人群的自然和社会属性分类下PM2.5对心血管疾病的影响

为了研究人群在自然属性和社会属性分类下的效应修饰作用，利用2005~2011年北京市大气PM_2.5日均浓度、气象要素及循环系统疾病每日死亡人数数据，根据不同年龄、性别及学历将人群分组，采用时间序列的半参数广义相加模型（GAM），定量评价大气PM_2.5对居民循环系统疾病死亡人数的影响.单污染物模型和多污染物模型结果表明，PM_2.5为影响循环系统疾病每日死亡人数的主要大气污染物.北京市空气中PM_2.5的浓度每增加10μg/m³，循环系统疾病总死亡人数增加0.50%（95% CI：0.36，0.63）.不同人群的易感程度不同，各人群死亡人数的增加范围为0.23~0.71%，女性、60~74岁人群、文盲人群的健康风险相对较高.在文盲人群中，老年（60+）女性占比为66.2%，为了分离社会属性人群分类中可能存在的自然属性因素干扰，本文去除其中老年、女性这两个混杂因素的影响，文盲人群健康风险仍然大于较高学历的人群.年龄和性别因素叠加在学历因素上，可能加大低学历人群的健康风险，对于这部分叠加了自然因素和社会因素双重敏感性的人群应给与重点关注.

Natural and social factor as modifiers of the effects of PM2.5 on daily cardiovascular mortality in Beijing,China

To quantitatively analyze the modification effects of natural factor and social factor, people was classified by sex, age and education in our study. A semi-parametric generalized additive model (GAM) was used to calculate the exposure-response relationship between ambient particulate matter pollution and daily cardiovascular mortality from 2005 to 2011 in Beijing. The results of the single- and the multi-pollutant model indicated that PM_2.5 was the main air pollution health risk factor affecting the daily cardiovascular mortality. A 10μg/m³ increase in PM_2.5 was associated with 0.50% (95%CI: 0.36, 0.63) increase for overall group. Different susceptibility showed in different subgroups, whose excess risks (ER) were range from 0.23%~0.71%. A much higher ER has been found in the subgroups of age 60~74years, female and illiterate. However, it showed that elderly (60+) women accounted for 66.2% among the illiterate. In order to isolate the possible interference of natural factors in the classification of social factor, distractions of elderly and female has been removed, but ER of illiterate were still greater than those with higher education attainment level. Adverse health effects of the lower education attainment level subgroup may be increase when the modification effects of age and sex are overlay on it. It is necessary to give priority attention to those people who have the dual susceptibility of both natural factor and social factor.