荷兰乌得勒支大学Gerard Hoek团队研究了8个欧洲队列长期暴露于低水平空气污染和死亡率的相关性。2021年9月2日出版的《英国医学杂志》发表了这项成果。
为了调查空气污染与死亡率之间的关联，重点关注低于欧盟、美国和世界卫生组织现行标准和准则的相关性，研究组对8个队列进行了汇总分析，在6个欧洲国家开展多中心项目：低水平空气污染的影响研究（ELAPSE）。
20世纪90年代至21世纪初，研究组招募了325367名来自普通人群的成年人，均有详细的生活方式数据。分层Cox比例风险模型用于分析空气污染与死亡率之间的关系。西欧范围内的土地利用回归模型用于描述环境细颗粒物（PM2.5）、二氧化氮、臭氧和黑碳的住宅空气污染浓度。主要结局为自然原因和特定原因造成的死亡。
325367名成年人平均随访19.5年，观察到47131人死亡。较高的PM2.5、二氧化氮和炭黑暴露与几乎所有结局的风险显著增加相关。PM2.5增加5 µg/m3与自然死亡增加13%相关；二氧化氮增加10 µg/m3与自然死亡增加8.6%相关。在低浓度下，PM2.5、二氧化氮和炭黑与死亡增加的关联仍然显著。对于暴露在低于美国标准12 µg/m3的参与者，PM2.5增加5 µg/m3与自然死亡增加29.6%相关。
该研究有助于证明室外空气污染与死亡率相关，即使在低于当前欧洲和北美标准以及世卫组织指导值的低污染水平下也是如此。
附：英文原文
Title: Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis
Author: Maciej Strak, Gudrun Weinmayr, Sophia Rodopoulou, Jie Chen, Kees de Hoogh, Zorana J Andersen, Richard Atkinson, Mariska Bauwelinck, Terese Bekkevold, Tom Bellander, Marie-Christine Boutron-Ruault, Jrgen Brandt, Giulia Cesaroni, Hans Concin, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, Nicole A H Janssen, Karl-Heinz Jckel, Jeanette T Jrgensen, Matthias Ketzel, Jochem O Klompmaker, Anton Lager, Karin Leander, Shuo Liu, Petter Ljungman, Patrik K E Magnusson, Amar J Mehta, Gabriele Nagel, Bente Oftedal, Gran Pershagen, Annette Peters, Ole Raaschou-Nielsen, Matteo Renzi, Debora Rizzuto, Yvonne T van der Schouw, Sara Schramm, Gianluca Severi, Torben Sigsgaard, Mette Srensen, Massimo Stafoggia, Anne Tjnneland, W M Monique Verschuren, Danielle Vienneau, Kathrin Wolf, Klea Katsouyanni, Bert Brunekreef, Gerard Hoek, Evangelia Samoli
Issue&Volume: 2021/09/02
Abstract:
Objective To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines.
Design Pooled analysis of eight cohorts.
Setting Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries.
Participants 325367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM2.5), nitrogen dioxide, ozone, and black carbon.
Main outcome measures Deaths due to natural causes and cause specific mortality.
Results Of 325367 adults followed-up for an average of 19.5 years, 47131 deaths were observed. Higher exposure to PM2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 μg/m3 in PM2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 μg/m3 increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 μg/m3 an increase of 5 μg/m3 in PM2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths.
Conclusions Our study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about revision of air quality limits, guidelines, and standards, and future assessments by the Global Burden of Disease.
DOI: 10.1136/bmj.n1904
Source: https://www.bmj.com/content/374/bmj.n1904
BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
官方网址：http://www.bmj.com/
投稿链接：https://mc.manuscriptcentral.com/bmj
本期文章：《英国医学杂志》：Online/在线发表
