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    大气PM2.5暴露与中低收入国家育龄期女性贫血的关联研究

    Association between atmospheric PM2.5 exposure and anemia among women of reproductive age in low- and middle-income countries

      摘要
    • 摘要:
      目的 评估细颗粒物(fine particulate matter, PM2.5)长期暴露与中低收入国家育龄期女性贫血的关联, 及其在人群亚组中的效应差异。
      方法 采用2005—2019年美国国际开发署的人口与健康调查(Demographic and Health Surveys, DHS)项目收集的40个中低收入国家1 074 790例15~49岁育龄期女性的血红蛋白浓度、地理坐标、人口学特征、家庭因素及社会经济地位数据。PM2.5的年平均浓度数据及归一化植被指数(normalized difference vegetation index, NDVI)的年均数据通过家庭集群坐标匹配以表征个体暴露。使用广义线性混合模型量化PM2.5长期暴露与贫血的关联。
      结果 PM2.5年均浓度每增加1个四分位数间距, 贫血的比值比(odds ratio, OR)及其95%可信区间(confidence interval, CI)为1.104(95%CI: 1.096~1.112)。这种关联强度在年轻的女性中显著增强, OR值为1.121(95%CI: 1.107~1.136), 而低体重、肥胖或农村地区的女性中减弱, OR值分别为1.084(95%CI: 1.065~1.103)、1.034(95%CI: 1.011~1.059)和1.100(95%CI: 1.090~1.110)。较富有和最富有女性PM2.5暴露的效应值相对较高, OR值分别为1.134(95%CI: 1.118~1.150)和1.131(95%CI: 1.112~1.151)。
      结论 PM2.5长期暴露与中低收入国家育龄期女性贫血患病增加显著相关, 提示应采取有效的节能减排措施, 以进一步降低PM2.5浓度, 对相应人群贫血的早期预防具有重要的公共卫生意义。

       

      Abstract:
      Objective To evaluate the association between long-term exposure to fine particulate matter (PM2.5) and anemia among women of reproductive age in low- and middle-income countries, and to determine the variation in effects across different population subgroups.
      Methods The data of 1 074 790 women of reproductive age (15-49 years) from 40 low- and middle-income countries collected through the Demographic and Health Surveys program in 2005—2019 funded by the U.S. Agency for International Development were used, including hemoglobin concentration, geographic coordinates, demographic characteristics, family factors, and socioeconomic status. The mean annual PM2.5 concentration and mean annual normalized difference vegetation index were assigned to the coordinates of household clusters to characterize individual exposure. The association between long-term PM2.5 exposure and anemia was quantified using a generalized linear mixed model.
      Results The odds ratio (OR) and 95% confidence interval (CI) of anemia were 1.104 (95% CI: 1.096-1.112) for each interquartile range increase in mean annual PM2.5 concentration. The strength of association was significantly higher in younger women with the OR being 1.121 (95% CI: 1.107-1.136), and lower in underweight women, obese women, or women living in rural areas with the ORs being 1.084 (95% CI: 1.065-1.103), 1.034 (95% CI: 1.011-1.059), and 1.100 (95% CI: 1.090-1.110), respectively. The effective value of PM2.5 exposure was relatively higher in the richer or richest women, and the ORs were 1.134 (95% CI: 1.118-1.150) and 1.131 (95% CI: 1.112-1.151), respectively.
      Conclusion Long-term exposure to PM2.5 is significantly associated with increased prevalence of anemia in women of reproductive age in low- and middle-income countries. The finding suggests that effective energy conservation and emission reduction measures should be taken to further reduce the concentration of PM2.5, which has significant public health implications for the early prevention of anemia in the corresponding population.

       

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