北京市延庆区大气污染物对呼吸系统疾病门急诊量的影响
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摘要
目的探讨北京市延庆区大气污染对人群呼吸系统疾病门急诊量影响。方法收集2014-2017年北京市延庆区二级医疗机构的呼吸系统疾病每日门急诊量数据和同期气象数据资料以及大气污染数据资料,运用时间序列的广义相加模型,在控制混杂因素的基础上,分析大气污染物浓度与呼吸系统门急诊量的关系以及滞后效应。结果研究表明,大气中空气动力学直径当量直径≤2.5μm的颗粒物(particulate matter 2.5,PM_(2.5))每增加10μg/m~3,呼吸系统门急诊量增加0.11%(RR=0.11,95%CI:0.09～0.14,P=0.001);大气中空气动力学直径当量直径≤10μm的颗粒物(particulate matter 10,PM_(10))每增加10μg/m~3,呼吸系统门急诊量增加0.17%(RR=0.17,95%CI:0.15～0.19,P=0.001;二氧化氮(nitrogen dioxide,NO_2)每增加10μg/m~3,呼吸系统门急诊量增加0.44%(RR=0.44,95%CI:0.37～0.50,P=0.001);一氧化碳(carbon monoxide,CO)每增加10μg/m~3,呼吸系统门急诊量增加3.34%(RR=3.34,95%CI:1.57～5.15,P=0.001),且最强效应期均在第0 d。二氧化硫(sulfur ioxide,SO_2)每增加10μg/m~3呼吸系统门急诊量增加-1.69%(RR=-1.69,95%CI:-1.80～-1.57,P=0.001),且在第1 d达到最强效应值。臭氧(ozone,O_3)每增加10μg/m~3呼吸系统门急诊量增加-0.12%(RR=0.12,95%CI:-0.15～-0.10,P=0.001),且在第5 d达到最强效应值。双污染物模型分析中,CO在SO_2的影响下,对呼吸系统疾病门急诊人数影响尤为明显。结论本研究结果提示延庆区PM_(2.5)、PM_(10)、NO_2、CO浓度的增加均会导致呼吸系统门急诊量的增加,且不同污染物之间存在相互作用。
Objective To explore the association between air pollutants and the number of outpatient and emergency visits for respiratory diseases in Yanqing District,Beijing.MethodsData from 2014-2017 of the number of outpatient and emergency visits for respiratory diseases was collected from secondary medical institutions in Yanqing District of Beijing,and data of meteorological monitoring and atmospheric pollution were also collected.On the basis of controlling confounding factor,a generalized additive model was used to analyze the relationship between air pollutant concentration and the number of outpatient and emergency visits for respiratory diseases,and lag effect.ResultsThe results showed that,Particulate Matter 2.5(PM_(2.5))increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 0.11%(95%CI:0.09-0.14,P=0.001);Particulate Matter 10(PM10)increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 0.17%(95%CI:0.15-0.19,P=0.001);Nitrogen dioxide(NO_2)increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 0.44%(95%CI:0.37-0.50,P=0.001);carbon monoxide(CO)increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 3.34%(95%CI:1.57-5.15,P=0.001),and the most effective period was on the Zeroth day.The number of respiratory outpatient and emergency visits would increase-1.69%(95%CI:-1.80--1.57,P=0.001)with sulfur ioxide(SO_2)increased 10μg/m3,and the most effective period was on the 1th day.The number of respiratory outpatient and emergency visits would increase -0.12%(95%CI:-0.15--0.10,P=0.001)with O_3 increased 10μg/m~3,and the most effective period was on the 5th day.In the analysis of double pollutant model,under the influence of SO_2,CO had a significant effect on the number of outpatient and emergency visits with respiratory diseases.Conclusion The results of this study suggest that in Yanqing District,increasing concentrations of PM_(2.5),PM_(10),NO_2 and CO will cause an increase in the number of outpatient and emergency visits for respiratory diseases,and there are interactions between different pollutants.
Objective To explore the association between air pollutants and the number of outpatient and emergency visits for respiratory diseases in Yanqing District,Beijing.MethodsData from 2014-2017 of the number of outpatient and emergency visits for respiratory diseases was collected from secondary medical institutions in Yanqing District of Beijing,and data of meteorological monitoring and atmospheric pollution were also collected.On the basis of controlling confounding factor,a generalized additive model was used to analyze the relationship between air pollutant concentration and the number of outpatient and emergency visits for respiratory diseases,and lag effect.ResultsThe results showed that,Particulate Matter 2.5(PM_(2.5))increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 0.11%(95%CI:0.09-0.14,P=0.001);Particulate Matter 10(PM10)increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 0.17%(95%CI:0.15-0.19,P=0.001);Nitrogen dioxide(NO_2)increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 0.44%(95%CI:0.37-0.50,P=0.001);carbon monoxide(CO)increased by 10μg/m~3,the number of respiratory outpatient and emergency visits would increase 3.34%(95%CI:1.57-5.15,P=0.001),and the most effective period was on the Zeroth day.The number of respiratory outpatient and emergency visits would increase-1.69%(95%CI:-1.80--1.57,P=0.001)with sulfur ioxide(SO_2)increased 10μg/m3,and the most effective period was on the 1th day.The number of respiratory outpatient and emergency visits would increase -0.12%(95%CI:-0.15--0.10,P=0.001)with O_3 increased 10μg/m~3,and the most effective period was on the 5th day.In the analysis of double pollutant model,under the influence of SO_2,CO had a significant effect on the number of outpatient and emergency visits with respiratory diseases.Conclusion The results of this study suggest that in Yanqing District,increasing concentrations of PM_(2.5),PM_(10),NO_2 and CO will cause an increase in the number of outpatient and emergency visits for respiratory diseases,and there are interactions between different pollutants.
