我国臭氧短期暴露与人群死亡风险的Meta分析

Meta-analysis of association between short-term ozone exposure and population mortality in China

为评价中国臭氧短期暴露对人群死亡率的影响,获取臭氧污染与人群死亡的暴露-反应关系.检索了Pub Med、SCI（Science Ciation Index）、Ebsco、Ovid、中国生物医学文献数据库、维普中文科技期刊全文数据库、万方数据库和中国知网等,检索时间均为1990年1月1日至2014年12月31日,以＂O3or ozone＂、＂mortality＂、＂China＂、＂臭氧＂及＂死亡＂为关键词查找关于臭氧短期暴露对人群死亡率影响的文献.依据文献纳入和排除标准,进行文献筛选和质量评价.纳入文献后分别提取臭氧的暴露反应关系,采用Stata12.0软件进行Meta分析,根据异质性结果选择相应的效应模型合并效应值,并对结果进行敏感性分析、发表偏倚检验与校正.结果显示,大气中臭氧浓度每增加10μg·m-3,人群非意外总死亡率、心血管系统疾病和呼吸系统疾病死亡率分别增加0.40%（95%可信限（CI）：0.303%-0.498%）、0.448%（95%CI：0.171%-0.724%）和0.461%（95%CI：0.225%-0.697%）.与国外其它未纳入中国研究文献的Meta分析结果进行比较发现,中国的臭氧短期暴露对死亡风险影响的暴露-反应关系系数较高.大气中臭氧浓度的上升会导致我国人群非意外总死亡率、心血管系统疾病死亡率和呼吸系统疾病死亡率的增加.

This paper aims to evaluate the impact of short-term exposure to ozone on the population mortality and to identify the exposure-response relationship between ozone pollution and population mortality. The Pub Med,SCI（ Science Citation Index）,Ebsco,Ovid and four Chinese periodical databases were retrieved for studies related to short-term effects of ozone on population mortality published from 1 January 1990 to 31 December 2014,with key words＂O_3＂or＂ozone＂,＂mortality＂,＂China＂,＂ozone（ in Chinese） ＂,and＂mortality（ in Chinese） ＂. Literature filtering and quality evaluation were conducted according to inclusion and exclusion criteria. Afterwards,the exposure-response relationship was extracted. 11 studies were selected for meta-analysis. Relative risk（ RR） or odds ratio（ OR） and 95% confidence intervals（ CI） of mortality per 10 μg·m-3increase of ozone were obtained from each study. Stata12. 0 was used to test the heterogeneity of the results among different studies and to combine the effect size by fixed or random effect model. Sensitivity analysis and publication bias inspection and correction were performed as well. With 10 μg·m-3increase in ozone concentration,total non-accidental mortality and mortality from cardiovascular and respiratory diseases increased by 0. 40%（ 95% confidence interval（ CI） ： 0. 303% -0. 498%）,0. 448%（ 95% CI： 0. 171% - 0. 724%） and 0. 461%（ 95% CI： 0. 225% - 0. 697%）,respectively. Compared with international meta analysis findings,the exposure-response coefficient in China was higher. The increase in ozone concentration led to increases in total non-accidental mortality and the mortality from cardiovascular and respiratory diseases.