太原市环境空气质量改善与儿童健康效益

Benefits of Improving Air Quality on Children'Health in Taiyuan

目的研究建立太原市空气中SO_2和PM_(10)污染状况与儿科门诊量的浓度—反应关系,并估计空气质量改善带来的儿童健康收益。方法 2001—2010年间儿科门诊量数据来自于太原市中心某综合性医院,太原市涧河站空气质量监测数据来自于太原市环境监测站,气象数据来源于山西省气象局。应用广义相加模型(GAM)建立空气污染物与儿科门诊量之间的浓度—反应关系,应用多种结构断裂点测试确定曲线拐点,分段估计危险度,计算以国家《环境空气质量标准》二级标准限值和世界卫生组织《空气质量标准》推荐值为基线,估计全年和采暖期SO_2和PM_(10)污染的超额健康风险。结果研究期间太原市空气中SO_2和PM_(10)污染水平分别从2003年和2007年出现明显的下降。在2001—2002年、2003年和2004—2010年期间因SO_2浓度超过国家环境空气质量二级标准限值致儿科每日门诊量平均增加11.3%、2.5%和1.1%;在2001—2002年、2003—2006年和2007—2010年期间因空气PM_(10)质量浓度超过国家环境空气质量二级标准限值致儿科每日门诊量平均增加3.1%、2.2%和0.7%。以WHO指导值为基线,计算得到2003年SO_2致儿科每日门诊量的增加比2001—2002年降低57.9%,2007—2010年PM_(10)的平均儿科门诊增量比2005—2006年降低52.3%。结论空气质量的改善可降低儿童医院门诊就诊的风险。

Objectives To establish a concentration- response relationships between the level of SO_2 and PM_（10）with the daily number of visits in an outpatient service of pediatric department in Taiyuan in 2001—2010,and to estimate the benefit from the improvement of air quality. Methods The number of visits in the outpatient service of pediatric department was collected from a general hospital in Taiyuan. The data of daily SO_2 and PM_（10）level in Jianhe Station was collected from Taiyuan Environment Monitoring Central Station. Meteorological data was provided by Shanxi Meteorological Service. The concentration-response function（ CRF） was estimated by using a generalized additive modeling（ GAM） with natural log link function,while the changing point in the curve of CRF was determined by a multiple structural break point test. Then,the risk for children visiting the outpatient service of the pediatric department was estimated by different segments of CRF and the extra risk from air pollution and the calculation of benefits from improving air quality was based on the WHO Air Quality Guidelines（ Global update 2005）and the National Ambient Air Quality Standards（ GB 3095- 2012）. Results The level of SO_2 and PM_（10）in the ambient air of Taiyuan city was significantly decreased in 2003 and 2007,respectively. Compared with the secondary national standard limits,the extra risk of increasing outpatient in the pediatric department for SO_2 exposure in Taiyuan was 11. 3% in 2001—2002,2. 5% in 2003 and 1. 1% in 2004—2010. Meanwhile,the extra risk for increasing outpatient visits in the pediatric department for PM_（10） exposure was 3. 1% in 2001—2002,2. 2% in 2003-2006 and 0. 7% in 2007—2010. Based on the WHO Air Quality Guideline,the risk of SO_2 exposure on outpatient visits in pediatric department was reduced 57. 9% in 2003 compared with the years in 2001—2002,while the risk of PM_（10） exposure on outpatient in the pediatric department reduced 52. 3% in 2007—2010 compared with the years in 2005—2006. Conclusion The improvement of air quality might reduce the risk of children visiting outpatient service of pediatric department.