银川市大气污染物对循环系统疾病门诊量的影响

Effect of Atmospheric Pollutants on Outpatient Visits of Circulatory Diseases in Yinchuan City

目的 探讨大气污染物对循环系统疾病门诊量的短期影响。方法 收集宁夏银川市2019—2021年气象、大气污染物及循环系统疾病门诊量的时序资料,控制时间趋势并消除气象因素、周末效应等混杂因素的影响,构建广义相加模型评估可吸入颗粒物(PM_(10))、细颗粒物(PM_(2.5))、二氧化氮(NO_(2))对循环系统疾病门诊量的短期影响,包括单日滞后效应(lag0~lag7)和累计滞后效应(lag01~lag07)。结果 单污染物模型中,PM_(2.5)、PM_(10)和NO_(2)的浓度每升高10μg·m^(-3),循环系统疾病日门诊量效应值分别在lag06、lag07和lag05最大,ER(95%CI)分别为2.35%(2.17%~2.53%)、0.45%(0.40%~0.49%)和8.54%(8.18%~8.90%)。双污染物模型提示,调整污染物前后各污染物效应值变化较小且方向未发生改变(P<0.05)。季节分层结果显示,PM_(2.5)的最大效应值出现在秋季[超额危险度(ER)=7.15%(6.37%~7.94%)];PM_(10)、NO_(2)的最大效应值出现在冬季[ER=2.91%(2.74%~3.07%)、13.80%(13.10%~14.51%)]。结论 大气污染物对循环系统疾病门诊量存在影响,并具有滞后效应;循环系统疾病在冷季对污染物更敏感;NO_(2)造成循环系统疾病门诊量增加的风险最高。

Objective To investigate the short-term effect of atmospheric pollutants on outpatient visits of circulatory diseases.Methods Time series data of meteorological,daily atmospheric pollutants and outpatient visits of circulatory diseases in Yinchuan from 2019 to 2021 were collected.After controlling for the time trend and eliminating the confounding factors such as meteorological and weekend effect,the generalized additive model was used to evaluate the short-term effects of PM_(2.5),PM_(10)and NO_(2)on outpatient visits of circulatory diseases,including the single-day effect(lag0 to lag7)and cumulative lag effect(lag01 to lag07).Results In the single pollutant model,for every 10μg·m^(-3)increase in PM_(2.5),PM_(10)and NO_(2),the largest effect in the daily outpatient visits of circulatory diseases on lag06,lag07 and lag05,with ER(95%CI) being 2.35%(2.17%~2.53%),0.45%(0.40%~0.49%)and 8.54%(8.18%~8.90%),respectively.The two-pollutant model suggested that when other pollutants added into the model,the effect value of each pollutant changed little and the direction didn’t change(P<0.05).The stratified analysis of season showed that PM_(2.5)had a greater effect in autumn[ER=7.15%(6.37%~7.94%)],and PM_(10)and NO_(2)had a greater effect in winter[ER=2.91%(2.74%~3.07%)and 13.80%(13.10%~14.51%)].Conclusion Atmospheric pollutants have an effect on the outpatient visits of circulatory diseases and have a lag effect.Circulatory diseases are more sensitive to atmospheric pollutants in the cold season.NO_(2)is associated with the highest risk of increased outpatient visits of circulatory diseases.