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[张贴报告]Longitudinal association between ambient nitrogen dioxide exposure and all-cause mortality in Chinese adults
Longitudinal association between ambient nitrogen dioxide exposure and all-cause mortality in Chinese adults
编号：80
稿件编号：97 访问权限：仅限参会人
更新：2021-09-23 09:08:44 浏览：264次
张贴报告
报告开始：2021年10月30日 19:40 （Asia/Shanghai）
报告时间：20min
所在会议：[E] 墙报 » [E] 墙报
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摘要
Background
A number of population-based studies have investigated long-term effects of nitrogen dioxide (NO2) on mortality, while great heterogeneities exist between locations and studies. In highly populated countries in Asia, cohort evidence for NO2-mortality association was extensively sparse. This study primarily aimed to quantify longitudinal association of ambient NO2 exposure with all-cause mortality in Chinese adults.
Methods
A national cohort of 30,843 adult men and women were drawn from 25 provincial regions across mainland China, and followed up from 2010 through 2018. Participants’ exposures to ambient air pollutants (i.e., NO2, particulate matter with aerodynamic diameter ≤2.5 μm [PM2.5], and ozone [O3]) were assigned according to their residential counties at baseline, through deriving monthly estimates from high-quality gridded datasets developed by machine learning methods. Cox proportional hazards models with time-varying exposures were utilized to assess the association of all-cause mortality with long-term exposure to ambient NO2. NO2-attributable deaths in China were estimated by province and county for years 2010 and 2018, with reference to the counterfactual exposure of 6.9 μg/m3 (the lowest county-level average in this cohort).
Results
We observed a total of 1662 deaths during 224020.2 person-years of follow-up (median 8.1 year). An approximately linear NO2-mortality relation (p=0.273 for nonlinearity) was identified across a broad exposure range of 6.9–57.4 μg/m3. Per 10-µg/m3 increase in annual NO2 exposure was associated with an hazard ratio of 1.127 (95% confidence interval: 1.042–1.219, p<0.003) for all-cause mortality. Risk estimates remained robust after additionally adjusting for the confounding effects of co-pollutants (i.e., PM2.5 or O3). Subgroup analyses suggested a significant effect modification by sex (p=0.024), and only men suffered from NO2-related death risk. In 2018, 1.65 million deaths could be attributed to ambient NO2 exposure (national average 17.3 µg/m3) in China, representing a decrease of 4.3% compared with the estimate of 1.72 million in 2010 (20.5 µg/m3).
Conclusions
This cohort study provided national evidence for elevated risk of all-cause mortality associated with long-term exposure to ambient NO2 in Chinese adults. Future longitudinal investigations in China are warranted to differentiate the effects of NO2 exposure on cause-specific mortality outcomes.
A number of population-based studies have investigated long-term effects of nitrogen dioxide (NO2) on mortality, while great heterogeneities exist between locations and studies. In highly populated countries in Asia, cohort evidence for NO2-mortality association was extensively sparse. This study primarily aimed to quantify longitudinal association of ambient NO2 exposure with all-cause mortality in Chinese adults.
Methods
A national cohort of 30,843 adult men and women were drawn from 25 provincial regions across mainland China, and followed up from 2010 through 2018. Participants’ exposures to ambient air pollutants (i.e., NO2, particulate matter with aerodynamic diameter ≤2.5 μm [PM2.5], and ozone [O3]) were assigned according to their residential counties at baseline, through deriving monthly estimates from high-quality gridded datasets developed by machine learning methods. Cox proportional hazards models with time-varying exposures were utilized to assess the association of all-cause mortality with long-term exposure to ambient NO2. NO2-attributable deaths in China were estimated by province and county for years 2010 and 2018, with reference to the counterfactual exposure of 6.9 μg/m3 (the lowest county-level average in this cohort).
Results
We observed a total of 1662 deaths during 224020.2 person-years of follow-up (median 8.1 year). An approximately linear NO2-mortality relation (p=0.273 for nonlinearity) was identified across a broad exposure range of 6.9–57.4 μg/m3. Per 10-µg/m3 increase in annual NO2 exposure was associated with an hazard ratio of 1.127 (95% confidence interval: 1.042–1.219, p<0.003) for all-cause mortality. Risk estimates remained robust after additionally adjusting for the confounding effects of co-pollutants (i.e., PM2.5 or O3). Subgroup analyses suggested a significant effect modification by sex (p=0.024), and only men suffered from NO2-related death risk. In 2018, 1.65 million deaths could be attributed to ambient NO2 exposure (national average 17.3 µg/m3) in China, representing a decrease of 4.3% compared with the estimate of 1.72 million in 2010 (20.5 µg/m3).
Conclusions
This cohort study provided national evidence for elevated risk of all-cause mortality associated with long-term exposure to ambient NO2 in Chinese adults. Future longitudinal investigations in China are warranted to differentiate the effects of NO2 exposure on cause-specific mortality outcomes.
关键字
Air pollution,Nitrogen dioxide,Adult mortality,Cohort study,Attributable deaths
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