中国88个区/县大气臭氧对人群脑卒中死亡的急性效应研究

何敏 齐金蕾 殷鹏 周脉耕 刘江美 刘韫宁 由金玲 林琳 王黎君

引用本文: 何敏, 齐金蕾, 殷鹏, 周脉耕, 刘江美, 刘韫宁, 由金玲, 林琳, 王黎君. 中国88个区/县大气臭氧对人群脑卒中死亡的急性效应研究[J]. 疾病监测. DOI: 10.3784/j.issn.1003-9961.2020.06.007 shu
Citation:  Min He, Jinlei Qi, Peng Yin, Maigeng Zhou, Jiangmei Liu, Yunning Liu, Jinling You, Lin Lin and Lijun Wang. Acute effect of ozone on daily stroke mortality in the 88 districts/counties of China[J]. Disease Surveillance. DOI: 10.3784/j.issn.1003-9961.2020.06.007 shu

中国88个区/县大气臭氧对人群脑卒中死亡的急性效应研究

    作者简介: 何敏,女,湖南省岳阳市人,硕士研究生,主要从事环境与健康相关科学研究工作,Email:450428244@qq.com;
    通信作者: 王黎君, wangli_19@aliyun.com
  • 基金项目: 国家重点研发计划项目(No.2016YFC0206501)

摘要: 目的探究中国88个区/县大气臭氧(O3)对人群脑卒中死亡的急性效应。方法利用分布在全国31个省级行政区的88个区/县2015-2018年每日脑卒中死亡、大气污染和气象的数据。 采用时间序列分析的方法,首先运用准泊松分布和广义相加模型相连接的方法,控制长期和季节变化趋势、气象因素和“星期几效应”的影响,定量分析各个区/县大气O3对人群脑卒中死亡的影响,然后通过随机效应模型合并各区/县的效应值,获得88个区/县平均水平上O3对人群脑卒中死亡的急性效应,并对O3在不同区域、季节、性别和年龄的效应进行分层分析。结果在88个区/县平均水平上,大气O3浓度(lag1)每升高10 μg/m3,人群脑卒中的死亡风险增加0.30%(95% CI:0.13%~0.47%)。 在区域平均水平上,华南地区的效应最强,为0.74%(95% CI:0.08%~1.40%)。 分层分析结果表明,O3浓度对女性脑卒中死亡影响的效应值高于男性,分别为0.38%(95% CI:0.13%~0.63%)、0.23%(95% CI:0.002%~0.460%);O3和脑卒中死亡的关联强度在年长人群中更强;此外,暖季O3的效应值略高于冷季,但经统计学检验,不同区域、季节、性别和年龄组间效应值的差异均无统计学意义。结论大气O3浓度的升高增加了人群脑卒中死亡的风险,应加强开展O3污染防治工作。

English

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  • 图 1  双污染模型中O3引起脑卒中死亡风险增加的百分比(均值和95%CI

    Figure 1.  Estimated percentage difference (means and 95% confidence intervals) in daily stroke mortality caused by ozone in two-pollutant models

    图 2  不同滞后时间O3引起脑卒中死亡风险增加的百分比(均值和95%CI

    Figure 2.  Estimated percentage difference (means and 95% confidence intervals) in daily stroke mortality caused by ozone during different lags

    图 3  不同时间平滑趋势(df/年)O3引起脑卒中死亡风险增加的百分比(均值和95%CI

    Figure 3.  Estimated percentage difference (means and 95% confidence intervals) in daily stroke mortality caused by ozone, using different degrees of freedom in smoothness of time

    表 1  2015-2018年中国88个区/县大气污染物浓度、居民脑卒中死亡及气象情况

    Table 1.  Summary statistics of stroke mortality and environment data in 88 districts/counties in China, 2015–2018

     变量$\bar x $sMinP25P50P75Max
    脑卒中死亡(例/d)2101127
    O3(μg/m3
     全国90.0815.0714.8682.6592.06101.30112.57
     东北85.4713.5556.2679.5 88.72 91.76103.77
     华北95.52 7.0082.0592.7395.87100.00105.74
     华中93.08 7.2181.5590.6492.14 96.75104.76
     华东94.6618.5814.8688.9598.34106.28112.57
     华南80.83 2.0178.2279.3981.11 82.58 82.86
     西南76.5713.9452.2466.1579.24 84.40103.05
     西北93.2111.6169.0590.0594.57 99.31109.35
    共存污染物
     PM2.5 (μg/m347.9815.657.3637.9648.77 58.44 85.60
     SO2 (μg/m321.1412.353.5811.7018.23 26.70 70.13
     NO2 (μg/m332.4212.134.1024.5931.82 40.61 64.59
     CO(mg/m3 0.99 0.28 0.16 0.79 0.95 1.14 2.00
    气象条件
     平均气温(℃)14.72 4.31 4.4612.0715.06 17.51 24.78
     相对湿度(%)66.1011.2840.4457.1665.22 76.30 81.95
    下载: 导出CSV

    表 2  大气污染物与气象因素的Spearman相关系数

    Table 2.  Spearman correlation coefficients for air pollutants and meteorology factors

    变量PM2.5SO2NO2COO3平均气温相对湿度
    PM2.51.000.530.620.60 0.01−0.28−0.07
    SO21.000.520.52−0.08−0.33−0.21
    NO21.000.53−0.11−0.26−0.07
    CO1.00−0.14−0.25−0.01
    O3 1.00 0.53−0.23
    平均气温 1.00 0.23
    相对湿度 1.00
    下载: 导出CSV

    表 3  不同区域和季节下,O3浓度每升高10 μg/m3引起居民脑卒中死亡风险增加的百分比(均值和95%CI

    Table 3.  Estimated percentage difference(means and 95% CI)in daily stroke mortality per 10 μg/m3 increase in ozone concentration, according to region and season

     变量ER值(%)P
    区域
     全国0.30(0.13~0.47)
     东北 0.28(−0.26~0.83)0.442
     华北 0.45(−0.07~0.98)
     华中0.51(0.02~1.00)
     华东0.26(0.01~0.51)
     华南0.74(0.08~1.40)
     西南−0.03(−0.85~0.79)
     西北−0.07(−0.85~0.71)
    季节0.795
     冷季 0.23(−0.08~0.53)
     暖季0.27(0.03~0.51)
    性别0.391
     女性0.38(0.13~0.63)
     男性 0.23(0.002~0.460)
    年龄组(岁)0.656
     0~ 0.22(−0.23~0.68)
     65~0.39(0.02~0.76)
     ≥750.33(0.11~0.56)
    下载: 导出CSV
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  • 通信作者:  王黎君, wangli_19@aliyun.com
  • 收稿日期:  2020-04-22
  • 网络出版日期:  2020-06-16
  • 刊出日期:  2020-06-01
通信作者: 陈斌, bchen63@163.com
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