2015-2017年昆明市大气颗粒物与救护车出诊次数的时间序列分析
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摘要
目的探讨大气颗粒物(PM_(10)、PM_(2.5))与救护车出诊次数的关联性。方法收集云南省昆明市2015-01-01/2017-12-31期间逐日救护车出诊、大气污染物日均浓度、气象因子等数据,采用基于广义相加模型的时间序列分析,在控制数据长期趋势、气象混杂、星期几效应和节假日效应等基础上,分析不同滞后时间PM_(10)、PM_(2.5)与救护车出诊次数的关系,并对性别和年龄进行分层分析。结果救护车出诊次数与大气PM_(10)、PM_(2.5)呈正相关。PM_(10)(lag01)和PM_(2.5)(lag01)每升高10μg/m~3,救护车出诊次数增加的相对危险度分别为1.005 3(95%CI:1.001 4～1.009 3)和1.007 7(95%CI:1.000 5～1.014 9)。PM_(10)对男性和14岁以下人群影响更大,PM_(2.5)对65岁以上人群影响更强。在引入SO_2和NO_2后,PM_(10)、PM_(2.5)对救护车出诊次数的影响无统计学意义。结论 PM_(10)、PM_(2.5)浓度对救护车出诊次数增加均有不同程度影响,不同性别和年龄组人群易感性可能存在一定差异。
Objective To evaluate the association between ambient particulate matter(PM_(10), PM_(2.5))concentrations and the number of emergency ambulance dispatches. Methods Data on daily number emergency ambulance dispatches, air pollution and meteorological factors of Kunming in Yunnan Province from January 1, 2015 to December 31, 2017 were collected. Generalized additive model(GAM) was used to analyze the association between ambient particulate matter concentrations in different lag days and daily number of emergency ambulance dispatches after adjustment for long-term trend, weekday effect,meteorological factors and weekend effect, and stratification analyses were conducted by gender and age. Results The number of emergency ambulance dispatches was positively correlated with PM_(10) and PM_(2.5) concentrations. A 10 μg/m~3 increase in the lag01 day concentrations of PM_(10) and PM_(2.5) corresponded to a relative risk of 1.005 3(95%CI:1.001 4-1.009 3) and 1.007 7(95%CI:1.000 5-1.014 9) in increase of emergency ambulance dispatches, respectively. Males and children under 14 years of age were more affected by PM_(10).. PM_(2.5) had a stronger effect on people aged over65 years. With introduction of sulfur dioxide and nitrogen dioxide,the effects of PM_(10) and PM_(2.5) on the number of emergency ambulance dispatches were not statistically significant. Conclusion Exposure to PM_(10) and PM_(2.5) is associated with an increased number of emergency ambulance dispatches. There may be some differences in susceptibility among different gender and age groups.
Objective To evaluate the association between ambient particulate matter(PM_(10), PM_(2.5))concentrations and the number of emergency ambulance dispatches. Methods Data on daily number emergency ambulance dispatches, air pollution and meteorological factors of Kunming in Yunnan Province from January 1, 2015 to December 31, 2017 were collected. Generalized additive model(GAM) was used to analyze the association between ambient particulate matter concentrations in different lag days and daily number of emergency ambulance dispatches after adjustment for long-term trend, weekday effect,meteorological factors and weekend effect, and stratification analyses were conducted by gender and age. Results The number of emergency ambulance dispatches was positively correlated with PM_(10) and PM_(2.5) concentrations. A 10 μg/m~3 increase in the lag01 day concentrations of PM_(10) and PM_(2.5) corresponded to a relative risk of 1.005 3(95%CI:1.001 4-1.009 3) and 1.007 7(95%CI:1.000 5-1.014 9) in increase of emergency ambulance dispatches, respectively. Males and children under 14 years of age were more affected by PM_(10).. PM_(2.5) had a stronger effect on people aged over65 years. With introduction of sulfur dioxide and nitrogen dioxide,the effects of PM_(10) and PM_(2.5) on the number of emergency ambulance dispatches were not statistically significant. Conclusion Exposure to PM_(10) and PM_(2.5) is associated with an increased number of emergency ambulance dispatches. There may be some differences in susceptibility among different gender and age groups.
