PM2.5短期暴露与儿童青少年血压的关联

霍家康; 董彦会; 李伟铭; 吴立娟; 陈力; 陈曼曼; 马莹; 郭秀花; 马军

doi:10.16835/j.cnki.1000-9817.2021.05.020

PM2.5短期暴露与儿童青少年血压的关联

doi: 10.16835/j.cnki.1000-9817.2021.05.020

1.
北京大学公共卫生学院/儿童青少年卫生研究所，北京 100191
2.
首都医科大学公共卫生学院临床流行病学/北京市重点实验室

详细信息

作者简介:
霍家康(1996-)，男，北京市人，在读硕士，主要研究方向为儿童青少年生长发育及其影响因素

通讯作者:
马军，E-mail: majunt@bjmu.edu.cn

中图分类号: R 122 R 725.4
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-10
- 修回日期: 2020-12-31
- 网络出版日期: 2021-05-20
- 刊出日期: 2021-05-25

Association between short-term exposure of fine particulate matters and blood pressure in children and adolescents

1.
School of Public Health/Institute of Child and Adolescent Health, Peking University, Beijing (100191), China

摘要

摘要: 目的研究PM2.5短期暴露与儿童青少年血压的关联，为综合保护儿童青少年的健康提供科学依据。方法选择参加2017—2018学年某市中小学生健康体检中人口学特征和血压等资料完整且无心脏等重要脏器疾病史的144 813名初一和高一年级学生为研究对象。从各学校附近的空气质量和气象监测站获取PM2.5等污染物及气象要素数据，采用广义线性混合效应模型，分析PM2.5短期暴露与血压的关联。结果 PM2.5的6 d平均质量体积浓度(lag05)每增加10 μg/m³，收缩压增加0.177(95%CI=0.148~0.207)mm Hg(1 mm Hg=0.133 kPa)，收缩压偏高检出率增加4.4%(OR=1.044, 95%CI=1.030~1.058)，舒张压降低-0.021(95%CI=-0.040~-0.002)mm Hg，与舒张压偏高检出率关联无统计学意义；总体上PM2.5每增加10 μg/m³，可使血压偏高检出率增加3.3%(OR=1.03, 95%CI=1.02~1.05)。在体检当日至体检前第3~5天(lag3~lag5)时，男女生差异均有统计学意义(P值均 < 0.05)。结论 PM2.5短期暴露与儿童青少年收缩压升高以及血压偏高检出率的增加有关。应重视PM2.5短期暴露的防护，保护儿童青少年的血压健康。
- 环境暴露 /
- 血压 /
- 生长和发育 /
- 儿童 /
- 青少年
Abstract: Objective To evaluate the association of short-term fine particulate matters (PM2.5) exposure and blood pressure in children and adolescents. Methods A total of 144 813 junior and senior middle school students who participated in the physical examination in the 2017-2018 academic year in a northern city of China, with complete record of demographic characteristics, blood pressure and no history of heart and other important organ diseases were selected as the study subjects. Data on PM2.5 and other pollutants and meteorological data were obtained from the nearest air quality and meteorological monitoring stations of each schools. A generalized linear mixed effect model was used to analyze the association between short-term exposure of PM2.5 and blood pressure. Results The 6-day average concentration of PM2.5 (lag05) increased by 10 μg/m³ was associated with an increase of 0.177(95%CI=0.148-0.207)mm Hg (1 mm Hg=0.133 kPa) in systolic blood pressure and 4.4%(OR=1.044, 95%CI=1.030-1.058) increase of the prevalence of high systolic blood pressure. And it was also associated with -0.021(95%CI=-0.040--0.002)mm Hg decrease in diastolic blood pressure, but had no significant correlation with the prevalence of high diastolic blood pressure. In general, a 10 μg/m³ increase of PM2.5 was associated with 3.3% increase in the prevalence of high blood pressure (OR=1.03, 95%CI=1.02-1.05), and difference of boys and girls were found in different lagged days (P < 0.05). Conclusion Short-term exposure of PM2.5 is associated with increased systolic blood pressure and prevalence of high blood pressure among children and adolescents. Attention should be paid to the prevention of short-term exposure of PM2.5 to protect the health of children and adolescents.
- Environmental exposure /
- Blood pressure /
- Growth and development /
- Child /
- Adolescent

