Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China.
HeBei institute of Respiratory Disease, Shijiazhuang, China.
Environ Sci Pollut Res Int. 2019 Oct;26(30):31225-31233. doi: 10.1007/s11356-019-06242-3. Epub 2019 Aug 28.
Few researches have been investigated on the effects of ambient air pollutants from coal combustion on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalizations. The whole time series was split into heating season and non-heating season. We used a quasi-Poisson generalized linear regression model combined with distributed lag non-linear models (DLNMs) to estimate the relative cumulative risk and calculate the air pollutant hospitalization burden of AECOPD for lag 0-7 days in heating season and non-heating season. There were higher PM, PM, NO, SO, and CO concentrations in heating seasons than non-heating season in Shijiazhuang; however, O was higher in non-heating season than heating season. The AECOPD-associated relative cumulative risks for PM, PM, NO, and SO for lag 0-7 days were significantly positively associated with hospitalization in heating and non-heating season; we found that the cumulative relative risk of NO was the greatest in every 1 unit of air pollutants during the heating season and the cumulative relative risk of SO was the greatest during the non-heating season. The results showed that 17.8%, 12.9%, 1.7%, 16.7%, and 10.5% of AECOPD hospitalizations could be attributable to PM, PM, SO, NO, and CO exposure in heating season, respectively. However, the results showed that 19.5%, 22.4%, 15%, 8.3%, and 10.4% of AECOPD hospitalizations could be attributable to PM, PM, SO, NO and O exposure in non-heating season, respectively. The attributable burden of AECOPD hospitalization in heating season and non-heating season are different. PM, PM, NO, and CO are the main factors of heating season, while PM, PM, SO, and O are the main factors of non-heating season. In conclusions, the centralized heating can change the influence of attributable risk. When government departments formulate interventions to reduce the risk of acute hospitalization of chronic obstructive pulmonary disease (COPD), the influence of heating on disease burden should be considered.
针对燃煤引起的大气污染物对慢性阻塞性肺疾病急性加重（AECOPD）住院的影响，目前鲜有研究。本研究将全时间序列分为供暖季和非供暖季。采用拟泊松广义线性回归模型结合分布滞后非线性模型（DLNMs），估计滞后 0-7 天供暖季和非供暖季的 PM、PM、NO、SO、CO 对 AECOPD 的相对累积风险，并计算 AECOPD 的大气污染物住院负担。与非供暖季相比，石家庄供暖季 PM、PM、NO、SO 和 CO 浓度更高，而 O 浓度在非供暖季更高。AECOPD 相关的 PM、PM、NO 和 SO 滞后 0-7 天的相对累积风险与供暖季和非供暖季的住院呈显著正相关；结果发现，在供暖季，每增加 1 个单位的污染物，NO 的累积相对风险最大，而在非供暖季，SO 的累积相对风险最大。结果表明，在供暖季，17.8%、12.9%、1.7%、16.7%和 10.5%的 AECOPD 住院可归因于 PM、PM、SO、NO 和 CO 暴露，而非供暖季则分别为 19.5%、22.4%、15%、8.3%和 10.4%。供暖季和非供暖季 AECOPD 住院归因负担不同，PM、PM、NO 和 CO 是供暖季的主要因素，而 PM、PM、SO 和 O 是非供暖季的主要因素。总之，集中供暖会改变归因风险的影响。政府部门在制定降低慢性阻塞性肺病（COPD）急性住院风险的干预措施时，应考虑供暖对疾病负担的影响。
