上海市闵行区大气超细颗粒物污染与心脑血管事件发病及死亡的时间序列研究

Associations between ultrafine particles(UFPs)exposure and occurrence and mortality of cardio-cerebrovascular diseases in Minhang District,Shanghai:a time-series analysis

【目的】定量评价超细颗粒物(ultrafine particles,UFPs)暴露对人群心脑血管事件发病和心脑血管疾病死亡的短期效应。【方法】收集上海市闵行区2016年1月1日—2018年12月31日心脑血管事件(脑卒中和急性心肌梗死)发病和心脑血管疾病死亡及同期环境、气象等监测资料,采用时间序列的广义相加泊松回归模型,分析UFPs与心脑血管事件发病及疾病死亡的关系。以UFPs日均浓度每升高一个四分位数间距(interquartile range,IQR),心脑血管事件发病及疾病死亡人数增加的百分比及其95%CI估计UFPs的效应。【结果】单污染模型显示,UFPs水平每升高2 022个/cm^(3)(lag0)和1 795.6个/cm^(3)(lag02),心脑血管事件发病和心脑血管疾病死亡人数分别增加5.01%(95%CI:1.22%~8.94%)、6.05%(95%CI:1.53%~10.80%);在双污染物模型中,UFPs浓度与心脑血管事件发病和心脑血管疾病死亡人数的关联仍具有统计学意义。【结论】空气UFPs暴露对人群心脑血管事件发病和心脑血管疾病死亡存在急性影响。

[Objective] The study aimed to quantitatively evaluate the short-term effects of ultrafine particles(UFPs) exposure on the occurrence and mortality of cardio-cerebrovascular diseases.[Methods]The number of daily cases of cardio-cerebrovascular events,including stroke and acute myocardial infarction,and mortality of cardio-cerebrovascular diseases,daily concentrations of air pollutants and weather conditions in Minhang,Shanghai from January 1,2016 to December 31,2018 were collected. Associations between UFPs and the number of daily cases and deaths were analyzed by the general additive Poisson regression model with the control of meteorological variables,day-of-theweek effects and time trends. Increased percentages of the number of daily cases and deaths and 95%CI were used to indicate the short-term effects of UFPs.[Results]During the study period,in the single-pollutant model,an increase of 2022 particles/cm3showed significant effects with 5.01%(95%CI:1.22%-8.94%)and 6.05%(95%CI:1.53%-10.80%)increments in the percentages of the number of daily cases and deaths respectively. After adjusting other pollutants in the two-pollutant model,statistically significant associations were also observed.[Conclusion]UFPs exposure has acute impacts on the occurrence and mortality of cardio-cerebrovascular diseases.