宁波市江北区室外细颗粒物污染对儿科呼吸系统疾病的影响
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摘要
目的探索室外细颗粒物(PM_(2.5))对浙江省宁波市江北区儿科门诊患者呼吸系统疾病日门诊量的影响。方法收集2014—2017年江北区各医院儿科门诊患者资料及同期污染物浓度和气象资料,采用分布滞后非线性模型计算相对危险度。结果 2014—2017年儿科门诊因呼吸系统疾病就诊984 941人次。PM_(2.5)浓度较低时对儿科呼吸系统疾病日门诊量增加的效应增长缓慢,而在较高浓度时,累积效应随着浓度的增加快速上升。同浓度PM_(2.5)的效应随着滞后天数的增加而减少。不同浓度PM_(2.5)的滞后天数不同,最长可滞后20 d。同一浓度PM_(2.5)对不同性别儿童的效应无差别,而对不同年龄儿童作用强度不同,3岁组和4～6岁组受到的效应最强。在滞后10 d以前,各浓度PM_(2.5)更易引起急性上呼吸道感染,但在10 d之后,对慢性下呼吸道疾病的效应更强,且后者的滞后天数更长。结论 PM_(2.5)浓度的升高会增加儿科呼吸系统疾病门诊就诊量,并存在滞后效应。同一浓度PM_(2.5)对不同年龄段儿童造成的危害有差别,但在性别方面没有差别,PM_(2.5)在早期更易引起急性上呼吸道感染,但对慢性下呼吸道疾病的效应更持久。
Objective To evaluate the effect of outdoor air fine particle(PM_(2.5)) on pediatric outpatient visits due to respiratory diseases in Jiangbei district of Ningbo.Methods Data of pediatric outpatient visits due to respiratory diseases in hospitals of Jiangbei district from 2014 to 2017 was collected,and the air pollution and meteorological data during the same period were collected too.The relative risk was calculated by using the distributed lag nonlinear model.Results A total of984 941 pediatric outpatient visits due to respiratory diseases were recorded in Jiangbei district from 2014 to 2017.The effect of PM_(2.5) increased slowly at low concentration,but increased quickly at high concentration.The effect of PM_(2.5) at the same concentration decreased with the increase of lag days.The lag days of PM_(2.5) effects at different concentrations were different,and the longest could be 20 days.The effects of PM_(2.5) on boys and girls showed no difference,but the effects were different on age groups,the effects on 3 and 4–6 years old children were strongest.PM_(2.5) was more likely to cause acute upper respiratory tract infection before 10 lag days,but after 10 lag days,the effect on chronic lower respiratory diseases was stronger and longer.Conclusion The rise of PM_(2.5) concentration would increase the pediatric outpatient visits due to respiratory diseases and has a lag effect.A PM_(2.5) concentration has different health hazards to children with different age,but there is no gender specific difference.PM_(2.5) is more likely to cause acute upper respiratory tract infection in early stage,but the effect on chronic lower respiratory tract disease is longer.
Objective To evaluate the effect of outdoor air fine particle(PM_(2.5)) on pediatric outpatient visits due to respiratory diseases in Jiangbei district of Ningbo.Methods Data of pediatric outpatient visits due to respiratory diseases in hospitals of Jiangbei district from 2014 to 2017 was collected,and the air pollution and meteorological data during the same period were collected too.The relative risk was calculated by using the distributed lag nonlinear model.Results A total of984 941 pediatric outpatient visits due to respiratory diseases were recorded in Jiangbei district from 2014 to 2017.The effect of PM_(2.5) increased slowly at low concentration,but increased quickly at high concentration.The effect of PM_(2.5) at the same concentration decreased with the increase of lag days.The lag days of PM_(2.5) effects at different concentrations were different,and the longest could be 20 days.The effects of PM_(2.5) on boys and girls showed no difference,but the effects were different on age groups,the effects on 3 and 4–6 years old children were strongest.PM_(2.5) was more likely to cause acute upper respiratory tract infection before 10 lag days,but after 10 lag days,the effect on chronic lower respiratory diseases was stronger and longer.Conclusion The rise of PM_(2.5) concentration would increase the pediatric outpatient visits due to respiratory diseases and has a lag effect.A PM_(2.5) concentration has different health hazards to children with different age,but there is no gender specific difference.PM_(2.5) is more likely to cause acute upper respiratory tract infection in early stage,but the effect on chronic lower respiratory tract disease is longer.
引文
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[16]Hwang SL,Guo SE,Chi MC,et al.Association between atmospheric fine particulate matter and hospital admissions for chronic obstructive pulmonary disease in southwestern Taiwan:a population-based study[J].Int J Environ Res Public Health,2016,13(4):366.DOI:10.3390/ijerph13040366.
[17]Lin HL,Ma WJ,Qiu H,et al.Is standard deviation of daily PM2.5concentration associated with respiratory mortality?[J].Environ Pollut,2016,216:208-214.DOI:10.1016/j.envpol.2016.05.068.
