成都市大气PM_(2.5)相关的老年人超额死亡风险评估

Air pollutant PM_(2.5) related excess mortality risk assessment among elderly residents in Chengdu

目的探讨成都市大气颗粒物(PM_(2.5))污染所致老年人超额死亡风险。方法收集2013—2016年成都市大气颗粒物(PM_(2.5))日平均浓度、死亡个案数据及气象因素,利用广义相加模型,控制时间的长期趋势、气象因素等混杂因素,分析PM_(2.5)浓度对老年人死亡的影响。收集2017年成都市大气颗粒物(PM_(2.5))日平均浓度和死亡个案数据,根据健康损失计算模型,估算2017年成都市PM_(2.5)污染造成的老年人超额死亡人数。结果单污染物模型显示成都市PM_(2.5)浓度每升高10μg/m^3,老年人非意外总死亡风险增加0.36%(95%CI:0.25%～0.48%),呼吸系统疾病死亡风险增加0.51%(95%CI:0.30%～0.72%),循环系统疾病死亡风险增加0.36%(95%CI:0.16%～0.56%)。多污染物模型中,成都市PM_(2.5)浓度每升高10μg/m^3,老年人非意外总死亡风险增加0.33%(95%CI:0.21%～0.45%),呼吸系统疾病死亡风险增加0.48%(95%CI:0.26%～0.69%),循环系统疾病死亡风险增加0.29%(95%CI:0.09%～0.49%)。2017年成都市老年人因PM_(2.5)污染造成的非意外、呼吸系统疾病、循环系统疾病超额死亡数分别为1 252、540、409人,占当年老年人同死因别总死亡数的1.95%、2.72%、1.94%。结论 PM_(2.5)污染增加老年人超额死亡风险。

Objective To explore the excess mortality risk of fine particle matter(PM2.5)among the elderly residents in Chengdu.Methods Daily concentrations of PM2.5,daily mortality data and weather conditions from 2013 to 2016 in Chengdu were collected.After adjustment of the effects of long-term trend of death,weather conditions and other confounding factors,generalized additive model(GAM)was used to explore the relationship between the level of PM2.5 and the elderly mortality.Daily concentrations of PM2.5 and daily mortality data of Chengdu in 2017 were collected.Excess mortality of Chengdu in 2017 was estimated by using a Health loss calculation model.Results In single-pollutant model,the risks of all causes(non-accident),respiratory diseases and circulatory diseases of elderly increased by 0.36%(95%CI:0.25%-0.48%),0.51%(95%CI:0.30%-0.72%)and 0.36%(95%CI:0.16%-0.56%),respectively with every rise of 10μg/m3 in PM2.5 concentration.In multi-pollutant model,the risks of all causes(non-accident),respiratory diseases and circulatory diseases of elderly increased by 0.33%(95%CI:0.21%-0.45%),0.48%(95%CI:0.26%-0.69%)and 0.29%(95%CI:0.09%-0.49%),respectively with every rise of 10μg/m3 in PM2.5 concentration.The numbers of elderly excess mortality of all causes(nonaccident),respiratory diseases,circulatory disease were 1 252,540 and 409 in Chengdu,which accounted for 1.95%,2.72%and 1.94%of the same category death in 2017,respectively.Conclusion PM2.5 could increase the excess mortality risk among the elderly residents.