Xu Shanshan, Marcon Alessandro, Bertelsen Randi Jacobsen, Benediktsdottir Bryndis, Brandt Jørgen, Frohn Lise Marie, Geels Camilla, Gislason Thorarinn, Heinrich Joachim, Holm Mathias, Janson Christer, Markevych Iana, Modig Lars, Orru Hans, Schlünssen Vivi, Sigsgaard Torben, Johannessen Ane
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Environ Res. 2025 Apr 1;270:120938. doi: 10.1016/j.envres.2025.120938. Epub 2025 Jan 23.
Air pollution has been linked to respiratory diseases, while the effects of greenness remain inconclusive.
We investigated the associations between exposure to particulate matter (PM and PM), black carbon (BC), nitrogen dioxide (NO), ozone (O), and greenness (normalized difference vegetation index, NDVI) with respiratory emergency room visits and hospitalizations across seven Northern European centers in the European Community Respiratory Health Survey (ECRHS) study.
We used modified mixed-effects Poisson regression to analyze associations of exposure in 1990, 2000 and mean exposure 1990-2000 with respiratory outcomes recorded duing ECRHS phases II and III. We assessed interactions of air pollution and greenness, and of atopic status (defined by nasal allergies and hay fever status) and greenness, on these outcomes.
The analysis included 1675 participants, resulting in 119 emergency visits and 48 hospitalizations. Increased PM by 5 μg/m³ was associated with higher relative risk (RR) of emergency visits (1990: RR 1.16, 95% CI: 1.00-1.35; 2000: RR 1.24, 95% CI: 0.98-1.57; 1990-2000: RR 1.17, 95% CI: 0.97-1.41) and hospitalizations (1990: RR 1.42, 95% CI: 1.00-2.01; 2000: RR 2.20, 95% CI: 1.43-3.38; 1990-2000: RR 1.44, 95% CI: 1.04-2.00). Similar trends were observed for PM, BC, and NO, with only PM showing significant associations with hospitalizations across all periods. No associations were found for O. Greenness exposure was linked to more emergency visits in 2000 but to fewer hospitalizations in 1990. Significant interactions were observed between greenness and atopic status for emergency visits, and between NDVI with O and BC for some time windows.
Long-term exposure to particulate matter was associated with increased emergency room visits and hospitalizations. Significant associations were observed for BC and NO with hospitalizations. No link was found with O. Greenness indicated a lower risk of hospitalizations, but increased risks for emergency visits for those with atopic status.
空气污染已被证实与呼吸系统疾病有关，而绿化的影响尚无定论。
在欧洲共同体呼吸健康调查（ECRHS）研究中，我们调查了七个北欧中心的颗粒物（PM和PM）、黑碳（BC）、二氧化氮（NO）、臭氧（O）暴露以及绿化程度（归一化植被指数，NDVI）与呼吸道急诊就诊和住院之间的关联。
我们使用改良的混合效应泊松回归分析1990年、2000年的暴露以及1990 - 2000年的平均暴露与ECRHS第二和第三阶段记录的呼吸道疾病结局之间的关联。我们评估了空气污染与绿化程度之间以及特应性状态（由鼻过敏和花粉症状态定义）与绿化程度之间对这些结局的相互作用。
分析纳入了1675名参与者，共产生119次急诊就诊和48次住院。PM每增加5μg/m³与急诊就诊的相对风险（RR）升高相关（1990年：RR 1.16，95%置信区间：1.00 - 1.35；2000年：RR 1.24，95%置信区间：0.98 - 1.57；1990 - 2000年：RR 1.17，95%置信区间：0.97 - 1.41）以及住院（1990年：RR 1.42，95%置信区间：1.00 - 2.01；2000年：RR 2.20，95%置信区间：1.43 - 3.38；1990 - 2000年：RR 1.44，95%置信区间：1.04 - 2.00）。PM、BC和NO呈现相似趋势，仅PM在所有时间段均与住院有显著关联。未发现与O有关联。绿化暴露在2000年与更多急诊就诊相关，但在1990年与更少住院相关。在急诊就诊方面，绿化程度与特应性状态之间存在显著相互作用，在某些时间窗口，NDVI与O和BC之间也存在显著相互作用。
长期暴露于颗粒物与急诊就诊和住院增加有关。BC和NO与住院有显著关联。未发现与O有关联。绿化程度表明住院风险较低，但对于特应性状态的人来说，急诊就诊风险增加。
