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Associations between short-term exposure of ambient particulate matter and hemodialysis patients death: A nationwide, longitudinal case-control study in China

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机构: [1]Kidney Disease Center, The First Affiliated Hospital, College of Medicine, ZhejiangUniversity, Hangzhou, PR China. [2]National Key Clinical Department of Kidney Diseases, PR China [3]Institute of Nephropathy, Zhejiang University, Hangzhou, PR China [4]College of Medicine, Zhejiang University, Hangzhou, PR China [5]Zhejiang dialysis quality control center, PR China [6]School of public health, Zhejiang Chinese medical university, Hangzhou, PR China [7]School of Mathematical Sciences, Zhejiang University [8]First Hospital of Jilin University [9]Affiliated Zhongda Hospital of Southeast University [10]Qinghai Provincial Peoples Hospital [11]Tianjin Medical University General Hospital [12]Yan'an Hospital of Kunming Medical University [13]Second Affiliated Hospital of Chongqing Medical University [14]Guizhou Provincial People’s Hospital [15]Second Affiliated Hospital of Lanzhou University [16]First Affiliated Hospital of Sun yat-sen University [17]Second Affiliated Hospital of Nanchang University [18]Fourth Hospital of Hebei Medical University [19]First Affiliated Hospital of Xian Jiaotong University [20]Second Hospital of Tibet Autonomous Region [21]Shanghai First People’s Hospital [22]First Affiliated Hospital of Baotou Medical College [23]First Affiliated Hospital of Guangxi Medical University [24]Second Affiliated Hospital of Anhui Medical University [25]First Affiliated Hospital of China Medical University [26]General Hospital of Ningxia Medical University [27]Sichuan Provincial Peoples Hospital [28]Jiangxi Provincial Peoples Hospital [29]First Affiliated Hospital of Zhengzhou University [30]Peking Union Medical College Hospital [31]Peoples Hospital of Xinjiang Uygur Autonomous Region [32]Affiliated Hospital of Hainan Medical College [33]First affiliated Hospital of Fujian Medical University [34]Shanxi Provincial People’s Hospital [35]Xiangya Hospital Central South University [36]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology [37]Second Affiliated Hospital of Harbin Medical University [38]Research Center for Healthcare Data Science, Zhejiang Lab
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关键词: hemodialysis mortality ambient PM2 5 short-term exposure

摘要:
Long-term exposure to particulate air pollutants can lead to an increase in mortality of hemodialysis patients, but evidence of mortality risk with short-term exposure to ambient particulate matter is lacking. This study aimed to estimate the association of short-term exposure to ambient particulate matter across a wide range of concentrations with hemodialysis patients mortality.We performed a time-stratified case-crossover study to estimate the association between short-term exposures to PM2.5 and PM10 and mortality of hemodialysis patients. The study included 18,114 hemodialysis death case from 279 hospitals in 41 cities since 2013. Daily particulate matter exposures were calculated by the inverse distance-weighted model based on each case's dialysis center address. Conditional logistic regression were implemented to quantify exposure-response associations. The sensitivity analysis mainly explored the lag effect of particulate matter.During the study period, there were 18,114 case days and 61,726 control days. Of all case and control days, average PM2.5 and PM10 levels were 43.98 μg/m3 and 70.86 μg/m3, respectively. Each short-term increase of 10 μg/m3 in PM2.5 and PM10 were statistically significantly associated with a relative increase of 1.07 % (95 % confidence interval [CI]: 0.99 % - 1.15 %) and 0.89 % (95 % CI: 0.84 % - 0.94 %) in daily mortality rate of hemodialysis patients, respectively. There was no evidence of a threshold in the exposure-response relationship. The mean of daily exposure on the same day of death and one-day prior (Lag 01 Day) was the most plausible exposure time window.This study confirms that short-term exposure to particulate matter leads to increased mortality in hemodialysis patients. Policy makers and public health practices have a clear and urgent opportunity to pass air quality control policies that care for hemodialysis populations and incorporate air quality into the daily medical management of hemodialysis patients.Copyright © 2022. Published by Elsevier B.V.

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出版当年[2022]版:
大类 | 1 区 环境科学与生态学
小类 | 1 区 环境科学
最新[2025]版:
大类 | 2 区 环境科学与生态学
小类 | 2 区 环境科学
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Q1 ENVIRONMENTAL SCIENCES
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Q1 ENVIRONMENTAL SCIENCES

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第一作者:
第一作者机构: [1]Kidney Disease Center, The First Affiliated Hospital, College of Medicine, ZhejiangUniversity, Hangzhou, PR China. [2]National Key Clinical Department of Kidney Diseases, PR China [3]Institute of Nephropathy, Zhejiang University, Hangzhou, PR China [4]College of Medicine, Zhejiang University, Hangzhou, PR China
通讯作者:
通讯机构: [1]Kidney Disease Center, The First Affiliated Hospital, College of Medicine, ZhejiangUniversity, Hangzhou, PR China. [2]National Key Clinical Department of Kidney Diseases, PR China [3]Institute of Nephropathy, Zhejiang University, Hangzhou, PR China [5]Zhejiang dialysis quality control center, PR China [*1]Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China.
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