2016—2018年天津市大气PM2.5对儿童呼吸系统门诊量的时间序列分析

Effects of ambient PM2.5 pollution on hospital outpatient visits for respiratory diseases of children in Tianjin in 2016-2018:a time series analysis

目的了解天津市大气污染的基本特征,分析大气主要污染物PM2.5与儿童呼吸系统门诊量的关系。方法收集2016—2018年天津市儿童医院呼吸系统门诊量、三年逐日气象和环保资料。利用广义相加模型(基于Poisson分布),在控制时间趋势、温湿度、工作日等因素的条件下,分析PM2.5浓度对儿童呼吸系统门诊量前7日的滞后效应。结果2016—2018年天津市PM2.5平均浓度为62.3μg/m^3;Spearman等级相关分析提示儿童呼吸系统日门诊量与当日SO2、NO2、CO、PM10和PM2.5等污染物浓度均有一定的正相关关系(P<0.01)。GAM模型分析结果表明,PM2.5浓度对儿童呼吸系统门诊量的单日滞后及累积滞后效应分别在第5、第6日达到最大值,PM2.5浓度每升高10μg/m^3,超额危险度(ER)分别增加0.42%(95%CI:0.29%~0.55%)和0.88%(95%CI:0.65%~1.11%)。结论2016—2018年天津市PM2.5浓度增加会使儿童医院呼吸系统门诊量就诊风险增大。

Objective To understand the basic characteristics of ambient air pollution and to evaluate the effects of PM2.5 concentration on hospital outpatient visits for respiratory diseases of children in Tianjin.Methods Data on environmental factors and meteorological factors from 2016 to 2018 was obtained.Data on outpatient visits for respiratory disorders of children was collected from Tianjin Children Hospital.Controlling temporal trends,temperature and relative humidity,and working day,the generalized additive model based on Poisson regression was applied to analyze the lag effect of ambient PM2.5 pollution on the volume of outpatient visits in the hospital.Results The average concentration of PM2.5 from 2016 to 2018 in Tianjin city was 62.3μg/m3.According to the Spearman rank correlation analysis,the daily volume of respiratory outpatient visits was positively associated with the concentrations of sulfur dioxide(SO2),nitrogen dioxide(NO2),carbon monoxide(CO),PM10,and PM2.5.The results of GAM model analysis showed that the single-day lag and cumulative lag effects of PM2.5 concentration on children's respiratory system outpatient visits reached the maximum on the 5th and 6th day respectively.When PM2.5 concentration increased by 10μg/m3,the excess risk(ER)increased by 0.42%(95%CI:0.29%to 0.55%)and 0.88%(95%CI:0.65%to 1.11%),respectively.Conclusion The increase of PM2.5 concentration in Tianjin from 2016 to 2018 increased the risk of outpatient visits of respiratory system in children's hospital.