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台北(台湾)细颗粒物与呼吸道疾病之间基于人群的短期非线性浓度-反应关联:一项时空分析

Short-term population-based non-linear concentration-response associations between fine particulate matter and respiratory diseases in Taipei (Taiwan): a spatiotemporal analysis.

作者信息

Yu Hwa-Lung, Chien Lung-Chang

机构信息

Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan.

Department of Biostatistics, University of Texas School of Public Health at San Antonio Regional Campus, San Antonio, Texas, USA.

出版信息

J Expo Sci Environ Epidemiol. 2016 Mar-Apr;26(2):197-206. doi: 10.1038/jes.2015.21. Epub 2015 Apr 8.

Abstract

Fine particulate matter <2.5 μm (PM2.5) has been associated with human health issues; however, findings regarding the influence of PM2.5 on respiratory disease remain inconsistent. The short-term, population-based association between the respiratory clinic visits of children and PM2.5 exposure levels were investigated by considering both the spatiotemporal distributions of ambient pollution and clinic visit data. We applied a spatiotemporal structured additive regression model to examine the concentration-response (C-R) association between children's respiratory clinic visits and PM2.5 concentrations. This analysis was separately performed on three respiratory disease categories that were selected from the Taiwanese National Health Insurance database, which includes 41 districts in the Taipei area of Taiwan from 2005 to 2007. The findings reveal a non-linear C-R pattern of PM2.5, particularly in acute respiratory infections. However, a PM2.5 increase at relatively lower levels can elevate the same-day respiratory health risks of both preschool children (<6 years old) and schoolchildren (6-14 years old). In preschool children, same-day health risks rise when concentrations increase from 0.76 to 7.44 μg/m(3), and in schoolchildren, same-day health risks rise when concentrations increase from 0.76 to 7.52 μg/m(3). Changes in PM2.5 levels generally exhibited no significant association with same-day respiratory risks, except in instances where PM2.5 levels are extremely high, and these occurrences do exhibit a significant positive influence on respiratory health that is especially notable in schoolchildren. A significant high relative rate of respiratory clinic visits are concentrated in highly populated areas. We highlight the non-linearity of the respiratory health effects of PM2.5 on children to investigate this population-based association. The C-R relationship in this study can provide a highly valuable alternative for assessing the effects of ambient air pollution on human health.

摘要

细颗粒物(PM2.5,直径小于2.5微米)与人类健康问题相关;然而,关于PM2.5对呼吸系统疾病影响的研究结果仍不一致。通过考虑环境污染的时空分布和门诊就诊数据,对儿童呼吸系统门诊就诊与PM2.5暴露水平之间基于人群的短期关联进行了调查。我们应用时空结构加法回归模型来检验儿童呼吸系统门诊就诊与PM2.5浓度之间的浓度-反应(C-R)关联。该分析分别针对从台湾国民健康保险数据库中选取的三类呼吸系统疾病进行,该数据库涵盖了2005年至2007年台湾台北地区的41个行政区。研究结果揭示了PM2.5的非线性C-R模式,尤其是在急性呼吸道感染方面。然而,在相对较低水平上PM2.5的增加会提高学龄前儿童(<6岁)和学龄儿童(6-14岁)当日的呼吸健康风险。对于学龄前儿童,当浓度从0.76微克/立方米增加到7.44微克/立方米时,当日健康风险上升;对于学龄儿童,当浓度从0.76微克/立方米增加到7.52微克/立方米时,当日健康风险上升。PM2.5水平的变化通常与当日呼吸风险无显著关联,除非PM2.5水平极高,但这些情况确实对呼吸健康有显著的正向影响,在学龄儿童中尤为明显。呼吸门诊就诊的显著高相对率集中在人口密集地区。我们强调PM2.5对儿童呼吸健康影响的非线性,以研究这种基于人群的关联。本研究中的C-R关系可为评估环境空气污染对人类健康的影响提供极具价值的参考。

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