空气颗粒物与呼吸及心脑血管疾病每日住院率相关性研究

Association between particulate air pollution and daily respiratory and cardiovascular hospital admissions

目的建立颗粒物空气污染与每日住院率暴露反应关系模型，为颗粒物空气污染健康影响早期预警提供科学依据。方法应用Poisson广义可加模型鉴定暴露反应关系形状，分段线性拟合进行污染物危险度评估。结果年龄分组分析：颗粒物空气污染与所有年龄组每日住院率均呈正相关，且为非线性。可吸入颗粒物每增加10μg／m^3，呼吸系统疾病住院率上升百分比为0．716％。2．145％，心脑血管疾病住院率上升百分比为0．65％。病因分组分析：颗粒物空气污染与所有疾病每日住院率均呈正相关，且为非线性。影响显著的疾病为慢性阻塞性肺疾病和缺血性心脏病，颗粒物每升高10μg／m^3，相应的住院率上升百分比分别为2．94％、1．94％。非采暖期和采暖期分别分析，非采暖期颗粒物空气污染的影响大于采暖期影响。结论与有关死亡率研究结果比较，颗粒物空气污染对呼吸系统、心脑血管疾病住院率上升百分比大于死亡率上升百分比（0．25％），表明颗粒物空气污染对住院率的影响大于死亡率。

Objective To establish concentration-response relationship model for high particulate air pollution and daily hospital admissions for early warning system. Methods The Poisson generalized additive model was used with natural cubic spline smoothing for air pollutants of PM10, SO2, NO2, CO to determine the shape of concentration-response relationship. And piecewise linear regression was used for risk analysis. Results Age-specific analysis suggested the non-linear association between particulate air pollution and hospital admissions in all age groups. In respiratory and cardiovascular admissions, the percentage increase was 0. 716% - 2. 145% and 0. 65% for 10μg/m^3 increase in PM10 ,respectively. Cause-specific analysis suggested the non-linear association between particulate air pollution and hospital admissions for all diseases. The significant association was found with COPD and ischaemic heart disease, and the related percentage increase was 2.94% and 1.94%, respectively. Heating and noheating period analysis suggested the effect of PM10 was higher in noheating period than that in heating period. Conclusion Compared with mortality, particulate air pollution should affect the hospital admissions more greatly, the percentage increase should be higher for hospital admissions than that of mortality（0. 25% ）.