上海市复合型大气污染对儿童肺功能和呼出气一氧化氮的急性效应

Acute effects of air pollution on pulmonary function and exhaled nitric oxide in children in Shanghai

【目的】了解复合型大气污染对儿童呼吸道的急性影响。【方法】采用定组研究设计,在上海市徐汇区、虹口区各选择1所小学(A、B),随机抽取四年级5个班级的学生开展肺功能和呼出气一氧化氮(FeNO)的测定,前3次检测开展于2020年5—6月,第4次肺功能检测开展于2021年9—12月。同时收集同期2所学校就近空气质量监测点细颗粒物(PM_(2.5))、可吸入颗粒物(PM_(10))、SO_(2)、NO_(2)、O_(3)、CO大气污染物的日均值和小时均值,收集同期气象监测资料(温度、湿度、风速、大气压)。采用线性混合效应模型分析夏季大气污染对肺功能指标和呼吸道炎症改变指标的影响。【结果】单污染物模型结果显示,PM_(2.5)、PM10、SO_(2)和NO_(2)与FeNO呈正相关,效应体现在滞后0~3日(lag0~lag3)(均P<0.05),PM_(2.5)、PM_(10)和NO_(2)与肺功能最大呼气流量(PEF)、用力呼气流量25%的呼气流速(FEF_(25%))、FEF_(50%)、FEF_(75%)、FEF_(25%~75%)、用力呼气量(FVC)、第1秒用力呼气容积(FEV1)和FEV1/FVC改变呈负相关,效应体现在lag0~lag3(均P<0.05)。双污染物模型结果显示,O_(3)、PM_(2.5)分别与SO_(2)和NO_(2)组合时,SO_(2)、NO_(2)浓度变化与FEV1的降低显著相关(均P<0.01),PM_(2.5)分别与O_(3)、SO_(2)、NO_(2)组合时,PM_(2.5)浓度变化,与FeNO的上升显著相关(均P<0.01),且效应值大于PM_(2.5)的单污染物模型。【结论】夏季不同大气污染物与儿童呼吸道功能指标的健康效应表现不同。双污染物联合作用分析显示,污染物对儿童肺功能的效应有不同程度的升高。夏季大气污染虽然较轻,但对儿童呼吸道功能指标和炎症指标依然有影响,且双污染物联合作用较单一污染物效应更显著。

[Objective]To investigate the acute effects of compound air pollution on children’s respiratory function.[Methods]Using panel group study design,223 students in five classes of grade 4 from two primary schools(a,b)in Xuhui and Hongkou districts of Shanghai were randomly selected to measure pulmonary function and exhaled nitric oxide(FeNO).The first three tests were carried out from May to June in 2020,and the fourth test was carried out from September to December in 2021.At the same time,the daily and hourly mean values of PM_(2.5),PM_(10),SO_(2),NO_(2),O_(3)and CO was collected from the nearby air quality monitoring points of the two schools during the same period,as well as meteorological monitoring data(temperature,humidity,wind speed and atmospheric pressure).The linear mixed effect model was used to analyze the effects of air pollution on pulmonary function and respiratory inflammation in the summer.[Results]The results of single pollutant model showed that PM_(2.5),PM_(10),SO_(2)and NO_(2)were positively correlated with FeNO,and the effect was reflected in lag0,lag1 and lag3(P<0.05).PM_(2.5),PM_(10) and NO_(2)were negatively correlated with the changes of lung function FEF_(25%),FEF_(50%),FEF_(75%),FeF_(25%−75%),PEF,FVC,FEV1 and FEV1/FVC,and the effect was reflected in lag0 to lag3 days(P<0.05).The results of the dual pollutant model showed that the concentration changes of SO_(2)and NO_(2)were significantly correlated with the decrease of FEV1 when combined with O_(3)or PM_(2.5)(P<0.01),and the concentration changes of PM_(2.5)was significantly correlated with the increase of FeNO when O_(3),SO_(2)and NO_(2)were combined respectively(P<0.01).The effects of the dual pollutant model were greater than the effect of PM_(2.5)single pollutant model.[Conclusion]The health effects of different air pollutants on children’s respiratory tract function indexes in summer are different.The combined effects of two pollutants on the lung function of children increased to different degrees.Although air pollution is light in summer,it still has an impact on children’s respiratory tract function index and inflammation index,and the combined effect of dual pollutants is more significant than that of single pollutant.