金华市大气PM_(2.5)对儿童呼吸系统疾病门诊量的影响研究
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摘要
目的研究金华市大气PM_(2.5)对儿童呼吸系统门诊量的影响。方法采用基于Poisson分布的广义相加模型(generalized additive mode,GAM),控制气象因素、长期趋势和星期几效应等混杂因素,分析2015-2016年PM_(2.5)浓度和0～14岁儿童呼吸系统门诊量的关系及滞后效应。结果 2015-2016年金华市大气PM_(2.5)日均质量浓度为50.32μg/m3,PM_(2.5)浓度与5种气象因素日均值之间存在一定的相关性。Spearman相关性分析发现大气PM_(2.5)日均浓度与儿童呼吸系统日门诊量之间存在正相关(r=0.298,P<0.05)。广义相加模型结果分析,PM_(2.5)对儿童呼吸系统门诊量存在滞后效应,滞后效应第1 d最强,PM_(2.5)质量浓度每增加10μg/m3,儿童呼吸系统疾病门诊量增加0.048 8%(95%CI:0.030 1%～0.059 5%)。结论金华市大气PM_(2.5)浓度升高可导致儿童呼吸系统患病风险增加,应采取措施保护易感人群。
Objective To study the influence of ambient atmospheric PM_(2.5) on outpatient volume of paediatric respiratory system diseases in Jinhua City. Methods Generalized additive model( GAM) based on Poisson distribution was used to analyze the association between PM_(2.5) concentration during 2015-2016 and outpatient volume of respiratory system diseases in children aged 0-14 years as well as the related lag patterns after controlling meteorological variables,long term trend and the "day of the week"effect. Results The daily average mass concentration of atmospheric PM_(2.5) in Jinhua City during 2015-2016 was50.32 μg/m3. There was a certain correlation between the PM_(2.5) concentration and the daily average values of five meteorological factors. Spearman correlation analysis showed that the daily average mass concentration of atmospheric PM_(2.5) was positively correlated with the outpatient volume of paediatric respiratory system diseases( r = 0.298,P<0.05). The GAM revealed that there was the hysteresis effect on influence of atmospheric PM_(2.5) on daily outpatient volume of paediatric respiratory system diseases,which reached the strongest effect on the first day. An increase in atmospheric PM_(2.5) mass concentration by 10 μg/m3 increased the outpatient volume of respiratory system diseases by 0. 048,8%( 95% CI: 0.030 1%-0. 059 5%). Conclusions The increment of PM_(2.5) concentration can aggravate the risk of suffering from paediatric respiratory system diseases in Jinhua City; and hence,it is necessary to adopt corresponding measures to protect susceptible groups.
Objective To study the influence of ambient atmospheric PM_(2.5) on outpatient volume of paediatric respiratory system diseases in Jinhua City. Methods Generalized additive model( GAM) based on Poisson distribution was used to analyze the association between PM_(2.5) concentration during 2015-2016 and outpatient volume of respiratory system diseases in children aged 0-14 years as well as the related lag patterns after controlling meteorological variables,long term trend and the "day of the week"effect. Results The daily average mass concentration of atmospheric PM_(2.5) in Jinhua City during 2015-2016 was50.32 μg/m3. There was a certain correlation between the PM_(2.5) concentration and the daily average values of five meteorological factors. Spearman correlation analysis showed that the daily average mass concentration of atmospheric PM_(2.5) was positively correlated with the outpatient volume of paediatric respiratory system diseases( r = 0.298,P<0.05). The GAM revealed that there was the hysteresis effect on influence of atmospheric PM_(2.5) on daily outpatient volume of paediatric respiratory system diseases,which reached the strongest effect on the first day. An increase in atmospheric PM_(2.5) mass concentration by 10 μg/m3 increased the outpatient volume of respiratory system diseases by 0. 048,8%( 95% CI: 0.030 1%-0. 059 5%). Conclusions The increment of PM_(2.5) concentration can aggravate the risk of suffering from paediatric respiratory system diseases in Jinhua City; and hence,it is necessary to adopt corresponding measures to protect susceptible groups.
引文
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[12]Fecht D,Fischer P,Fortunato L,et al. Associations between air pollution and socioeconomic characteristics,ethnicity and age profile of neighbourhoods in England and the Netherlands[J]. Environ Pollut,2015,198(34):201-210.
[2]Chen R,Li Y,Ma Y,et al. Coarse particles and mortality in three Chinese cities:the China air pollution and health effects study(CAPES)[J]. Sci Total Environ,2011,409(23):4934-4938.
[3]Cao J,Xu H,Xu Q,et al. Fine particulate matter constituents and cardiopulmonary mortality in a heavily polluted Chinese city[J]. Environ Health Persp,2012,120(3):373-378.
[4]石同幸,杨轶戬,蒋琴琴,等.广州市部分公共场所室内空气中PM2. 5成份及健康危害分析[J].实用预防医学,2014,21(12):1412-1415.
[5]林宗伟,于彦杰,吴根容,等.广州市春季小学教学环境细颗粒物对学生呼吸系统影响的研究[J].实用预防医学,2014,21(3):281-284.
[6]Qiao L,Cai J,Wang H,et al. PM2. 5constituents and hospitalemergency-room visits in Shanghai,China[J]. Environ Sci Technol,2014,48(17):10406-10414.
[7]彭琦,饶俊,阳志文,等.室内可吸入颗粒物污染与哮喘和肺癌的相关性研究综述[J].实用预防医学,2018,25(18):1022-1024.
[8]殷永文,程金平,段玉森,等.上海市霾期间PM2. 5、PM10污染与呼吸科、儿呼吸科门诊人数的相关分析[J].环境科学,2011,32(7):1894-1898.
[9]项征剑,刘建英,陶芳,等.早期干预对早产儿呼吸道感染预防作用观察[J].河北医药,2011,33(8):1212-1213.
[10]崔亮亮,李新伟,耿兴义,等.2013年济南市大气PM2. 5污染及雾霾事件对儿童门诊量影响的时间序列分析[J].环境与健康杂志,2015,32(6):489-493.
[11]王大虎,石同幸,吕嘉韵. 2013-2015年广州市大气PM2. 5浓度对儿童呼吸系统门诊量影响分析[J].医学动物防制,2017,34(12):1230-1234.
[12]Fecht D,Fischer P,Fortunato L,et al. Associations between air pollution and socioeconomic characteristics,ethnicity and age profile of neighbourhoods in England and the Netherlands[J]. Environ Pollut,2015,198(34):201-210.