舟山市空气污染物与医院门诊量的相关性研究
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摘要
目的研究舟山市空气污染对医院门诊量的影响,为评价空气污染物健康效应和制定人群干预措施提供依据。方法收集舟山医院2016年每日门诊量和每日空气污染物资料,分析医院各科门诊在空气污染物浓度超标日和达标日的门诊量差异,采用Spearman秩相关分析日均门诊量与空气污染物浓度的相关性。结果 2016年舟山医院日均门诊总量M (Q_R)为3 304 (1 638)人次。2016年舟山市城市主要空气污染物为O3、PM_(2.5)和PM_(10)。空气质量轻度污染及以上日的日均门诊总量、内科日均门诊量、循环系统日均门诊量和其他疾病日均门诊量均高于空气质量优良日(P<0.05)。CO浓度与呼吸系统、循环系统日均门诊量均呈正相关(P<0.05),与日均门诊总量呈负相关(P<0.05);O3-8 h浓度与内科、其他疾病日均门诊量及日均门诊总量均呈正相关(P<0.05),与呼吸系统、儿科日均门诊量均呈负相关(P<0.05);SO_2浓度与呼吸系统、皮肤和皮下组织日均门诊量均呈负相关(P<0.05);NO_2、PM_(10)和PM_(2.5)浓度均与呼吸系统、儿科日均门诊量呈正相关(P<0.05)。结论舟山市主要空气污染物为O_3、PM_(2.5)、PM_(10),污染物浓度超标时医院门诊量增加。
Objective To explore the correlation between air pollution and outpatient visits,and to provide evidence for health risk assessment of air pollutants and intervention. Methods The data of air pollutants and outpatient visits in 2016 in Zhoushan Hospital were collected,and the outpatient volume on the days when the concentration of air pollutants reached and exceeded the standard were compared. Spearman rank correlation analysis was used to explore the relationship between outpatient volume and the concentration of air pollutants. Results In 2016,the median(inter-quartile range) of daily outpatient volume in Zhoushan Hospital was 3 304(1 638) person-times. O_3,PM_(2.5) and PM_(10) were the primary air pollutants in Zhoushan in 2016. The average daily outpatient volume of internal medicine,circulatory system,other diseases and all when the air was polluted at light level or above were higher than those when the air quality was good(P<0.05). CO concentration was positively correlated with the average daily outpatient volume of respiratory system and circulatory system(P <0.05), was negatively correlated with the average daily outpatient volume of all(P<0.05). O_3-8 h concentration was positively correlated with the average daily outpatient volume of internal medicine,other diseases and all(P<0.05),and was negatively correlated with the average daily outpatient volume of respiratory system and pediatrics(P <0.05). SO_2 concentration was negatively correlated with the average daily outpatient volume of respiratory system,skin and subcutaneous tissue(P<0.05). The concentration of NO_2,PM_(10) and PM_(2.5) were positively correlated with the average daily outpatient volume of respiratory system and pediatrics(P<0.05). Conclusion The main air pollutants in Zhoushan were O_3,PM_(2.5) and PM_(10). When they exceed the limits,the outpatient volume would increase.
Objective To explore the correlation between air pollution and outpatient visits,and to provide evidence for health risk assessment of air pollutants and intervention. Methods The data of air pollutants and outpatient visits in 2016 in Zhoushan Hospital were collected,and the outpatient volume on the days when the concentration of air pollutants reached and exceeded the standard were compared. Spearman rank correlation analysis was used to explore the relationship between outpatient volume and the concentration of air pollutants. Results In 2016,the median(inter-quartile range) of daily outpatient volume in Zhoushan Hospital was 3 304(1 638) person-times. O_3,PM_(2.5) and PM_(10) were the primary air pollutants in Zhoushan in 2016. The average daily outpatient volume of internal medicine,circulatory system,other diseases and all when the air was polluted at light level or above were higher than those when the air quality was good(P<0.05). CO concentration was positively correlated with the average daily outpatient volume of respiratory system and circulatory system(P <0.05), was negatively correlated with the average daily outpatient volume of all(P<0.05). O_3-8 h concentration was positively correlated with the average daily outpatient volume of internal medicine,other diseases and all(P<0.05),and was negatively correlated with the average daily outpatient volume of respiratory system and pediatrics(P <0.05). SO_2 concentration was negatively correlated with the average daily outpatient volume of respiratory system,skin and subcutaneous tissue(P<0.05). The concentration of NO_2,PM_(10) and PM_(2.5) were positively correlated with the average daily outpatient volume of respiratory system and pediatrics(P<0.05). Conclusion The main air pollutants in Zhoushan were O_3,PM_(2.5) and PM_(10). When they exceed the limits,the outpatient volume would increase.
