London School of Hygiene and Tropical Medicine, London, England, UK.
Environ Health. 2024 Oct 22;23(1):89. doi: 10.1186/s12940-024-01127-6.
Current evidence linking long-term exposure to fine particulate matter (PM) exposure and mortality is primarily based on persons that live in the same residence, city and/or country throughout the study, with few residential moves or relocations. We propose a novel method to quantify the health impacts of PM for United States (US) diplomats who regularly relocate to international cities with different PM levels.
Life table methods were applied at an individual-level to US mortality statistics using the World Health Organization's database of city-specific PM annual mean concentrations. Global Burden of Disease concentration-response (C-R) functions were used to estimate cause-specific mortality and days of life lost (DLL) for a range of illustrative 20-year diplomatic assignments for three age groups. Time lags between exposure and exposure-related mortality risks were applied. Sensitivity analysis of baseline mortality, exposure level, C-R functions and lags was conducted. The effect of mitigation measures, including the addition of air purifiers, was examined.
DLL due to PM exposure for a standard 20-year assignment ranged from 0.3 days for diplomats' children to 84.1 days for older diplomats. DLL decreased when assignments in high PM cities were followed by assignments in low PM cities: 162.5 DLL when spending 20 years in high PM cities compared to 62.6 DLL when spending one of every four years (5 years total) in a high PM city for older male diplomats. Use of air purifiers and improved home tightness in polluted cities may halve DLL due to PM exposure. The results were highly sensitive to lag assumptions: DLL increased by 68% without inception lags and decreased by 59% without cessation lags for older male diplomats.
We developed a model to quantify health impacts of changing PM exposure for a population with frequent relocations. Our model suggests that alternating assignments in high and low PM cities may help reduce PM-related mortality burdens. Adding exposure mitigation at home may help reduce PM related mortality. Further research on outcome-specific lag structures is needed to improve the model.
目前将长期暴露于细颗粒物（PM）暴露与死亡率联系起来的证据主要基于在整个研究期间居住在同一住所、城市和/或国家的人，他们很少搬家或搬迁。我们提出了一种新方法来量化 PM 对经常搬迁到不同 PM 水平的国际城市的美国（US）外交官的健康影响。
使用世界卫生组织特定城市 PM 年平均浓度数据库，在个体水平上应用寿命表方法对美国死亡率统计数据进行分析。使用全球疾病负担浓度-反应（C-R）函数来估算一系列说明性的 20 年外交任务对三个年龄组的特定原因死亡率和生命损失天数（DLL）。应用了暴露与暴露相关的死亡率风险之间的时间滞后。对基线死亡率、暴露水平、C-R 函数和滞后进行了敏感性分析。还检查了缓解措施的效果，包括添加空气净化器。
对于标准的 20 年任务，由于 PM 暴露而导致的 DLL 范围为外交官子女的 0.3 天至年长外交官的 84.1 天。在高 PM 城市的任务之后紧接着是低 PM 城市的任务，DLL 会降低：对于年长的男性外交官，在高 PM 城市中度过 20 年与在高 PM 城市中度过每四年（总共 5 年）相比，DLL 减少了 162.5 DLL。在污染城市中使用空气净化器和改善家庭密封性可能会使 PM 暴露导致的 DLL 减半。结果对滞后假设非常敏感：对于年长的男性外交官，如果没有起始滞后，则 DLL 增加 68％，如果没有停止滞后，则 DLL 减少 59％。
我们开发了一种模型，用于量化具有频繁搬迁人口的 PM 暴露变化的健康影响。我们的模型表明，在高 PM 和低 PM 城市之间交替分配任务可能有助于降低 PM 相关的死亡负担。在家中进行暴露缓解可能有助于降低与 PM 相关的死亡率。需要进一步研究特定于结果的滞后结构，以改进该模型。