引文
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[2]Jacobson LSV,Hacon SS,Castro HA,et al.Association between fine particulate matter and the peak expiratory flow of schoolchildren in the Brazilian subequatorial Amazon:a panel study[J].Environ Res,2012,117:27-35.DOI:10.1016/j.envres.2012.05.006.
[3]Darrow LA,Klein M,Flanders WD,et al.Air pollution and acute respiratory infections among children 0-4 years of age:an 18-year time-series study[J].Am J Epidemiol,2014,180(10):968-977.DOI:10.1093/aje/kwu234.
[4]Arbex MA,Pereira LAA,Carvalhooliveira R,et al.The effect of air pollution on pneumonia-related emergency department visits in a region of extensive sugar cane plantations:a 30-month time-series study[J].J Epidemiol Commun Health,2014,68(7):669-674.DOI:10.1136/jech-2013-203709.
[5]Greenberg N,Carel RS,Derazne E,et al.Different effects of long-term exposures to SO2and NO2air pollutants on asthma severity in young adults[J].J Toxicol Environ Health,2016,79(8):1-10.DOI:10.1080/15287394.2016.1153548.
[6]Carmo CN,Hacon S,Longo KM,et al.Association between particulate matter from biomass burning and respiratory diseases in the southern region of the Brazilian Amazon[J].Revista Panamericana De Salud Pública,2010,27(1):10-16.DOI:10.1590/S1020-49892010000100002.
[7]Ignotti E,Hacon SS,Junger WL,et al.Air pollution and hospital admissions for respiratory diseases in the subequatorial amazon:a time series approach[J].Cad Saude Publica,2010,26(4):747-761.
[8]赵凤敏,吴一峰,吴峰.大气污染物浓度与上呼吸道疾病门诊就诊的关联性研究[J].浙江预防医学,2016,28(2):165-170.DOI:10.19485/j.cnki.issn1007-0931.2016.02.018.Zhao FM,Wu YF,Wu F.Study on the relationship between air pollutant concentration and outpatient treatment for upper respiratory disease[J].Zhejiang Prev Med,2016,28(2):165-170.DOI:10.19485/j.cnki.issn1007-0931.2016.02.018.
[9]李玉荣,肖长春,林浩飞,等.合肥市大气污染与肺炎门诊量的时间序列研究[J].环境与健康杂志,2016,33(11):960-963.DOI:10.16241/j.cnki.1001-5914.2016.11.006.Li YR,Xiao CC,Lin HF,et al.Association between air pollution and daily outpatient visits for pneumonia in Hefei City:a time-series analysis[J].J Environ Health,2016,33(11):960-963.DOI:10.16241/j.cnki.1001-5914.2016.11.006.
[10]张江华,郭常义,许慧慧,等.上海市大气污染与某医院呼吸系统疾病门诊量关系的时间序列研究[J].环境与职业医学,2014,31(11):846-851.DOI:10.13213/j.cnki.jeom.2014.0205.Zhang JH,Guo CY,Xu HH,et al.Time-series analysis on association between air pollution and outpatient visits for respiratory diseases in a hospital in Shanghai[J].J Environ Occup Med,2014,31(11):846-851.DOI:10.13213/j.cnki.jeom.2014.0205.
[11]张莹,宁贵财,康延臻,等.北京市大气污染物与呼吸系统疾病入院人数的时间序列[J].兰州大学学报,2015,51(1):87-92.DOI:10.13885/j.issn.0455-2059.2015.01.013.Zhang Y,Ning GC,Kang YZ,et al.Time-series analysis of the association between outdoor air pollution and emergency room admissions for respiratory diseases in Beijing City[J].Journal of Lanzhou University,2015,51(1):87-92.DOI:10.13885/j.issn.0455-2059.2015.01.013.
[12]张莹,邵毅,王式功,等.北京市空气污染物对呼吸系统疾病门诊人数的影响[J].中国环境科学,2014,34(9):2401-2407.DOI:10.3969/j.issn.1000-6923.2014.09.043.Zhang Y,Shao Y,Wang SG,et al.Relationship between air pollutant and respiratory diseases hospital outpatient visits in Beijing[J].China Environmental Science,2014,34(9):2401-2407.DOI:10.3969/j.issn.1000-6923.2014.09.043.
[13]杨程,杨兴堂,沈先标.上海市某区2013-2015年大气污染物与医院门诊量的时间序列研究[J].环境与职业医学,2017,34(3):235-238,244.DOI:10.13213/j.cnki.jeom.2017.16489.Yang C,Yang XT,Shen XB.A time-series study on association between ambient air pollutants and hospital outpatients in a district of Shanghai[J].J Environ Occup Med,2017,34(3):235-238,244.DOI:10.13213/j.cnki.jeom.2017.16489.
[14]鲍玉星,晓开题-依不拉音,吴文华,等.乌鲁木齐大气污染与呼吸系统疾病日住院人数的时间序列分析[J].新疆医科大学学报,2013,(4):537-541,546.DOI:10.3969/j.issn.1009-5551.2013.04.027.Bao YX,Xiao KT-YBLY,Wu WH,et al.Time-series analysis on relationship between air pollution and daily hospital for respiratory system diseases in Urumqi[J].Journal of Xinjiang Medical University,2013,36(4):537-541,546.DOI:10.3969/j.issn.1009-5551.2013.04.027.
[15]马洪群,崔莲花.大气污染物(SO2、NO2)对中国居民健康效应影响的Meta分析[J].职业与健康,2016,32(8):1038-1044.Ma HQ,Cui LH.Meta-analysis on health effects of air pollutants(SO2and NO2)in the Chinese population[J].Occup and Health,2016,32(8):1038-1044.
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