大气PM_(2.5)与儿童支气管炎门诊量的相关性分析

Correlation between PM_(2.5) and bronchitis outpatient visits of children

目的了解大气PM_(2.5)浓度对儿童支气管炎门诊量的影响。方法收集金华市中心医院和金华市妇幼保健院2015—2016年支气管炎儿童门诊资料,收集同期金华市大气PM_(2.5)和气象监测资料,采用基于时间序列半参数广义Poisson回归模型(GAM)分析PM_(2.5)浓度与儿童支气管炎门诊量的相关性及其滞后效应。结果2015—2016年金华市大气PM_(2.5)日均浓度全年平均为(50.5±28.3)μg/m^3,冬季较高,均值为(70.1±36.3)μg/m^3;同期2家医院儿童支气管炎门诊量为94 795例次,平均130人次/d,就诊高峰期为冬春季;大气PM_(2.5)浓度与儿童支气管炎门诊量呈正相关(r_s=0.40,P<0.01)。控制气象因素影响后,大气PM_(2.5)浓度对儿童支气管炎门诊量的影响存在滞后效应,滞后第2天的效应最强(RR=1.002 433,95%CI:1.002 193~1.002 673),即大气PM_(2.5)日均浓度每增加10μg/m^3,2 d后儿童支气管炎门诊量增加0.243 3%。结论大气PM_(2.5)浓度升高与儿童支气管炎门诊量增加相关,且第2天的滞后效应最强。

Objective To explore the effect of PM2.5 on the bronchitis outpatient visits of children in Jinhua.Methods The data of bronchitis outpatient visits of children from 2015 to 2016 were collected from Jinhua municipal central hospital and Jinhua maternity and child healthcare hospital.The PM2.5 and the meteorological factors monitoring data in the same study period were also collected.Generalized additive model(GAM)based on the Poisson regression was conducted to analyze the correlation between PM2.5 and the bronchitis outpatient visits of children and the lag effects.Results The daily average mass concentration of PM2.5 from 2015 to 2016 was(50.5±28.3)μg/m3 in Jinhua.The mass concentration of PM2.5 in winter was higher,with average of(70.1±36.3)μg/m3.There were totally 94 795 bronchitis outpatient visits of children and with average of 130 visits per day.The peak seasons of outpatient visits were winter and spring.There was a positive correlation between daily bronchitis outpatient visits for children and mass concentration of PM2.5(rs=0.40,P<0.01).After controlling meteorological factors,there was a lag effect on the influence of mass concentration of PM2.5 on the bronchitis outpatient visits of children,which reached the strongest effect on the second day(RR=1.002 433,95%CI:1.002 193-1.002 673).An increase in mass concentration of PM2.5 by 10μg/m3 increased the bronchitis outpatient visits by 0.243 3%.Conclusion The higher mass concentration of PM2.5 may increase the bronchitis outpatient visits of children in Jinhua.There was a lag effect on the influence of mass concentration of PM2.5 on the bronchitis outpatient visits of children,and the hysteresis effect on second day was the strongest.