2017—2019年扬州市大气污染物与儿童呼吸系统门诊量的时间序列分析

Time-series Analysis of Association between Air Pollutants and Respiratory Outpatient Visits in Children in Yangzhou City in 2017—2019

收集扬州市2017—2019年大气污染物细颗粒物(PM_(2.5))、二氧化硫(SO_(2))、二氧化氮(NO_(2))和臭氧(O_(3))的日均质量浓度、气象因素(日均温度、相对湿度)以及每日儿童呼吸系统门诊量数据,运用广义相加模型(GAM)进行单污染物和多污染物分析。结果表明,单污染物分析中,大气污染物的质量浓度累积滞后效应均大于单独滞后效应。ρ(PM_(2.5))、ρ(SO_(2))和ρ(NO_(2))对儿童呼吸系统门诊量影响效应均在累积滞后7 d(lag 07)达到最大值,ρ(O3)在累积滞后6 d(lag 06)达到最大值。表现为ρ(PM_(2.5))、ρ(SO_(2))和ρ(NO_(2))在lag 07时,每升高10μg/m^(3),儿童呼吸系统门诊量超额危险度分别为0.720%[95%置信区间(95%CI):0.346%~1.095%]、6.955%(95%CI:5.197%~8.743%)和2.133%(95%CI:1.516%~2.754%);ρ(O_(3))在lag 06时,每升高10μg/m^(3),儿童呼吸系统门诊量超额危险度为1.160%(95%CI:0.873%~1.447%)。多污染物分析中,当引入所有污染物(SO_(2)+NO_(2)+O_(3))时,PM_(2.5)对儿童呼吸系统门诊量风险影响消失。大气污染物浓度的升高会增加儿童呼吸系统疾病的发生风险,并且其影响存在一定的滞后效应,有必要开展有针对性的大气污染物与儿童呼吸系统疾病的预警研究,保护易感人群,合理分配卫生资源。

The daily average concentrations of PM_(2.5),SO_(2),NO_(2) and O_(3),meteorological factors(including daily average temperature and relative humidity)and the number of outpatient patients in children's respiratory system were collected in Yangzhou City from 2017 to 2019.The single pollutant and multi-pollutant analysis were carried out by using generalized additive model(GAM).The results showed that in single pollution model,the cumulative lag effect of air pollutant concentration was greater than that of single pollution model.The effects ofρ(PM_(2.5)),ρ(SO_(2))andρ(NO_(2))on outpatient volume of pediatric respiratory system reached the maximum value in 7 days(lag 07),andρ(O3)reached the maximum value in 6 days(lag 06),which showed that whenρ(PM_(2.5)),ρ(SO_(2))andρ(NO_(2))(lag 07)increased by 10μg/m^(3),the risk score of outpatient volume increased by 0.720%(95%CI:0.346%~1.095%),6.955%(95%CI:5.197%~8.743%)and 6.133%(95%CI:1.516%~2.754%).The risk of outpatient outpatient service increased by 1.160%(95%CI:0.873%~1.447%)for every 10μg/m^(3) increase ofρ(O_(3))(lag 06).In the multi-pollution model,when all pollutants(SO_(2)+NO_(2)+O_(3))were introduced,the influence of PM_(2.5) on the outpatient volume risk of children respiratory system disappeared.The increase of air pollutant concentration will increase the risk of respiratory diseases in children,and the effect has a certain lag effect.Therefore,it is necessary to carry out targeted early warning research on air pollutants and respiratory diseases of children,so as to protect vulnerable people and allocate health resources reasonably.