蚌埠市某区2015-2020年空气污染对恶性肿瘤死亡风险影响的队列研究

A cohort study on the effect of air pollution on the risk of malignant tumor mortality in a district of Bengbu City from 2015 to 2020

目的探讨6种空气污染物对恶性肿瘤患者死亡风险的影响。方法本研究是采用蚌埠市禹会区2015—2020年恶性肿瘤的发病和死亡信息进行的一项回顾性队列研究。利用中国高分辨率的空气污染数据集(CHAP)收集PM2.5、PM10、NO_(2)、CO、SO_(2)和O_(3)浓度,并分析6种空气污染物之间的Spearman等级相关系数。以6种空气污染物的第1三分位数等分点(Q1组)为基线组,应用Cox比例风险回归模型估计6种空气污染物与恶性肿瘤患者死亡风险的风险比(HR)及其95%的置信区间(95%CI)。结果本研究最终纳入蚌埠市禹会区2015—2020年恶性肿瘤患者3840例,其中死亡人数为1443例。Spearman相关分析显示O_(3)与其他污染物之间呈负相关关系,而其他5种污染物互相之间呈正相关关系。Cox比例风险回归模型分析结果显示:除O_(3)外,其他空气污染物在高浓度时与恶性肿瘤的死亡风险呈正相关关系,其中PM2.5的HR(4.553,95%CI:3.853~5.381)最大。O_(3)与恶性肿瘤的死亡风险呈负相关关系。结论空气污染可以影响致癌过程,对确诊的恶性肿瘤患者死亡风险具有显著的影响。本研究为降低恶性肿瘤患者的死亡风险提供了重要的公共卫生意义。

Objective To explore the impact of six types of air pollution on the risk of death in patients with malignancies.Methods This was a retrospective cohort study using the information on incidence and mortality of malignant tumors in Yuhui District,Bengbu City,from 2015 to 2020.PM2.5,PM10,NO_(2),CO,SO_(2),and O_(3) concentrations were collection of using a high-resolution air pollution dataset from China(CHAP)and analyzed by Spearman's rank correlation coefficients between the six air pollutants.Using the first tri quantile(Q1 group)of the six air pollutants as the baseline group,risk ratios(HR)and their 95%confidence intervals(95%CI)for six types of air pollution and the risk of death in patients with malignancies were estimated by Cox proportional hazards models.Results This study finally included 3840 cases of malignant tumors in Yuhui District,Bengbu City,from 2015 to 2020,of which 1443 cases died.Spearman's correlation showed a negative correlation between O_(3) and the other pollutants,while the other five had a positive correlation.Cox proportional risk regression model analysis showed that air pollutants other than O_(3) were positively associated with the risk of death from malignancy at high concentrations,with PM2.5 having the most significant HR(4.553,95%CI:3.853-5.381).O_(3) was negatively associated with the risk of death from malignancy.Conclusion Air pollution can influence carcinogenic processes and significantly impact the risk of death in patients with diagnosed malignancies.Since environmental factors are not usually used as survival healing factors after diagnosis,this study provides important public health implications.