合肥市空气污染与某儿童医院肺炎门诊量关系的时间序列分析

Relationship betw een air pollutants and outpatient visits due to pneumonia in a children's hospital in Hefei City: a time series analysis

目的探讨合肥市空气污染物短期暴露对儿童肺炎日门诊量的影响。方法收集合肥市2014～2017年逐日空气污染物资料(PM_(10)、PM_(2.5)、SO_2、NO_2、CO、O_3)、气象资料(气温、气压、相对湿度)以及某儿童医院肺炎门诊资料,采用时间序列半参数广义相加模型,建立单污染物模型及多污染物模型,分析空气污染物与儿童肺炎的暴露-反应关系,包括滞后效应(lag0～lag6)、移动平均滞后效应(lag01～lag06),采用滞后天数最大效应值作为空气污染物对门诊量影响的相对危险度。结果 2014～2017年合肥市空气PM_(10)、PM_(2.5)、SO_2、NO_2、CO、O_3日平均浓度分别为90. 24、64. 72、16. 08、39. 10、969. 90、76. 97μg/m^3,其中PM_(10)、PM_(2.5)高于《GB 3095-2012环境空气质量标准》二级标准。研究期间共记录67 569条儿童肺炎门诊病例,平均日门诊量为46. 25例。单污染物模型显示,PM_(10)、PM_(2.5)、SO_2、NO_2、CO、O_3浓度每增加10μg/m^3,儿童肺炎日门诊量的相对危险度分别为1. 011 1、1. 0098、1. 021 8、1. 001 5、1. 001 2、1. 003 4,其中SO_2效应最强。在调整其他污染物的全污染物模型中,仅PM_(10)与儿童肺炎日门诊量仍存在统计学关联(RR=1. 008 9,P <0. 05)。结论空气污染物的短期暴露影响儿童肺炎日门诊量,其中PM_(10)、PM_(2.5)、SO_2、CO影响较大。

Objective To estimate the association between air pollutants exposure and hospital admission for pneumonia among children in Hefei City. Methods The data of air pollutions（ PM10,PM2.5）,SO2,NO2,CO and O3）,meteorological factors（ the daily average temperature and relative humidity） and daily outpatient visits due to pneumonia in a children＇s hospital in Hefei City during 2014-2017 were collected. The models of single pollutant and total-pollutant analysis developed by using generalized additive model were used to analyze the exposure-effect relationship between air pollutants and hospital admission for pneumonia among children. The lag effects（ lag0-lag6） and cumulative lag effects（ lag01-lag06） of air pollutions were estimated as the relative risk value of hospital admission due to pneumonia. Results The annual average concentrations of PM10,PM2.5,SO2,NO2,CO and O3 were 90. 24,64. 72,16. 08,39. 10,969. 90 and 76. 97 μg/m3 respectively. PM10 and PM2.5 concentrations were higher than the national class II standard.During the study period,a total of 67 569 outpatient visits with pneumonia were recorded,with an average daily outpatient volume of 46. 25. In single pollutant models,the relative risk of hospital admission due to pneumonia were as follows：1. 011 1,1. 009 8,1. 021 8,1. 001 5,1. 001 2 and 1. 003 4 between pneumonia outpatients and PM10,PM2.5,SO2,NO2,CO,O3 with an increase of 10 μg/m3,respectively. In the total-pollutant models,only PM10 significantly correlated with pneumonia outpatients in children（ RR = 1. 008 9,P〈 0. 05）. Conclusion The short-term exposure of air pollutants affects the pneumonia outpatient visits in children,and PM10,PM2.5,SO2 and CO have great influence.