广州市大气NO_(2)污染对暴露人群不同疾病死亡的影响

Impacts of atmospheric NO_(2) pollution on cause-specific mortality of different diseases in exposed population in Guangzhou

通过收集广州市2011~2015年6种疾病(非意外因素、心血管疾病、脑卒中、缺血性心脏病、呼吸系统疾病以及慢性阻塞性肺疾病)逐日死亡人数、逐日NO_(2)浓度以及同期气象资料,采用广义相加模型探讨了NO_(2)暴露对不同疾病死亡的影响(相对危险度,RR值)和累积滞后效应,并进一步采用分层分析方法解析了冷季(11月至次年4月)和暖季(5~10月)NO_(2)死亡风险的差异.结果表明,NO_(2)影响急促短暂,通常持续4d.当NO_(2)浓度升高10μg/m^(3),在Lag0-4d时,人群非意外死亡人数将上升2.18%(RR=1.0218;95%CI:1.0167,1.0270),在冷季与暖季分别上升2.6%(RR=1.0260;95%CI:1.0191,1.0328)与0.57%(RR=1.0057;95%CI:0.9952,1.0163),两者差异有统计学意义(P=0.002).在不同疾病中,NO_(2)对慢性阻塞性肺疾病的影响最大.因而NO_(2)仍然为广州地区人群健康重要的危险因素,需要加强NO_(2)排放的控制与治理,并且加强冷季健康风险预警以保护公共健康.

Atmospheric NO_(2),a major gaseous pollutant,has received increasing attentions due to its high health risk,especially to human cardiopulmonary function.However,current assessments of the health effects of NO_(2)mainly focused on one single disease.In this study,the generalized additive model(GAM)was used to evaluate impacts of atmospheric NO_(2)pollution on cause-specific mortality(Relative risk,RR)in exposed population in Guangzhou during 2011~2015,as well as its cumulative lag effects2.Furthermore,the stratified analysis was performed in the cold season(November through April)and the warm season(May to October).The results show that effects of NO_(2)were observed to be rapid and transient,usually lasting for four days.In lag 0~4 days when the NO_(2)increased by 10μg/m^(3),the number of non-accidental deaths increased by 2.18%(RR=1.0218;95%CI:1.0167,1.0270)in the full year,and 2.6%(RR=1.0260;95%CI:1.0191,1.0328)in the cold season and 0.57%(RR=1.0057;95%CI:0.9952,1.0163)in the warm season.The difference in the NO_(2)-induced mortality risks between cold and warm seasons was statistically significant(P=0.002).Among different diseases,NO_(2)pollution showed the greatest influence on chronic obstructive pulmonary disease.Therefore,atmospheric NO_(2)pollution is still an important risk to the residents in Guangzhou.And it is necessary to strengthen the control and management of NO_(2)emissions and implement the early warning of NO_(2)pollution to protect the public health,particularly during the cold season.