2014—2020年成都市大气污染物与呼吸系统疾病门诊量的时间序列研究

Time series study on the relationship between air pollutants and respiratory outpatients of hospitals in Chengdu from 2014 to 2020

目的了解成都市空气污染物污染状况及对成人和儿童呼吸系统疾病门诊量的影响。方法收集2014—2020年度成都市3家综合医院的成人和儿科呼吸系统疾病日门诊量、空气污染物(PM_(10)、PM_(2.5)、NO_(2)、CO、SO_(2))浓度和气象数据(温度、湿度)资料。在控制时间趋势、"星期几效应"以及温湿度等混杂因素基础上,采用时间序列的广义线性模型,对空气中污染物和门诊量的关系进行相关分析,包括当日(lag0)和滞后数日(lag1~lag10)。结果时间序列研究表明,各污染物浓度增加均会引起呼吸系统疾病门诊量的增加,滞后效应不明显,但成人和儿童略有差异,不同污染物超额危险度(ER)最高值滞后天数略有差异。PM_(10)浓度每增加10μg/m^(3)(lag0),成人和儿童呼吸系统疾病门诊量分别增加0.338%(95%CI:0.293%~0.382%)和0.655%(95%CI:0.626%~0.683%)。PM_(2.5)浓度每增加10μg/m^(3),成人呼吸系统疾病门诊量(lag3)增加0.402%(95%CI:0.334%~0.469%),儿童呼吸系统疾病门诊量(lag0)增加0.729%(95%CI:0.687%~0.772%)。NO_(2)浓度每增加10μg/m^(3)(lag0),成人和儿童呼吸系统疾病门诊量分别增加4.305%(95%CI:4.157%~4.454%)和7.188%(95%CI:7.088%~7.287%)。CO浓度每增加10μg/m^(3),成人呼吸系统疾病门诊量(lag3)增加0.004%(95%CI:0.002%~0.005%),儿童呼吸系统疾病门诊量(lag4)增加0.005%(95%CI:0.003%~0.006%)。SO_(2)浓度每增加10μg/m^(3)(lag0),成人和儿童呼吸系统疾病门诊量分别增加3.461%(95%CI:3.053%~3.869%)和7.680%(95%CI:7.425%~7.935%)。结论空气中PM_(10)、PM_(2.5)、NO_(2)、CO、SO_(2)浓度升高均可使成人和儿童呼吸系统疾病门诊量增加。

Objective To investigate the air pollutant pollution status in Chengdu and its impact on the outpatient volume of respiratory system in adult and child populations.Methods The daily outpatient volumes,air pollution(PM_(10),PM_(2.5,)NO_(2),CO,SO_(2)) concentrations and meteorological data(temperature and humidity) of adult and pediatric respiratory system in 3 general hospitals of Chengdu city from 2014 to 2020 were collected.Based on the control of time trend,the day of the week and meteorological factors such as temperature and humidity,the relationship between the air pollutant and outpatient volume was analyzed by using the generalized linear model of time series,including the day(lag0) and the lag days(lag1-lag10).Results The time series study showed that elevated concentrations of all pollutants increased the outpatient volume of respiratory diseases,the lag effect was not significant,and there were differences between child and adult population,as well as the lag days achieving the peak excess risk(ER).For every 10 μg/m^(3) increase of PM_(10) concentration(lag0),the respiratory outpatient volume of adults and children increased by 0.338%(95% CI:0.293%-0.382%) and 0.655%(95%CI:0.626%-0.683%),respectively.For every 10 μg/m^(3) increase of PM_(2.5 )concentration,the respiratory outpatient volume of adults(lag3) and children(lag0) increased by 0.402%(95% CI:0.334%-0.469%) and 0.729%(95%CI:0.687%-0.772%),respectively.For every 10 μg/m^(3) increase of NO_(2 )concentration(lag0),the respiratory outpatient volume of adults and children increased by 4.305%(95% CI:4.157%-4.454%) and 7.188%(95% CI:7.088%-7.287%).For every 10 μg/m^(3) increase of COconcentration(lag3),the respiratory outpatient volume of adults and children(lag0) increased by 0.004%(95% CI:0.002%-0.005%) and 0.005%(95% CI:0.003%-0.006%).For every 10 μg/m^(3) increase of SO_(2 )concentration(lag0),the respiratory outpatient volume of adults and children increased by 3.461%(95%CI:3.053%-3.869%) and 7.680%(95%CI:7.425%-7.935%),respectively.Conclusion The increase of PM_(10),PM_(2.5),NO_(2),CO and SO_(2) concentration can increase the outpatient volume of respiratory system in adults and children.