2013—2019年郑州市大气污染物对循环系统疾病就诊量影响的时间序列研究

Effects of air pollutants on circulatory diseases visits in Zhengzhou,Henan province,2013-2019:a time-series study

目的探讨大气污染物PM_(2.5)、PM_(10)、SO_(2)、CO、NO_(2)、O_(3)暴露与循环系统疾病就诊量之间的关系。方法收集2013年10月28日至2019年8月28日期间某医院每日循环系统疾病就诊量及大气污染物数据。采用分布滞后非线性模型分析大气污染物与循环系统就诊量的相关性,并根据性别、年龄及季节进行分层分析。结果PM_(2.5)、PM_(10)、SO_(2)、NO_(2)浓度的升高对高血压、冠心病就诊量均有明显影响。PM_(10)、SO_(2)、NO_(2)对女性、男性循环系统疾病就诊量均有影响。PM_(2.5)、O_(3)对女性影响明显,RR_(PM2.5)为1.001%(95%CI:1.000%~1.002%),RR_(O3)为1.002%(95%CI:1.000%~1.004%)。CO对男性影响明显,RR_(CO)为1.174%(95%CI:1.001%~1.377%)。PM_(2.5)、SO_(2)、NO_(2)对19~59岁、≥60岁人群影响明显;CO对≥60岁人群影响明显,RR_(CO)为1.184%(95%CI:1.000%~1.402%)。秋、冬季PM_(2.5)对循环系统疾病就诊量影响明显,RR_(秋季)为1.007%(95%CI:1.001%~1.013%),RR_(冬季)为1.004%(95%CI:1.000%~1.007%);冬季PM_(10)、NO_(2)对循环系统疾病就诊量影响明显,RR_(PM10)为1.005%(95%CI:1.002%~1.008%),RR_(NO2)为1.012%(95%CI:1.000%~1.023%)。结论大气污染物对循环系统疾病就诊量有影响,以≥60岁人群、冬季就诊量更为敏感。

Objective To understand the effects of air pollutants on circulatory disease visits in Zhengzhou,Henan province.Methods The data on daily visits of patients with circulatory diseases and the air pollutants from October 28,2013 to August 29,2019 were collected.A distributed lag nonlinear model was used to analyze the correlation between air pollutants and circulatory system diseases visits,stratified by gender,age,and season.Results PM_(2.5),PM_(10),SO_(2),and NO_(2)demonstrated notable effects on hypertension and coronary heart disease.PM_(10),SO_(2),and NO_(2)affected both men and women.PM_(2.5)and O_(3)had a substantial effect on women[PM_(2.5):RR=1.001%(95%CI:1.000%-1.002%),O_(3):RR=1.002%(95%CI:1.000%-1.004%)].The effect of CO on men was considerable[CO:RR=1.174%(95%CI:1.001%-1.377%)].On the 19-59 and 60-year-old populations,PM_(2.5),SO_(2),and NO_(2)all had a significant impact.CO only had a substantial effect on the 60-year-old group[CO:RR=1.184%(95%CI:1.000%-1.402%)].Autumn and winter circulatory diseases visits were significantly impacted by PM_(2.5)[autumn:RR=1.007%(95%CI:1.001%-1.013%),winter:RR=1.004%(95%CI:1.000%-1.007%)],while winter circulatory diseases visits were greatly influenced by PM_(10)and NO_(2)[PM_(10):RR=1.005%(95%CI:1.002%-1.008%),NO_(2):RR=1.012%(95%CI:1.000%-1.023%)].Conclusion The air pollutants have obvious influence on daily visits of patients with circulatory diseases,especially in the people over 60,and in winter.