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表 1 不同时间污染物和气象基本指标

Table 1. General characteristics of pollutants and meteorology

时间	PM2.5/ (μg·m^-3)	O₃/ (μg·m^-3)	温度/℃	相对湿度/%
lag0	49.96±40.91	31.56±22.48	8.63±7.73	52.90±21.46
lag1	51.87±41.74	30.10±23.75	8.64±7.88	55.13±22.18
lag2	49.56±41.25	31.01±24.96	8.83±7.95	53.95±21.82
lag3	53.94±42.38	34.11±28.87	9.39±7.97	53.78±21.86
lag4	56.74±42.44	35.62±31.91	9.88±7.93	55.80±21.61
lag5	59.12±44.97	32.74±25.46	10.07±7.97	57.04±21.45
lag05	53.53±20.08	32.52±20.74	9.24±7.71	54.77±18.14

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表 2 PM2.5短期暴露与儿童青少年血压的关联(n=144 813)

Table 2. Association of short-term exposure to PM2.5 and blood pressure in children and adolescents(n=144 813)

时间	血压值[β值(β值95%CI)]		血压偏高[OR值(OR值95%CI)]
时间	收缩压	舒张压	收缩压	舒张压
lag0	0.038(0.023~0.052)^**	0.001(-0.008~0.011)	1.005(0.998~1.012)	0.996(0.986~1.006)
lag1	0.075(0.061~0.089)^**	0.005(-0.004~0.014)	1.016(1.009~1.022)^**	1.005(0.996~1.015)
lag2	0.107(0.092~0.121)^**	-0.009(-0.018~0.001)	1.026(1.019~1.032)^**	0.998(0.988~1.008)
lag3	0.063(0.049~0.077)^**	-0.029(-0.038~-0.020)^**	1.014(1.008~1.021)^**	0.995(0.985~1.005)
lag4	0.015(0.000~0.030)	-0.033(-0.043~-0.024)^**	1.013(1.006~1.020)^**	1.004(0.994~1.015)
lag5	0.089(0.073~0.104)^**	-0.010(-0.020~0.000)^*	1.027(1.019~1.034)^**	1.012(1.002~1.023)^*
lag05	0.177(0.148~0.207)^**	-0.021(-0.040~-0.002)^*	1.044(1.030~1.058)^**	0.997(0.977~1.019)
注：模型调整年龄、性别、身高、BMI、人均GDP、O3、温度、相对湿度、区聚集性; P＜0.05，*P＜0.01。

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表 3 PM2.5短期暴露与儿童青少年血压偏高关联的性别分层分析[OR值(OR值95%CI)]

Table 3. Association of short-term exposure to PM2.5 and HBP in children and adolescents stratified by gender[OR(95%CI)]

时间	男性(n=74 176)	女性(n=70 637)	总体(n=144 813)	P_交互值
lag0	1.00(0.99~1.01)	1.00(0.99~1.01)	1.00(1.00~1.01)	0.23
lag1	1.02(1.01~1.02)^**	1.01(1.00~1.02)^*	1.01(1.01~1.02)^**	0.42
lag2	1.02(1.01~1.03)^**	1.02(1.01~1.03)^**	1.02(1.01~1.03)^**	0.89
lag3	1.01(1.00~1.02)	1.01(1.00~1.02)^*	1.01(1.00~1.02)^*	0.05
lag4	1.01(1.00~1.02)^*	1.02(1.01~1.03)^**	1.01(1.01~1.02)^**	0.00
lag5	1.04(1.03~1.05)^**	1.01(1.00~1.02)^*	1.02(1.02~1.03)^**	0.01
lag05	1.04(1.02~1.06)^**	1.03(1.01~1.05)^**	1.03(1.02~1.05)^**	0.14
注：模型调整年龄、性别、身高、BMI、人均GDP、O₃、温度、相对湿度、区聚集性; P＜0.05，*P＜0.01。

