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空气污染与中国杭州市居民每日死亡率的关系:一项生态学研究

Air pollution and cancer daily mortality in Hangzhou, China: an ecological research.

机构信息

Department of Chronic and Non-Communicable Disease, Hangzhou Center for Disease Control and Prevention, Hangzhou, China.

Department of Chronic and Non-Communicable Disease, Hangzhou Center for Disease Control and Prevention, Hangzhou, China

出版信息

BMJ Open. 2024 Jun 10;14(6):e084804. doi: 10.1136/bmjopen-2024-084804.

Abstract

BACKGROUND

Long-term exposure to air pollution has been linked to cancer incidence. However, the evidence is limited regarding the effect of short-term exposure to air pollution on cancer mortality.

OBJECTIVES

This study aimed to investigate associations between short-term exposure to air pollutants (sulfur dioxide (SO), nitrogen dioxide (NO), particulate matter with an aerodynamic diameter <10 mm (PM) and PM) and cancer daily mortality.

METHODS

This study used air quality, meteorological and daily cancer death data from 2014 to 2019 in Hangzhou, China. Generalised additive models (GAM) with quasi-Poisson regression were used to analyse the associations between air pollutants and cancer mortality with adjustment for confounding factors including time trends, day of week, temperature and humidity. Then, we conducted stratified analyses by sex, age, season and education. In addition, stratified analyses of age, season and education were performed within each sex to determine whether sex difference was modified by such factors.

RESULTS

After adjusting for potential confounders, the GAM results indicated a statistically significant relationship between increased cancer mortality and elevated air pollution concentrations, but only in the female population. For every 10 μg/m rise in pollutant concentration, the increased risk of cancer death in females was 6.82% (95% CI 3.63% to 10.10%) for SO on lag 03, and 2.02% (95% CI 1.12% to 2.93%) for NO on lag 01 and 0.89% (95% CI 0.46% to 1.33%) for PM on lag 03 and 1.29% (95% CI 0.64% to 1.95%) for PM on lag 03. However, no statistically significant association was found among males. Moreover, the differences in effect sizes between males and females were more pronounced during the cold season, among the elderly and among subjects with low levels of education.

CONCLUSIONS

Increased cancer mortality was only observed in females with rising concentrations of air pollutants. Further research is required to confirm this sex difference. Advocate for the reduction of air pollutant emissions to protect vulnerable groups.

摘要

背景

长期暴露于空气污染与癌症发病率有关。然而,关于短期暴露于空气污染对癌症死亡率的影响,证据有限。

目的

本研究旨在探讨短期暴露于空气污染物(二氧化硫(SO)、二氧化氮(NO)、粒径小于 10μm 的颗粒物(PM)和 PM)与癌症每日死亡率之间的关系。

方法

本研究使用了 2014 年至 2019 年中国杭州的空气质量、气象和每日癌症死亡数据。采用广义加性模型(GAM)与拟泊松回归分析了空气污染物与癌症死亡率之间的关系,并调整了混杂因素,包括时间趋势、星期几、温度和湿度。然后,我们按性别、年龄、季节和教育程度进行了分层分析。此外,在每个性别内按年龄、季节和教育程度进行了分层分析,以确定性别差异是否受这些因素的影响。

结果

在调整了潜在混杂因素后,GAM 结果表明,癌症死亡率的升高与空气污染浓度的升高之间存在统计学上的显著关系,但仅在女性人群中。与污染物浓度每升高 10μg/m 相比,女性的癌症死亡风险增加 6.82%(95%CI 3.63%至 10.10%),SO 在滞后 03 时,NO 在滞后 01 和 0.89%(95%CI 0.46%至 1.33%),PM 在滞后 03 和 1.29%(95%CI 0.64%至 1.95%),PM 在滞后 03 时。然而,在男性中没有发现统计学上的显著关联。此外,男性和女性之间的效应大小差异在寒冷季节、老年人和教育程度较低的人群中更为明显。

结论

仅在女性中观察到随着空气污染物浓度的升高而导致的癌症死亡率升高。需要进一步的研究来证实这种性别差异。倡导减少空气污染物的排放,以保护弱势群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a1c/11168133/cb57fba46ec8/bmjopen-2024-084804f01.jpg

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