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    2020—2023年马鞍山市大气颗粒物对居民心脑血管疾病死亡影响的时间序列分析

    Time series analysis of the impact of atmospheric particulate matter on cardiovascular and cerebrovascular disease mortality among residents in Ma'anshan, China, 2020—2023

      摘要
    • 摘要:
      目的 探讨马鞍山市大气颗粒物与居民心脑血管疾病死亡的关系, 为心脑血管疾病防治提供科学依据。
      方法 获取马鞍山市2020—2023年大气环境监测、气象观测及居民死因登记数据, 构建分布滞后非线性模型(distributed lag non-linear model, DLNM), 评估大气颗粒物对居民心脑血管疾病死亡的非线性暴露-反应关系及滞后效应。通过性别、年龄和时期分层分析以控制潜在混杂因素。
      结果 2020—2023年马鞍山市PM2.5和PM10日均浓度中位数分别为29和52 μg/m3; 大气颗粒物与居民心脑血管疾病死亡风险增加有显著关联, 在lag 02 d时PM2.5暴露效应值最大, 相对危险度RR值为1.035(95%CI: 1.023~1.046);在lag07 d时PM10暴露效应值最大, RR值为1.018(95%CI: 1.007~1.028)。暴露-反应曲线显示居民心脑血管疾病死亡风险随着大气颗粒物浓度的增加呈现出明显的上升趋势。PM2.5和PM10暴露对不同性别居民心脑血管疾病死亡均有影响, PM2.5和PM10暴露对男性最大效应分别出现在lag02 d和lag07 d, RR值分别为1.042(95%CI: 1.026~1.058)和1.019(95%CI: 1.004~1.034), 对女性则分别出现在lag04 d和lag07 d, RR值为1.029(95%CI: 1.011~1.047)和1.016(95%CI: 1.002~1.030);年龄分层中, PM2.5和PM10暴露仅对≥65岁人群表现出显著风险, 分别在lag02 d和lag07 d中效应最强, RR值分别为1.037(95%CI: 1.025~1.049)和1.019(95%CI: 1.009~1.030)。
      结论 马鞍山市大气颗粒物对居民心脑血管疾病死亡有影响, 其中≥65岁人群为易感人群, 今后应针对该群体加强健康防护与干预措施。

       

      Abstract:
      Objective To investigate the relationship between atmospheric particulate matter and cardiovascular and cerebrovascular disease (CCD) mortality among residents of Ma'anshan, and to provide scientific evidence for CCD prevention and control.
      Methods Data on atmospheric environmental monitoring, meteorological observations, and resident cause-of-death registrations in Ma'anshan from 2020 to 2023 were collected. A distributed lag non-linear model was constructed to assess the non-linear exposure-response relationships and lag effects of atmospheric particulate matters on CCD mortality. Stratified analyses by sex, age, and period were conducted to control for potential confounding factors.
      Results From 2020 to 2023, the median daily concentrations of PM2.5 and PM10 in Ma'anshan were 29 and 52 μg/m3, respectively. Atmospheric particulate matters were significantly associated with an increased risk of CCD mortality. The exposure effect of PM2.5 was the strongest at lag 02 days (relative risk RR=1.035, 95% confidence interval CI: 1.023-1.046), while that of PM10 was the greatest at lag07 days (RR=1.018, 95% CI: 1.007-1.028). The exposure-response curves showed a clear upward trend in mortality risk with increasing particulate matter concentrations. Exposure to PM2.5 and PM10 affected CCD mortality in both males and females. For males, the maximum effects of PM2.5 and PM10 exposure occurred at lag02 days (RR=1.042, 95% CI: 1.026-1.058) and lag07 days (RR=1.019, 95% CI: 1.004-1.034), respectively. For females, the maximum effects occurred at lag04 days (RR=1.029, 95% CI: 1.011-1.047) and lag07 days (RR=1.016, 95% CI: 1.002-1.030), respectively. In the age-stratified analysis, a significant risk was observed only in the population aged≥65 years. The strongest effects of PM2.5 and PM10 exposure in this group were at lag02 days (RR=1.037, 95% CI: 1.025-1.049) and lag 07 days (RR=1.019, 95% CI: 1.009-1.030), respectively.
      Conclusion Atmospheric particulate matters in Ma'anshan were associated with CCD mortality among residents, with individuals aged ≥65 years identified as a susceptible subgroup. Targeted health protection and intervention measures should be strengthened for this population.

       

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