环境与职业医学2025，Vol.42Issue(11)：1289-1298,10.DOI:10.11836/JEOM25198
2015-2023年济南市臭氧污染对老年人心血管疾病死亡的影响
Ozone pollution and cardiovascular mortality in the elderly:A time-series analysis in Jinan,China(2015-2023)
摘要
Abstract
[Background]Ozone(O3),a key air pollutant,significantly contributes to cardiovascular disease(CVD)-related mortality,with particularly pronounced effects in the elderly. [Objective]To explore the association between acute O3 exposure and mortality from CVD and its subtypes in the elderly population in Jinan,and to investigate the modifying effects of gender,age,and seasonal factors on O3-related effects,as well as to clarify the interaction with other air pollutants. [Methods]Daily mortality data for CVD,air pollutants,and meteorological parameters were collected in Jinan from 2015 to 2023.Gener-alized additive models(GAM)combined with distributed lag nonlinear models(DLNM)were used to analyze the lag effects of acute O3 exposure on mortalities from CVD,ischemic heart disease(IHD),and stroke in elderly individuals aged≥60 years.Subgroup analyses were conducted to explore effect differences by gender(male vs.female),age(non-high-aged elderly<80 years vs.high-aged elderly≥80 years),and season(warm season:April-September vs.cold season:October-March of the following year).Relative excess risk due to interaction(RERI),attributable proportion of interaction(API),and Synergy index(SI)were used to assess the interactions of O3 with PM2.5 and NO2. [Results]During the study period,the mean daily concentration of ozone reached(105.01±54.18)μg·m-3,exceeding the Grade I limit value specified in Ambient Air Quality Standard(GB 3095-2012).Among the 203834 CVD deaths,IHD(53.07%)and stroke(33.33%)were the predominant mortality subtypes.The single-day lag analysis revealed peak excess risk(ER)for CVD mortality at lag0(ER=0.64%,95%CI:0.29%,1.00%)per 10 μg·m-3 O3 increase.The cumulative effects peaked at lag04(ER=1.61%,95%CI:0.77%,2.46%).The subtype-specific analyses showed the maximal single-day effects at lag0 were identified for both IHD(ER=0.61%,95%CI:0.20%,1.03%)and stroke(ER=0.65%,95%CI:0.19%,1.11%),while the cumulative risks peaked at lag04 for IHD(ER=1.54%,95%CI:0.56%,2.54%)and lag03 for stroke(ER=1.74%,95%CI:0.76%,2.73%).The gender subgroup analyses suggested that both male and female subgroups showed the most significant impact on CVD mortality at lag0,with ER values of 0.53%(95%CI:0.11%,0.95%)and 0.75%(95%CI:0.33%,1.18%),re-spectively,but the differences were not statistically significant(P>0.05).No statistically significant difference in effect values was found between high-aged and non-high-aged elderly(P>0.05)after age subgroup analyses.The seasonal subgroup analyses indicated that the effects of O3 on CVD and its subtypes in the warm season were significantly higher than those in the cold season(P<0.05).At lag0 in the warm season,the ER values for CVD,IHD,and stroke mortality were 0.86%(95%CI:0.57%,1.14%),0.84%(95%CI:0.49%,1.19%),and 0.84%(95%CI:0.43%,1.26%),respectively.The interaction analyses revealed an antagonistic effect between O3 and PM2.5 on stroke mor-tality in the elderly[RERI=-4.64%(95%CI:-9.27%,-0.01%),API=-4.39%(95%CI:-8.77%,-0.01%),SI=0.55(95%CI:0.26,0.84)].The O3 effect remained robust in the multi-pollutant models(P<0.05). [Conclusion]Acute O3 exposure increases the risk of mortality from CVD and its subtypes in the elderly,and this effect is amplified in the warm season.Additionally,O3 and PM2.5 have an antagonistic effect on stroke mortality in the elderly.关键词
大气污染/臭氧/心血管疾病/老年人/死亡风险/时间序列分析/交互作用Key words
air pollution/ozone/cardiovascular disease/elderly/risk of death/time-series analysis/interactive effect分类
医药卫生引用本文复制引用
张岩,李云静,公为美,王莹,彭秀苗,周敬文,张迎建..2015-2023年济南市臭氧污染对老年人心血管疾病死亡的影响[J].环境与职业医学,2025,42(11):1289-1298,10.基金项目
2025年济南市卫生健康委员会科技发展计划项目(2025106001) （2025106001）
