大气颗粒物(PM_(10)/PM_(2.5))与人群循环系统疾病死亡关系的病例交叉研究

Association between ambient PM_(10)/PM_(2.5) levels and population mortality of circulatory diseases: a case-crossover study in Beijing

目的:探讨北京市大气颗粒物(PM10及PM2.5)污染对居民循环系统疾病死亡的影响。方法:连续监测2007年至2008年北京市大气中PM2.5日均浓度,并收集同时期海淀区居民循环系统疾病死亡数据、北京市大气污染物和气象条件资料,应用双向对称性病例交叉研究和条件Logistic回归对数据进行分析,同时调整了性别、年龄及季节等潜在混杂因素的影响。结果:在控制当日气温、相对湿度、平均气压、风速的影响后,PM2.5每升高10μg/m3,所关联的总循环系统疾病、心血管疾病、脑血管疾病死亡的超额危险度分别为0.78%(95%CI:0.07%-1.49%)、0.85%(95%CI:-0.28%1.99%)和0.75%(95%CI:-0.17%1.68%);PM10每升高10μg/m3,所关联的总循环系统疾病、心血管疾病、脑血管疾病死亡的超额危险度分别为0.36%(95%CI:-0.07%0.78%)、0.63%(95%CI:-0.02%1.28%)和0.33%(95%CI:-0.26%0.92%),其中PM2.5与循环系统疾病死亡的关联有统计学意义(P<0.05)。颗粒物在温暖季节(4月至9月)与循环系统疾病死亡的关联比寒冷季节时更强,差异有统计学意义。结论:北京市海淀区循环系统疾病死亡人数的增加可能与颗粒物污染浓度的升高有关,该效应在温暖季节更强,大气PM2.5对健康的影响比PM10更大。

Objective：To explore the association between levels of ambient particulate matters （PM10 and PM25 ） and population mortality of circulatory diseases （ICD10：100 -199） in Beijing. Methods： The daily data of ambient PM2 5 levels were monitored by the research team in Peking University from Jan. 1, 2007 to Dec. 31,2008, and the corresponding meteorological and other air quality data （ PM10, SO2 and NO2 ） were collected from National Meteorological Information Center （NMIC） of China and Bei- jing Environmental Monitoring Center. The data of daily death for the circulatory diseases were collected from the local center for Disease Control and Prevention of Haidian District in Beijing. The symmetric bi- directional case-crossover design and conditional logistic regression model were used for the data analysis. The cases were stratified by gender, age and seasons. The lagged effect was analyzed and the related confounders from meteorological factors and other air pollutants were adjusted. Results： For a 10 μg/m3 increase of the ambient concentration of PM2.5, the corresponding increase of daily mortality of the circulatory diseases, cardiovascular diseases and cerebrovascular diseases was 0.78% （95% CI： 0. 07% to 1.49%）, 0.85% （95% CI： -0.28% to 1.99%）, and 0.75% （95% CI： -0.17% to 1.68%）, respectively, for a 10 p,g/m3 increase of the ambient concentration of PM10, the corresponding increase of daily mortality of the circulatory diseases, cardiovascular diseases and cerebrovascular diseases was 0.36% （95% CI： -0.07% to0.78%）, 0.63% （95% CI： -0.02% to 1.28%）, and 0.33% （95 % CI： -0. 26% to 0.92% ）, respectively. The significant positive associations were observed statis- tically between PM2 5 and the circulatory diseases （P 〈 0.05 ）. The association between ambient PMs and the population mortality was stronger in ＂warm season （April to September）＂ than in ＂cool season （October to the next March）＂ in Beijing （P 〈 0.05 ）. Conclusion： The elevated levels of ambient PM25 and PM10 were positively associated with the increase of the population mortality of the circulatory diseases, and the association is stronger in warm season, and the adverse effect of PM2.5 is greater than that of PM10.