济南市重污染区域大气污染物对循环系统疾病门诊量的急性效应

Acute Effect of Air Pollutants in Heavy Polluted Areas on Outpatients Visit for Cardiovascular Diseases in Jinan

目的评价济南市空气污染严重区域大气污染物PM_(2. 5)、PM_(10)、NO_2、SO_2及O_3对当地居民循环系统疾病门诊就诊的暴露反应关系。方法收集2014—2016年济南市重污染区域某综合医院循环系统疾病逐日门诊信息、空气污染物浓度及气象信息,并进行描述性分析。采用广义线性模型,定量评估逐日大气污染物PM_(2. 5)、PM_(10)、NO_2、SO_2及O_3浓度与当地居民循环系统门诊就诊量之间的相关关系。结果 2014—2016年期间该综合医院循环系统疾病门诊量合计55 858人次,日均就诊量51人次/天,PM_(2. 5)、PM_(10)、NO_2、SO_2及O_3日均浓度分别为100、205、53、58及90μg/m3。PM_(2. 5)、PM_(10)、NO_2浓度每升高10μg/m3,当日循环系统疾病门诊量分别增加0.40%(95%CI:0.01%~0.80%)、0.25%(95%CI:0.03%~0.47%)、1.66%(95%CI:0.64%~2.68%)。仅发现NO_2与循环系统疾病门诊量存在累积滞后效应,NO_2浓度每升高10μg/m3,在Lag02时,循环系统疾病门诊量可增加2.13%(95%CI:0.81%~3.46%)。未发现SO_2及O_3与循环系统疾病门诊量之间存在显著效应。结论空气污染严重区域大气污染物PM_(2. 5)、PM_(10)及NO_2与循环系统疾病门诊量之间存在相关关系,未发现SO_2及O_3与循环系统疾病门诊量之间存在显著效应。

Objectives To evaluate the exposure of air pollutants, PM2.5, PM10, NO2, SO2 and O3 , in heavy polluted areas of Jinan on the outpatients visit for cardiovascular diseases. Methods The information on daily car- diovascular outpatients visit in a general hospital, the concentration of air pollutants and meteorological information in a heavy polluted area of Jinan during 2014 to 2016 were collected and analyzed by descriptive analysis. A gener- alized linear model was used to quantitatively assess the correlation between the concentration of daily air pollu- tants, PM2.5, PM10, NO2, SO2 and O3, and the outpatient visits for cardiovascular diseases. Results The total number of outpatient with cardiovascular diseases in the general hospital was 55 858 in 2014--2016 with an average attendance of 51 patients per day. The average concentration of PM2.5, PM,0, NO2, SO2and 03 were 100, 205, 53, 58 and 90 μg/m3, respectively. With an increase of PM2.5, PMj0 and NO2 by 10 μg/m3 per day, the visit of outpatients with cardiovascular diseases was increased by 0.40% （95% CI：0. 01% -0.80% ） , 0.25% （95% CI：0.03% -0.47% ） and 1.66% （95% CI： 0. 64% ~ 2.68% ） , respectively. When the NO2 concentration was in- creased by 10 μg/m3, there was only a cumulative lag effect of increasing cardiovascular outpatient visits by 2. 13% （95% CI：0.81% -3.46% ） on LagO2. No significant different effect was observed between SO2 and O3with the increase of outpatient visits for cardiovascular diseases. Conclusions There was a significant correla- tion between air pollutants, PM2.5, PM10 and NO2, with outpatients visit for cardiovascular diseases, and no significant different effect was observed on the concentration of SO2 and O3 with outpatient visits for cardiovascular diseases.