大气PM_(2.5)与呼吸系统、心脑血管疾病急救病例数的相关性研究

Correlation between atmospheric PM_(2.5) and emergency call for respiratory and cardio-cerebrovascular diseases

目的探讨大气细颗粒物(PM_(2.5))与呼吸系统疾病和心脑血管疾病急救病例数的相关性。方法通过杭州市急救中心收集2018—2020年每日呼吸系统疾病和心脑血管疾病急救病例数;通过杭州市生态环境监测中心收集同期日均气温、日均相对湿度、PM_(2.5)、可吸入颗粒物(PM_(10))、二氧化硫(SO_(2))等气象和大气污染物资料;采用广义相加模型分析PM_(2.5)与呼吸系统和心脑血管疾病急救病例数的相关性,采用超额危险度(ER)及其95%CI作为风险估计值。结果2018—2020年杭州市呼吸系统疾病和心脑血管疾病每日急救病例数[M(QR)]分别为14(12)和20(7)例,PM_(2.5)日均质量浓度为29.77(21.32)μg/m^(3)。PM_(2.5)累积暴露5 d或6 d时对呼吸系统急救病例数的影响最大,PM_(2.5)质量浓度每升高10μg/m^(3),呼吸系统疾病急救病例数增加1.93%(95%CI:0.76%~3.11%);PM_(2.5)累积暴露4 d时对心脑血管疾病急救病例数的影响最大,PM_(2.5)质量浓度每升高10μg/m^(3),心脑血管疾病急救病例数增加1.88%(95%CI:0.80%~2.97%)。PM_(2.5)累积暴露7 d时对≥60岁居民呼吸系统疾病急救病例数的影响最大,PM_(2.5)质量浓度每升高10μg/m^(3),急救病例数增加4.37%(95%CI:2.70%~6.06%);PM_(2.5)累积暴露4 d时对≥60岁居民心脑血管疾病急救病例数的影响最大,PM_(2.5)质量浓度每升高10μg/m^(3),急救病例数增加2.24%(95%CI:0.97%~3.52%);PM_(2.5)对<60岁居民呼吸系统和心脑血管疾病急救病例数未产生明显影响。结论大气PM_(2.5)质量浓度升高可导致居民呼吸系统和心脑血管疾病日急救病例数增加,尤其对60岁及以上居民影响较明显。

Objective To examine the correlation between atmospheric PM_(2.5) and emergency call for respiratory diseases.Methods The daily emergency call for respiratory and cardio-cerebrovascular diseases was collected from Hangzhou Emergency Medical Center from 2018 to 2020,and meteorological and atmospheric pollutant data were collected from Hangzhou Municipal Center for Ecological and Environmental Monitoring during the same period,including daily mean air temperature,daily mean relative humidity,PM_(2.5),PM_(10) and SO_(2) levels.The correlation between atmospheric PM_(2.5) and emergency call for respiratory and cardio-cerebrovascular diseases was examined using a generalized additive model,and the risk of emergency call was predicted using excessive risk(ER)and its 95%CI.Results The daily mean emergency call was 14(interquartile range,12)cases for respiratory diseases and 20(interquartile range,7)cases for cardio-cere⁃brovascular diseases in Hangzhou City from 2018 to 2020,and the daily mean PM_(2.5) mass concentration was 29.77(in⁃terquartile range,21.32)μg/m^(3).Cumulative exposure to PM_(2.5) for 5 or 6 d caused the largest effect on the emergency call for respiratory diseases,and an increase in PM_(2.5) by 10μg/m^(3)led to a 1.93%(95%CI:0.76%-3.11%)rise in the emergency call for respiratory diseases.Cumulative exposure to PM_(2.5) for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases,and an increase in PM_(2.5) by 10μg/m3 led to a 1.88%(95%CI:0.80%-2.97%)rise in the emergency call for cardio-cerebrovascular diseases.Cumulative exposure to PM_(2.5) for 7 d caused the largest effect on the emergency call for respiratory diseases among residents aged 60 years and older,and an increase in PM_(2.5) by 10μg/m^(3)led to a 4.37%(95%CI:2.70%-6.06%)rise in the emergency call for respiratory diseases.Cumulative ex⁃posure to PM_(2.5) for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases among resi⁃dents aged 60 years and older,and an increase in PM_(2.5) by 10μg/m^(3) led to a 2.44%(95%CI:0.97%-3.52%)rise in the emergency call for cardio-cerebrovascular diseases.However,exposure to PM_(2.5)had no marked effects on emergency call for respiratory or cardio-cerebrovascular diseases among residents aged<60 years.Conclusions Elevated atmo⁃spheric PM_(2.5) mass concentration may lead to an increase in the daily emergency calls for respiratory and cardio-cere⁃brovascular diseases,notably among residents aged 60 years and older.