Zhao Yiju, Wang Shengyong, Lang Lingling, Huang Caiyan, Ma Wenjun, Lin Hualiang
Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan, China.
Medical College, Jinan University, Guangzhou, China.
Environ Pollut. 2017 Mar;222:126-131. doi: 10.1016/j.envpol.2016.12.070. Epub 2016 Dec 29.
We estimated the short-term effects of particulate matter (PM) pollution with aerodynamic diameters ≤2.5 μm (PM) and between 2.5 and 10 μm (PM) on hospital outpatient visits due to overall and specific respiratory diseases, as well as the associated morbidity burden in Dongguan, a subtropical city in South China. A time-series model with quasi-Poisson link was used to examine the association between PM pollution and morbidities from respiratory diseases, COPD, asthma and pneumonia in Dongguan during 2013-2015. We further estimated the morbidity burden (population attributable fraction and attributable morbidity) due to ambient PM pollution. A total of 44,801 hospital outpatient visits for respiratory diseases were recorded during the study period. Both PM and PM were found to be significantly associated with morbidity of overall respiratory diseases, COPD, and asthma. An IQR (interquartile range) increase in PM at lag day was associated with 15.41% (95% CI: 10.99%, 20.01%) increase in respiratory morbidity, and each IQR increase in PM at lag corresponded to 7.24% (95% CI: 4.25%, 10.32%) increase in respiratory morbidity. We did not find significant effects of PM and PM on pneumonia. Using WHO's guideline (25 μg/m) as reference concentration, about 8.32% (95% CI: 5.90%, 10.86%) of respiratory morbidity (3727, 95% CI: 2642, 4867, in morbidity number) were estimated to be attributed to PM, and 0.86% (95% CI: 0.50%, 1.23%) of respiratory morbidity, representing 385 (95% CI: 225, 551) hospital outpatient visits, could be attributed to coarse particulate pollutant. Our study suggests that both fine and coarse particulate pollutants are an important trigger of hospital outpatient visits for respiratory diseases, and account for substantial respiratory morbidity in Dongguan, China.
我们评估了空气动力学直径≤2.5微米的颗粒物（PM₂.₅）以及直径在2.5至10微米之间的颗粒物（PM₁₀）对因各类及特定呼吸道疾病导致的医院门诊就诊的短期影响，以及在中国南方亚热带城市东莞的相关发病负担。采用具有准泊松链接的时间序列模型，研究2013 - 2015年期间东莞PM污染与呼吸系统疾病、慢性阻塞性肺疾病（COPD）、哮喘和肺炎发病之间的关联。我们进一步估算了因环境PM污染导致的发病负担（人群归因分数和归因发病率）。研究期间共记录了44,801例呼吸系统疾病的医院门诊就诊病例。发现PM₂.₅和PM₁₀均与各类呼吸系统疾病、COPD和哮喘的发病显著相关。滞后日PM₂.₅每增加一个四分位数间距（IQR），呼吸系统发病率增加15.41%（95%置信区间：10.99%，20.01%），滞后日PM₁₀每增加一个IQR，呼吸系统发病率增加7.24%（95%置信区间：4.25%，10.32%）。我们未发现PM₂.₅和PM₁₀对肺炎有显著影响。以世界卫生组织的指南（25μg/m³）作为参考浓度，估计约8.32%（95%置信区间：5.90%，10.86%）的呼吸系统发病率（发病例数为3727，95%置信区间：2642，4867）可归因于PM₂.₅，0.86%（95%置信区间：0.50%，1.23%）的呼吸系统发病率（相当于385例（95%置信区间：225，551）医院门诊就诊病例）可归因于粗颗粒物污染物。我们的研究表明，细颗粒物和粗颗粒物污染物都是导致呼吸系统疾病医院门诊就诊的重要诱因，在中国东莞造成了相当大的呼吸系统发病负担。
