机动车尾气暴露对广州某社区中老年人心血管系统影响的panel研究

Mobile Vehicle Exhaust Exposure and Impacts of Cardiovascular System in Middle and Old Aged People:a panel Study in a Community of Guangzhou

目的研究机动车尾气污染对中老年人心血管系统的影响,探讨可用于评价尾气污染效应的敏感指标。方法于2008年6和12月对居住在广州市靠近交通干道的某社区32位中老年人进行两阶段的panel研究(专门小组研究),测定与心血管系统有关的健康指标,包括动态心电图、肺功能、血细胞指标和炎症因子,同时监测体检前5d的社区区域监测点和社区内3个有代表性的老年人活动点的空气污染物日平均浓度,计算个体室外污染物时间加权暴露浓度,估计机动车尾气主要污染物对中老年人健康指标的影响。结果在单污染物模型中,肿瘤坏死因子-α(TNF-α)和PM10、SO2、NO2呈正相关关系,而用力肺活量(FVC)、白介素-6(IL-6)则呈负相关关系;心率变异性指标(HRV)中的SDNN(24h内每5minR-R间期均值的标准差,β:-0.57,SE:0.18),SDNN index(每5min窦性R-R间期标准差的均值,β:-0.74,SE:0.20)和PM10相关性较强,与NO2相关较大的指标是SDNNindex(β:-0.66,SE:0.17)。在多污染物模型中,调整了其他污染物的影响后,IL-6和PM10呈正相关,和NO2、SO2呈负相关;TNF-α和NO2、SO2呈正相关;而FVC则和PM10呈负相关。结论目标社区的空气污染物的超标状况符合机动车尾气型污染的特征,且污染水平较高;研究对象的TNF-α、IL-6、FVC、SDNN、SDNNindex与机动车尾气暴露密切相关,一定程度上反映了暴露效应,可作为机动车尾气污染对中老年人心血管系统影响研究的参考指标。

Objective To explored the effects of vehicle exhaust on the cardiovascular system in a panel of 32 middle and old aged people , to discover the sensitive effect indicators of vehicle exhaust. Methods Thirty-two middle and old aged people living near a main road were followed-up, The health-related indicators and individual time-weighted outdoor exposure concentration of air pollutants were determined; The mixed model was used to evaluate association between vehicle exhaust and health indicators of cardiovascular system. Results In single-pollutant models, TNF-αwas positively associated with PMIO, SO2, NO2 and FVC, IL-6 was negative. The indicators of heart rate variability （HRV） in SDNN （β：-0.57, SE： 0.18）, SDNN index （β： -0.74, SE： 0.20） had a strong association with PM 10, and NO2 related indicators was SDNN index （β： -0.66, SE： 0.17）. In the multi-pollutant model, after adjusting the effect of other pollutants, IL-6 had a positive correlation with PM 10;And TNF-α was positively correlated to NO2, SO2; FVC had a negative correlation with PM10. Conclusion The air pollutants of this location show a vehicle exhausts characteristic, and the pollution is serious; TNF-α, IL-6, FVC, SDNN, SDNN index are closely related to exposure of the vehicle exhaust, and can be used to evaluate the effects of vehicle exhaust pollution on the cardiovascular system of the elderly.