大气 PM 空气污染对中国日常急诊就诊的影响：一项流行病学研究。
Effects of ambient PM air pollution on daily emergency hospital visits in China: an epidemiological study.
机构信息
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
出版信息
Lancet Planet Health. 2017 Sep;1(6):e221-e229. doi: 10.1016/S2542-5196(17)30100-6. Epub 2017 Sep 7.
BACKGROUND
China is experiencing severe ambient air pollution. However, few studies anywhere have examined the health effects of PM (particulate matter with aerodynamic diameter <1 μm), which are a major part of PM (particulate matter with aerodynamic diameter <2·5 μm) and even potentially more harmful than PM. We aimed to estimate the effects of ambient daily PM and PM concentrations on emergency hospital visits in China.
METHODS
In this epidemiological study, we collected daily counts of emergency hospital visits from the 28 largest hospitals in 26 Chinese cities from Sept 9, 2013, to Dec 31, 2014. Ground-based monitoring data for PM and PM and meteorological data were also collected. Hospital-specific emergency hospital visits associated with PM or PM were evaluated with a time-series Poisson regression. The effect estimates were then pooled at the country level using a random-effects meta-analysis.
FINDINGS
The mean daily concentration of PM in all cities was 42·5 μg/m (SD 34·6) and of PM was 51·9 μg/m (41·5). The mean daily number of emergency hospital visits in all hospitals was 278 (SD 173). PM and PM concentrations were significantly associated with an increased risk of emergency hospital visits at lag 0-2 days (cumulative relative risk [RRs] 1·011 [95% CI 1·006-1·017] for a 10 μg/m increase in PM and 1·010 [1·005-1·016] for a 10 μg/m increase in PM). Slightly higher RRs of ambient PM and PM pollution were noted among women and children than among men and adults, respectively, but without statistical significance. Given a cause-effect association, 4·47% (95% CI 2·05-6·79) and 5·05% (2·23-7·75) of daily emergency hospital visits in China could be attributed to ambient PM and PM pollution, respectively.
INTERPRETATION
Exposure to both ambient PM and PM were significantly associated with increased emergency hospital visits. The results suggest that most of the health effects of PM come from PM.
FUNDING
None.
背景
中国正面临严重的大气污染问题。然而，目前仅有少数研究调查了 PM（空气动力学直径小于 1μm 的颗粒物）对健康的影响，PM 是 PM（空气动力学直径小于 2.5μm 的颗粒物）的主要组成部分，其危害性甚至可能超过 PM。本研究旨在评估大气环境中 PM 和 PM 日浓度对中国医院急诊量的影响。
方法
本项流行病学研究收集了 2013 年 9 月 9 日至 2014 年 12 月 31 日期间中国 26 个城市 28 家大型医院的每日急诊量数据，并采集了 PM 和 PM 地面监测数据及气象数据。采用时间序列泊松回归模型评估 PM 和 PM 与医院特定急诊量之间的关系。使用随机效应荟萃分析汇总全国水平的效应估计值。
结果
所有城市的 PM 平均日浓度为 42.5μg/m（标准差 34.6），PM 平均日浓度为 51.9μg/m（标准差 41.5）。所有医院的平均每日急诊量为 278（标准差 173）。PM 和 PM 浓度与滞后 0-2 天的急诊量增加显著相关（PM 浓度每增加 10μg/m，累积相对风险 [RR] 为 1.011[95%置信区间 1.006-1.017]；PM 浓度每增加 10μg/m，RR 为 1.010[1.005-1.016]）。PM 和 PM 污染对女性和儿童的影响高于男性和成人，但无统计学意义。在因果关系假设下，中国 4.47%（95%置信区间 2.05-6.79）和 5.05%（2.23-7.75）的每日急诊量可归因于大气环境中 PM 和 PM 污染。
结论
大气环境中 PM 和 PM 暴露均与急诊量增加显著相关。结果表明，PM 对健康的影响主要来自 PM。
资金
无。
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