目的 探究大气氧化性污染物与气温的单独效应,以及两者交互作用分别对我国某地区呼吸、循环系统疾病死亡的影响.方法 使用2014-2018年中国某地区188 039例人群死亡数据、大气污染物日均浓度资料和同期的气象资料,采用基于Poisson分布的广义相加模型(generalized additive model,GAM)及分布滞后非线性模型(distributed lag non-linear model,DLNM)分别探讨大气氧化性污染物和气温对人群因循环、呼吸系统疾病死亡的影响,采用双变量响应面模型和分层法探究两者交互作用对循环、呼吸系统疾病死亡的影响.结果 O3、NO2和Ox每增加10 μg/m3对循环系统疾病死亡的累积效应最大值分别为0.82％(95％CI:0.30％～1.34％)、1.58％(95％CI:0.28％～2.90％)和1.11％(95％CI:0.51％～1.72％),对呼吸系统疾病死亡的累积效应最大值分别为0.53％(95％CI:0.31％～1.37％)、2.66％(95％CI:1.07％～4.27％)和 1.22％(95％CI:0.22％～2.23％).高温和低温对2种疾病死亡影响的差异较大,高温效应即时,低温效应滞后.使用交互作用相对超额危险度(relative excess risk due to interaction,RERI)评估交互作用的大小和方向,交互作用研究结果表明,高温与高浓度的NO2(RERI=0.118,95％CI:0.031～0.206)对人群循环系统疾病死亡风险有协同放大作用,低温与高浓度的 O3(RERI=0.127,95％CI:0.104～0.150)、和 Ox(RERI=0.025,95％CI:0.002～0.049)对人群呼吸系统疾病死亡风险有协同放大作用.结论 高温、低温和大气氧化性污染物(O3、NO2和Ox)均能增加入群循环、呼吸系统疾病的死亡风险,高温与高浓度的NO2、低温与高浓度的O3、Ox对人群循环和呼吸系统疾病死亡的风险有协同作用.
Interactive effects of oxidant air pollutants and temperature on disease mortality in a region of China
Objective To explore the individual and interactive effects of oxidant air pollutants and temperature on mortality from respiratory and circulatory diseases in a defined Chinese region.Meth-ods Using information from 2014 to 2018 in a Chinese region,including 188 039 death cases,air pollu-tant concentrations,and meteorological records.A Poisson generalized additive model(GAM)and a dis-tributed lag nonlinear model(DLNM)were applied to assess the impacts of atmospheric oxidative pollu-tants and temperature on mortality form respiratory and circulatory diseases.And the interactions between temperature and pollutants were evaluated using a bivariate response surface model and stratification meth-od.Results For each 10 µg/m3 increase in O3,NO2,and Ox,the maximum cumulative excess risks of death from circulatory diseases were 0.82％(95％CI:0.30％-1.34％),1.58％(95％CI:0.28％-2.90％)and 1.11％(95％CI:0.51％-1.72％),respectively.Corresponding values for respiratory diseases were 0.53％(95％CI:0.31％-1.37％),2.66％(95％CI:1.07％-4.27％)and 1.22％(95％CI:0.22％-2.23％).The difference between the effects of high and low temperature on mortality of the two diseases was large,with an immediate effect of high temperature and a lagging effect of low temperature.The interaction effect and direction were evaluted using the relative excess risk due to inter-action(RERI).Interaction studies showed that there was a synergistic amplification of the risk of death from circulatory diseases in the population by high temperature with high concentrations of NO2(RERI=0.118,95％CI:0.031-0.206).And low temperature with high concentrations of O3(RERI=0.127,95％CI:0.104-0.150),and Ox(RERI=0.025,95％CI:0.002-0.049)had a synergistic amplifica-tion effect on the risk of death from respiratory diseases in the population.Conclusions High tempera-ture,low temperature and atmospheric oxidative pollutants(O3,NO2 and Ox)all increase the risk of death from circulatory and respiratory diseases in the population.There is a synergistic amplification of the risk of death from circulatory and respiratory diseases in the population by high temperature and high con-centrations of NO2 and low temperature and high concentrations of O3 and Ox,respectively.
Air pollutionOxidant air pollutantAmbient temperatureMortality riskInteractive effect
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