PM_2.5及其化学组分长期暴露对中老年人衰弱发生的影响：一项前瞻性队列研究^*

Effect of Long-term Exposure to PM_2.5 and Its Chemical Components on Frailty Incidence in Middle-aged and Older Adults in China: A Prospective Cohort Study

摘要

目的 探讨PM_2.5及其化学组分长期暴露对中老年人衰弱发生风险的影响。方法 基于2011–2020年中国健康与养老追踪调查和大气成分近实时追踪数据集开展前瞻性队列研究。采用衰弱指数评估衰弱状况，运用时间依赖的Cox比例风险模型分析PM_2.5及其化学组分（黑碳、有机化合物、硫酸盐、硝酸盐、铵盐）长期暴露对衰弱发生风险的影响。结果 研究共纳入9 603名受访者。在调整混杂因素后，受访者过去一年平均暴露于PM_2.5质量浓度每增加一个四分位距，衰弱发生风险升高10.0%〔风险比（hazard ratio, HR）=1.100，95%置信区间（confidence interval, CI）：1.015～1.193〕。在具体化学组分方面，有机化合物、黑碳、铵盐、硫酸盐、硝酸盐等长期暴露浓度每增加一个四分位距，衰弱风险分别升高14.2%（HR=1.142，95%CI：1.055～1.236）、13.1%（HR=1.131，95%CI：1.041～1.229）、9.8%（HR=1.098，95%CI：1.010～1.194）、8.8%（HR=1.088，95%CI：0.996～1.187）和8.1%（HR=1.081，95%CI：0.996～1.172）。结论 PM_2.5及黑碳、有机化合物、铵盐等化学组分长期暴露是中老年人衰弱发生的风险因素。建议在环境政策制定中优先加强对黑碳及有机气溶胶排放的控制，以降低空气污染对人口老龄化背景下的公共卫生负担。

Abstract

Objective To investigate the effect of long-term exposure to PM_2.5 and its chemical components on frailty risk among middle-aged and older adults in China. Methods A prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2020 and the Tracking Air Pollution (TAP) dataset. The frailty status of the participants was assessed using the frailty index. A time-dependent Cox proportional hazards model was applied to examine the associations between frailty risk and long-term exposure to PM_2.5 and its chemical components, including black carbon, organic matter, sulfate, nitrate, and ammonium. Results A total of 9 603 participants were included in the analysis. After adjusting for potential confounders, each interquartile range increase in the average PM_2.5 concentration during the preceding year was associated with a 10.0% higher risk of frailty (hazard ratio [HR] = 1.100, 95% CI: 1.015-1.193). For individual chemical components, each interquartile range increase in the one-year average concentrations of organic matter, black carbon, ammonium, sulfate, and nitrate, the participants were exposed to was associated with a 14.2% (HR = 1.142, 95% CI: 1.055-1.236), 13.1% (HR = 1.131, 95% CI: 1.041-1.229), 9.8% (HR = 1.098, 95% CI: 1.010-1.194), 8.8% (HR = 1.088, 95% CI: 0.996-1.187), and 8.1% (HR = 1.081, 95% CI: 0.996-1.172) higher risk of frailty, respectively. Conclusion Long-term exposures to PM_2.5 and its chemical components, particularly black carbon, organic matter, and ammonium, were associated with a higher risk of frailty among middle-aged and older adults in China. Priority should be given to strengthening emission control of black carbon and organic aerosols to mitigate the public health burden of air pollution in the context of an aging society.

关键词

衰弱 / 细颗粒物 / 公共卫生 / 前瞻性研究

Key words

Frailty / Fine particulate matter / Public health / Prospective study

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基金资助

*国家科技重大专项(2024ZD0523900)

国家科技重大专项(2024ZD0523901)