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BMJ:减轻空气污染与死亡率降低相关

2013-01-17 BMJ 高晓方 编译

  澳大利亚学者的一项研究表明,减轻生物燃料烟气所致空气污染与男性年死亡率降低,以及冬季心血管和呼吸系统疾病死亡率降低具有相关性。论文于2013年1月8日在线发表于《英国医学杂志》(BMJ)。   此项研究以实施和未实施空气污染干预的澳大利亚朗塞斯顿市和霍巴特市为研究对象;两市分别由67,000和148,000例居民。对温度、湿度、周日期、呼吸系统流行病和长期死亡率趋势进行校正之后,利用Pois

  澳大利亚学者的一项研究表明,减轻生物燃料烟气所致空气污染与男性年死亡率降低,以及冬季心血管和呼吸系统疾病死亡率降低具有相关性。论文于2013年1月8日在线发表于《英国医学杂志》(BMJ)。

  此项研究以实施和未实施空气污染干预的澳大利亚朗塞斯顿市和霍巴特市为研究对象;两市分别由67,000和148,000例居民。对温度、湿度、周日期、呼吸系统流行病和长期死亡率趋势进行校正之后,利用Poisson回归模型对每日死亡率进行年龄分层时间序列分析。干预措施包括起始于2001年的社区教育活动、强化环境管理以及木材炉具置换。主要转归为2001年前后6.5年间的患者全因、心血管和呼吸系统疾病每日死亡率变化。

  结果显示,朗塞斯顿市冬季平均每日PM10浓度由1994~2000年的44 µg/m3降低至2001~2007年的27 µg/m3。此时期的空气质量改善与年死亡率轻度非显著性降低具有相关性。在男性中年死亡率降低更为显著,并且全因、心血管和呼吸系统疾病死亡率出现显著降低(P值分别为0.01、0.02和0.05)。冬季心血管和呼吸系统疾病死亡率降低具有临界显著性(P值分别为0.06和0.07)(男、女性综合)。在对照城市霍巴特市中死亡率无显著变化。


Evaluation of interventions to reduce air pollution from biomass smoke on mortality in Launceston, Australia: retrospective analysis of daily mortality, 1994-2007

Objective 
To assess the effect of reductions in air pollution from biomass smoke on daily mortality.
Design 
Age stratified time series analysis of daily mortality with Poisson regression models adjusted for the effects of temperature, humidity, day of week, respiratory epidemics, and secular mortality trends, applied to an intervention and control community.
Setting 
Central Launceston, Australia, a town in which coordinated strategies were implemented to reduce pollution from wood smoke and central Hobart, a comparable city in which there were no specific air quality interventions.
Participants 
67 000 residents of central Launceston and 148 000 residents of central Hobart (at 2001 census).
Interventions 
Community education campaigns, enforcement of environmental regulations, and a wood heater replacement programme to reduce ambient pollution from residential wood stoves started in the winter of 2001.
Main outcome measures 
Changes in daily all cause, cardiovascular, and respiratory mortality during the 6.5 year periods before and after June 2001 in Launceston and Hobart.
Results 
Mean daily wintertime concentration of PM10 (particulate matter with particle size <10 µm diameter) fell from 44 µg/m3 during 1994-2000 to 27 µg/m3 during 2001-07 in Launceston. The period of improved air quality was associated with small non-significant reductions in annual mortality. In males the observed reductions in annual mortality were larger and significant for all cause (−11.4%, 95% confidence interval −19.2% to −2.9%; P=0.01), cardiovascular (−17.9%, −30.6% to −2.8%; P=0.02), and respiratory (−22.8%, −40.6% to 0.3%; P=0.05) mortality. In wintertime reductions in cardiovascular (−19.6%, −36.3% to 1.5%; P=0.06) and respiratory (−27.9%, −49.5% to 3.1%; P=0.07) mortality were of borderline significance (males and females combined). There were no significant changes in mortality in the control city of Hobart.
Conclusions 
Decreased air pollution from ambient biomass smoke was associated with reduced annual mortality in males and with reduced cardiovascular and respiratory mortality during winter months.

    

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