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大气臭氧长期暴露与中老年人群抑郁的关联

杜鹏, 张文静, 张翼, 陈晨, 方建龙, 李湉湉, 施小明. 大气臭氧长期暴露与中老年人群抑郁的关联[J]. 中华疾病控制杂志, 2021, 25(10): 1126-1132, 1138. doi: 10.16462/j.cnki.zhjbkz.2021.10.003
引用本文: 杜鹏, 张文静, 张翼, 陈晨, 方建龙, 李湉湉, 施小明. 大气臭氧长期暴露与中老年人群抑郁的关联[J]. 中华疾病控制杂志, 2021, 25(10): 1126-1132, 1138. doi: 10.16462/j.cnki.zhjbkz.2021.10.003
DU Peng, ZHANG Wen-jing, ZHANG Yi, CHEN Chen, FANG Jian-long, LI Tian-tian, SHI Xiao-ming. Chronic ozone exposure and depression among middle-aged and elderly people in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(10): 1126-1132, 1138. doi: 10.16462/j.cnki.zhjbkz.2021.10.003
Citation: DU Peng, ZHANG Wen-jing, ZHANG Yi, CHEN Chen, FANG Jian-long, LI Tian-tian, SHI Xiao-ming. Chronic ozone exposure and depression among middle-aged and elderly people in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(10): 1126-1132, 1138. doi: 10.16462/j.cnki.zhjbkz.2021.10.003

大气臭氧长期暴露与中老年人群抑郁的关联

doi: 10.16462/j.cnki.zhjbkz.2021.10.003
基金项目: 

国家重点研发计划 2016YFC0206500

大气重污染成因与治理攻关项目 DQGG0401

详细信息
    通讯作者:

    李湉湉,E-mail: litiantian@nieh.chinacdc.cn

    施小明:E-mail: shixm@chinacdc.cn

  • 中图分类号: R181;R122.2

Chronic ozone exposure and depression among middle-aged and elderly people in China

Funds: 

National Key Research and Development Program of China 2016YFC0206500

National Research Program for Key Issues in Air Pollution Control DQGG0401

More Information
  • 摘要:   目的  探究大气臭氧(ozone, O3)长期暴露与我国中老年人群抑郁的关联,为预防和干预抑郁提供科学指导。  方法  在我国大气污染防治重点区域中选择16个省、自治区、直辖市的45个县、区作为研究现场,按照严格的调查社区选择原则和调查对象纳入标准进行随机抽样,选择8 584名40~<90岁中老年人作为研究对象。采用统一编制的调查问卷收集调查对象的人口学特征、社会经济状况、疾病和症状信息,使用9条目患者健康问卷(Patient Health Questionnaire 9, PHQ-9)评估调查对象的抑郁患病情况。通过距离社区最近的空气质量监测国控站点数据估算调查前1年大气污染物平均浓度和调查前2年大气污染物滑动平均浓度,采用多因素Logistic回归分析模型探讨O3暴露与罹患抑郁的关联。  结果  纳入研究的8 584名调查对象中,抑郁患病率为6.79%(583/8 584)。Logistic回归分析模型显示,未发现O3长期暴露与抑郁患病风险有关,总体上看,调查前2年的O3滑动平均年均浓度对应的效应值最大(OR=1.04, 95% CI: 0.96~1.13, P=0.326),但无统计学意义;分层分析显示,与女性和不吸烟的调查对象相比,男性和现在吸烟的调查对象抑郁患病与O3暴露的关联更强,且组间差异具有统计学意义(均有P<0.05);空气动力学直径<2.5 μm的颗粒物(particulate matter smaller than 2.5 μm in aerodynamic diameter, PM2.5)浓度和气温对抑郁患病与O3暴露的关联存在修饰作用,低PM2.5浓度、较高气温地区抑郁患病与O3暴露关联更强。  结论  本研究发现男性人群、吸烟人群以及生活在PM2.5浓度较低和年均气温较高地区的人群中,O3暴露与抑郁患病风险存在关联。
  • 图  1  不同O3指标每升高10 μg/m3与抑郁患病的关联

    Figure  1.  Association between different O3 exposure indicators with 10 μg/m3 increase and depression

    图  2  调查前2年O3滑动平均年均浓度每升高10 μg/m3与抑郁患病关联的分层分析

    注:调查前2年PM2.5滑动平均年均浓度≤P25浓度为低PM2.5浓度,P25~<P75浓度为中PM2.5浓度,≥P75浓度为高PM2.5浓度;调查前2年滑动平均温度≤P25温度为较低温,P25~<P75温度为中等温,≥P75温度为较高温。

    Figure  2.  Risk of depression with 10 μg/m3 increase in two-year moving average concentration of O3 by subgroup

    图  3  调查前2年O3滑动平均的年均浓度每升高10 μg/m3与抑郁患病关联的曲线分析

    Figure  3.  Curve association between depression and 10 μg/m3 increase in 2-year moving average concentration of O3

