基于DLNM模型评估大气污染物对济南市2015-2019年流感样病例发病影响

Assessment based on DLNM model on the impact of atmospheric pollutants on incidence of influenza-like illness in Jinan city from 2015-2019

目的探讨2015-2019年济南市大气污染物与流感样病例发病之间的关系,为流感预警提供科学依据.方法本研究收集了2015-2019年济南市流感样病例、气象及大气污染物数据,对流感样病例的流行概况进行描述.采用R 4.2.2软件进行spearman相关性分析,并构建分布滞后非线性模型(distributed lag non-linear model,DLNM)以探索大气污染物与流感样病例发病的关联.结果济南市5所国家级流感哨点医院共报告156699例流感样病例.济南市大气污染物与流感样病例发病存在相关性,并有滞后效应.在特定浓度下,PM_(2.5)、SO_(2)、NO_(2)、O_(3)具有统计学意义的累积滞后效应最大值分别为1.134(95%CI:1.018~1.263),1.291(95%CI:1.055~1.580),1.341(95%CI:1.229~1.462),1.267(95%CI:1.085~1.481),且大气污染物的累积滞后效应大于单日滞后效应.结论大气污染物会导致济南市流感样病例发病风险增加.建议相关部门加强大气污染物的预报工作,应在污染天气及时提醒公众采取适当的防护措施.

Objective To investigate the relationship between atmospheric pollutants and the incidence of influenza-like illness(ILI)in Jinan from 2015 to 2019,so as to provide a scientific basis for early warning of influenza.Methods Data on ILI,meteorology and atmospheric pollutants in Jinan from 2015 to 2019 were collected.The epidemiological profile of ILI was described.R 4.2.2 software was used for spearman correlation analysis,and a distributed lag non-linear model(DLNM)was constructed to explore the association between atmospheric pollutants and the incidence of ILI.Results A total of 156699 ILI cases were reported from five sentinel hospitals in Jinan.There was a significant correlation between atmospheric pollutants and the incidence of ILI,with a lag effect.At specific concentrations,the maximum values of statistically significant cumulative effects of PM_(2.5),SO_(2),NO_(2),and O_(3) were 1.134(95%CI:1.018-1.263),1.291(95%CI:1.055-1.580),1.341(95%CI:1.229-1.462)and 1.267(95%CI:1.085-1.481),respectively.The cumulative lag effect of pollutants was greater than the single lag effect.Conclusions The pollutants would increase the risk of ILI in Jinan city.Enhanced forecasting of pollution by relevant agencies are recommended to provide suggestions of rational protection for the public during air pollutions.