上海市大气污染与居民每日死亡关系的病例交叉研究

A case-crossover study of ambient air pollution and daily mortality in Shanghai

目的 以病例交叉的研究方法 ,估计大气污染急性暴露对上海市居民每日死亡的影响 ,并探讨该设计用于大气污染急性健康效应研究的可行性。方法 采用病例交叉设计的方法分析上海市 2 0 0 0年 6月 1日至 2 0 0 1年 12月 3 1日大气污染与居民每日总死亡和分疾病别死亡的关系 ,同时比较双向对照设计和单向回顾性对照设计研究结果的差异。结果 采用不同的对照选择方案 ,病例交叉设计的研究结果变化较大 ;采用双向 1∶6的对照设计 ,大气可吸入颗粒物 (PM10 )、二氧化硫(SO2 )、二氧化氮 (NO2 ) 48h平均浓度每增加 10 μg m3 ,上海市城区居民总死亡发生的相对危险度分别为 1.0 0 3 ( 95%CI :1.0 0 1～ 1.0 0 5)、1.0 16( 95%CI :1.0 11～ 1.0 2 1)、1.0 2 0 ( 95%CI :1.0 12～ 1.0 2 7)。结论 上海市城区目前的PM10 、SO2 、NO2 水平对居民死亡确有影响 ;

Objective Using case-crossover design to e stimate the acute effect of ambient air pollution on daily mortality in Shanghai ,and to explore the applicability of if in studying the acute health effects of air pollution. Methods Case-crossover technique was used to evaluate th e relationship between air pollution and daily mortality from June 2000 to Decem ber 2001 in Shanghai. The results of the bi-directional control sampling ap proach were compared with unidirectional approach. Results The validity of relative risks in case-crossover studies varied greatly depending on the strategy used in control sampling. When a bi-directional six control sampling approach was used an increase of relat ive risk of non-accident mortality on each 10 μg/m 3 over a 48-hr moving ave rage of PM 10 ,SO 2 and NO 2 corresponds to 1.003 (95%CI: 1.001- 1.005 ), 1.016 (95%CI: 1.011- 1.021 ),and 1.020 (95%CI : 1.012- 1.027 ) respectively was seen. Conclusion The results reinforced the deleterious role of current air pollution level on human health in Shanghai,and provided informatio n on the applicability of case-crossover design in studying the acute health ef fects of air pollution.