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表 4 PM2.5短期暴露与儿童青少年血压偏高关联的距离敏感性分析[OR值(OR值95%CI)]

Table 4. Sensitivity analysis of association of short-term exposure to PM2.5 and HBP in children and adolescents by distance [OR(95%CI)]

时间	≤3.5 km(n=79 875)	≤5 km(n=102 612)
lag0	0.99(0.98~1.00)	1.00(0.99~1.01)
lag1	1.01(1.00~1.02)	1.01(1.00~1.01)
lag2	1.02(1.02~1.03)^**	1.02(1.01~1.02)^**
lag3	1.02(1.01~1.03)^**	1.02(1.01~1.03)^**
lag4	1.01(1.00~1.02)^*	1.01(1.01~1.02)^**
lag5	1.01(1.00~1.02)^*	1.01(1.00~1.02)^*
lag05	1.02(1.00~1.04)^*	1.02(1.01~1.04)^*
注：模型调整年龄、性别、身高、BMI、人均GDP、O₃、温度、相对湿度、区聚集性; P＜0.05，*P＜0.01。

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参考文献(21)

[1]	STANAWAY J D, AFSHIN A, GAKIDOU E, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017[J]. Lancet, 2018, 392(10159): 1923-1994. doi: 10.1016/S0140-6736(18)32225-6
[2]	RAJAGOPALAN S, AL-KINDI S G, BROOK R D. Air pollution and cardiovascular disease[J]. J Am Coll Cardiol, 2018, 72(17): 2054-2070. doi: 10.1016/j.jacc.2018.07.099
[3]	YANG B, QIAN Z, HOWARD S W, et al. Global association between ambient air pollution and blood pressure: a systematic review and meta-analysis[J]. Environ Pollut, 2018, 235: 576-588. DOI: 10.1016/j.envpol.2018.01.001.
[4]	环境保护部. 环境空气颗粒物(PM10和PM2.5)连续自动监测系统技术要求及检测方法HJ 653-2013[S]. 北京: 中国标准出版社, 2013-07-30. Ministry of Environmental Protection of the People's Republic of China. Specifications and test procedures for ambient air quality continuous automated monitoring system for PM10 and PM2.5 HJ 653-2013[S]. Beijing: Standards Press of China, 2013-07-30.
[5]	ZHANG Z, DONG B, LI S, et al. Exposure to ambient particulate matter air pollution, blood pressure and hypertension in children and adolescents: a national cross-sectional study in China[J]. Environ Int, 2019, 128: 103-108. DOI: 10.1016/j.envint.2019.04.036.
[6]	WANG X, ZOU Z, DONG B, et al. Association of school residential PM2.5 with childhood high blood pressure: results from an observational study in 6 cities in China[J]. Int J Environ Res Public Health, 2019, 16(14): 2515. doi: 10.3390/ijerph16142515
[7]	米馨, 张云婷, 胡立文, 等. 大气PM2.5长期暴露与儿童血压升高的关联研究[J]. 中华预防医学杂志, 2019, 53(1): 45-50. doi: 10.3760/cma.j.issn.0253-9624.2019.01.005 MI X, ZHANG Y T, HU L W, et al. The study on the association of long-term ambient fine particulate matters exposure and elevated blood pressure in children[J]. Chin J Prev Med, 2019, 53(1): 45-50. doi: 10.3760/cma.j.issn.0253-9624.2019.01.005
[8]	生态环境部. 2018中国环境状况公报[R]. 北京: 生态环境部, 2019. Ministry of Ecology and Environment of the People's Republic of China. Bulletin on the State of China's ecology and environment in 2018[R]. Beijing: Ministry of Ecology and Environment of the People's Republic of China, 2019.
[9]	YANG H, TENG C, HU J, et al. Short-term effects of ambient particulate matter on blood pressure among children and adolescents: a cross-sectional study in a city of Yangtze River delta, China[J]. Chemosphere, 2019, 237: 124510. DOI: 10.1016/j.chemosphere.2019.124510.
