2013年1月灰霾期间太原市空气污染对儿科急诊量和门诊量的影响

Association of air pollution with pediatric outpatient visits and pediatric energency room visits in Taiyuan during haze period, in January, 2013

目的研究2013年1月灰霾期间太原市空气污染对儿科急诊量和门诊量的影响。方法从山西省环保厅网站获取2012年9月至2013年3月12日（观察期）和2011年9月至2012年3月1213（对照期）的空气污染数据，同期气温数据来自天气网，同期门诊量和急诊量数据来自太原市区某妇幼保健院。计算观察期较对照期的儿科每日急诊和门诊增量百分比。以广义相加模型确定剂量－反应关系曲线特征，以多种结构断裂点测试确定曲线拐点，危险度估计采用分段线性模型进行。结果灰霾期间儿科急诊和门诊高峰期就诊量分别增加52．00％和8．70％；广义相加模型分析结果显示高剂量空气污染与儿科门诊量相关，当API〉105时，控制了温度的影响后，API每升高10个单位，儿科门诊量增加5．07％（95％CI：1．37％-8．92％）。结论本次调查的灰霾期间空气污染是儿科门诊量升高的重要原因。

Objective To determine the adverse effect of air pollution on health in Taiyuan during haze period, in January, 2013. Methods The health data were from local children and women＇ health center, API data from Shanxi Environmental Protection Agency website, and the weather data from China Weather website. The study period was defined from Sep. 2012 to Mar. 2013 and the same period last year. Percent increase for hospital outpatient visits was obtained by comparing visits during haze period with those in control periods. Generalized additive model （GAM） was used to examine the shape of dose-response relation （DRR）, muhiple structural change test to determine the change points in DRRs, and constrained piecewise linear function to estimate risks for different segments of DRR. Results The percent increase was 52.00% and 8.70% for pediatric emergency room visits and pediatric outpatient visits. GAM result suggested three shapes of DRR： C-, S-, and J-shape. Of which, Jshape confirmed the association between high level of air pollution and hospital outpatient visits during haze period. After controlling for the effect of temperature, for each 10 unit increase in API, pediatric outpatient visits increased 5.07% （95%CI： 1.37%-8.92%） in the range of API〉105. Conclusion Air pollution is a plausible explanation for the increase of children outpatient visits during haze episode.