2013年北京灰霾事件对医院成人门急诊量影响的定量研究

Quantitative study on the effects of haze episode on outpatient and emergency room visits in Beijing in January 2013

目的定量研究北京某医院成人门(急)诊量的改变与空气污染的关系。方法医院门(急)诊量数据来自北京市某三甲综合医院,空气污染指数(API)来自于北京市环保局网站,空气环境质量监测数据来自中国环境科学研究院超级监测站,气温数据来自于天气网。研究时间为2012年10月至2013年1月(灰霾期,T1序列)及2011年10月至2012年1月(对照期,T2序列);采用Poisson回归模型估计危险度。结果灰霾期间,API每升高1个四分位数间距,呼吸内科门诊量和内科急诊量分别增加8.3%(lag0)和10.1%(lag4)。SO2每升高1个四分位数间距,呼吸内科门诊量、心血管内科门诊量、内科门诊量和神经内科急诊量分别增加22.6%(lag4)、31.4%(lag4)、40.7%(lag4)和41.7%(lag5)。NOx每升高1个四分位数间距,呼吸内科门诊量和神经内科急诊量分别升高21.5%(lag4)和48.0%(lag5)。PM10每升高1个四分位数间距,神经内科门诊量和急诊量分别增加5.7%(lag0)和14.1%(lag2),且高于相对于的T2序列。结论灰霾期间空气污染与北京市该医院多个科室的门(急)诊量存在定量的相关关系,且危险度明显高于其它时间段。

Objective To descript the quantitative relationship between air pollution and outpatient or emergency room visits in Beijing at early 2013. Methods Daily outpatient and emergency visit record was collected from a comprehensive hospital in Beijing; Data of API were from Local Environmental Protection Bureau; Data of pollutants were from Chinese Research Academy of Environmental Sciences, and data of temperature were from China Weather website. Research periods were from Oct. 2012 to Jan. 2013（T1） and Oct. 2011 to Jan. 2012（T2）. Poisson regression model was used to estimate the relative risks.Results Significant increase was observed during haze period of January 2013. The estimated risk of respiratory outpatient visits and internal medicine emergency room visits were 8.3%（lag0） and 10.1%（lag4） for an interquartile range increase in API. The estimated risk of respiratory outpatient visits, cardiovascular outpatient visits, internal outpatient room visits and neurology emergency room visits were 22.6%（lag4）, 31.4%（lag4）, 40.7%（lag4） and 41.7%（lag5） for an interquartile range increase in SO2. The estimated risk of respiratory outpatient visits and neurology emergency room visits were 21.5%（lag4） and 48.0%（lag5） for an interquartile range increase in NOx. The estimated risk of neurology outpatient room visits and emergency room visits were 5.7%（lag0） and 14.1%（lag2） for an interquartile range increase in PM10. Conclusion Evident increase of hospital outpatient and emergency room visits is observed during haze period in Beijing, and the observed increase is associated with air pollution, which is unlikely to be explained by weather, coincidental epidemic factors.