Kumar Ashish, Khadke Sumanth, AlKindi Sadeer, Rajagopalan Sanjay, Nasir Khurram, Kazi Dhruv, Ahmad Javaria, Khan Safi, Asnani Aarti, Addison Daniel, Sadler Diego, Deswal Anita, Barac Ana, Guha Avirup, Liu Jennifer, Lenihan Daniel, Neilan Tomas G, Hayek Salim, Hermann Joerg, Nohria Anju, Dani Sourbha S, Ganatra Sarju
Department of Internal Medicine, Cleveland Clinic, Akron General, Akron, Ohio, USA.
Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA.
JACC Adv. 2024 Jul 13;3(8):101106. doi: 10.1016/j.jacadv.2024.101106. eCollection 2024 Aug.
Evidence regarding the effect of long-term exposure to particulate matter (PM) 2.5 and comorbid cancer and cardiovascular disease (CVD) mortality is limited.
In this study, the author report the association between long-term exposure to PM 2.5 and CVD mortality, cancer mortality and comorbid cancer and CVD mortality in the U.S. population.
The Centers for Disease Control and Prevention (CDC) WONDER (Wide-Ranging Online Data for Epidemiologic Research) multiple-cause-of-death database was used to obtain U.S. county-level mortality and population estimates from 2016 to 2020. Data on average daily density of PM 2.5 were abstracted from the 2018 CDC's National Environmental Public Health Tracking system. Counties were divided into quartiles with Q1 representing counties with least average daily density and Q4 representing counties with maximum average daily density of PM 2.5. Age-adjusted mortality rates were abstracted for each quartile, for the overall population and subgroups of population.
The age-adjusted mortality rates for CVD, cancer, and comorbid cancer and CVD mortality were 505.3 (range: 505.0-505.7), 210.7 (range: 210.5-210.9), and 62.0 (range: 61.8-62.1) per 100,000 person-years, respectively. CVD mortality had the highest percentage excess mortality in Q4 compared with Q1, followed by comorbid cancer and CVD. Cancer had the least percentage excess mortality. A disproportionate effect of PM 2.5 exposure was noted on vulnerable and minority groups, based on Social Vulnerability Index and race stratification, respectively.
Higher levels of long-term PM 2.5 exposure reported increased CVD mortality, cancer mortality and comorbid cancer and CVD disease mortality, with a pronounced detrimental effect in vulnerable and minority population.
关于长期暴露于细颗粒物(PM)2.5与癌症合并心血管疾病(CVD)死亡率之间关系的证据有限。
在本研究中,作者报告了美国人群长期暴露于PM 2.5与CVD死亡率、癌症死亡率以及癌症合并CVD死亡率之间的关联。
使用疾病控制与预防中心(CDC)的WONDER(用于流行病学研究的广泛在线数据)多死因数据库,获取2016年至2020年美国县级死亡率和人口估计数据。PM 2.5日均密度数据取自2018年CDC的国家环境公共卫生跟踪系统。各县被分为四分位数,Q1代表PM 2.5日均密度最低的县,Q4代表PM 2.5日均密度最高的县。提取了每个四分位数、总体人群和人群亚组的年龄调整死亡率。
CVD、癌症以及癌症合并CVD的年龄调整死亡率分别为每10万人年505.3(范围:505.0 - 505.7)、210.7(范围:210.5 - 210.9)和62.0(范围:61.8 - 62.1)。与Q1相比,Q4中CVD死亡率的超额死亡率百分比最高,其次是癌症合并CVD。癌症的超额死亡率百分比最低。基于社会脆弱性指数和种族分层,分别注意到PM 2.5暴露对弱势群体和少数群体有不成比例的影响。
较高水平的长期PM 2.5暴露报告显示CVD死亡率、癌症死亡率以及癌症合并CVD疾病死亡率增加,对弱势群体和少数族裔人群有明显的有害影响。