林芝市温度对臭氧所致人群门诊量的效应修饰研究

Modification effects of temperature on outpatient visits caused by ozone in Linzhi

目的探讨温度对林芝市臭氧所致门诊量的效应修饰作用。方法收集2018—2019年林芝市人民医院的每日门诊资料以及林芝市逐日O_(3)浓度资料和气象资料(日平均气温、平均相对湿度等),采用分布滞后非线性模型(DLNM)定量评估不同温度层内O_(3)对人群门诊风险的影响。结果低温时,O_(3)每增加10μg/m^(3),每日总门诊量、非伤害门诊量的累计风险(CRR)分别增加53.8%(4.2%~126.9%)和59.1%(5.8%~139.2%)。亚组分析结果显示,低温时,O_(3)每增加10μg/m^(3),循环系统疾病、男性、女性、<14岁和14~65岁的年龄段人群门诊量的累积风险(CRR)分别增加152.1%(15.1%~451.9%)、58.3%(2.1%~145.5%)、49.2%(3.0%~116.1%)、39.6%(2.5%~90.3%)和61%(0.8%~157.1%)。结论林芝市日平均气温对O_(3)所致人群门诊量的影响可能存在效应修饰作用,低温会加大O_(3)所致门诊量的累积风险。

Objective To investigate the modification effect of atmospheric temperature on outpatient visits caused by O_(3)in Linzhi City.Methods The daily outpatient data,the daily O_(3)concentration and daily meteorological data(including daily average temperature,average relative humidity,etc.)in Linzhi City from 2018 to 2019 were collected.The distributed lag non-liner-model(DLNM)was used to quantitatively evaluate the impact of O_(3)in different temperature layers on the risk of outpatient visits.Results At low temperature layers,the cumulative relative risk(CRR)of total outpatient visits and non-injury outpatient visits increased by 53.8%(4.2%-126.9%)and 59.1%(5.8%-139.2%)for every 10μg/m^(3)increase of O_(3)concentration,respectively.The subgroup analysis showed that for every 10μg/m^(3)increase of O_(3)concentration at low temperature,the CRR of patients with circulatory diseases,men,women,and people being<14 years old and 14-65 years old increased by 152.1%(15.1%-451.9%),58.3%(2.1%-145.5%),49.2%(3.0%-116.1%),39.6%(2.5%-90.3%),and 61%(0.8%-157.1%),respectively.Conclusion The average temperature may have a modifying effect on the outpatient visits caused by O_(3)in Linzhi City.In general,the cumulative risk increases as the temperature decreases.