引文
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[14]翁俊，韦性富，聂永红，等.颗粒物污染对高血压门急诊就诊人数的影响-时间序列研究[J].中国环境科学，2018,38(7):2751-2757.
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[16]曹宇，刘徽，张俊，等.北京市颗粒物污染对慢性阻塞性肺疾病急性加重住院的影响[J].北京大学学报（医学版），2017,49(3):403-408.
[17]陈浪，赵川，关茗洋，等.石家庄市大气颗粒污染物浓度与居民死亡率的时间序列分析[J].中华疾病控制杂志，2018,22(3):272-277.
[2]Kioumourtzoglou MA, Schwartz J, James P, et al.PM2.5and Mortality in 207 US Cities:Modification by Temperature and City Characteristics[J].Epidemiology(Cambridge,Mass),2016,27(2):221-227.
[3]刘晓剑，吴永胜，付英斌，等.深圳市空气PM2.5与心脑血管疾病死亡的广义相加模型分析[J].中华疾病控制杂志，2016,20(2):207-209.
[4]陈楠，程娟，孙鉴，等.2014年武汉市大气颗粒物数浓度与呼吸系统疾病日门诊量的时间序列研究[J].环境与职业医学，2016,33(10):970-976.
[5]马洪群，崔莲花.青岛市大气细颗粒物对呼吸系统疾病患者住院影响的病例交叉研究[J].职业与健康，2017,33(7):961-964.
[6]管愉.昆山市救护车出车次数、医院急诊人次与每日气温变化的关联性分析[D].上海：复旦大学，2012:38-42.
[7]宋杰，徐东群，赵伟，等.华北某城市大气颗粒物浓度对神经系统疾病救护车出诊次数的急性影响[J].卫生研究，2016,45(6):932-937.
[8]张云权，朱耀辉，李存禄，等.广义相加模型在R软件中的实现[J].中国卫生统计，2015,32(6):1073-1075.
[9]Chen R,Yin P,Meng X,et al. Fine Particulate Air Pollution and Daily Mortality. A Nationwide Analysis in 272 Chinese Cities[J]. Am J Respir Crit Care Med,2017,196(1):73-81.
[10]Brunekreef B, Dockery DW, Krzyzanowski M.Epidemiologic Studies on Short-Term Effects of Low Levels of Major Ambient Air Pollution Components[J]. Environmental Health Perspectives,1995,103(Suppl 2):3-13.
[11]Michikawa T, Ueda K,Takeuchi A, et al. Impact of short-term exposure to fine particulate matter on emergency ambulance dispatches in Japan[J]. Journal of Epidemiology and Community Health,2015,69(1):86-91.
[12]胥芹，王超，潘蕾，等.广义相加模型在北京市PM2.5与救护车出车次数关联性研究中的应用[J].中国卫生统计，2015,32(5):738-740.
[13]廖玉学，彭朝琼，余淑苑，等.深圳市大气PM10与呼吸系统疾病日门诊量的时间序列分析[J].华南预防医学，2014,40(4):301-305.
[14]翁俊，韦性富，聂永红，等.颗粒物污染对高血压门急诊就诊人数的影响-时间序列研究[J].中国环境科学，2018,38(7):2751-2757.
[15]谷少华，陆蓓蓓，边国林，等.大气可吸入颗粒物对心血管疾病急救人次的短期影响[J].环境与职业医学，2016,33(10):965-969.
[16]曹宇，刘徽，张俊，等.北京市颗粒物污染对慢性阻塞性肺疾病急性加重住院的影响[J].北京大学学报（医学版），2017,49(3):403-408.
[17]陈浪，赵川，关茗洋，等.石家庄市大气颗粒污染物浓度与居民死亡率的时间序列分析[J].中华疾病控制杂志，2018,22(3):272-277.