[10]	SUGHIS M, NAWROT T S, IHSAN-UL-HAQUE S, et al. Blood pressure and particulate air pollution in schoolchildren of Lahore, Pakistan[J]. BMC Public Health, 2012, 12(1). DOI: 10.1186/1471-2458-12-378.
[11]	PIETERS N, KOPPEN G, VAN POPPEL M, et al. Blood pressure and same-day exposure to air pollution at school: associations with nano-sized to coarse PM in children[J]. Environ Health Perspect, 2015, 123(7): 737-742. doi: 10.1289/ehp.1408121
[12]	HU J, FU H, SHEN H, et al. Does underweight amplify the relationship between short-term particulate matter exposure and blood pressure in children and adolescents: a large cross-sectional study in a metropolis of China[J]. Environ Sci Pollut Res Int, 2020. DOI: 10.1007/s11356-020-10215-2.
[13]	董彦会, 邹志勇, 王政和, 等. 中国2014年7~18岁儿童青少年血压偏高流行的区域分析[J]. 中华流行病学杂志, 2017, 38(7): 931-937. doi: 10.3760/cma.j.issn.0254-6450.2017.07.017 DONG Y H, ZOU Z Y, WANG Z H, et al. Analysis on geographic distribution of high blood pressure prevalence in children and adolescents aged 7-18 years in China, 2014[J]. Chin J Epidemiol, 2017, 38(7): 931-937. doi: 10.3760/cma.j.issn.0254-6450.2017.07.017
[14]	全国学生体质与健康调研组. 2014年全国学生体质与健康调研工作手册[M]. 北京: 高等教育出版社, 2014. Chinese National Survey on Students' Constitution and Health Group. 2014 National survey on students' constitution and health research manual[M]. Beijing: Higher Education Press, 2014.
[15]	国家卫生健康委员会. 7~18岁儿童青少年血压偏高筛查界值WS/T 610-2018[S]. 2018-06-13. National Health Commission of the People's Republic of China. Reference of screening for elevated blood pressure among children and adolescents aged 7-18 years WS/T 610-2018[S]. 2018-06-13.
[16]	XIA Y, NIU Y, CAI J, et al. Effects of personal short-term exposure to ambient ozone on blood pressure and vascular endothelial function: a mechanistic study based on DNA methylation and metabolomics[J]. Environ Sci Technol, 2018, 52(21): 12774-12782. doi: 10.1021/acs.est.8b03044
[17]	PEREZ C M, HAZARI M S, FARRAJ A K. Role of autonomic reflex arcs in cardiovascular responses to air pollution exposure[J]. Cardiovasc Toxicol, 2015, 15(1): 69-78. doi: 10.1007/s12012-014-9272-0
[18]	KRZYZANOWSKI M, COHEN A. Update of WHO air quality guidelines[J]. Air Q Atmos Health, 2008, 1: 7-13. DOI: 10.1007/311869-008-0008-9.
[19]	RAO X, ZHONG J, BROOK R D, et al. Effect of particulate matter air pollution on cardiovascular oxidative stress pathways[J]. Antioxid Redox Signal, 2018, 28(9): 797-818. doi: 10.1089/ars.2017.7394
[20]	GIORGINI P, DI GIOSIA P, GRASSI D, et al. Air pollution exposure and blood pressure: an updated review of the literature[J]. Curr Pharm Des, 2015, 22(1): 28-51. doi: 10.2174/1381612822666151109111712
[21]	CASCIO W E, GILMOUR M I, PEDEN D B. Ambient air pollution and increases in blood pressure[J]. Hypertension, 2015, 66(3): 469-471. doi: 10.1161/HYPERTENSIONAHA.115.05563