Liu Cong, Chen Renjie, Lei Jian, Zhu Yixiang, Zhou Lu, Meng Xia, Xuan Jianwei, Kan Haidong
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China.
Health Economic Research Institute, School of Pharmacy, Sun Yat-Shen University, Guangzhou 510275, China.
Environ Health (Wash). 2023 Jul 16;1(2):130-138. doi: 10.1021/envhealth.3c00039. eCollection 2023 Aug 18.
Few multicity studies have examined the acute effects of nitrogen dioxide (NO) on respiratory disease (RD), especially its specific causes. This study aimed to investigate the associations between short-term exposure to NO and hospitalization of full-spectrum RDs in China. Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013-2020. A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO and RDs. NO was significantly associated with increased hospitalization of eight major RDs (acute upper respiratory infections, influenza and pneumonia, acute lower respiratory infections, upper respiratory tract diseases, chronic lower respiratory diseases, respiratory interstitium diseases, pleura diseases, and other respiratory diseases) and 18 specific causes of RDs, with the largest associations observed on lag 0-1 day. The effect estimates ranged from 0.75 to 4.09% per 10 μg/m of NO exposure. The associations remained robust after controlling for copollutants. The concentration-response curves were mostly positive and linear. This nationwide study provides comprehensive information on the acute effects of NO on respiratory morbidity across the full spectrum, highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.
很少有多城市研究考察二氧化氮（NO）对呼吸系统疾病（RD）的急性影响，尤其是其具体病因。本研究旨在调查中国短期接触NO与全谱RD住院之间的关联。在2013 - 2020年的研究期间，从20个省份获取了10大类和40种特定病因的RD住院数据。在个体层面进行了时间分层病例交叉研究，以探索NO与RD之间的关联。NO与八大类RD（急性上呼吸道感染、流感和肺炎、急性下呼吸道感染、上呼吸道疾病、慢性下呼吸道疾病、呼吸间质疾病、胸膜疾病和其他呼吸系统疾病）以及18种特定病因的RD住院增加显著相关，在滞后0 - 1天观察到的关联最大。每10 μg/m³的NO暴露，效应估计范围为0.75%至4.09%。在控制了共污染物后，这些关联仍然稳健。浓度 - 反应曲线大多为正且呈线性。这项全国性研究提供了关于NO对全谱呼吸系统发病率急性影响的全面信息，凸显了在当前污染控制计划中对这种重要的交通相关空气污染物保持谨慎的必要性。
