2017-2019年南通市臭氧短期暴露对医院门诊量的影响

Impacts of short-term ozone exposure on outpatient visits in Nantong,China,2017-2019

目的定量评估南通市大气臭氧短期暴露对居民呼吸系统及循环系统疾病门诊量的影响。方法收集整理2017—2019年南通市大气污染资料、气象资料及第一人民医院门诊病例资料。利用广义线性模型探讨臭氧水平与此医院门诊量的暴露—反应关系。结果研究期间,臭氧日最大8小时平均(O_(3)-8 h)质量浓度M(P_(25),P_(75))为102(80,134)μg/m 3,超标天数为151 d,超标率为13.78%。南通市O_(3)暴露与全年和冷季时呼吸系统疾病门诊量呈正相关关系,与暖季时呼吸系统疾病门诊量、循环系统疾病门诊量和儿科呼吸系统疾病门诊量呈负相关。研究期间,O_(3)-8 h质量浓度每升高10μg/m^(3),呼吸系统疾病门诊量增加1.21%(95%CI:0.45%,1.97%),循环系统疾病门诊量和儿科呼吸系统疾病门诊量分别减少1.15%(95%CI:0.64%,1.65%)和1.25%(95%CI:0.62%,1.88%);冷季时臭氧暴露对呼吸系统疾病门诊量的影响增大,O_(3)-8 h质量浓度每升高10μg/m^(3),呼吸系统疾病门诊量增加3.02%(95%CI:1.22%,4.85%),暖季时臭氧暴露与三种疾病门诊量均成负相关。结论臭氧质量浓度升高与居民呼吸系统疾病门诊量呈正相关。冷季时臭氧水平升高对居民的急性健康效应影响更明显,敏感人群应及时做好防护。

Objective To quantitatively evaluate the impacts of atmospheric ozone exposure on outpatient visits for respiratory and circulatory diseases in Nantong.Methods Data were collected on air pollutants,meteorological factors and outpatient visits in Nantong First People’s Hospital from 2017 to 2019.A generalized linear model was used to investigate the exposure-response relationship between ozone mass concentration and outpatient visits.Results In 2017—2019,the median(P_(25),P_(75))of daily maximum 8-hour mean ozone concentration(O_(3)-8 h)was 102(80,134)μg/m^(3),with 151 days(13.78%)exceeding the recommended limit.In Nantong,O_(3)-8 h exposure was positively correlated with the number of outpatients for respiratory diseases during the year and in cold season,and negatively correlated with the number of outpatients for respiratory diseases,circulatory diseases and pediatric respiratory diseases in warm season.In year-round analysis,every 10μg/m^(3)increase of O_(3)-8 h mass concentration resulted in a 1.21%(95%CI:0.45%,1.97%)increase in respiratory outpatient visits,while 1.15%(95%CI:0.64%,1.65%)and 1.25%(95%CI:0.62%,1.88%)decrease in outpatient visits for circulatory diseases and pediatric respiratory diseases,respectively.In cold season,the impact of ozone exposure on outpatients with respiratory diseases increased,and each 10μg/m 3 increase of O_(3)-8 h mass concentration result ed in a 3.02%(95%CI:1.22%,4.85%)increase in outpatient visits for respiratory diseases.In warm season,ozone exposure was negatively correlated with outpatient visits for all three diseases.Conclusion There is a positive correlation between the increase of ozone mass concentration and outpatients visits with respiratory diseases.Elevated ozone levels have more pronounced acute health effects in cold season,and the sensitive population should be protected promptly.