PM10与表观温度交互作用对北京市某医院呼吸系统疾病急诊的影响

Interaction between Inhalable Particulate Matter and Apparent Temperature on Respiratory Emergency Room Visits of a Hospital in Beijing

目的探讨PM10与表观温度交互作用对北京市某医院呼吸系统疾病急诊的影响。方法收集北京市某三甲医院急诊科2005年1月至2009年6月每日呼吸系统急诊病例资料、同期北京市环境监测中心大气污染物数据和中国科学数据共享服务网的气象数据。采用广义相加模型，通过惩罚样条函数控制长期趋势、星期几效应及其他可能的混杂因素，对数据进行分析。结果PM10与平均表观温度和最低表观温度的交互作用在低温时有统计学意义（P〈0．05），与日表观温度差值的交互作用在温差较大时有统计学意义（P〈0．05）。在表观温度为低温、中温、高温3个水平时，PMIO对于呼吸系统急诊的超额危险度分别为5．90％（95％CI：2．15％～9．78％），0．01％（95％CI：-0．65％～0．63％1，-0．22％（95％CI：-0．63％～0．17％）；在最低表观温度为低温、高温水平时，PM10对于呼吸系统急诊的超额危险度分别为1．42％（95％CI：0．37％～2．53％），-0．17％（95％CI：-0．56％-0．20％）；在日表观温度差值的高、中、低3个水平时，PM10对于呼吸系统急诊的超额危险度分别为0．05％（95％CI：0．65％～0．75％），0．01％（95％CI：-0．37％～0．40％），1．75％（95％CI：0．50％～3．02％）。结论在低温和温差比较大的情况下，PMIO对呼吸系统疾病的风险较大，应该加强对呼吸系统疾病患者的防护。

Objective To explore the interactive effects between inhalable particulate matter and apparent temperature on respiratory diseases （ICD-10 J00-J99） emergency room visits of a hospital in Beijing, China. Methods The data of the daily emergency room visits for respiratory diseases from a grade III-A general hospital, the data of relevant ambient air pollution from the Beijing Municipal Environmental Monitoring Center and the data of meteorological index from China meteorological data sharing service system from January, 2005 to June, 2009 were collected. Generalized additive models（GAM） were used to analyze the data. Results The interactive effects between air particulate matter and average apparent temperature （AT）-minimum AT were significant in low temperature level, and the interactive effects between air particulate matter and diurnal AT range was significant when the range was wider. In low, medium and high temperature levels, as for average AT, the excess risks of particulate matter were 5.90%（95% CI：2.15%-9.78%）, 0.01%（95% CI：0.65%-0.63%）, -0.22%（95% CI：-0.63%-0.17%） respectively; as for minimum temperature, the excess risks of particulate matter were 1.42%（95% CI：0.37%-2.53%）, -0.17% （95% CI：-0.56%-0.2%） respectively; as for diurnal AT range, the excess risks of particulate matter were 0.05%（95% CI： -0.65%-0.75%）, 0.01%（95% C1：-0.37%-0.40%）, 1.75%（95% CI：0.5%-3.02%） respectively. Conclusion Because PM10 has adverse effects on respiratory disease when AT is low or diurnal AT range is wide, the protection of patients with respiratory disease should be strengthened.