Abstract:
Addressing environmental factors has recently been recommended to curb the growing trend of anemia in low- and middle-income countries (LMICs). Fine particulate matter (PM2.5) generated by dust storms were concentrated in place with a high prevalence of anemia. In a multicounty, multicenter study, we analyzed the association between anemia and life-course averaged exposure to dust PM2.5 among children aged <5 years based on 0.65 million records from 47 LMICs. In the fully adjusted mixed effects model, each 10 μg/m3 increase in life-course averaged exposure to dust PM2.5 was associated with a 9.3% increase in the odds of anemia. The estimated exposure-response association was nonlinear, with a greater effect of dust PM2.5 exposure seen at low concentrations. Applying this association, we found that, in 2017, among all children aged <5 years in the 125 LMICs, dust PM2.5 contributed to 37.98 million cases of anemia. Results indicated that dust PM2.5 contributed a heavier burden than all of the well-identified risk factors did, except for iron deficiency. Our study revealed that long-term exposure to dust PM2.5 can be a novel risk factor, pronouncedly contributed to the burden of child anemia in LMICs, affected by land degradations or arid climate.
摘要:
最近建议解决环境因素,以遏制低收入和中等收入国家(LMICs)贫血的增长趋势。沙尘暴产生的细颗粒物(PM2.5)集中在贫血患病率高的地方。在一个多国家,多中心研究,我们基于来自47个LMIC的65万份记录,分析了<5岁儿童中贫血与生活过程中平均粉尘PM2.5暴露量之间的关联.在完全调整的混合效果模型中,生活过程中粉尘PM2.5平均暴露量每增加10μg/m3,贫血几率增加9.3%.估计的暴露-反应关联是非线性的,在低浓度下,粉尘PM2.5暴露的影响更大。应用这个关联,我们发现,2017年,在125个低收入国家的所有5岁以下儿童中,粉尘PM2.5导致3798万例贫血。结果表明,灰尘PM2.5造成的负担比所有明确的风险因素都要重,除了缺铁。我们的研究表明,长期接触灰尘PM2.5可能是一个新的危险因素,明显地导致了LMICs儿童贫血的负担,受土地退化或干旱气候的影响。