唐山市空气污染物对某医院呼吸系统疾病门诊量的影响
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摘要
目的探讨唐山市空气污染对人群呼吸系统疾病门诊量的影响。方法采用广义相加泊松模型的时间序列研究方法,在控制门诊量的长期趋势、星期几效应、气象因素等混杂因素的影响的基础上,分析唐山市2014年1月1日—2016年12月31日大气污染物质量浓度与呼吸系统疾病日门诊量的关系。结果大气PM_(2.5)、PM_(10)及SO_2与呼吸系统疾病门诊量呈正相关,且与一定的滞后效应,并且质量浓度每升高10μg/m~3,呼吸系统疾病日门诊量分别上升0.37%(RR=1.003 7,95%CI:1.001 6～1.005 8)、0.26%(RR=1.002 6,95%CI:1.001 1～1.004 1)、0.70%(RR=1.007 0,95%CI:1.003 5～1.010 5),多污染物模型中,PM_(2.5)、PM_(10)及SO_2每升高10μg/m~3,呼吸系统疾病日门诊量分别上升0.07%(RR=1.000 7,95%CI:0.994 0～1.007 5)、0.08%(RR=1.000 8,95%CI:0.996 0～1.005 6)、0.49%(RR=1.004 9,95%CI:1.000 3～1.009 6)。结论唐山市的大气污染物与居民呼吸系统疾病日门诊量之间存在正相关。
Objectives To investigate the effect of air pollution on the outpatient amount with respiratory diseases in Tangshan. Methods The relationship between atmospheric pollutant concentration and daily outpatient rate of respiratory diseases from January 1~(st), 2014 to December 31~(st), 2016 in Tangshan was analyzed on the basis of Generalized Addictive model with the controlling of the long-term trend of outpatient service as well as the effects of weeks and meteorological factors. Results Atmospheric PM_(2.5), PM_(10), and SO_2 were positively correlated with the outpatient rate of respiratory diseases with some lag effects. For each 10 μg/m~3 increase in concentration, the daily outpatient rate of respiratory diseases increased by 0.37%(RR=1.003 7, 95%CI:1.001 6～1.005 8), 0.26%(RR=1.002 6,95%CI:1.001 1～1.004 1) and 0.70%(RR=1.007 0, 95%CI:1.003 5～1.010 5), respectively. In multi-pollutant models, the daily outpatient rates of respiratory diseases were increased by 0.07%(RR=1.000 7, 95%CI:0.994 0～1.007 5) and 0.08%(RR=1.000 8, 95%CI:0.996 0～1.005 6), 0.49%(RR=1.004 9, 95%CI:1.000 3～1.009 6), respectively, with the increase of every 10 μg/m~3 of PM_(2.5), PM_(10) and SO_2. Conclusions There is a positive correlation between the atmospheric pollutants in Tangshan and the daily outpatient rate of respiratory diseases among residents.
Objectives To investigate the effect of air pollution on the outpatient amount with respiratory diseases in Tangshan. Methods The relationship between atmospheric pollutant concentration and daily outpatient rate of respiratory diseases from January 1~(st), 2014 to December 31~(st), 2016 in Tangshan was analyzed on the basis of Generalized Addictive model with the controlling of the long-term trend of outpatient service as well as the effects of weeks and meteorological factors. Results Atmospheric PM_(2.5), PM_(10), and SO_2 were positively correlated with the outpatient rate of respiratory diseases with some lag effects. For each 10 μg/m~3 increase in concentration, the daily outpatient rate of respiratory diseases increased by 0.37%(RR=1.003 7, 95%CI:1.001 6～1.005 8), 0.26%(RR=1.002 6,95%CI:1.001 1～1.004 1) and 0.70%(RR=1.007 0, 95%CI:1.003 5～1.010 5), respectively. In multi-pollutant models, the daily outpatient rates of respiratory diseases were increased by 0.07%(RR=1.000 7, 95%CI:0.994 0～1.007 5) and 0.08%(RR=1.000 8, 95%CI:0.996 0～1.005 6), 0.49%(RR=1.004 9, 95%CI:1.000 3～1.009 6), respectively, with the increase of every 10 μg/m~3 of PM_(2.5), PM_(10) and SO_2. Conclusions There is a positive correlation between the atmospheric pollutants in Tangshan and the daily outpatient rate of respiratory diseases among residents.
