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[背景]短期臭氧暴露与日死亡率增加相关。浓度-反应关系的形状对于估算公众健康影响至关重要,特别是假设存在阈值时。[目的]研究1993—2006年间,英国5个城市及5个乡村地区每日臭氧暴露浓度与死亡率之间的浓度-反应关系。[方法]采用泊松回归,控制季节性、温度和流感等变量,分析每日最大8h臭氧浓度与每日全死因死亡率之间的相关性,分别为全年及特定季节假设了线性、线性阈值和样条模型。作者还检测了灵敏度以及替代温度指标,前者用以调整对颗粒物的测定(仅限市区)。[结果]在所有年份的分析中,在伦敦发现臭氧与全死因死亡率的浓度-反应关系中存在明确的阈值,为65μg/m(395%CI:58～83);但是,在其他城市或乡村地区存在阈值的证据却很少。综合线性效应估计城市和乡村地区的全死因死亡率具有可比性:臭氧浓度每增加10μg/m3,全死因死亡率分别增加0.48%(95%CI:0.35～0.60)和0.58%(95%CI:0.36～0.81)。季节性分析表明,夏季的月份中在城市和乡村地区都存在臭氧影响的阈值。[结论]应该采用阈值和非阈值模型评价整个环境范围内臭氧对健康的影响,并且根据季节进行分层。在伦敦存在阈值效应,但在其他研究区域却未发现,这一点需要进一步研究探讨。乡村地区臭氧暴露对公众健康的影响不容忽视。
[Background] Short-term ozone exposure is associated with increased daily mortality. The shape of the concentration-response relationship is crucial to assessing the public health impact, especially if there is a threshold. [Objective] To study the concentration-response relationship between daily ozone exposure and mortality in five cities of England and five rural areas from 1993 to 2006. [Methods] The Poisson regression was used to control the seasonal, temperature and flu variables, and the correlation between daily maximum 8h ozone concentration and daily all-cause mortality was analyzed. For the whole year and the specific season, the linear and linear Threshold and spline model. The authors also examined the sensitivity as well as alternative temperature indicators, the former used to adjust the measurement of particles (urban only). [Results] In all years of analysis, a clear threshold of 65 μg / m (395% CI: 58-83) was found in the concentration-response relationship between ozone and all-cause mortality in London; however, in other cities or There is very little evidence of a threshold in rural areas. The overall linear effect estimates that all-cause mortality in urban and rural areas is comparable: an all-cause mortality increase of 0.48% (95% CI: 0.35-0.60) and 0.58% (95% CI: 0.36 ~ 0.81). Seasonal analyzes show that there is a threshold of ozone impact in urban and rural areas during the summer months. [Conclusions] The threshold and non-threshold models should be used to evaluate the health effects of ozone over the entire environment and stratified by season. Threshold effect exists in London, but not found in other research areas, which needs further study and discussion. The public health impact of ozone exposure in rural areas can not be ignored.