CAJ | 학술논문

目的：分析2003—2010年武汉市江岸区大气污染物的短期暴露对人群脑卒中死亡的影响。方法收集武汉市江岸区CDC自2003年1月1日至2010年12月31日的脑卒中死亡监测资料和同期环境监测中心大气污染物数据，应用基于广义相加模型的时间序列分析方法，定量评价大气污染中可吸入颗粒物（PM10）、SO2和NO2与人群脑卒中死亡的关系。结果2003—2010年PM10、SO2和NO2日均浓度分别为(115.0±60.0)、(50.2±33.7)和(57.6±25.3)μg/m3，脑卒中总死亡人数为9204例，其中女性4495例，≥65岁人群占7628例。PM10、SO2和NO2滞后1 d的浓度每升高10μg/m3，人群脑卒中死亡率分别增加0.67%(95%CI：0.25%~1.10%)、0.87%(95%CI：0.13%~1.63%)和2.07%(95%CI：1.08%~3.07%)。在调整了其他污染物后的多污染物模型中，仅NO2与脑卒中死亡仍存在统计学关联（β=2.07,95%CI：1.08~3.07，P<0.001）。其中，调整了PM10、SO2、PM10+SO2后，NO2浓度每升高10μg/m3，在滞后1 d的情况下，人群脑卒中死亡率分别增加1.77%(95%CI：0.54%~3.01%)、2.27%(95%CI：0.98%~3.57%)和2.00%(95%CI：0.59%~3.43%)。对不同性别、年龄组人群的分层分析发现，大气污染对女性和≥65岁人群脑卒中死亡的影响较大[滞后1 d时，PM10、SO2、NO2对女性脑卒中死亡率增加的β（95%CI）值分别为0.97%（0.37%~1.57%）、1.73%（0.69%~2.78%）、2.98%（1.59%~4.39%），对年龄≥65岁老人的死亡率增加的β（95%CI）值分别为0.94%（0.47%~1.42%）、1.06%（0.23%~1.90%）、2.50%（1.40%~3.62%）]。结论大气污染物的短期暴露与人群脑卒中死亡有关，且不同性别和年龄组人群的敏感性可能存在一定差异。
목적：분석2003—2010년무한시강안구대기오염물적단기폭로대인군뇌졸중사망적영향。방법수집무한시강안구CDC자2003년1월1일지2010년12월31일적뇌졸중사망감측자료화동기배경감측중심대기오염물수거，응용기우엄의상가모형적시간서렬분석방법，정량평개대기오염중가흡입과립물（PM10）、SO2화NO2여인군뇌졸중사망적관계。결과2003—2010년PM10、SO2화NO2일균농도분별위(115.0±60.0)、(50.2±33.7)화(57.6±25.3)μg/m3，뇌졸중총사망인수위9204례，기중녀성4495례，≥65세인군점7628례。PM10、SO2화NO2체후1 d적농도매승고10μg/m3，인군뇌졸중사망솔분별증가0.67%(95%CI：0.25%~1.10%)、0.87%(95%CI：0.13%~1.63%)화2.07%(95%CI：1.08%~3.07%)。재조정료기타오염물후적다오염물모형중，부NO2여뇌졸중사망잉존재통계학관련（β=2.07,95%CI：1.08~3.07，P<0.001）。기중，조정료PM10、SO2、PM10+SO2후，NO2농도매승고10μg/m3，재체후1 d적정황하，인군뇌졸중사망솔분별증가1.77%(95%CI：0.54%~3.01%)、2.27%(95%CI：0.98%~3.57%)화2.00%(95%CI：0.59%~3.43%)。대불동성별、년령조인군적분층분석발현，대기오염대녀성화≥65세인군뇌졸중사망적영향교대[체후1 d시，PM10、SO2、NO2대녀성뇌졸중사망솔증가적β（95%CI）치분별위0.97%（0.37%~1.57%）、1.73%（0.69%~2.78%）、2.98%（1.59%~4.39%），대년령≥65세노인적사망솔증가적β（95%CI）치분별위0.94%（0.47%~1.42%）、1.06%（0.23%~1.90%）、2.50%（1.40%~3.62%）]。결론대기오염물적단기폭로여인군뇌졸중사망유관，차불동성별화년령조인군적민감성가능존재일정차이。
Objective Using time?series analyses to determine the association between ambient air pollution and stroke mortality in Jiang'an District of Wuhan, China from 2003 to 2010.Methods Data on daily stroke mortality for the period 2003 January 1 to 2010 December 31 was obtained from Jiang'an District Center for Disease Control and Prevention, Wuhan and data on relevant air pollution and meteorological factors from the local municipal environmental monitoring center and meteorology bureau of Wuhan, respectively. Application of a time-series analysis in generalized additive model was applied to evaluate the association between air pollution and stroke mortality. Results Annual average concentrations of PM10, SO2 and NO2 during the study period were (115.0 ± 60.0), (50.2 ± 33.7), and (57.6 ± 25.3)μg/m3, respectively. The total stroke death was 9 204, including 4 495 women, and 7 628 people aged over 65?years old. In single?pollutant model, a 10μg/m3 increase in previous day (lag 1 d) ambient pollutants was associated with 0.67%(95%CI:0.25%-1.10%) excess risk in stroke mortality for PM10, 0.87%(95%CI:0.13%-1.63%) excess risk for SO2 and 2.07% (95%CI: 1.08%-3.07%) excess risk for NO2, respectively. When co-pollutants were involved into the models, only NO2 remained strongly associated with stroke mortality(β=2.07,95%CI:1.08-3.07, P<0.001). A 10μg/m3 increase of NO2 in lag 1 d was associated with 1.77%(95%CI:0.54%-3.01%), 2.27%(95%CI:0.98%-3.57%) and 2.00%(95%CI:0.59%-3.43%) excess risk in stroke mortality, respectively, after adjusting for PM10, SO2, both PM10 and SO2. Age?specific and gender?specific analyses showed that the association between ambient air pollution and stroke mortality was stronger in the elderly (≥65 years old) people and women. A 10μg/m3 increase of PM10, SO2 and NO2 in lag 1 d was associated with excess stroke mortality of 0.97%(95%CI:0.37%-1.57%), 1.73%(95%CI:0.69%-2.78%) and 2.98% (95%CI:1.59%-4.39%) for women, respectively and 0.94%(95%CI:0.47%-1.42%), 1.06%(95%CI: 0.23%-1.90%) and 2.50%(95%CI:1.40%-3.62%) for the elderly people (>65 years old), respectively. Conclusion PM10 and gaseous pollutants (SO2, NO2) were significant risk factors for acute stroke death, and people aged over 65?years old and women were more susceptible to the effect of ambient pollutants on stroke mortality.