CAJ | 학술논문

目的：探讨2009—2013年南京市大气PM10污染对居民循环系统疾病死亡的急性影响，以及季节因素在PM10暴露与循环系统死亡之间关系中的作用。方法收集南京市2009—2013年逐日大气污染物资料、气象资料以及循环系统疾病死亡资料，应用时间分层病例交叉设计的方法分析PM10日均浓度与循环系统疾病死亡之间的关系，计算OR（95%CI）值，并通过分层分析的方式对不同季节PM10暴露对循环系统疾病死亡的效应进行探讨。结果2009—2013年南京市大气PM10、NO2、SO2年平均浓度分别为109.1、51.5、35.4μg/m3。研究期间共记录78299条常住人口循环系统疾病死亡病例，平均每天43例，其中，每日心脏病、缺血性心脏病及脑血管死亡病例分别为19、10、24例。在控制了气温、相对湿度及气压等气象因素的影响后，PM10浓度每上升10μg/m3，南京市居民所有循环系统疾病、心脏病、缺血性心脏病以及脑血管病死亡风险均增加，其OR（95%CI）值分别为1.0024（1.0001～1.0048）、1.0048（1.0013～1.0083）、1.0073（1.0024～1.0123）与1.0005（0.9985～1.0024）。温暖季节居民所有循环系统疾病、脑血管病死亡发生的OR（95%CI）值分别为1.0080(1.0039～1.0122)与1.0057(1.0020～1.0094)，寒冷季节的OR（95%CI）值分别为1.0014(0.9985～1.0042)与0.9988(0.9964～1.0012)，且暖季的OR值高于冷季。结论南京市大气中PM10浓度的升高可能引起人群循环系统疾病死亡风险的增加，且季节因素可能会对PM10暴露与循环系统死亡之间的关系产生修饰作用。
목적：탐토2009—2013년남경시대기PM10오염대거민순배계통질병사망적급성영향，이급계절인소재PM10폭로여순배계통사망지간관계중적작용。방법수집남경시2009—2013년축일대기오염물자료、기상자료이급순배계통질병사망자료，응용시간분층병례교차설계적방법분석PM10일균농도여순배계통질병사망지간적관계，계산OR（95%CI）치，병통과분층분석적방식대불동계절PM10폭로대순배계통질병사망적효응진행탐토。결과2009—2013년남경시대기PM10、NO2、SO2년평균농도분별위109.1、51.5、35.4μg/m3。연구기간공기록78299조상주인구순배계통질병사망병례，평균매천43례，기중，매일심장병、결혈성심장병급뇌혈관사망병례분별위19、10、24례。재공제료기온、상대습도급기압등기상인소적영향후，PM10농도매상승10μg/m3，남경시거민소유순배계통질병、심장병、결혈성심장병이급뇌혈관병사망풍험균증가，기OR（95%CI）치분별위1.0024（1.0001～1.0048）、1.0048（1.0013～1.0083）、1.0073（1.0024～1.0123）여1.0005（0.9985～1.0024）。온난계절거민소유순배계통질병、뇌혈관병사망발생적OR（95%CI）치분별위1.0080(1.0039～1.0122)여1.0057(1.0020～1.0094)，한랭계절적OR（95%CI）치분별위1.0014(0.9985～1.0042)여0.9988(0.9964～1.0012)，차난계적OR치고우랭계。결론남경시대기중PM10농도적승고가능인기인군순배계통질병사망풍험적증가，차계절인소가능회대PM10폭로여순배계통사망지간적관계산생수식작용。
Objective To explore the short-term effects of ambient PM10 pollution on mortality due to circulatory diseases, and to study the modifying effect of season on the association between ambient PM 10 concentration and mortality in Nanjing. Methods Daily mortality, air pollution, and meteorological data from 1 January 2009 to 31 December 2013 in Nanjing were collected;Time-stratified case-crossover design was used to analyze the associations between daily average concentration of inhalable particle (PM10) and mortality due to circulatory diseases;Odds ratios (OR) and 95%confidence intervals (CI) were calculated;And stratified analysis was conducted to compare the mortality risks of circulatory diseases exposed to outdoor PM10 in warm season (May-October) with that in cool season (November-April). Results The mean daily average concentrations of PM10, NO2, and SO2 from 2009 to 2013 in Nanjing were 109.1, 51.5, and 35.4μg/m3, respectively. During our study period, a total of 78 299 circulatory disease deaths were recorded. On average, there were approximately 43 circulatory disease deaths per day; and deaths due to cardiac diseases, ischemic heart disease and cerebrovascular diseases were 19, 10 and 24 per day, respectively. After adjusting for the meteorological variables such as daily temperature, relative humidity and air pressure, a10μg/m3 increment of PM10 was associated with the mortality on values of (OR) 1.002 4(95%CI:1.000 1-1.004 8) for total circulatory diseases, 1.004 8 (95%CI: 1.001 3-1.008 3) for cardiac diseases, 1.007 3 <br> (95%CI: 1.002 4-1.012 3) for ischemic heart disease and 1.000 5 (95%CI: 0.998 5-1.002 4) for cerebrovascular diseases, respectively. In summer season, the OR values of daily mortality for total circulatory diseases and cerebrovascular diseases were 1.008 0(95%CI:1.003 9-1.012 2) and 1.005 7(95%CI:1.002 0-1.009 4), respectively ,the corresponding OR values in cool season were 1.001 4(95%CI:0.998 5-1.004 2) and 0.998 8 (95%CI:0.996 4-1.001 2), respectively;The effect estimates in warm season were higher than that in cool season. Conclusion The elevated levels of ambient PM10 were positively associated with the increase of mortality due to circulatory diseases, and season may modify the effects of outdoor PM10 pollution on mortality.