扬州市大气污染对儿童门诊量的影响

Impact of air pollution on pediatric outpatient visits in Yangzhou

目的探讨扬州市大气污染状况及其对儿童门诊就诊的影响。方法收集扬州市2016—2018年大气污染物资料、气象数据及儿科门诊资料,采用广义相加模型分析大气污染物对儿童总门诊量及呼吸系统疾病门诊量的影响。结果与《环境空气质量标准》(GB 3095—2012)二级标准相比,2016—2018年扬州市大气PM2.5和PM10日均浓度的超标率分别为16.07%和9.86%;1、2月PM2.5月均浓度最高,8月月均浓度最低。2017—2018年O3、NO2日均浓度的超标率分别为8.36%和0.82%。大气PM2.5浓度每增加10μg/m3,当日及滞后4 d的儿科总门诊量ER值分别为0.286%(95%CI:0.137%~0.434%)和0.211%(95%CI:0.075%~0.347%);当日、滞后4 d及5 d的儿童呼吸系统门诊量ER值分别为0.255%(95%CI:0.071%~0.438%),0.259%(95%CI:0.091%~0.427%),0.183%(95%CI:0.017%~0.349%)。引入其他污染物(SO2、NO2、CO、O3)后,PM2.5浓度对儿科总门诊量及呼吸系统门诊量的影响消失(P>0.05)。结论扬州市大气污染物以PM2.5和PM10为主,且冬季污染最严重。大气PM2.5浓度增加对儿童总门诊量及呼吸系统疾病门诊量的增加均有明显影响,且存在滞后效应。

Objectives To explore the air pollution situation in Yangzhou city and its impact on children’s health.Methods The data of air pollutiona,meteorology and pediatric outpatient visits were collected in Yangzhou during 2016-2018.Univariate and multivariate generalized additive models were used to analyze the effects of atmospheric pollutants on total outpatient visits and respiratory disease outpatient visits.Results In 2016-2018,the over standard rates of daily average concentrations of PM2.5 and PM10 were 16.07%and 9.86%based on the secondary standard of Ambient Air Quality Standards(GB 3095-2012),respectively.The monthly average concentration of PM2.5 revealed the highest in January and February,and the lowest in August.In 2017-2018,the over standard rates of the daily average concentration of O3 and NO2 were 8.36%and 0.82%respectively.The PM2.5 concentration had a significant effect on the total outpatient visits of the day and the lag of 4 days(P<0.01)and had the greatest impact on the total outpatient visits of the day(P<0.01).An increase of 10μg/m3 PM2.5 was associated with the increased total outpatient visits of the day[ER:0.286%(0.137%-0.434%)]and the lag of 4 days[ER:0.211%(0.075%-0.347%)]respectively,and the increased outpatient visits of pediatric respiratory diseases on the day[ER:0.255%(0.071%-0.438%)],lag4 d[ER:0.259%(0.091%-0.427%)],lag5 d[ER:0.183%(0.017%-0.349%)]respectively.After the introduction of other pollutants(SO2,NO2,CO,O3),the effect of PM2.5 concentration on total pediatric outpatient visits and respiratory system outpatient visits disappeared(P>0.05).Conclusion The air pollutants in Yangzhou are mainly PM2.5 and PM10,air pollution in winter is the most serious.The increase of PM2.5 concentration in air pollutants has a significant impact on the increase of the total outpatient visits of children and the outpatient visits of chileren with respiratory diseases,and there is a significant lag effect.