沈阳市大气O_(3)与人群心血管疾病死亡及寿命损失关系

Relationship between atmospheric ozone and cardiovascular disease mortality and years of life lost in Shenyang

目的了解2014—2018年沈阳市O_(3)污染对人群心血管疾病死亡及寿命损失的影响,并探讨人口特征和季节对研究结果的潜在影响。方法收集沈阳市2014—2018年心血管疾病(包括脑卒中和缺血性心脏病)逐日死亡人数、O_(3)逐日平均浓度及同期气象资料,并计算逐日寿命损失年(YLL),采用广义相加模型(GAM)探讨O_(3)污染对心血管疾病死亡的影响(ER及YLL效应值)。结果O_(3)对心血管疾病的影响在累积滞后3 d(lag03)达到最大效应,O_(3)每增加10μg/m^(3),ER及YLL效应值分别为1.08%(95%CI:0.53%~1.62%)和3.97(0.54~7.40)人年。不同人口特征下,O_(3)对女性、≥65岁和文化程度高的人群死亡风险ER更高,分别为1.23%(95%CI:0.48%~1.98%),1.33%(95%CI:0.73%~1.93%),1.17%(95%CI:0.08%~2.27%),但仅不同性别和年龄间差异有统计学意义(P<0.05)。YLL效应值在男性、≥65岁及文化程度低的人群中表现出更高风险,但不同亚组人群间差异均无统计学意义(P>0.05)。在暖季,O_(3)对人群心血管疾病死亡风险ER及YLL效应值的影响均明显增加。结论沈阳市大气O_(3)污染与人群心血管疾病死亡及YLL有一定相关性,女性、≥65岁人群为O_(3)健康损伤的脆弱人群,暖季可增加O_(3)对人群死亡风险及YLL的影响。

Objective To understand the effects of ozone pollution on cardiovascular disease mortality and life expectancy loss in the residents of Shenyang from 2014-2018 and the potential influence of demographic characteristics and seasons on the study results.Method Generalized additive model(GAM)was used to explore the effects of O_(3)pollution on cardiovascular disease mortality(ER and YLL).Results The maximum effect of O_(3)on cardiovascular disease was reached at a cumulative lag 3d(lag03),with ER and YLL of 1.08%(95%CI:0.53%-1.62%)and 3.97(0.54-7.40)years per 10μg/m^(3)increase in ozone.The risk of death(ER)was higher for women,those aged over 65 years and those with a high level of education at 1.23%(95%CI:0.48%-1.98%),1.33%(95%CI:0.73%-1.93%)and 1.17%(95%CI:0.08%,2.27%)for different demographic characteristics,however,the difference was only statistically significant among different genders and age groups(P<0.05).The YLL effect size was observed to be higher in males,individuals aged≥65 years,and people with a lower level of education,however,there was no statistical significance among different subgroups(P>0.05).In the warm season,the effects of O_(3)on the risk of cardiovascular mortality(ER)and YLL in the population were significantly increased.Conclusion Ozone pollution in Shenyang is associated with cardiovascular mortality and years of life lost.Women and the people aged over 65 are vulnerable to ozone damage.The warm season(peak season)can increase the effects of ozone on mortality risk and years of life lost.