Long-term exposure to particulate matter and COPD mortality: Insights from causal inference methods based on a large population cohort in southern China.
Sci Total Environ
; 863: 160808, 2023 Mar 10.
Article
em En
| MEDLINE
| ID: mdl-36502970
ABSTRACT
BACKGROUND:
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.METHODS:
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.RESULTS:
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.CONCLUSION:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença Pulmonar Obstrutiva Crônica
/
Poluentes Atmosféricos
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Poluição do Ar
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Sci Total Environ
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China