臭氧短期暴露与我国人群死亡之间关系的meta分析

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

[背景]近年来,我国大气颗粒物污染显著改善,而臭氧(O3)污染却日益严重。O3作为二次污染物,与人群健康有着密切的关联。[目的]探究中国环境空气中臭氧短期暴露对中国人群死亡率的影响。[方法]通过检索Web of Science、PubMed、中国知网、万方、维普中文科技期刊全文数据库,分别以中文关键词“臭氧或O3”“死亡”“时间序列分析”或英文关键词“ozone”“mortality”“China”检索1990年1月1日至2021年12月31日关于臭氧短期暴露对人群死亡率影响的研究。依据主题的纳入和排除标准筛选文献及进行质量评价,并采用R 4.1.2软件对提取的相关效应量进行meta分析。[结果]共检索到978篇文献,依据文献纳入和排除标准,最终纳入18篇文献,包含39个效应量估计值。结果表明,大气中臭氧浓度每增加10μɡ·m^(-3),伴随着人群总死亡率、呼吸系统疾病和心血管系统疾病死亡率增加值及其95%CI分别为0.45%(0.39%~0.51%)、0.50%(0.33%~0.68%)、0.60%(0.48%~0.72%)。按照不同年龄、性别、季节等进行亚组分析后,臭氧浓度每增加10μɡ·m^(-3),≥65岁人群死亡率增加值[0.34%(95%:0.17%~0.51%)]大于<65岁人群[0.09%(95%CI:–0.21%~0.39%)];女性死亡率增加值[0.44%(95%CI:0.30%~0.58%)]大于男性[0.35%(95%CI:0.22%~0.48%)];相比于暖季[0.29%(95%CI:0.16%~0.42%)],冷季的死亡率增加值更高[1.03%(95%CI:0.71%~1.35%)]。[结论]空气臭氧是影响人群死亡率的重要影响因素,我国65岁及以上老年人和女性对臭氧更敏感;在寒冷季节,臭氧暴露对人群死亡率的影响增强。

[Background]In recent years,our country’s atmospheric particulate matter pollution has improved significantly,while ozone(O3)pollution has become increasingly serious.As a secondary pollutant,O3is closely related to human health.[Objective]To study the effect of short-term exposure to ozone in ambient air on population mortality in China.[Methods]A computer search with key words of"ozone or O3","death",and"time series"in Chinese or"ozone","mortality",and"China"in English was performed in Web of Science,Pub Med,China National Knowledge Infrastructure,Wanfang,and VIP databases to find literature on effects of short-term ozone exposure on population mortality covering a time period from January 1,1990 to December 31,2021.According to a set of inclusion and exclusion criteria developed for this study,literaturescreening,quality evaluation,and relevant data extraction were carried out.Finally,R 4.1.2 software was used to perform meta-analysis to estimate target effect sizes.[Results]A total of 978 articles were retrieved.According to the inclusion and exclusion criteria,18 articles were finally included,including39 effect size estimates.The results showed that every 10μɡ·m-3increase in ambient ozone concentration was associated with an increase of 0.45%(95%CI:0.39%-0.51%),0.50%(95%CI:0.33%-0.68%),and 0.60%(95%CI:0.48%-0.72%)in total,respiratory,and cardiovascular disease mortalities,respectively.The results of subgroup analysis by age,sex,and season showed that when ozone concentration increased10μɡ·m-3,an increase of 0.34%(95%CI:0.17%-0.51%)in mortality was observed in the≥65-year-old population,higher than 0.09%(95%CI:-0.21%-0.39%)increase in the<65-year-old population;the mortality increase in females[0.44%(95%CI:0.30%-0.58%)]was greater than that in males[0.35%(95%CI:0.22%-0.48%)];compared with the warm season[0.29%(95%CI:0.16%-0.42%)],mortality increase was higher in the cold season[1.03%(95%CI:0.71%-1.35%)].[Conclusion]Ambient ozone is an important factor affecting population mortality.The elderly and women≥65 years old in China are more sensitive to ozone,and the impact of ozone exposure on population mortality is greater in cold season.