2015—2021年新疆部分地区大气污染物与肺癌发病人数的时间序列关联分析

Time series association analysis of air pollutants and lung cancer incidence in some regions of Xinjiang from 2015-2021

目的探讨新疆多地区大气污染物与肺癌发病的关联性及污染物对肺癌发病的滞后效应,并分析地区间的效应差异。方法收集乌鲁木齐市、克拉玛依市、和田地区2015年1月1日—2021年12月31日之间的细颗粒物(fine particles,PM_(2.5))、可吸入颗粒物(inhalable particles,PM_(10))、NO_(2)、SO_(2)、CO、臭氧日最大8 h平均浓度(O_(3-8 h))、气象因素以及居民肺癌发病资料,运用时间序列的广义相加泊松回归模型控制长期趋势、气象因素和星期几效应等因素的影响后,定量分析单污染物模型和双污染物模型中大气污染物与肺癌发病的关联性。结果在单污染物模型中,乌鲁木齐市PM_(10)在累积滞后02 d(Lag 02)时,对肺癌发病效应值最大为1.30%(95%CI:0.56%~2.05%),NO_(2)在Lag 04时效应值最大为15.40%(95%CI:8.33%~22.94%),CO在Lag 02时效应值最大为23.84%(95%CI:7.29%~42.94%);克拉玛依市PM_(10)、O_(3-8 h)暴露对肺癌每日发病人数的效应值在滞后6、2 d(Lag 6、Lag 2)最大,为1.89%(95%CI:0.12%~3.70%)和5.93%(95%CI:0.46%~11.69%);和田地区PM_(2.5)、PM_(10)暴露对肺癌发病的滞后效应在滞后当日和Lag 5最大,为1.72%(95%CI:0.14%~3.32%)和0.68%(95%CI:0.23%~1.14%)。在双污染物模型中,乌鲁木齐市PM_(10)、NO_(2)和CO分别与其余5种污染物对肺癌发病影响具有协同效应。克拉玛依市PM_(10)与PM_(2.5)、NO_(2)和O_(3-8 h)对肺癌发病影响具有协同效应,不受SO_(2)和CO的影响;O_(3-8 h)与其余5种污染物具有协同效应。和田地区PM_(2.5)与SO_(2)、NO_(2)和CO对肺癌发病影响具有协同效应,而调整PM_(10)和O_(3-8 h)后,PM_(2.5)对肺癌效应消失;PM_(10)与PM_(2.5)、O_(3-8 h)具有联合效应,不受SO_(2)、NO_(2)和CO的影响。结论大气污染物暴露可导致居民肺癌发病风险的增加,这种风险在不同地区间存在差异。

Objective To explore the correlation between air pollutants and lung cancer incidence in multiple regions of Xinjiang and the lag effect of pollutants on lung cancer incidence,and analyze the effect differences between regions.Method The data of fine particles(PM_(2.5)),inhalable particles(PM_(10)),NO_(2),SO_(2),CO,ozone daily maximum 8-h average concentration(O_(3-8 h)),meteorological factors and lung cancer incidence of residents in Urumqi,Karamay and Hotan from January 1,2015 to December 31,2021 were collected.The generalized additive Poisson regression model of time series was used to control the long-term trend after the influence of meteorological factors and day of the week effect,the correlation between air pollutants and lung cancer incidence in single pollutant model and two pollutant model was quantitatively analyzed.Results In the single pollutant model,the maximum effect value of PM_(10)on lung cancer incidence was 1.30%(95%CI:0.56%-2.05%)in Urumqi with a cumulative lag of 2 days(lag 02),while the maximum effect value of NO_(2)was 15.40%(95%CI:8.33%-22.94%)in lag 04,and the maximum effect value of CO was 23.84%(95%CI:7.29%-42.94%)in lag 02;The effect value of PM_(10),O_(3-8 h)exposure on the daily incidence of lung cancer in karamay was 1.89%(95%CI:0.12%-3.70%)and 5.93%(95%CI:0.46%-11.69%)when lag 6 and 2 days(lag 6 and lag 2);The lag effect of PM_(2.5)and PM_(10)exposure on lung cancer incidence in Hotan was the largest on the lag day and lag 05,with 1.72%(95%CI:0.14%-3.32%)and 0.68%(95%CI:0.23%-1.14%).In the two pollutant model,PM_(10),NO_(2)and CO in Urumqi had synergistic effects with the other five pollutants on lung cancer incidence.PM_(10),PM_(2.5),NO_(2)and O_(3-8 h)in Karamay had a synergistic effect on the incidence of lung cancer,which was not affected by SO_(2)and CO;O_(3-8 h)had synergistic effect with the other five pollutants.PM_(2.5)and SO_(2),NO_(2)and CO in Hotan had a synergistic effect on the incidence of lung cancer,while adjusting PM_(10)and O_(3-8 h),the effect of PM_(2.5)on lung cancer disappeared;PM_(10),PM_(2.5),O_(3-8 h)had a combined effect,which was not affected by SO_(2),NO_(2)and CO.Conclusion Exposure to air pollutants can lead to an increase in the risk of lung cancer among residents,and this risk varies among different regions.