空气细颗粒物PM2.5浓度与皮炎湿疹类皮肤病日门诊人次的相关性研究——以兰州两所医院为例

The effects of PM2.5 concentrations on the number of daily outpatient visits for eczema or dermatitis:a study in two hospitals in Lanzhou city

目的:探讨兰州地区空气细颗粒物PM2.5浓度对本地区皮炎湿疹类皮肤病日门诊人次的影响。方法:收集2013年1月—2016年12月期间皮炎湿疹类患者的门诊记录和同期气象及环境污染物资料。对日门诊人次和气象数据采用quasi-Poisson连接函数进行拟合。在控制季节性和长期趋势、星期几效应基础上,采用分布滞后非线性模型研究PM2.5浓度对就诊人数影响的滞后效应。结果:2013年—2016年期间,PM2.5浓度与皮炎湿疹类调查人群就诊人数的增加无统计学意义,进行性别分层后发现:大气中PM2.5每升高10μg/m3,女性皮炎湿疹类患者门诊人次在滞后0～6 d时增加1.67%(RR:1.0167,95%CI:1.0001～1.0336),在滞后0～7 d时增加1.70%(RR:1.0170,95%CI:1.0003～1.0339);进行年龄分层后发现:PM2.5升高可引起老年患者滞后0～1 d门诊人次增加2.43%(RR:1.0243,95%CI:1.0046～1.0444),青少年患者滞后0～9 d时门诊人次增加1.95%(RR:1.0195,95%CI:1.0002～1.0391),成年患者滞后0～9 d时门诊人次增加2.45%(RR:1.0245,95%CI:1.0004～1.0394)。结论:兰州地区PM2.5浓度升高对皮炎湿疹类老年患者日门诊人次增加存在即时效应,对女性患者、青年患者和成年患者的日门诊人次增加存在滞后效应。

Objectives： To determine the impact of PM2.5 concentrations on outpatient visits for eczema or dermatitis in two hospitals in Lanzhou, China. Methods： Daily outpatient visits between 2013 and 2016 were counted in both the First and the Second Hospital of Lanzhou University in Lanzhou, China. Data of daily average concentrations of PM2.5 were obtained from Lanzhou Municipal Environmental Protection Bureau. After controlling confounding variables, a distributed lag nonlinear model（DLNM） was used to determine the association between PM2.5 and outpatient visits for eczema or dermatitis. Results： The average of daily outpatient visits for eczema or dermatitis and PM2.5 concentration were 100.56±35.93 and 58.98±33.92 μg/m^3, respectively. No correlation was observed between daily average PM2.5 concentrations and the number of daily visits for eczema or dermatitis. After stratifying patients according to their gender and age, every increase in 10 p,g/m3 of daily PM2.5 concentration increased 1.70% of lag7 visits of female outpatients（RR：l.0170, 95%CI：1.0003-1.0339）. Increased daily PM2.5 concentrations were associated with a 2.43% increase in lagl visits of aged（over 65 years old） outpatients（RR：l.0243, 95%CI： 1.0046-1.0444）, a 1.95% increase in lag9 visits of young （under 18 years old） outpatients（RR：l.0195, 95%CI： 1.0002-1.0391）, and a 2.45% increase in lag9 visits of adult （19-64 years old） outpatients（RR：l.0245, 95%CI：1.0004-1.0394）. Conclusions： Increased PM2.5 concentration is associated with immediate increase in visits of old outpatients, and delayed increase in visits of female, youth and adult outpatients in Lanzhou.