尽管观察性研究已将空气污染暴露与各种慢性疾病广泛联系起来，但比较同一人不同暴露情况的证据仍然有限。本研究考察了因搬迁而造成的空气污染暴露变化与 14 种主要疾病的发病率和死亡率之间的关联。我们纳入了 2006 年至 2010 年期间在英国生物银行登记的 50,522 名参与者。暴露于直径≤2.5μm 的颗粒物（PM2.5）。 5），跟踪期间根据每位参与者的居住地址和搬迁经历，估算了直径≤10μm的颗粒物（PM10）、氮氧化物（NOx）、二氧化氮（NO2）和二氧化硫（SO2） 。根据居住流动性导致的长期暴露变化，对九个暴露组进行了分类。通过与医院住院患者记录和死亡登记处的联系，确定了 14 种主要疾病的发病率和死亡率。 Cox 比例风险模型用于估计 14 种感兴趣疾病的发病率和死亡率的风险比 (HR) 和 95% 置信区间 (CI)。在中位随访 12.6 年期间，29,869 名参与者被诊断患有以下任何疾病：利息，3,144 人死亡。从空气污染程度较低的地区搬到空气污染程度较高的地区的人中，发现疾病和全因死亡率的风险显着增加。与持续低暴露相比，从低暴露到中度 PM2.5 暴露与所有 14 种疾病的风险增加相关，但与全因死亡率无关，调整后的 HR (95% CI) 范围为 1.18 (1.05, 1.33) 至 1.48 （1.30，1.69）；从低 PM2.5 地区转向高 PM2.5 地区，所有 14 种疾病的风险均增加：感染 [1.37 (1.19, 1.58)]、血液疾病 [1.57 (1.34, 1.84)]、内分泌疾病 [1.77 (1.50, 2.09)]、精神和疾病行为障碍[1.93 (1.68, 2.21)]、神经系统疾病[1.51 (1.32, 1.74)]、眼部疾病[1.76 (1.56, 1.98)]、耳部疾病[1.58 (1.35, 1.86)]、循环系统疾病[1.59 ( 1.42, 1.78)]、呼吸系统疾病[1.51 (1.33, 1.72)]、消化系统疾病[1.74 (1.58, 1.92)]、皮肤疾病[1.39 (1.22, 1.58)]、肌肉骨骼疾病[1.62 (1.45, 1.81)]、泌尿生殖系统疾病[1.54 (1.36, 1.74)]和癌症[1.42 (1.24, 1.63)]。我们观察到 PM10 和 SO2 与 14 种疾病有类似的关联（但与全因死亡率无关）； NO2 和 NOx 的增加与 14 种疾病和全因死亡率呈正相关。这项研究支持环境空气污染暴露与发病率和死亡率之间的潜在关联。研究结果还强调了保持空气污染持续处于低水平以保护公众健康的重要性。 https://doi.org/10.1289/EHP14367。

Though observational studies have widely linked air pollution exposure to various chronic diseases, evidence comparing different exposures in the same people is limited. This study examined associations between changes in air pollution exposure due to relocation and the incidence and mortality of 14 major diseases.We included 50,522 participants enrolled in the UK Biobank from 2006 to 2010. Exposures to particulate matter with a diameter ≤2.5μm (PM2.5), particulate matter with a diameter ≤10μm (PM10), nitrogen oxides (NOx), nitrogen dioxide (NO2), and sulfur dioxide (SO2) were estimated for each participant based on their residential address and relocation experience during the follow-up. Nine exposure groups were classified based on changes in long-term exposures due to residential mobility. Incidence and mortality of 14 major diseases were identified through linkages to hospital inpatient records and death registries. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incidence and mortality of the 14 diseases of interest.During a median follow-up of 12.6 years, 29,869 participants were diagnosed with any disease of interest, and 3,144 died. Significantly increased risk of disease and all-cause mortality was observed among individuals who moved from a lower to higher air polluted area. Compared with constantly low exposure, moving from low to moderate PM2.5 exposure was associated with increased risk of all 14 diseases but not for all-cause mortality, with adjusted HRs (95% CIs) ranging from 1.18 (1.05, 1.33) to 1.48 (1.30, 1.69); moving from low to high PM2.5 areas increased risk of all 14 diseases: infections [1.37 (1.19, 1.58)], blood diseases [1.57 (1.34, 1.84)], endocrine diseases [1.77 (1.50, 2.09)], mental and behavioral disorders [1.93 (1.68, 2.21)], nervous system diseases [1.51 (1.32, 1.74)], ocular diseases [1.76 (1.56, 1.98)], ear disorders [1.58 (1.35, 1.86)], circulatory diseases [1.59 (1.42, 1.78)], respiratory diseases [1.51 (1.33, 1.72)], digestive diseases [1.74 (1.58, 1.92)], skin diseases [1.39 (1.22, 1.58)], musculoskeletal diseases [1.62 (1.45, 1.81)], genitourinary diseases [1.54 (1.36, 1.74)] and cancer [1.42 (1.24, 1.63)]. We observed similar associations for PM10 and SO2 with 14 diseases (but not with all-cause mortality); increases in NO2 and NOx were positively associated with 14 diseases and all-cause mortality.This study supports potential associations between ambient air pollution exposure and morbidity as well as mortality. Findings also emphasize the importance of maintaining consistently low levels of air pollution to protect the public's health. https://doi.org/10.1289/EHP14367.