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Evidence on Vulnerability and Susceptibility to Health Effects Associated with Short-Term Exposure to Particulate Matter: Systematic Review and Meta Analysis

机译:关于与短期暴露于颗粒物质相关的健康效应的脆弱性和易感性的证据:系统审查和META分析

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Background: While there is strong evidence that particulate matter (PM) affects health, less is known about whether some sub-populations face higher risk. There is no consensus on which individual- or community-level characteristics affect PM risk estimates and to what degree (i.e., effect modification). Aims: The goal of this work is to summarize the state of scientific evidence on effect modification of health effects for short-term exposure to particulate matter. Methods: We performed a systematic review of the scientific literature on effect modification for short-term exposure to PM and performed meta-analysis for mortality associations by age and sex. Results: We identified 108 papers that directly investigate factors that might modify mortality or hospital admission risks from short-term PM exposure. Results indicate strong, consistent evidence that the elderly experience higher risks; suggestive evidence that those with lower education, income, or employment status have higher risks; and weak evidence for higher risks for women. Meta-analysis showed statistically higher effects for older populations (0.64% [0.50, 0.80%] increase in mortality per 10 μg/m3 increase in PM10) than younger populations (0.37% [0.27, 0.48%]). For women, a 10 μg/m3 increase in PM10 was associated with a 0.55% [0.41, 0.70%] increase in mortality, whereas for men this increase was 0.50% [0.34, 0.65%]. Conclusions: Evidence indicates that some populations facing larger health burdens from airborne particles. Our synthesis on modifiers for PM effects can aid design of air quality policies and suggest directions for future research. Studies of biological mechanism could be informed by evidence of differential effects by population, such as by sex and pre-existing conditions.
机译:背景:虽然存在强有力的证据表明颗粒物质(PM)影响了健康,但尚不熟悉某些子人群是否面临着更高的风险。没有共识,其中个人或社区级别的特征会影响下午的风险估计以及程度(即效果修改)。目的:这项工作的目标是总结有关颗粒物质短期暴露的健康效果的有效修饰的科学证据。方法:对科学文献进行了系统审查,以对PM短期暴露的影响改性,并按年龄和性别进行死亡期协会的荟萃分析。结果:我们确定了108篇论文直接调查可能从短期PM暴露中修改死亡率或医院入学风险的因素。结果表明,老年人经历了更高的风险;建议证明教育,收入或就业状况下降的人具有更高的风险;对女性风险较高的证据薄弱。 Meta分析表现出对较年轻的人群的统计学上更高的影响(0.64%,0.80%] PM10的10μg/ m 3增加的死亡率增加)比年轻人群(0.37%[0.27,0.48%])。对于女性,PM10的10μg/ m 3增加与死亡率增加0.55%[0.41,0.70%],而男性此案增加0.50%[0.34,0.65%]。结论:证据表明,一些面临着较大的健康负担来自空中粒子的人口。我们对PM效果的改性剂的合成可以帮助设计空气质量政策,并建议未来研究的方向。可以通过人口差异效应的证据来了解生物机制的研究,例如通过性和预先存在的条件。

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