空气污染物对兰州市儿童特应性皮炎门诊人次的影响

Impact of Air Pollutants on Outpatient Visits for Pediatric Atopic Dermatitis in Lanzhou

目的分析兰州市空气污染物与儿童特应性皮炎门诊人次的关系,为患儿的生活指导和相关部门的疾病预防提供科学依据。方法采用广义相加模型在控制长期趋势、假期效应、星期几效应和气象因素等混杂因素的基础上,分析兰州市空气污染物对儿童特应性皮炎门诊人次的影响和滞后效应。结果NO_(2)、PM_(2.5)、PM_(10)、SO_(2)对儿童特应性皮炎门诊人次的影响在滞后当天(Lag0)最显著,但均无统计学意义(P均>0.05);CO也在Lag0影响最显著,其浓度每升高10μg/m^(3),儿童特应性皮炎门诊人次增加的超额危险度(ER)值为0.05%(95%CI=0~0.10%,P=0.049);O 3在累积滞后第7天(Lag07)影响最显著,其浓度每升高10μg/m^(3),儿童特应性皮炎门诊人次增加的ER值为7.40%(95%CI=5.31%~9.53%,P<0.001)。年龄分层显示,0~3岁特应性皮炎患儿对CO最敏感,其浓度每升高10μg/m^(3),门诊人次增加的ER值为0.09%(95%CI=0.04%~0.15%,P<0.001);7~14岁特应性皮炎患儿对O 3最敏感,其浓度每升高10μg/m^(3),门诊人次增加的ER值为8.26%(95%CI=4.99%~11.64%,P<0.001)。季节分层显示,CO在夏季和秋季对儿童特应性皮炎门诊人次的影响较强,ER值分别为0.45%和0.16%(P均<0.001);而O 3在冬季对门诊人次影响明显,ER值为20.48%(P<0.001)。结论兰州市空气污染物CO、O 3日平均浓度的升高与儿童特应性皮炎的门诊人次呈正相关,具有显著的季节效应和年龄分层敏感性。

Objective To analyze the correlation between air pollutants and pediatric atopic dermatitis outpatient visits in Lanzhou,and provide scientific insights for the life guidance of the affected children and disease prevention by relevant departments.Methods A generalized additive model was employed to analyze the effects and lagged effects of air pollutants on pediatric atopic dermatitis outpatient visits in Lanzhou while controlling for confounding factors such as long-term trends,holiday effects,day of the week effects and meteorological factors.Results The effects of NO_(2),PM_(2.5),PM_(10),and SO_(2)on pediatric atopic dermatitis outpatient visits were most significant on the current day(Lag0),but were not statistically significant(all P>0.05);CO also had the most significant effect on Lag0,and for every 10μg/m^(3)increase in its concentration,the excess risk(ER)for pediatric atopic dermatitis outpatient visits was 0.05%(95%CI=0-0.10%,P=0.049);and O 3 exhibited the most significant effect on day 7 of the cumulative lag(Lag07),with a statistically significant increase in the ER for each 10μg/m^(3)increase in its concentration of 7.40%(95%CI=5.31%-9.53%,P<0.001)for pediatric atopic dermatitis outpatient visits.Age stratification showed that children aged 0-3 years with atopic dermatitis were the most sensitive to CO,with an increased ER of 0.09%(95%CI=0.04%-0.15%,P<0.001)for every 10μg/m^(3)increase in concentration,and children aged 7-14 years with atopic dermatitis were the most sensitive to O 3,with an increased ER of 8.26%(95%CI=4.99%-11.64%,P<0.001)for every 10μg/m^(3)increase in concentration.Seasonal stratification showed that CO exerted a stronger effect on pediatric atopic dermatitis outpatient visits in summer and fall,with ER values of 0.45%and 0.16%(both P<0.001),respectively,while O 3 had a significant effect on outpatient visits in winter,with an ER value of 20.48%(P<0.001).Conclusion Elevated daily average concentrations of air pollutants CO and O 3 in Lanzhou were positively correlated with the number of outpatient visits for atopic dermatitis in children,with significant seasonal effects and age-stratified sensitivities.