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Low concentrations of fine particle air pollution and mortality in the Canadian Community Health Survey cohort
Environmental Health ( IF 6 ) Pub Date : 2019-10-10 , DOI: 10.1186/s12940-019-0518-y
Tanya Christidis 1 , Anders C Erickson 2 , Amanda J Pappin 1, 3 , Daniel L Crouse 4 , Lauren L Pinault 1 , Scott A Weichenthal 5, 6 , Jeffrey R Brook 7, 8 , Aaron van Donkelaar 9, 10 , Perry Hystad 11 , Randall V Martin 9, 10, 12 , Michael Tjepkema 1 , Richard T Burnett 13 , Michael Brauer 2
Affiliation  

Approximately 2.9 million deaths are attributed to ambient fine particle air pollution around the world each year (PM2.5). In general, cohort studies of mortality and outdoor PM2.5 concentrations have limited information on individuals exposed to low levels of PM2.5 as well as covariates such as smoking behaviours, alcohol consumption, and diet which may confound relationships with mortality. This study provides an updated and extended analysis of the Canadian Community Health Survey-Mortality cohort: a population-based cohort with detailed PM2.5 exposure data and information on a number of important individual-level behavioural risk factors. We also used this rich dataset to provide insight into the shape of the concentration-response curve for mortality at low levels of PM2.5. Respondents to the Canadian Community Health Survey from 2000 to 2012 were linked by postal code history from 1981 to 2016 to high resolution PM2.5 exposure estimates, and mortality incidence to 2016. Cox proportional hazard models were used to estimate the relationship between non-accidental mortality and ambient PM2.5 concentrations (measured as a three-year average with a one-year lag) adjusted for socio-economic, behavioural, and time-varying contextual covariates. In total, 50,700 deaths from non-accidental causes occurred in the cohort over the follow-up period. Annual average ambient PM2.5 concentrations were low (i.e. 5.9 μg/m3, s.d. 2.0) and each 10 μg/m3 increase in exposure was associated with an increase in non-accidental mortality (HR = 1.11; 95% CI 1.04–1.18). Adjustment for behavioural covariates did not materially change this relationship. We estimated a supra-linear concentration-response curve extending to concentrations below 2 μg/m3 using a shape constrained health impact function. Mortality risks associated with exposure to PM2.5 were increased for males, those under age 65, and non-immigrants. Hazard ratios for PM2.5 and mortality were attenuated when gaseous pollutants were included in models. Outdoor PM2.5 concentrations were associated with non-accidental mortality and adjusting for individual-level behavioural covariates did not materially change this relationship. The concentration-response curve was supra-linear with increased mortality risks extending to low outdoor PM2.5 concentrations.

中文翻译:

加拿大社区健康调查队列中的低浓度细颗粒空气污染和死亡率

全球每年约有 290 万人死于环境细颗粒空气污染 (PM2.5)。一般来说,死亡率和室外 PM2.5 浓度的队列研究对暴露于低水平 PM2.5 的个体以及吸烟行为、饮酒和饮食等协变量的信息有限,这些可能会混淆与死亡率的关系。本研究提供了对加拿大社区健康调查死亡率队列的更新和扩展分析:一个基于人群的队列,包含详细的 PM2.5 暴露数据和许多重要的个人行为风险因素的信息。我们还使用这个丰富的数据集来深入了解低 PM2.5 水平下死亡率的浓度-响应曲线的形状。2000 年至 2012 年加拿大社区健康调查的受访者通过 1981 年至 2016 年的邮政编码历史与高分辨率 PM2.5 暴露估计值以及截至 2016 年的死亡率联系起来。Cox 比例风险模型用于估计非意外事件之间的关系死亡率和环境 PM2.5 浓度(以三年平均值衡量,滞后一年)根据社会经济、行为和随时间变化的背景协变量进行调整。在随访期间,该队列中总共有 50,700 人因非意外原因死亡。年平均环境 PM2.5 浓度较低(即 5.9 μg/m3,sd 2.0),接触量每增加 10 μg/m3,非意外死亡率就会增加(HR = 1.11;95% CI 1.04–1.18) 。对行为协变量的调整并没有实质性改变这种关系。我们使用形状约束的健康影响函数估计了延伸至低于 2 μg/m3 浓度的超线性浓度响应曲线。男性、65 岁以下和非移民与接触 PM2.5 相关的死亡风险增加。当模型中包含气态污染物时,PM2.5 的风险比和死亡率都会降低。室外 PM2.5 浓度与非意外死亡率相关,调整个体水平的行为协变量并没有实质性改变这种关系。浓度响应曲线呈超线性,室外 PM2.5 浓度较低时死亡风险增加。
更新日期:2019-10-10
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