.2024.114472. Epub 2024 Oct 5.
Cohort evidence linking increased mortality with airborne fine particulate matter (PM, particulate matter [PM] with aerodynamic diameter ≤2.5 μm) exposure was extensively validated worldwide. Nevertheless, long-term survival associated with submicron particulate matter (PM, PM with aerodynamic diameter ≤1 μm) exposure remained largely unstudied, particularly in highly exposed populations.
We performed a population-based investigation involving 86844 adults aged 16+ years from 3 national dynamic cohorts spanning from 2005 to 2018. Residential annual exposure to PM and PM was assigned for each follow-up year using satellite-derived spatiotemporal estimates at a 1-km resolution. The concentration of PM (PM with aerodynamic diameter between 1 and 2.5 μm) was calculated by subtracting PM from PM. Time-independent Cox proportional hazards regression models were applied to assess the associations of all-cause mortality with long-term exposure to size-specific particles. To investigate the effect of PM on PM-mortality associations, we categorized participants into low, medium, and high groups based on PM/PM ratio and examined the risk of PM-associated mortality in each stratum. Effect modifications were checked via subgroup analyses.
A total of 18722 deaths occurred during 497069.2 person-years of follow-up (median 5.7 years). Participants were exposed to an average annual concentration of 31.8 μg/m³ (range: 7.6-66.8 μg/m³) for PM, 56.3 μg/m³ (range: 19.8-127.2 μg/m³) for PM, and 24.5 μg/m³ (range: 7.3-60.3 μg/m³) for PM. PM, PM, and PM were consistently associated with elevated mortality risks, with a hazard ratio (HR) of 1.029 (95% confidence interval [CI]: 1.013-1.046), 1.014 (95% CI: 1.005-1.023), and 1.019 (95% CI: 1.001-1.038) for each 10-μg/m increase in exposure, respectively. Compared with low (HR = 0.986, 95% CI: 0.967-1.004) and medium (HR = 1.015, 95% CI: 1.002-1.029) PM/PM ratio groups, PM-related risk of mortality was more pronounced in high PM/PM ratio stratum (HR = 1.041, 95% CI: 1.019-1.064). Greater risks of mortality associated with size-specific particles were found among the elderly (>80 years old), southeastern participants, and those living in warmer areas.
This study demonstrated that long-term exposure to PM, PM, and PM was associated with heightened mortality, and PM may play a predominant role in PM-induced risk. Our results emphasized the population health implications of establishing ambient PM air quality guidelines to mitigate the burden of premature mortality stemming from particulate air pollution.
将死亡率增加与空气中细颗粒物（PM，空气动力学直径≤2.5μm的颗粒物）暴露联系起来的队列证据在全球范围内得到了广泛验证。然而，与亚微米颗粒物（PM，空气动力学直径≤1μm的颗粒物）暴露相关的长期生存情况在很大程度上仍未得到研究，尤其是在高暴露人群中。
我们进行了一项基于人群的调查，涉及来自2005年至2018年的3个国家动态队列的86844名16岁及以上的成年人。使用分辨率为1公里的卫星衍生时空估计值为每个随访年份分配居住年度PM和PM暴露量。通过从PM中减去PM来计算PM（空气动力学直径在1至2.5μm之间的颗粒物）的浓度。应用非时间依赖性Cox比例风险回归模型来评估全因死亡率与长期暴露于特定粒径颗粒物之间的关联。为了研究PM对PM-死亡率关联的影响，我们根据PM/PM比值将参与者分为低、中、高组，并检查每个亚组中与PM相关的死亡风险。通过亚组分析检查效应修饰。
在497069.2人年的随访期间（中位数5.7年）共发生18722例死亡。参与者的PM年均暴露浓度为31.8μg/m³（范围：7.6 - 66.8μg/m³），PM为56.3μg/m³（范围：19.8 - 127.2μg/m³），PM为24.5μg/m³（范围：7.3 - 60.3μg/m³）。PM、PM和PM均与死亡率风险升高一致相关，暴露每增加10μg/m³，风险比（HR）分别为1.029（95%置信区间[CI]：1.013 - 1.046）、1.014（95%CI：1.005 - 1.023）和1.019（95%CI：1.001 - 1.038）。与低（HR = 0.986，95%CI：0.967 -