引文
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[8] 刘华军,杜广杰.中国城市大气污染的空间格局与分布动态演进——基于161个城市AQI及6种分项污染物的实证[J].经济地理,2016,36(10):33-38.(In English:Liu HJ,Du GJ.Spatial pattern and distributional dynamics of urban air pollution in China—an empirical study based on AQI and six sub-pollutants of 161 cities[J].Econ Geogr,2016,36(10):33-38.)
[9] An X,Zhu T,Wang Z,et al.A modeling analysis of a heavy air pollution episode occurred in Beijing[J].Atmos Chem Phys,2007,7(12):3103-3114.
[10] 李丽霞,郜艳晖,周舒冬,等.广义加性模型及其应用[J].中国卫生统计,2007,24(3):243-244.(In English:Li LX,Gao YH,Zhou SD,et al.Generalized additive models and its application[J].Chin J Health Stat,2007,24(3):243-244.)
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[12] Lin YK,Chang SC,Lin C,et al.Comparing ozone metrics on associations with outpatient visits for respiratory diseases in Taipei metropolitan area[J].Environ Pollut,2013,177:177-184.
[13] 张燕萍,李晋芬,张志琴.太原市颗粒物空气污染与居民每日门诊率的暴露-反应关系[J].环境与健康杂志,2008,25(6):479-482.(In English:Zhang YP,Li JF,Zhang ZQ.Exposure-response relationship between particulate pollution level and hospital outpatient visits in Taiyuan[J].J Environ Health,2008,25(6):479-482.)
[14] 王艳,张宜升,李欣鹏.济南城区空气污染对呼吸道疾病门诊量的影响[J].中国环境科学,2008,28(6):571-576.(In English:Wang Y,Zhang YS,Li XP.The effect of air pollution on hospital visits for respiratory symptoms in urban areas of Jinan[J].China Environ Sci,2008,28(6):571-576.
[15] 陶燕,羊德容,兰岚,等.兰州市空气污染对呼吸系统疾病入院人数的影响[J].中国环境科学,2013,33(1):175-180.(In English:Tao Y,Yang DR,Lan L,et al.Relationship between air pollutant and respiratory diseases hospitalization in Lanzhou[J].China Environ Sci,2013,33(1):175-180.)
[16] 谷少华,贾红英,李萌萌,等.济南市空气污染对呼吸系统疾病门诊量的影响[J].环境与健康杂志,2015,32(2):95-98.(In English:Gu SH,Jia HY,Li MM,et al.Effects of air pollution on hospital visits for respiratory diseases in Ji'nan city[J].J Environ Health,2015,32(2):95-98.)
[2] 张莹,邵毅,王式功,等.北京市空气污染物对呼吸系统疾病门诊人数的影响[J].中国环境科学,2014,34(9):2401-2407.(In English:Zhang Y,Shao Y,Wang SG,et al.Relationship between air pollutant and respiratory diseases hospital outpatient visits in Beijing[J].China Environ Sci,2014,34(9):2401-2407.)
[3] 张晓,杨琼英,林国桢,等.大气污染与居民肺癌发病及死亡灰色关联分析[J].中国公共卫生,2014,30(2):165-170.(In English:Zhang X,Yang QY,Lin GZ,et al.Grey relational analysis on association between urban air pollution and lung cancer in China[J].Chin J Public Health,2014,30(2):165-170.)
[4] Touloumi G,Samoli E,Quenel P,et al.Short-term effects of air pollution on total and cardiovascular mortality:the confounding effect of influenza epidemics[J].Epidemiology,2005,16(1):49-57.