[18]Deng WJ,Zheng HL,Tsui AKY,et al.Measurement and health risk assessment of PM2.5,flame retardants,carbonyls and black carbon in indoor and outdoor air in kindergartens in Hong Kong[J].Environ Int,2016,96:65-74.DOI:10.1016/j.envint.2016.08.013.
[2]Sinclair AH,Edgerton ES,Wyzga R,et al.A two-time-period comparison of the effects of ambient air pollution on outpatient visits for acute respiratory illnesses[J].J Air Waste Manag Assoc,2010,60(2):163-175.DOI:10.3155/1047-3289.60.2.163.
[3]Jo EJ,Lee WS,Jo HY,et al.Effects of particulate matter on respiratory disease and the impact of meteorological factors in Busan,Korea[J].Respir Med,2017,124:79-87.DOI:10.1016/j.rmed.2017.02.010.
[4]杨阳.北京市大气污染与人群健康研究[D].北京:北京协和医学院,2015.Yang Y.Study on air pollution and population health in Beijing[D].Beijing:Peking Union Medical College,2015.
[5]中华人民共和国环境保护部,中华人民共和国国家质量监督检验检疫总局.环境空气质量标准:GB 3095-2012[S].北京:中国环境科学出版社,2012.Ministry of Environmental Protection of the people’s Republic of China,General Administration of quality Supervision,Inspection and Quarantine of the people's Republic of China.Ambient air quality standards GB 3095-2012[S].Beijing:China Environmental Science Press,2012.
[6]World Health Organization.Air Quality Guidelines[M].Germany:Druckpartner Moser,2006:278.ISBN 9289021926
[7]Zhao YJ,Wang SY,Lang LL,et al.Ambient fine and coarse particulate matter pollution and respiratory morbidity in Dongguan,China[J].Environ Pollut,2017,222:126-131.DOI:10.1016/j.envpol.2016.12.070.
[8]Tao Y,Mi SQ,Zhou SH,et al.Air pollution and hospital admissions for respiratory diseases in Lanzhou,China[J].Environ Pollut,2014,185:196-201.DOI:10.1016/j.envpol.2013.10.035.
[9]Halonen JI,Lanki T,Yli-Tuomi T,et al.Urban air pollution,and asthma and COPD hospital emergency room visits[J].Thorax,2008,63(7):635-641.DOI:10.1136/thx.2007.091371.
[10]Luong LMT,Phung D,Sly PD,et al.The association between particulate air pollution and respiratory admissions among young children in Hanoi,Vietnam[J].Sci Total Environ,2017,578:249-225.DOI:10.1016/j.scitotenv.2016.08.012.
[11]Bai LJ,Su X,Zhao DS,et al.Exposure to traffic-related airpollution and acute bronchitis in children:season and age as modifiers[J].J Epidemiol Community Health,2018,72(5):426 -433.DOI:10.1136/jech-2017-209948.
[12]Vahedian M,Khanjani N,Mirzaee M,et al.Associations of shortterm exposure to air pollution with respiratory hospital admissions in Arak,Iran[J].J Environ Health Sci Eng,2017,15:17.DOI:10.1186/s40201-017-0277-z.
[13]Liu P,Wang XN,Fan JY,et al.Effects of air pollution on hospital emergency room visits for respiratory diseases:Urban-suburban differences in Eastern China[J].Int J Environ Res Public Health,2016,13(3):341.DOI:10.3390/ijerph13030341.
[14]Xia XL,Zhang A,Liang S,et al.The association between air pollution and population health risk for respiratory infection:a case study of Shenzhen,China[J].Int J Environ Res Public Health,2017,14(9):950.DOI:10.3390/ijerph14090950.
[15]Zhang H,Niu Y,Yao YL,et al.The impact of ambient air pollution on daily hospital visits for various respiratory diseases and the relevant medical expenditures in Shanghai,China[J].Int JEnviron Res Public Health,2018,15(3):425.DOI:10.3390/ijerph15030425.
[16]Hwang SL,Guo SE,Chi MC,et al.Association between atmospheric fine particulate matter and hospital admissions for chronic obstructive pulmonary disease in southwestern Taiwan:a population-based study[J].Int J Environ Res Public Health,2016,13(4):366.DOI:10.3390/ijerph13040366.
[17]Lin HL,Ma WJ,Qiu H,et al.Is standard deviation of daily PM2.5concentration associated with respiratory mortality?[J].Environ Pollut,2016,216:208-214.DOI:10.1016/j.envpol.2016.05.068.
[18]Deng WJ,Zheng HL,Tsui AKY,et al.Measurement and health risk assessment of PM2.5,flame retardants,carbonyls and black carbon in indoor and outdoor air in kindergartens in Hong Kong[J].Environ Int,2016,96:65-74.DOI:10.1016/j.envint.2016.08.013.
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