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儿童粗颗粒物与呼吸系统疾病住院情况:一项生态时间序列研究

Coarse particles and hospital admissions due to respiratory diseases in children. An ecological time series study.

作者信息

César Ana Cristina Gobbo, Nascimento Luiz Fernando

机构信息

PhD. Assistant Professor, Instituto Federal de Educação Ciência e Tecnologia de São Paulo (IFSP), Campus Bragança Paulista (SP), Brazil.

MD, PhD. Researcher, Postgraduate Program on Environmental Sciences, Universidade de Taubaté (UNITAU), Taubaté (SP), Brazil.

出版信息

Sao Paulo Med J. 2018 May-Jun;136(3):245-250. doi: 10.1590/1516-3180.2017.0362080218. Epub 2018 Jun 25.

Abstract

BACKGROUND

Exposure to particulate matter (PM) is associated with hospitalizations due to respiratory diseases among children.

DESIGN AND SETTING

An ecological time series study was carried out to identify the role of coarse fractions of particulate matter (PM10-2.5) in hospitalizations among children up to 10 years of age, in Piracicaba (SP) in the year 2015.

METHODS

A generalized additive model of Poisson regression was used to estimate the risk of hospitalization due to acute laryngitis and tracheitis, pneumonia, bronchitis, bronchiolitis and asthma. Lags of 0 to 7 days were considered, and the model was adjusted for the temperature and relative humidity of the air and controlled for short and long-term exposure. Proportional attributable ratios, population-attributable fractions and hospital costs were calculated with increasing concentrations of these pollutants.

RESULTS

638 hospitalizations were evaluated during this period, with a mean of 1.75 cases per day (standard deviation, SD = 1.86). The daily averages were 22.45 µg/m3 (SD = 13.25) for the coarse fraction (PM10-2.5) and 13.32 µg/m3 (SD = 6.38) for the fine fraction. Significant risks of PM10-2.5 exposure were only observed at lag 0, with relative risk (RR) = 1.012, and at lag 6, with RR = 1.011. An increase of 5 µg/m3 in the coarse fraction concentration implied an increase in the relative risk of hospitalizations of up to 4.8%, with an excess of 72 hospitalizations and excess expenditure of US$ 17,000 per year.

CONCLUSIONS

This study showed the impact of coarse-fraction exposure on hospital admissions among children due to respiratory diseases.

摘要

背景

儿童接触颗粒物(PM)与因呼吸系统疾病住院有关。

设计与背景

开展了一项生态时间序列研究,以确定粗颗粒部分(PM10 - 2.5)在2015年皮拉西卡巴(圣保罗州)10岁以下儿童住院情况中的作用。

方法

采用泊松回归广义相加模型来估计因急性喉炎、气管炎、肺炎、支气管炎、细支气管炎和哮喘住院的风险。考虑了0至7天的滞后,模型针对空气温度和相对湿度进行了调整,并对短期和长期暴露进行了控制。随着这些污染物浓度的增加,计算了比例归因比、人群归因分数和住院费用。

结果

在此期间评估了638例住院病例,平均每天1.75例(标准差,SD = 1.86)。粗颗粒部分(PM10 - 2.5)的日平均浓度为22.45 μg/m³(SD = 13.25),细颗粒部分为13.32 μg/m³(SD = 6.38)。仅在滞后0时观察到PM10 - 2.5暴露的显著风险,相对风险(RR)= 1.012,在滞后6时,RR = 1.011。粗颗粒部分浓度每增加5 μg/m³,住院相对风险增加高达4.8%,每年额外住院72例,额外支出17,000美元。

结论

本研究显示了粗颗粒部分暴露对儿童因呼吸系统疾病住院的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8711/9907743/58739f2e59a4/1806-9460-spmj-136-03-245-gf1.jpg

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