引文
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[19]张媛媛,刘宗伟,李文龙,等.2016年潍坊市空气污染对儿童呼吸系统疾病门诊量的影响[J].环境与职业医学,2018(1):24-28.
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[21]李玉荣.2014-2015年合肥市空气污染物与某儿童医院0~14岁儿童上呼吸道感染日均门诊量的时间序列研究[D].合肥:安徽医科大学,2017.
[22]刘波,刘晓峰,杨冬梅,等.北京市通州区空气污染与医院门诊量关系初探[J].首都公共卫生,2017,11(5):212-215,227.
[2]张中文,王玖,孙红卫,等.基于广义泊松模型的空气质量对医院呼吸科门诊人次的影响研究[J].现代预防医学,2017,44(7):1157-1160.
[3]王在翔,赵晶,牛泽亮,等.空气污染对心脑血管疾病门诊量影响的Poisson广义可加模型分析[J].中国卫生统计,2017,34(2):232-235.
[4]李惠,赵学良,程芳,等.雾霾天气对荨麻疹就诊量和病情的影响[J].皮肤性病诊疗学杂志,2017,24(2):112-115.
[5]刘志连.变应性鼻炎发病与空气污染的相关性研究[D].乌鲁木齐:新疆医科大学,2006.
[6]吴安花,谭钢,邵毅,等.环境污染与眼表疾病的关系研究进展[J].山东医药,2017,57(7):101-104.
[7]International Agency for Research on Cancer.List of IARC Group 1carcinogens[R/OL].(2018-09-09)[2018-12-10].https://monographs.iarc.fr/agents-classified-by-the-iarc/.
[8]VAN DNKELAARA,MARTIN R V,BRAUER M,et al.Use of satellite observations for long-term exposure assessment of global concentrations of fine particulate matter[J].Environ Health Perspect,2015,123(2):135-143.
[9]中华人民共和国环境保护部.2013年中国环境状况公报[R].2014.
[10]浙江省环境保护厅.2016年浙江省环境状况公报[R].2017.
[11]王颖硕,李淑娴,杨德华,等.杭州市空气污染对儿童门诊量的影响[G].杭州:浙江省医学会儿科学分会学术年会暨儿内科疾病诊治新进展国家级继续教育学习班论文汇编,2014:1.
[12]张燕萍,赵宝新,桑田,等.2013年初灰霾期间太原市空气污染与医院门诊量的相关性分析[J].环境与健康杂志,2014,31(10):878-883.
[13]朱丽.合肥市大气污染与某医院儿科呼吸系统疾病门诊量的时间序列分析[D].合肥:安徽医科大学,2015.
[14]张永利,戴亚欣.舟山市空气污染物对呼吸门诊就诊人数的影响研究[J].中国预防医学杂志,2017,18(10):753-757.
[15]李阳.杭州市主要空气污染物浓度与呼吸系统疾病的关系研究[D].杭州:浙江农林大学,2017.
[16]芮婷.PM2.5对咳嗽、胸痹患者门诊量的短期效应[D].北京:北京中医药大学,2014.
[17]王大虎,石同幸,吕嘉韵,等.2013-2015年广州市大气PM2.5浓度对儿童呼吸系统门诊量影响分析[J].医学动物防制,2017,33(12):1230-1234.
[18]崔亮亮,李新伟,耿兴义,等.2013年济南市大气PM2.5污染及雾霾事件对儿童门诊量影响的时间序列分析[J].环境与健康杂志,2015,32(6):489-493.
[19]张媛媛,刘宗伟,李文龙,等.2016年潍坊市空气污染对儿童呼吸系统疾病门诊量的影响[J].环境与职业医学,2018(1):24-28.
[20]钱旭君,李国星,贺天锋,等.宁波市大气污染物一氧化碳及臭氧对人群心肌梗死死亡的急性效应研究[J].中华流行病学杂志,2017,38(3):297-302.
[21]李玉荣.2014-2015年合肥市空气污染物与某儿童医院0~14岁儿童上呼吸道感染日均门诊量的时间序列研究[D].合肥:安徽医科大学,2017.
[22]刘波,刘晓峰,杨冬梅,等.北京市通州区空气污染与医院门诊量关系初探[J].首都公共卫生,2017,11(5):212-215,227.
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