背景:关于空气污染物(AP)对多种疾病的长期影响的不确定性仍然存在,尤其是心血管疾病(CVD)的亚型。我们旨在评估细颗粒物(PM2.5)的个体和联合关联,连同它的化学成分,二氧化氮(NO2)和臭氧(O3),有32种健康状况的风险。
方法:四川省共有17,566名参与者,中国,于2018年纳入,随访至2022年,平均随访期为4.2年。使用机器学习方法测量AP的浓度。应用Cox比例风险模型和分位数g计算来评估AP和CVD之间的关联。
结果:PM2.5质量的四分位数间距(IQR)增加,NO2、O3、硝酸盐、铵,有机质(OM),黑碳(BC),氯化物,和硫酸盐与各种疾病的风险增加显着相关,风险比(HR)范围从1.06到2.48。暴露于多种空气污染物与总心血管疾病相关(HR1.75,95%置信区间(CI)1.62-1.89),高血压疾病(1.49,1.38-1.62),心脏骤停(1.52,1.30-1.77),心律失常(1.76,1.44-2.15),脑血管疾病(1.86,1.65-2.10),行程(1.77,1.54-2.03),缺血性卒中(1.85,1.61-2.12),动脉粥样硬化(1.77,1.57-1.99),静脉疾病,淋巴管,和淋巴结(1.32,1.15-1.51),肺炎(1.37,1.16-1.61),炎症性肠病(1.34,1.16-1.55),肝病(1.59,1.43-1.77),2型糖尿病(1.48,1.26-1.73),脂蛋白代谢紊乱(2.20,1.96-2.47),嘌呤代谢紊乱(1.61,1.38-1.88),贫血(1.29,1.15-1.45),睡眠障碍(1.54,1.33-1.78),肾衰竭(1.44,1.21-1.72),肾结石(1.27,1.13-1.43),骨关节炎(2.18,2.00-2.39),骨质疏松症(1.36,1.14-1.61)。OM在许多情况下对AP的联合作用具有最大权重。
结论:长期暴露于增加水平的多种空气污染物与多种健康状况的风险有关。OM占了这些风险增加的很大比重,这表明它可能在这些关联中发挥重要作用。
BACKGROUND: Uncertainty remains about the long-term effects of air pollutants (AP) on multiple diseases, especially subtypes of cardiovascular disease (CVD). We aimed to assess the individual and joint associations of fine particulate matter (PM2.5), along with its chemical components, nitrogen dioxide (NO2) and ozone (O3), with risks of 32 health conditions.
METHODS: A total of 17,566 participants in Sichuan Province, China, were included in 2018 and followed until 2022, with an average follow-up period of 4.2 years. The concentrations of AP were measured using a machine-learning approach. The Cox proportional hazards model and quantile g-computation were applied to assess the associations between AP and CVD.
RESULTS: Per interquartile range (IQR) increase in PM2.5 mass, NO2, O3, nitrate, ammonium, organic matter (OM), black carbon (BC), chloride, and sulfate were significantly associated with increased risks of various conditions, with hazard ratios (HRs) ranging from 1.06 to 2.48. Exposure to multiple air pollutants was associated with total cardiovascular disease (HR 1.75, 95% confidence intervals (CIs) 1.62-1.89), hypertensive diseases (1.49, 1.38-1.62), cardiac arrests (1.52, 1.30-1.77), arrhythmia (1.76, 1.44-2.15), cerebrovascular diseases (1.86, 1.65-2.10), stroke (1.77, 1.54-2.03), ischemic stroke (1.85, 1.61-2.12), atherosclerosis (1.77, 1.57-1.99), diseases of veins, lymphatic vessels, and lymph nodes (1.32, 1.15-1.51), pneumonia (1.37, 1.16-1.61), inflammatory bowel diseases (1.34, 1.16-1.55), liver diseases (1.59, 1.43-1.77), type 2 diabetes (1.48, 1.26-1.73), lipoprotein metabolism disorders (2.20, 1.96-2.47), purine metabolism disorders (1.61, 1.38-1.88), anemia (1.29, 1.15-1.45), sleep disorders (1.54, 1.33-1.78), renal failure (1.44, 1.21-1.72), kidney stone (1.27, 1.13-1.43), osteoarthritis (2.18, 2.00-2.39), osteoporosis (1.36, 1.14-1.61). OM had max weights for joint effects of AP on many conditions.
CONCLUSIONS: Long-term exposure to increased levels of multiple air pollutants was associated with risks of multiple health conditions. OM accounted for substantial weight for these increased risks, suggesting it may play an important role in these associations.