空气花粉浓度与变应性鼻炎就医人次的暴露-反应关系初探

Exposure-Response Relationship between Airborne Pollen Concentrations and Allergic Rhinitis Medical Consultations

目的研究北京市海淀区夏秋季空气花粉浓度与变应性鼻炎就医人次的暴露-反应关系,对空气花粉浓度进行危险度分级,评价人群花粉暴露的致敏危险度。方法以周为单位研究北京市海淀区2000—2002年4—9月空气花粉浓度和同期公费医疗病例资料中变应性鼻炎就医人次随时间变化的趋势.对变应性鼻炎就医人次和空气花粉浓度、空气总悬浮颗粒物(TSP)浓度、6种气象因素(日均气温、日最高气温、日最低气温、日均气压、24 h 降水量、日均相对湿度)以及年份哑变量 A_1、A_2进行多重线性回归分析。采用美国环境保护局(EPA)的基准剂量计算软件(BMDS V1.4.1C)计算空气花粉浓度对人群变应性鼻炎致敏基准剂量的95%可信下限(BMDL)值。以变应性鼻炎就医人次为效应终点,用基准剂量(BMD)法进行日花粉浓度分级。结果仅空气花粉浓度和年份哑变量进入了变应性鼻炎就医人次的回归方程.空气花粉浓度与变应性鼻炎就医人次的暴露.反应关系为线性,呈正相关(P<0.001)。空气花粉浓度对人群变应性鼻炎致敏基准剂量的95%可信下限值为21.38粒/1 000 mm^2。以变应性鼻炎就医人次为效应终点,应用 BMD 法进行花粉浓度分级,可初步评估花粉致敏危险度。结论北京市海淀区夏秋季花粉浓度与变应性鼻炎就医人次有一定暴露-反应关系.以 BMD 法进行花粉浓度分级评估花粉致敏危险度有较大的可行性和可信度。

Objective To evaluate the exposure-response relationship between airborne pollen concentrations and the number of medical eonsuhations for allergic rhinitis, to determine the risk of pollen concentrations and assess the human allergic risk exposed to the airborne pollen. Methods To collect the data of airborne pollen concentrations and the database on medical insurance focus on patients who were diagnosed with allergic rhinitis during April and September, as well as atmospheric concentrations of total suspended particles （TSP）, the related meteorological factors （average temperature, maximum temperature, minimum temperature, average air pressure, precipitation and relative humidity） from 2000 to 2002 in Haidian district, Beijing. The correlation between airborne pollen concentrations in summer-autumn, TSP concentrations, the related meteorological factors and the number of medical consultations for anaphylactic rhinitis were analyzed by multiple regression models using SPSS 15.0 software. Based on the exposure-response relationship between airborne pollen concentrations and the number of medical consultations for allergic rhinitis, the benchmark dose （BMD） and the BMD lower confidence limit （BMDL） of the pollen concentrations were calculated by the Benchmark Dose Software （BMDS） provided by US Environmental Protection Agency （EPA）. The pollen concentrations classification for risk assessment by using BMD method was examined. Results The multiple regression analysis indicated that the airborne pollen concentrations in summer-autumn and the number of medical eonsuhations for anaphylactic rhinitis was positive correlated （P〈0.001）, the exposure-response relationships were found to be linear. The BMDL of the pollen concentrations was 21.38 （BMR=0.364）. Conclusion The exposure-response relationships between the airborne pollen concentrations in summer-autumn and number of medieal consultations for anaphylaetic rhinitis has been observed. The pollen concentrations classification for risk assessment in the present paper is considered as available and reliable.