芬兰赫尔辛基大学Pekka Martikainen团队研究了重金属带密度与特定入院率和死亡率之间的相关性。这一研究成果发表在2021年12月15日出版的《英国医学杂志》上。
为了评估重金属带区域密度与特定原因住院和死亡之间的关系，研究组在芬兰的311个市镇进行了一项基于纵向登记的队列研究。
共招募了3644944名15至70岁截至2001年底仍居住在芬兰的参与者，主要结局为全因、内部原因、酒精原因、意外伤害和暴力、自杀或自我伤害以及与心理健康相关的原因导致的住院和死亡率。阑尾炎和金属毒性是阴性对照结果。
在2002-2017年5040万人-年的后续随访中，共有4237807人-年住院，221912例参与者死亡。重金属带密度中等的城市死亡率（<5.7/1万居民）低于没有重金属带的城市。与没有重金属带的城市相比，有重金属带的城市的住院率较低。
这些相关性的部分原因是这些城市居民的社会人口特征不同。在对个人特征和地区层面的文化和经济特征（无宗教信仰人口比例、失业率和人均文化教育支出）进行校正后，重金属带密度高的大城市（8.2-11.2/1万）显示出死亡率优势。
相比之下，住院的相关性完全减弱。具体原因分析显示了类似的结果，在完全校正的模型中，与酒精所致死亡率和酒精所致住院率的相关性最为显著。将阑尾炎作为阴性对照结果进行分析，未发现与重金属带密度相关。
该研究未发现重金属带密度增加对健康产生不良影响的证据。重金属带密度高的城市死亡率和因酒精相关问题和自我伤害住院率略低。尽管在观察性研究中残留的混淆仍然是一个问题，但与许多其他形式的文化资本相比，充满活力的当地重金属区域可能有助于通过更健康的生活方式、更好的应对机制和更强的社区意识来促进健康。
附：英文原文
Title: Heavy metal toxicity and mortality—association between density of heavy metal bands and cause specific hospital admissions and mortality: population based cohort study
Author: Pekka Martikainen, Kaarina Korhonen, Lasse Tarkiainen
Issue&Volume: 2021/12/15
Abstract:
Objective To assess the association between area level density of heavy metal bands and cause specific hospital admissions and mortality.
Design Longitudinal register based cohort study.
Setting 311 municipalities in Finland.
Participants 3644944 people aged 15 to 70 residing in Finland at the end of 2001.
Main outcome measures Hospital admission and mortality from all causes, internal causes, alcohol attributable causes, accidental injury and violence, suicide or self-harm, and mental health related causes. Appendicitis and toxic effects of metals were negative control outcomes.
Results During 50.4 million person years of follow-up in 2002-17, 4237807 person years with hospital admissions were observed and 221912 individuals died. Mortality in municipalities with a moderate density of heavy metal bands (<5.7 per 10000 inhabitants) was lower than in municipalities with no heavy metal bands. Hospital admission rates were lower in municipalities with heavy metal bands compared with those with none. These associations could be explained partly by differences in the sociodemographic characteristics of residents in these municipalities. After adjustment for individual characteristics and area level cultural and economic characteristics—proportion of the population with no religious affiliation, unemployment rate, and per capita expenditure on culture and education—large cities with a high density of heavy metal bands (8.2-11.2 per 10000) showed a mortality advantage (hazard ratio 0.92, 95% confidence interval 0.88 to 0.96). In contrast, the association for hospital admission was fully attenuated (incidence rate ratio 0.99, 95% confidence interval 0.92 to 1.06). The cause specific analysis showed similar results, with the association most pronounced for alcohol attributable mortality (hazard ratio 0.83, 95% confidence interval 0.75 to 0.93 for cities with a high density of heavy metal bands) and alcohol attributable hospital admissions (incidence rate ratio 0.84, 95% confidence interval 0.74 to 0.97 for cities with a high density of heavy metal bands) in the fully adjusted models. No association with heavy metal band density was found for the analysis using appendicitis as a negative control outcome.
Conclusions The study found no evidence for adverse health outcomes with increasing density of heavy metal bands. Cities with a high density of heavy metal bands showed slightly lower rates of mortality and of hospital admissions for alcohol related problems and self-harm. Although residual confounding remains a problem in observational studies, vibrant local heavy metal scenes—comparable to many other forms of cultural capital—might help to promote health through healthier lifestyles, better coping mechanisms, and a stronger sense of community.
DOI: 10.1136/bmj-2021-067633
Source: https://www.bmj.com/content/375/bmj-2021-067633
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
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本期文章：《英国医学杂志》：Online/在线发表
