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秘鲁利马 PM 浓度与 5 岁以下儿童呼吸道疾病就诊人数的关系。

Association of PM concentration with health center outpatient visits for respiratory diseases of children under 5 years old in Lima, Peru.

机构信息

Faculty of Sciences and Philosophy, and Laboratory of Investigation and Development, Universidad Peruana Cayetano Heredia, Lima, Peru.

National Center for Epidemiology, Prevention and Control of Diseases, Minsa, Peru.

出版信息

Environ Health. 2020 Jan 15;19(1):7. doi: 10.1186/s12940-020-0564-5.

Abstract

BACKGROUND

Lima is one of the more polluted cities in Latin America. High levels of PM have been shown to increase health center outpatient visits of respiratory diseases.

METHODS

Health center outpatient visits for children < 5 years for childhood respiratory disease (acute lower respiratory infections (ALRI), pneumonia and acute bronchiolitis/asthma) from 498 public clinics in Lima were available on a weekly basis from 2011 to 2015 from Peru's Ministry of Health (MINSA). The association between the average weekly concentrations of PM was evaluated in relation to the number of weekly health center outpatient visits for children. Weekly PM values were estimated using a recently developed model that combined data observed from ground monitors, with data from space satellite and meteorology. Ground monitoring data came from 10 fixed stations of the Peruvian National Service of Meteorology and Hydrology (SENAMHI) and from 6 mobile stations located in San Juan de Miraflores by Johns Hopkins University. We conducted a time-series analysis using a negative binomial model.

RESULTS

We found a significant association between exposure to PM and all three types of respiratory diseases, across all age groups. For an interquartile increase in PM, we found an increase of 6% for acute lower respiratory infections, an increase of 16-19% for pneumonia, and an increase of 10% for acute bronchiolitis / asthma.

CONCLUSIONS

Higher emissions of environmental pollutants such as PM could be a trigger for the increase of health center outpatients visits for respiratory diseases (ALRI, pneumonia and asthma), which are themselves risk factors for mortality for children in Lima province, Peru.

摘要

背景

利马是拉丁美洲污染较为严重的城市之一。已有研究表明,高水平的 PM 会增加卫生中心呼吸系统疾病的门诊就诊量。

方法

秘鲁卫生部(MINSA)每周提供利马 498 家公立诊所 5 岁以下儿童呼吸系统疾病(急性下呼吸道感染(ALRI)、肺炎和急性细支气管炎/哮喘)的门诊就诊数据,时间范围为 2011 年至 2015 年。利用最近开发的模型,评估每周 PM 平均浓度与儿童每周卫生中心门诊就诊量之间的关系。该模型将地面监测器观察到的数据与来自卫星和气象学的数据相结合,从而估算每周 PM 值。地面监测数据来自秘鲁国家气象局和水文局(SENAMHI)的 10 个固定站和约翰霍普金斯大学位于圣胡安市米拉弗洛雷斯的 6 个移动站。我们采用负二项式模型进行时间序列分析。

结果

我们发现,PM 暴露与所有三种类型的呼吸系统疾病均存在显著相关性,且在所有年龄段均如此。与 PM 中位数增加一个四分位距相比,急性下呼吸道感染增加 6%,肺炎增加 16-19%,急性细支气管炎/哮喘增加 10%。

结论

PM 等环境污染物排放量的增加可能是利马省儿童呼吸系统疾病(ALRI、肺炎和哮喘)门诊就诊量增加的一个诱因,而这些疾病本身就是秘鲁利马省儿童死亡的一个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dacf/6964058/4b04d2898c80/12940_2020_564_Fig1_HTML.jpg

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