2020年中国大气臭氧对慢性阻塞性肺病死亡影响的疾病负担分析和健康经济学评价

大气臭氧暴露对人群慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)的影响不断加剧.为评价大气臭氧暴露对COPD的不良影响，量化与大气臭氧暴露相关的COPD死亡负担以及相应的健康经济损失，本研究收集了2020年我国31个省(自治区、直辖市)臭氧浓度高峰季(4—9月)数据、社会经济及人口数据，基于已有研究中确立的大气臭氧暴露与COPD死亡的暴露-反应关系，以世界卫生组织2021年提出的臭氧浓度高峰季平均值(60μg/m³)为参考，分别估算我国大气臭氧暴露的COPD归因死亡人数和经济损失.结果表明：(1) 2020年我国大气臭氧暴露的COPD总死亡风险比为1.1295%CI (95%置信区间)为1.00～1.21].(2) 2020年我国大气臭氧暴露的COPD归因死亡人数为10.12×10⁴人(95%CI为0.00～17.49×10⁴人).(3) 2020年我国大气臭氧暴露造成的COPD的健康经济损失为2 131×10⁸元，占GDP的0.21%.研...

COPD Mortality Burden and Related Health Economic Assessment Associated Related with to Ambient Ozone in 2020 in China

The harmful effects of ambient ozone exposure on chronic obstructive pulmonary disease (COPD) mortality are increasing. To evaluate the effects of COPD mortality burden and the corresponding economic losses associated with ambient ozone exposure, the ambient ozone concentration and mortality records of 31 provinces, autonomous regions and municipalities in China in peak season (April to September) in 2020 were collected. Based on the hazard ration between COPD deaths and ambient ozone exposure reported in a previous study, the risk of COPD deaths from ozone exposure was estimated with reference to the air quality guidelines level of peak season (60 μg/m3) proposed by the World Health Organization in 2021. Besides, socioeconomic and demographic data were collected to quantify the COPD deaths and corresponding economic losses due to ambient ozone exposure in 31 provinces, autonomous regions and municipalities in China. The results showed that the exposure-response hazard ratio between ambient ozone and COPD mortality was 1.12 (95%CI: 1.00-1.21) per 10 μg/m3, with increased COPD mortality risk for ambient ozone. It is estimated that 10.12×104 (95%CI: 0.00-17.49×104) COPD deaths are attributed to ambient ozone in 2020 in China. The corresponding economic loss is 2131×108 RMB. The proportion of the overall economic loss to the gross domestic product (GDP) was 0.21%. The study indicated that ambient ozone exposure caused substantial COPD mortality and economic loss in China. It is necessary to formulate corresponding policies to reduce ozone concentration in accordance with local conditions to achieve the target of the Air Quality Guidelines level of peak season (60 μg/m3) proposed by the World Health Organization in 2021, and actively deal with the health threats of ambient ozone exposure to human.