Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China.
Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
Sci Total Environ. 2019 Jun 10;668:825-834. doi: 10.1016/j.scitotenv.2019.03.049. Epub 2019 Mar 5.
At present, there are few studies on the effect of short-term interactions between ambient air pollutants and temperature on cause-specific emergency department visits in China. This study aimed to explore their short-term interactions on cause-specific emergency department visits using data collected from a total of 65 public hospitals in Guangzhou city, south China.
We included a total of 226,443 emergency department visits which were diagnosed as neurological, respiratory and circulatory disease in Guangzhou from January 1, 2014 to December 31, 2017. Average daily concentrations of air pollutants including carbon monoxide (CO), particulate matter having a median diameter of 2.5 μm or less (PM), sulfur dioxide (SO), nitrogen dioxide (NO) and ozone (O) were collected from the Guangzhou Environmental Protection Bureau. We employed quasi-Poisson varying coefficient regression models to assess the interaction effects between air pollutants and daily temperature levels (DTLs) on emergency department visits for neurological, respiratory and circulatory diseases, respectively.
Average number of emergency department visits for neurological, respiratory and circulatory diseases were 92, 26 and 38, respectively. After controlling for other pollutants, meteorological factors and other time-varying confounders, we found the interactions between NO and the 1st DTL (3.4-17.1 °C), NO and the 2nd DTL (17.1-23.5 °C) for neurological emergency department visits were statistically significant, displaying a nonlinear relationship. Additionally, we found that the interactions between SO and the 4th DTL (27.4-31.1 °C) also had a significantly adverse effect on respiratory emergency department visits.
Our findings provide novel evidence on SO-by-temperature interactions, and NO-by-temperature interactions for emergency department visits of cause-specific diseases.
目前，关于环境空气污染物和温度对中国特定病因急诊就诊的短期相互作用的研究较少。本研究旨在利用中国南方广州市 65 家公立医院收集的数据，探讨它们对特定病因急诊就诊的短期相互作用。
我们纳入了 2014 年 1 月 1 日至 2017 年 12 月 31 日期间广州市因神经系统、呼吸系统和循环系统疾病而就诊的 226443 例急诊病例。从广州市环境保护局收集了包括一氧化碳（CO）、粒径为 2.5μm 或以下的颗粒物（PM）、二氧化硫（SO）、二氧化氮（NO）和臭氧（O）在内的空气污染物的平均日浓度。我们采用准泊松变系数回归模型，分别评估空气污染物与每日温度水平（DTL）对神经系统、呼吸系统和循环系统疾病急诊就诊的交互作用。
神经系统、呼吸系统和循环系统疾病的急诊就诊平均人数分别为 92、26 和 38。在控制其他污染物、气象因素和其他时变混杂因素后，我们发现 NO 与第 1 个 DTL（3.4-17.1°C）、NO 与第 2 个 DTL（17.1-23.5°C）之间的交互作用对神经系统急诊就诊有统计学意义，呈现非线性关系。此外，我们发现 SO 与第 4 个 DTL（27.4-31.1°C）之间的相互作用对呼吸系统急诊就诊也有明显的不利影响。
我们的研究结果为特定病因急诊就诊的 SO-温度相互作用和 NO-温度相互作用提供了新的证据。