[5] 阚海东,陈秉衡.我国大气颗粒物暴露与人群健康效应的关系[J].环境与健康杂志,2002,19(6):422-424.(In English:Kan HD,Chen BH.Analysis of exposure-response relationships of air particulate matter and adverse health outcomes in China[J].J Environ Health,2002,19(6):422-424.)
[6] 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.(In English:Liao YX,Peng ZQ,Yu SY,et al.Time series study of relationship between ambient PM10 and outpatient visits for respiratory diseases in Shenzhen[J].South China J Prev Med,2014,40(4):301-305.)
[7] 张江华,郭常义,许慧慧,等.上海市大气污染与某医院呼吸系统疾病门诊量关系的时间序列研究[J].环境与职业医学,2014,31(11):846-851.(In English:Zhang JH,Guo CY,Xu HH,et al.Time-series analysis on association between air pollution and outpatient visits for respiratory diseases in a hospital in Shanghai[J].J Environ Occup Med,2014,31(11):846-851.)
[8] 刘华军,杜广杰.中国城市大气污染的空间格局与分布动态演进——基于161个城市AQI及6种分项污染物的实证[J].经济地理,2016,36(10):33-38.(In English:Liu HJ,Du GJ.Spatial pattern and distributional dynamics of urban air pollution in China—an empirical study based on AQI and six sub-pollutants of 161 cities[J].Econ Geogr,2016,36(10):33-38.)
[9] An X,Zhu T,Wang Z,et al.A modeling analysis of a heavy air pollution episode occurred in Beijing[J].Atmos Chem Phys,2007,7(12):3103-3114.
[10] 李丽霞,郜艳晖,周舒冬,等.广义加性模型及其应用[J].中国卫生统计,2007,24(3):243-244.(In English:Li LX,Gao YH,Zhou SD,et al.Generalized additive models and its application[J].Chin J Health Stat,2007,24(3):243-244.)
[11] 中华人民共和国国家质量监督检验检疫总局,中国国家标准化管理委员会.GB 3095-2012 环境空气质量标准[S].北京:中国环境科学出版社,2016.(In English:General Administration of Quality Supervision,Inspection and Quarantine of the People's Republic of China,Standardization Administration of the People's Republic of China.GB 3095-2012 Ambient air quality standards[S].Beijing:China Environmental Science Press,2016.)
[12] Lin YK,Chang SC,Lin C,et al.Comparing ozone metrics on associations with outpatient visits for respiratory diseases in Taipei metropolitan area[J].Environ Pollut,2013,177:177-184.
[13] 张燕萍,李晋芬,张志琴.太原市颗粒物空气污染与居民每日门诊率的暴露-反应关系[J].环境与健康杂志,2008,25(6):479-482.(In English:Zhang YP,Li JF,Zhang ZQ.Exposure-response relationship between particulate pollution level and hospital outpatient visits in Taiyuan[J].J Environ Health,2008,25(6):479-482.)
[14] 王艳,张宜升,李欣鹏.济南城区空气污染对呼吸道疾病门诊量的影响[J].中国环境科学,2008,28(6):571-576.(In English:Wang Y,Zhang YS,Li XP.The effect of air pollution on hospital visits for respiratory symptoms in urban areas of Jinan[J].China Environ Sci,2008,28(6):571-576.
[15] 陶燕,羊德容,兰岚,等.兰州市空气污染对呼吸系统疾病入院人数的影响[J].中国环境科学,2013,33(1):175-180.(In English:Tao Y,Yang DR,Lan L,et al.Relationship between air pollutant and respiratory diseases hospitalization in Lanzhou[J].China Environ Sci,2013,33(1):175-180.)
[16] 谷少华,贾红英,李萌萌,等.济南市空气污染对呼吸系统疾病门诊量的影响[J].环境与健康杂志,2015,32(2):95-98.(In English:Gu SH,Jia HY,Li MM,et al.Effects of air pollution on hospital visits for respiratory diseases in Ji'nan city[J].J Environ Health,2015,32(2):95-98.)
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