重庆市主城区域2014-2018年大气污染物PM2.5对居民呼吸系统疾病死亡影响的时间序列研究

Impact of atmospheric pollutant PM2.5 on deaths from respiratory diseases in the main urban areas of Chongqing from 2014 to 2018:a time-series study

目的分析重庆市5个主要城区细颗粒物(PM2.5)对居民呼吸系统疾病死亡的影响。方法收集重庆市5个城区2014年1月1日至2018年12月31日PM2.5日均浓度、呼吸系统疾病死亡数据和气象监测数据。采用广义相加模型,控制长期趋势、气象因素及星期几效应等混杂因素,分析PM2.5单独暴露及其与二氧化硫(SO2)、二氧化氮(NO2)、一氧化碳(CO)联合暴露时对全人群及不同性别人群呼吸系统疾病死亡的急性效应。结果2014-2018年重庆市5个城区PM2.5日均浓度为51.08μg/m^3。单污染模型显示,PM2.5对全人群呼吸系统疾病死亡的影响在滞后2 d时最大,其浓度每升高10μg/m^3导致全人群呼吸系统疾病死亡率增加0.98%(95%CI:0.28%~1.69%);女性、男性分别在滞后1 d和2 d时效应最大,PM2.5对女性呼吸系统疾病死亡率的影响高于男性,其浓度每升高10μg/m^3对应的死亡率分别增加1.45%(95%CI:0.40%~2.52%)、0.88%(95%CI:0.05%~1.71%)。多污染模型显示,分别校正SO2、NO2、CO及全部污染物后,PM2.5对男性呼吸系统疾病死亡率的影响消失,而对女性呼吸系统疾病死亡率的效应增高,在全污染模型中PM2.5浓度每升高10μg/m^3导致女性死亡率增加2.11%(95%CI:0.57%~3.67%)。结论重庆市主要城区PM2.5浓度升高导致呼吸系统疾病死亡率增加,对女性呼吸系统疾病死亡的急性效应更强。

Objective To analyse the impact of fine particulate matter(particulate matter with an aerodynamic diameter less than or equal to 2.5μm,PM2.5)on deaths from respiratory diseases of residents in five typical urban areas of Chongqing.Methods The average daily concentration of PM2.5,respiratory system death data and meteorological monitoring data from January 1,2014 to December 31,2018 in five urban areas of Chongqing were collected.The generalized additive model was used to adjust confounding factors,including the long-term trend,meteorological conditions and day-of-week effects,and the acute effects of exposure to PM2.5 and PM2.5 combined with SO2,NO2 and CO on deaths from respiratory diseases of general population of Chongqing and different genders were analysed.Results The average daily concentration of PM2.5 in the five urban areas in Chongqing from 2014 to 2018 was 51.08μg/m^3.The single pollutant model revealed that the impact of PM2.5 on deaths from respiratory diseases in the whole population was the greatest lagging 2 d,and increasing the PM2.5 concentration by 10μg/m^3 resulted in a 0.98%(95%CI:0.28%-1.69%)increase in the mortality of respiratory diseases.The impact of PM2.5 on deaths from respiratory diseases in females and males was the greatest lagging 1 d and 2 d,respectively.The impact of PM2.5 on deaths from respiratory diseases in females was higher than that in males,of which the mortality was increased by 1.45%(95%CI:0.40%-2.52%)and 0.88%(95%CI:0.05%-1.71%)respectively while the PM2.5 concentration increased by 10μg/m^3.The combinational model indicated that after adjusting for SO2,NO2,CO and other air pollutants,the impact of PM2.5 on the mortality of respiratory diseases of males was reduced to a negligible level,while the impact on mortality in females was increased.The mortality of respiratory diseases in females was increased by 2.11%(95%CI:0.57%-3.67%),when the PM2.5 concentration increased by 10μg/m^3 in the all-pollutant model.Conclusion The increase of PM2.5 concentration in the five typical urban areas of Chongqing would lead to an increase in the mortality of respiratory diseases of the residents,and the acute effects might be more severe on female populations.