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Long-term exposure to particulate matter and COPD mortality: Insights from causal inference methods based on a large population cohort in southern China

慢性阻塞性肺病 医学 危险系数 混淆 队列 比例危险模型 队列研究 置信区间 因果推理 前瞻性队列研究 人口 边际结构模型 人口学 微粒 环境卫生 内科学 生物 病理 社会学 生态学
作者
Ying Wang,Zhicheng Du,Yuqin Zhang,Shirui Chen,Shao Lin,Philip K. Hopke,David Q. Rich,Kai Zhang,Xiaobo Xue Romeiko,Xin Deng,Yanji Qu,Yu Liu,Ziqiang Lin,Shuming Zhu,Wangjian Zhang,Yuantao Hao
出处
期刊:Science of The Total Environment [Elsevier BV]
卷期号:863: 160808-160808 被引量:18
标识
DOI:10.1016/j.scitotenv.2022.160808
摘要

Evidence of the association between long-term exposure to particulate matter (PM) and chronic obstructive pulmonary disease (COPD) mortality from large population-based cohort study is limited and often suffers from residual confounding issues with traditional statistical methods. We hereby assessed the casual relationship between long-term PM (PM2.5, PM10 and PM10-2.5) exposure and COPD mortality in a large cohort of Chinese adults using state-of-the-art causal inference approaches.A total of 580,757 participants in southern China were enrolled in a prospective cohort study from 2009 to 2015 and followed up until December 2020. Exposures to PM at each residential address were obtained from the Long-term Gap-free High-resolution Air Pollutant Concentration dataset. Marginal structural Cox models were used to investigate the association between COPD mortality and annual average exposure levels of PM exposure.During an average follow-up of 8.0 years, 2250 COPD-related deaths occurred. Under a set of causal inference assumptions, the hazard ratio (HR) for COPD mortality was estimated to be 1.046 (95 % confidence interval: 1.034-1057), 1.037 (1.028-1.047), and 1.032 (1.006-1.058) for each 1-μg/m3 increase in annual average concentrations of PM2.5, PM10, and PM10-2.5 respectively. Additionally, the detrimental effects appeared to be more pronounced among the elderly (age ≥ 65) and inactive participants. The effect estimates of PM2.5, PM10, and PM10-2.5 tend to be greater among participants who were generally exposed to PM10 concentrations below 70 μg/m3 than that among the general population.Our results support causal links between long-term PM exposure and COPD mortality, highlighting the urgency for more effective strategies to reduce PM exposure, with particular attention on protecting potentially vulnerable groups.
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