美国佐治亚州的儿科急诊就诊情况与PM2.5浓度的短期变化
Pediatric Emergency Visits and Short-Term Changes in PM2.5 Concentrations in the U.S. State of Georgia.
作者信息
Strickland Matthew J, Hao Hua, Hu Xuefei, Chang Howard H, Darrow Lyndsey A, Liu Yang
机构信息
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
出版信息
Environ Health Perspect. 2016 May;124(5):690-6. doi: 10.1289/ehp.1509856. Epub 2015 Oct 9.
BACKGROUND
Associations between pediatric emergency department (ED) visits and ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) have been reported in previous studies, although few were performed in nonmetropolitan areas.
OBJECTIVE
We estimated associations between daily PM2.5 concentrations, using a two-stage model that included land use parameters and satellite aerosol optical depth measurements at 1-km resolution, and ED visits for six pediatric conditions in the U.S. state of Georgia by urbanicity classification.
METHODS
We obtained pediatric ED visits geocoded to residential ZIP codes for visits with nonmissing PM2.5 estimates and admission dates during 1 January 2002-30 June 2010 for 2- to 18-year-olds for asthma or wheeze (n = 189,816), and for 0- to 18-year-olds for bronchitis (n = 76,243), chronic sinusitis (n = 15,745), otitis media (n = 237,833), pneumonia (n = 52,946), and upper respiratory infections (n = 414,556). Daily ZIP code-level estimates of 24-hr average PM2.5 were calculated by averaging concentrations within ZIP code boundaries. We used time-stratified case-crossover models stratified on ZIP code, year, and month to estimate odds ratios (ORs) between ED visits and same-day and previous-day PM2.5 concentrations at the ZIP code level, and we investigated effect modification by county-level urbanicity.
RESULTS
A 10-μg/m3 increase in same-day PM2.5 concentrations was associated with ED visits for asthma or wheeze (OR = 1.013; 95% CI: 1.003, 1.023) and upper respiratory infections (OR = 1.015; 95% CI: 1.008, 1.022); associations with previous-day PM2.5 concentrations were lower. Differences in the association estimates across levels of urbanicity were not statistically significant.
CONCLUSION
Pediatric ED visits for asthma or wheeze and for upper respiratory infections were associated with PM2.5 concentrations in Georgia.
CITATION
Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y. 2016. Pediatric emergency visits and short-term changes in PM2.5 concentrations in the U.S. state of Georgia. Environ Health Perspect 124:690-696; http://dx.doi.org/10.1289/ehp.1509856.
背景
先前的研究已报道了儿科急诊科就诊与直径≤2.5μm的颗粒物（PM2.5）环境浓度之间的关联，不过在非都市地区开展的研究较少。
目的
我们使用一个两阶段模型来估计每日PM2.5浓度与美国佐治亚州六种儿科疾病的急诊科就诊之间的关联，该模型纳入了土地利用参数和1公里分辨率的卫星气溶胶光学厚度测量数据，并按城市化程度进行分类。
方法
我们获取了2002年1月1日至2010年6月30日期间居住邮编经地理编码、年龄在2至18岁的哮喘或喘息患者（n = 189,816）以及年龄在0至18岁的支气管炎（n = 76,243）、慢性鼻窦炎（n = 15,745）、中耳炎（n = 237,833）、肺炎（n = 52,946）和上呼吸道感染（n = 414,556）患者的儿科急诊科就诊记录，且这些记录的PM2.5估计值和入院日期均无缺失。通过对邮编边界内的浓度进行平均计算出每日邮编层面24小时平均PM2.5的估计值。我们使用按邮编、年份和月份分层的时间分层病例交叉模型来估计邮编层面急诊科就诊与当日及前一日PM2.5浓度之间的比值比（OR），并研究县级城市化程度的效应修正。
结果
当日PM2.5浓度每增加10μg/m³与哮喘或喘息的急诊科就诊（OR = 1.013；95%置信区间：1.003，1.023）以及上呼吸道感染的急诊科就诊（OR = 1.015；95%置信区间：1.008，1.022）相关；与前一日PM2.5浓度的关联较低。不同城市化程度水平的关联估计差异无统计学意义。
结论
在佐治亚州，哮喘或喘息以及上呼吸道感染的儿科急诊科就诊与PM2.5浓度相关。
引用文献
Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y. 2016. Pediatric emergency visits and short-term changes in PM2.5 concentrations in the U.S. state of Georgia. Environ Health Perspect 124:690 - 696; http://dx.doi.org/10.1289/ehp.1509856.
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