Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada.
Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
Sci Total Environ. 2024 Dec 10;955:177046. doi: 10.1016/j.scitotenv.2024.177046. Epub 2024 Oct 22.
Considerable evidence has been accumulated on serious acute health outcomes associated with short-term exposure to ambient fine particulate matter (PM). Modifying factors of those associations, however, have been less explored and need further analyses. In this national study, we investigated whether short-term effects of PM are modified according to region, cause of mortality/hospitalization, season, age, and sex. PM-related adverse health effects were estimated by an ecological time-series study, covering about 80 % of the Canadian population for 18 years (2001-2018). We estimated city-specific associations using daily averages of PM and temperature, and daily counts of hospitalizations and mortality (non-accidental all-cause, circulatory, and respiratory). National and regional associations were then estimated with a 2-stage model. We considered potential modifying factors of PM-related adverse health effects, and examined linear trends in the annual associations. Nationally, PM exposure was associated with both hospitalizations and mortality, and there was evidence of differences by the modifying factors. Of the various causes, circulatory mortality and respiratory hospitalization were more attributable to PM exposure. We found regional differences for both all-cause hospitalization and all-cause mortality, and seasonal differences for respiratory hospitalization (warm season) and circulatory hospitalization (cold season). Circulatory mortality risk was significant for seniors and females. All-cause hospitalizations appeared to gradually decrease over time, but annual all-cause mortality remained constant at 0.6 % of the population. Adverse health effects of PM exposures may depend on not only PM concentration, but also other factors (region, cause, season, age, sex). National estimates for the baseline (age ≥ 1 year, both sexes) risk cannot be interpreted without consideration of the differences by modifying factors. Study findings can be used by seniors, women, and those who have pre-existing health conditions to make informed decisions regarding their health risks from daily exposure to ambient PM.
已经积累了大量证据表明，短期暴露于环境细颗粒物（PM）会导致严重的急性健康后果。然而，这些关联的修正因素研究较少，需要进一步分析。在这项全国性研究中，我们调查了 PM 的短期影响是否因地区、死亡/住院原因、季节、年龄和性别而有所改变。通过一项生态时间序列研究，我们估计了 PM 相关不良健康影响，该研究涵盖了 18 年（2001-2018 年）约 80%的加拿大人口。我们使用 PM 和温度的日平均值以及住院和死亡（非意外全因、循环和呼吸）的日计数来估计每个城市的关联。然后使用两阶段模型估计全国和地区关联。我们考虑了 PM 相关不良健康影响的潜在修正因素，并检查了年度关联的线性趋势。全国范围内，PM 暴露与住院和死亡均有关联，并且这些关联存在修正因素的差异。在各种原因中，循环系统死亡率和呼吸系统住院率与 PM 暴露的关系更为密切。我们发现全因住院和全因死亡存在区域性差异，呼吸住院（温暖季节）和循环系统住院（寒冷季节）存在季节性差异。循环系统死亡率对老年人和女性的影响显著。全因住院似乎随时间逐渐减少，但全因死亡率仍保持在人口的 0.6%不变。PM 暴露的不良健康影响可能不仅取决于 PM 浓度，还取决于其他因素（地区、原因、季节、年龄、性别）。如果不考虑修正因素的差异，就无法解释针对基本情况（年龄≥1 岁，男女）的风险的全国性估计值。研究结果可用于指导老年人、女性和有潜在健康状况的人群做出有关日常环境 PM 暴露对其健康风险的知情决策。
