A cohort study of air pollutant exposure with the risk of pulmonary nodules progression in Suzhou City
Objective This study aimed to investigate the impact of exposure to common air pol-lutants on the risk of pulmonary nodule progression.Methods A cohort was constructed including indi-viduals identified with pulmonary nodules from a medical examination at a hospital in Suzhou.The average daily exposure concentrations of air pollutants in the year prior to baseline were estimated using the data from environmental monitoring stations.The nodule progression and outcomes were diagnosed by the guidelines for the management of pulmonary nodules proposed by the Fleischner Society.The log-rank test was used to compare the differences in progression rates,and the Cox proportional hazards model was used to estimate the risk of pulmonary nodule progression.Results A total of 785 individuals identified with pulmonary nodules at baseline were included,and among them,354 cases were observed with progression of pulmonary nodules during a median follow-up of 23.50 months.The individuals exposed to higher con-centrations of NO2,PM2 5,and PM10 had higher progression rates.Subjects with the highest exposure group(Q4)for PM2.5(HR=1.48,95％CI:1.06-2.06,P＜0.01)and PM10(HR=1.56,95％CI:1.08-2.25,P=0.02)had significantly higher risks of pulmonary nodules progression compared to that of the lowest exposure group(QI),and there was a positive dose-response relationship between pulmonary nodules progression risks and highest level of PM10 exposure.Conclusions With the increased levels of air pollutants,the risk of pulmonary nodule progression is increased.It is necessary to strengthen the follow-up management of individuals with pulmonary nodules who are expose to the high levels of air pollutants.
Lung nodule progressionAir pollutantsCohort studyCox proportional risk regression model
万方数据
维普
