大气黑碳颗粒浓度与儿童哮喘门急诊人数的关系研究

Association between ambient black carbon concentration and hospital visits of childhood asthma

目的污染物暴露可能通过多种途径诱导儿童哮喘的加重,大气黑碳(black carbon,BC)是东北地区典型的污染物,目前东北地区尚无大气BC暴露与儿童哮喘之间关系的研究报道。该研究探讨每日儿童哮喘发病(门急诊患者)人数与大气BC浓度之间的关系。方法收集来自沈阳市各医疗机构2019年1月1日至8月31日期间门急诊就诊的主要诊断包含"哮喘"的患儿52653人次,通过时间序列分析确定每日儿童哮喘发病(门急诊患者)人数与大气BC浓度之间的关系。结果研究期间沈阳市儿童哮喘门急诊入院总人数为52653人次,BC平均浓度为2.58 mg/m^(3)。其中BC变化(2.00~10.03 mg/m^(3))(RR=1.17,95%CI:1.07~1.28)和NO2变化(0~88μg/m^(3))(RR=1.21,95%CI:1.06~1.39)对儿童哮喘门急诊人数的影响有统计学意义(P<0.05)。污染物浓度升高后累积10 d内对儿童哮喘影响,其中最大的是BC浓度变化对男性儿童哮喘的影响(RR=1.60,95%CI:1.23~2.08)。结论BC浓度与男性儿童哮喘的门急诊就诊人数呈正相关,且BC对儿童哮喘的累积作用大于其他污染物。

Objective Exposure to pollutants may induce aggravation of asthma in children through various ways.Ambient black carbon(BC)is a typical pollutant in Northeast China,and there has been no research report on the relationship between atmospheric BC exposure and childhood asthma in Northeast China.This study is to investigate the association between the atmospheric concentration of BC and hospital visits of daily childhood asthma.Methods During the period of January 1 to August 31 in 2019,52653 hospital visits of childhood asthma children were recorded in several hospitals in Shenyang.A time series analysis was conducted to explore the relationship between the atmospheric concentration of BC and hospital visits of daily childhood asthma.Results During the study period,the total number of children with asthma in outpatient and emergency departments in Shenyang was 52653,the average concentration of BC was 2.58 mg/m^(3).Increased concentrations of BC(2.00~10.03 mg/m^(3))(RR=1.17,95%CI:1.07~1.28)and NO2(0~88μg/m^(3))(RR=1.21,95%CI:1.06~1.39)were significantly associated with elevated number of childhood asthma in outpatient and emergency departments(P<0.05).The highest cumulative effect of increased pollutants on children′s asthma within 10 days was BC(RR=1.60,95%CI:1.23~2.08).Conclusion There is a positive association between BC concentration and hospital visits of childhood asthma,the accumulative effect of BC on childhood asthma is greater than other pollutants.