大气细颗粒物对中国兰州地区呼吸系统疾病日门诊量的影响。
Effect of PM on daily outpatient visits for respiratory diseases in Lanzhou, China.
机构信息
School of Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China.
School of Management, Lanzhou University, Lanzhou 730000, PR China; School of Economics and Management, Lanzhou University of Technology, Lanzhou 730050, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China.
出版信息
Sci Total Environ. 2019 Feb 1;649:1563-1572. doi: 10.1016/j.scitotenv.2018.08.384. Epub 2018 Aug 28.
The present study assessed the effect of short-term exposure to PM of daily outpatient visits for respiratory diseases. Electronic records of daily outpatient visits were collected from two large general hospitals in Lanzhou, China from 01 January 2007 to 31 December 2016. Daily air pollution data from the Lanzhou Environmental Monitoring Station and daily meteorological data from the Lanzhou Meteorological Bureau were collected in the same period. A distributed lag non-linear model, based on a gender and age groups, was applied to analyse the exposure-response relationship between the air pollutants, and the daily outpatient visits for respiratory diseases. From 2007 to 2016, the PM concentrations were associated with an increase in the daily outpatient visits for respiratory diseases in Lanzhou. In addition, a lag effect was observed and this effect was the strongest on day 1. For every 10 μg/m increase in the PM concentration, the daily outpatient visits for respiratory diseases increased by 0.53% (95% CI: 0.22%-0.84%). People aged 18 years or younger were most sensitive to PM, and the influence of PM was more significant for females than for males. The cumulative effect of the PM concentration for the number of outpatient visits was greater than its daily effect, and the cumulative effect peaked on day 12. From day 0 to day 14, every 10-μg/m increase in the PM concentration had a statistically significant cumulative effect on the outpatient visits for respiratory diseases among individuals aged 18 years or younger (p < 0.05), reaching a maximum value on day 14 (PM: RR = 1.0213, 95% CI: 1.0128-1.0299).
本研究评估了短期暴露于 PM 对呼吸道疾病每日门诊就诊的影响。从 2007 年 1 月 1 日至 2016 年 12 月 31 日,从中国兰州的两家大型综合医院收集了每日门诊就诊的电子记录。同期还收集了兰州环境监测站的每日空气污染数据和兰州气象局的每日气象数据。基于性别和年龄组,应用分布式滞后非线性模型分析了空气污染物与呼吸道疾病每日门诊就诊之间的暴露-反应关系。从 2007 年到 2016 年,PM 浓度与兰州呼吸道疾病每日门诊就诊量的增加有关。此外,还观察到了滞后效应,这种效应在第 1 天最强。PM 浓度每增加 10μg/m,呼吸道疾病的每日门诊就诊量增加 0.53%(95%CI:0.22%-0.84%)。18 岁或以下的人群对 PM 最敏感,PM 对女性的影响比男性更显著。PM 浓度对门诊就诊人数的累积效应大于其日效应,累积效应在第 12 天达到峰值。从第 0 天到第 14 天,PM 浓度每增加 10μg/m,18 岁或以下人群的呼吸道疾病门诊就诊量具有统计学显著的累积效应(p<0.05),在第 14 天达到最大值(PM:RR=1.0213,95%CI:1.0128-1.0299)。