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短期接触NO2增加每日总死亡率、心血管死亡率和呼吸系统死亡率
作者:小柯机器人 发布时间:2021/3/28 15:25:24

复旦大学阚海东教授团队分析了环境二氧化氮与每日总死亡率、心血管死亡率和呼吸死亡率的短期相关性。2021年3月25日,该研究发表在《英国医学杂志》上。

为了使用统一的分析方案,评估二氧化氮(NO2)与全球多个国家/地区的总死亡率、心血管死亡率和呼吸系统死亡率之间的短期相关性,研究组在在22个低收入至高收入国家/地区中的398个城市进行了一项两阶段时间序列的荟萃分析。主要结局为1973-2018年间,每日死于非意外(6280万)、心血管原因(1970万)和呼吸原因(550万)的人数。

平均而言,滞后1天(前一天)的NO2浓度增加10 μg/m3分别与总死亡率、心血管死亡率和呼吸死亡率增加0.46%、0.37%和0.47%相关。在校正了共污染物(PM10和PM2.5、臭氧、二氧化硫和一氧化碳)后,这些关联仍然很强。所有三种原因的混合浓度-反应曲线几乎呈线性,没有明显的阈值。在398个城市中,由于NO2浓度高于正常值而导致的死亡比例为1.23%。

该研究提供了关键证据,证明短期接触NO2与总死亡率、心血管死亡率和呼吸系统死亡率风险增加呈独立线性关系,表明通过加强NO2的指导方针和监管限制,可以实现健康效益。

附:英文原文

Title: Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities

Author: Xia Meng, Cong Liu, Renjie Chen, Francesco Sera, Ana Maria Vicedo-Cabrera, Ai Milojevic, Yuming Guo, Shilu Tong, Micheline de Sousa Zanotti Stagliorio Coelho, Paulo Hilario Nascimento Saldiva, Eric Lavigne, Patricia Matus Correa, Nicolas Valdes Ortega, Samuel Osorio, Garcia, Jan Kysely, Ale Urban, Hans Orru, Marek Maasikmets, Jouni J K Jaakkola, Niilo Ryti, Veronika Huber, Alexandra Schneider, Klea Katsouyanni, Antonis Analitis, Masahiro Hashizume, Yasushi Honda, Chris Fook Sheng Ng, Baltazar Nunes, Joo Paulo Teixeira, Iulian Horia Holobaca, Simona Fratianni, Ho Kim, Aurelio Tobias, Carmen íiguez, Bertil Forsberg, Christofer strm, Martina S Ragettli, Yue-Liang Leon Guo, Shih-Chun Pan, Shanshan Li, Michelle L Bell, Antonella Zanobetti, Joel Schwartz, Tangchun Wu, Antonio Gasparrini, Haidong Kan

Issue&Volume: 2021/03/24

Abstract:

Objective To evaluate the short term associations between nitrogen dioxide (NO2) and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide, using a uniform analytical protocol.

Design Two stage, time series approach, with overdispersed generalised linear models and multilevel meta-analysis.

Setting 398 cities in 22 low to high income countries/regions.

Main outcome measures Daily deaths from total (62.8 million), cardiovascular (19.7 million), and respiratory (5.5 million) causes between 1973 and 2018.

Results On average, a 10 μg/m3 increase in NO2 concentration on lag 1 day (previous day) was associated with 0.46% (95% confidence interval 0.36% to 0.57%), 0.37% (0.22% to 0.51%), and 0.47% (0.21% to 0.72%) increases in total, cardiovascular, and respiratory mortality, respectively. These associations remained robust after adjusting for co-pollutants (particulate matter with aerodynamic diameter ≤10 μm or ≤2.5 μm (PM10 and PM2.5, respectively), ozone, sulfur dioxide, and carbon monoxide). The pooled concentration-response curves for all three causes were almost linear without discernible thresholds. The proportion of deaths attributable to NO2 concentration above the counterfactual zero level was 1.23% (95% confidence interval 0.96% to 1.51%) across the 398 cities.

Conclusions This multilocation study provides key evidence on the independent and linear associations between short term exposure to NO2 and increased risk of total, cardiovascular, and respiratory mortality, suggesting that health benefits would be achieved by tightening the guidelines and regulatory limits of NO2

DOI: 10.1136/bmj.n534

Source: https://www.bmj.com/content/372/bmj.n534

期刊信息

BMJ-British Medical Journal:《英国医学杂志》,创刊于1840年。隶属于BMJ出版集团,最新IF:27.604
官方网址:http://www.bmj.com/
投稿链接:https://mc.manuscriptcentral.com/bmj