    表  1  不同调查对象抑郁状态比较[n (%)]

    Table  1.   Characteristics of enrolled participants [n (%)]

    变量 抑郁 χ2 P
    年龄(岁) 13.81 <0.001
      40~<65 236(40.48) 3 876(48.44)
      65~<90 347(59.52) 4 125(51.56)
    性别 51.08 <0.001
      男 204(34.99) 4 026(50.32)
      女 379(65.01) 3 975(49.68)
    BMI(kg/m2) 17.07 <0.001
      <18.5 37(6.35) 286(3.57)
      18.5~<24.0 260(44.60) 3 528(44.09)
      24.0~<28.0 192(32.93) 3 063(38.28)
      ≥28.0 93(15.95) 1 102(13.77)
    受教育程度 57.57 <0.001
      小学及以下 264(45.28) 2 518(31.47)
      中学 272(46.66) 4 207(52.58)
      大学/大专及以上 47(8.06) 1 276(15.95)
    就业情况 32.68 <0.001
      就业 163(27.96) 2 854(35.67)
      无业 163(27.96) 1 507(18.84)
      退休 257(44.08) 3 640(45.49)
    家庭年收入(万元) 13.87 <0.001
      <10 467(80.10) 5 997(74.95)
      ≥10 99(16.98) 1 936(24.19)
    社会支持程度 65.04 <0.001
      低 27(4.63) 111(1.39)
      中 242(41.51) 2 545(31.81)
      高 314(53.86) 5 342(66.77)
    吸烟 14.53 <0.001
      不吸烟 444(76.16) 5 604(70.04)
      过去吸烟 58(9.95) 764(9.55)
      现在吸烟 81(13.89) 1 633(20.41)
    饮酒 20.52 <0.001
      是 60(10.29) 1 409(17.61)
      否 523(89.71) 6 592(82.39)
    自报慢性病患病 92.29 <0.001
      是 415(71.18) 4 046(50.57)
      否 168(28.82) 3 951(49.38)
    下载: 导出CSV

    表  2  污染物和气象数据描述性分析

    Table  2.   Summary statistics of air pollutants, meteorological indicators

    变量 x±s Min a P50 Max b Q c
    调查前1年
      O3(μg/m3)
        年均浓度 55.84±14.34 16.14 56.40 91.88 14.17
        8 h最大值年均浓度 71.37±15.29 35.51 72.76 115.22 13.79
        1 h最大值年均浓度 110.00±20.48 51.30 112.45 144.04 15.01
      PM2.5(μg/m3) 53.06±15.37 24.76 52.33 89.22 19.25
      NO2(μg/m3) 41.16±11.98 14.17 42.87 66.32 16.85
      平均气温(℃) 15.49±4.15 4.36 14.75 23.20 4.36
    调查前2年滑动平均
      O3(μg/m3)
        年均浓度 54.30±12.92 26.27 54.72 87.63 14.68
        8 h最大值年均浓度 76.88±14.64 44.86 77.04 109.65 17.54
        1 h最大值年均浓度 107.20±17.66 57.09 111.91 135.35 14.25
      PM2.5(μg/m3) 55.98±15.88 27.03 54.51 93.09 21.34
      NO2(μg/m3) 41.07±12.39 11.46 42.67 64.24 19.00
      平均气温(℃) 15.41±4.14 4.67 14.71 23.28 4.14
    注:a表示最小值;b表示最大值;c Q=P75-P25
    下载: 导出CSV

    表  3  调查前2年O3滑动平均年均浓度每升高10 μg/m3与抑郁患病关联的敏感性分析

    Table  3.   Sensitivity analysis of association between depression and 10 μg/m3 increase in two-year moving average concentration of O3

    模型 OR (95% CI)值 P
    模型1 1.04(0.96~1.13) 0.326
    模型2 1.04(0.96~1.13) 0.354
    模型3 0.99(0.93~1.07) 0.865
    模型4 1.03(0.95~1.12) 0.413
    模型5 1.04(0.96~1.13) 0.323
    模型6 1.02(0.94~1.11) 0.666
    模型7 1.03(0.95~1.11) 0.475
    注:主模型(模型1)中调整PM2.5、年龄、性别、婚姻状况、BMI、吸烟状态、饮酒状态、受教育程度、就业情况、家庭年收入、慢性病史、社会支持程度、实际睡眠时长、地理区域划分(华北、东北、华东、华中、华南、西南和西北)、居住方式和平均气温; 模型2:在模型1基础上将年龄作为连续变量纳入模型;模型3:在模型1基础上将地理区域重新划分为南方和北方纳入模型;模型4:在模型1基础上调整体力活动;模型5:在模型1基础上删除调整PM2.5;模型6:在模型1基础上删除调整PM2.5,调整NO2;模型7:在模型1基础上删除调整实际睡眠时长。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-06-09
  • 修回日期:  2021-09-16
  • 网络出版日期:  2021-11-17
  • 刊出日期:  2021-10-10

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