太原市空气PM2.5污染对医院呼吸系统疾病门诊急性效应的病例交叉分析

Case-crossover analysis on acute effects of air PM2.5 pollution on respiratory diseases outpatient department, Taiyuan city

目的 分析太原市空气PM污染对医院呼吸系统疾病日门诊人次数的急性影响。方法 收集太原市2016-2018年期间大气污染物资料(PM、SO、NO、CO、O)、气象资料(平均温度、相对湿度)以及太原市第二人民医院呼吸系统疾病门诊个案。采用时间分层病例交叉设计,分析每日PM对呼吸系统疾病门诊人次数影响的超额危险度(ER)。结果 太原市空气PM日平均浓度与医院呼吸系统疾病门诊人次数具有相关性,当日效应最大,当日PM浓度每升高10 μg/m可致呼吸系统疾病门诊量增加0.76%(95%CI:0.52%~0.99%)。性别和年龄可能是效应修正因子,PM对男性(ER=0.94,95%CI:0.60~1.28)的影响大于女性(ER=0.61,95%CI:0.28~0.95),对0~14岁的儿童(ER=1.06,95%CI:0.76~1.35)和60岁及以上老年人(ER=1.18,95%CI:0.56~1.81)的影响大于15~59岁的青壮年人口(ER=0.53,95%CI:0.04~1.02)。结论 PM污染可明显导致医院呼吸系统疾病门诊量增加,儿童和老年人风险更高,因此应继续加强监测。

Objective To analyze the acute influence of PM2.5 pollution in the air of Taiyuan city on the number of outpatients with respiratory diseases in hospitals. Methods The data of air pollutants(PM,SO,NO,CO and O),meteorological data(average temperature, relative humidity) and respiratory disease outpatient cases of Taiyuan second people’s hospital from 2016 to 2018 were collected.Time-stratified case crossover design was used to analyze the excess risk(ER) of daily PMon the number of outpatients with respiratory diseases. Results The daily average concentration of PMin Taiyuan city was correlated with the number of outpatients with respiratory diseases, and the largest effect was at the same day.Every 10 μg/m3 increase of PMconcentration on the same day could increase the outpatient number of respiratory diseases by 0.76 %(95 %CI:0.52%-0.99%).Gender and age were potential effect modification factors.PMhad more influence on male[0.94(95 %CI:0.60-1.28)] than female [0.61(95%CI:0.28-0.95)],and the influence of PMon children aged 0-14 [1.06(95%CI:0.76-1.35)] and elderly people aged 60 and above [1.18(95%CI:0.56-1.81)] were greater than those of adults aged 15-59[0.53(95%CI:0.04-1.02)]. Conclusion PMpollution could significantly lead to the increase of outpatient number of respiratory diseases, and the risks for children and the elderly are higher.It is necessary to continue the monitoring.