淄博市主城区大气PM2.5与呼吸系统疾病门诊人次的相关性研究

Effect of PM2.5 on daily outpatient numbers for respiratory diseases in a main urban area of Zibo

目的探讨淄博市主城区PM2.5污染对医院每日呼吸系统疾病门诊人次的影响。方法收集淄博市主城区3家综合性医院2016年1月1日-2017年12月31日的呼吸系统疾病逐日门诊人次资料,结合同期的逐日大气污染数据和气象数据,在用广义相加模型(GAM)控制长期趋势、季节趋势、星期几效应及气象因素的影响后,分析PM2.5日均浓度与呼吸系统疾病日门诊人次的关系。结果淄博市主城区2016-2017年PM2.5日均浓度为68.4μg/m^3,医院呼吸系统疾病日门诊人次平均为386.6人次/d。Spearman相关分析表明,呼吸系统疾病日门诊人次与PM2.5、SO2、NO2、CO均呈正相关(P<0.05)。时间序列分析的单污染物模型显示,PM2.5浓度对医院呼吸系统疾病日门诊人次的影响存在滞后效应,以滞后3 d时效应最强,PM2.5浓度每升高10μg/m^3,呼吸系统日门诊人次的超额危险度(ER)为0.321%(95%CI:0.077%~0.566%);多污染物模型显示,分别引入SO2、NO2后,PM2.5浓度每升高10μg/m^3,呼吸系统日门诊人次的ER分别为0.389%(95%CI:0.143%~0.636%)和0.334%(95%CI:0.091%~0.578%),而同时引入SO2和NO2后,ER无统计学意义(P>0.05)。结论淄博市主城区呼吸系统疾病日门诊人次与短期PM2.5浓度升高存在正向关联,可能会增加呼吸系统疾病的发病风险。

Objective To understand the acute effects of PM2.5 pollution on daily outpatient visits of respiratory disease in a main urban area of Zibo , Shandong province. Methods The daily outpatient visits of respiratory disease , daily a ir pollution monitoring and meteorology data from January 1,2016 to Decem ber 31,2017 were collected in Zibo. Generalized addictive model (GAM) with Poisson regression was used to estim ate the excess relative risks of daily hospital visits of respiratory disease associated with increased am bient PM25 lev e ls,after controlling confounding facto rs,su ch as tim e tre n d s, seasonal tren d s,d ay of week (DOW) and meteorological factors. Results The m ean concentration of PM2.5 during 2016 to 2017 was 68.4 μg/m3,a n d the daily outpatient num bers for respiratory diseases was 386.6. The hospital outpatient visits for respiratory diseases was significant positively correlated with PM2.5,SO2,NO2 and CO by the Spearm an correlation analysis (P<0.05). Unger the single-pollutant model, PM2.5 revealed lag affects on daily outpatient visits for respiratory d ise a se s, which was the most obvious at lag3 day ,it was estim ated that an increase of 10 μg/m3 PM23 was associated with excess risk (ER) of 0.321%(95%C/:0.077%-0.566%) for daily outpatient visits for respiratory disease at lag3. Under the multi-pollutan ts model,it indicated that for every 10 (xg/m3 increase in PM2.5 concentration, the ER of daily outpatient visits for respiratory disease was 0.389%(95%C/:0.143%-0.636%),0.334%(95%C/:0.091%-0.578%) when S02 and N02 were introduced separately. The ER had no statistical significance with sim ultaneous control of N02 and N02. Conclusion The sh o rt-term exposure to PM2.5 in Zibo is positively correlated with the increases of daily outpatient visits of respiratory daily ,w h ich may increase the risk of respiratory diseases.