兰州地区主要空气污染物对湿疹日门诊人次的影响

Association of Air Pollutants and Outpatient Visits for Eczema in Lanzhou

目的探讨兰州地区主要空气污染物与湿疹日门诊人次的相关性,以及不同季节、各性别、各年龄层人群对空气污染物的敏感性。方法收集2013年1月-2016年12月期间湿疹患者的门诊记录、同期主要空气污染物(PM_(2. 5)、PM_(10)、SO_2、NO_2)浓度和气象资料。在控制长期趋势和星期几效应基础上,采用分布滞后非线性模型研究空气污染物对日门诊人次影响的滞后效应和累积效应。结果研究期间,平均每日就诊湿疹患者(40. 38±14. 93)例,PM_(2. 5)、PM_(10)、SO_2、NO_2的平均浓度分别为57. 67μg/m^3、129. 75μg/m^3、24. 20μg/m^3和45. 82μg/m^3。经Spearman相关性分析发现湿疹日门诊人次与空气污染物、风速正相关,与气压、相对湿度、降水量负相关。经分布滞后非线性模型分析发现,空气污染物浓度升高对湿疹全人群门诊人次的增加无统计学意义,分季节讨论后,夏季PM_(2. 5)和PM_(10)浓度每增加10μg/m^3,湿疹全人群日门诊人次分别增加12. 33%(95%CI:0. 70%~25. 30%)和3. 61%(95%CI:0. 05%~7. 30%);经性别分层后,PM_(2. 5)浓度每增加10μg/m^3,女性湿疹患者门诊人数增加2. 11%(95%CI:0. 45%~3. 81%);经年龄分层后,PM_(2. 5)和PM_(10)浓度每增加10μg/m^3,≥65岁人群门诊人次分别增加4. 10%(95%CI:1. 54%~6. 73%)和1. 34%(95%CI:0. 39%~2. 31%),NO_2浓度每升高10μg/m^3,≤18岁青少年门诊人次增加4. 05%(95%CI:0. 42%~7. 81%)。结论兰州地区主要空气污染物对湿疹日门诊人次有影响,且不同空气污染物在不同季节对全人群湿疹日门诊人次影响不同,对各性别、年龄人群湿疹日门诊人次的影响有差异。

Objective To determine the relationship between air pollutants and outpatient visits for eczema, and the sensitivity of different seasons, gender, and age groups to air pollutants in Lanzhou, China. Methods Data of daily eczema outpatient visits, concentrations of major air pollutants （ PM2.5, PM10, SO2, and NO2 ） and meteorological variables during the period from 2013.1.1 to 2016. 12.31 were collected. Distributed lag nonlinear model （DLNM） was used to analyze the lag and cumulative effect of air pollutants on the outpatient visits, based on the control of long-term trends and ＂day- of-week＂ effects. Results During the study period, the average daily patient visits were 40.38 ± 14.93. The average concentrations of PM2.5 ,PM10 ,SO2 ,and NO2 were 57. 67μg/m3, 129.75μg/m3, 24. 20μg/m3, and 45.82μg/m3, respectively. The Spearman＇s correlations analysis showed that eczema day outpatients＇ visits were positively correlated with air pollutants and wind speed, whereas they were negatively correlated with air pressure, relative humidity, and precipitation. The analysis of DLNM showed no significant correlation between daily average air pollutants concentrations and the number of visits for eczema. After stratifying based on seasons, a 10μG/m3 increase of daily concentrations of PM2.5 and PM10 in summer was associated with 12.33% （95%CI：0. 70% -25.30%） and 3.61% （95%CI：0. 05% -7.30%） increase in eczema outpatient visits. After stratifying the patients according to gender and age ,an increase of 10μg/m3 in PM2.5 were significantly associated with the percentage increase of 2. 11% （95% CI：0.45% -3.81%） and 4. 10% （95% CI： 1.54% ～ 6.73% ） for female and at or above the age of 65 hospital outpatient visits, respectively. A 10μg/m3 increase of daily concentrations of PM10 was associated with 1.34% （95% CI：0. 39% -2. 31% ） increase in above 65 years old patients,and the number of outpatient attendances of below the age of 18 increased 4.05% （95% CI： 0.42% -7.81% ） with the increase of 10μg/m3 NO2. Conclusion The major air pollutants in Lanzhou affected the frequency of outpatient visits for eczema, and outpatient visits varied by different air pollutants, seasons, gender and the age of the eczema patient.