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中国鄞州区大气细颗粒物污染与慢性阻塞性肺疾病就诊的短期关联。

Short-term associations between ambient fine particulate matter pollution and hospital visits for chronic obstructive pulmonary disease in Yinzhou District, China.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China.

Department of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China.

出版信息

Environ Sci Pollut Res Int. 2020 Jun;27(17):21647-21653. doi: 10.1007/s11356-020-08448-2. Epub 2020 Apr 11.

Abstract

Ambient particulate matter is one of the main risk factors of chronic obstructive pulmonary disease (COPD) in developing countries. However, the studies were scant in China concerning the health effects of the fine particulate matter (PM; particulate matter ≤ 2.5 μm in diameter) on hospital visits for COPD. We applied a generalized additive model (GAM) to calculate relative risks (RRs) with 95% confidence intervals (CIs) for the associations between hospital visits for COPD and an interquartile range (24.50 μg/m) increment of ambient PM concentrations in Yinzhou District between 2016 and 2018. The ambient PM concentration was positively associated with hospital visits for COPD at a distributed lag of 0-7 days (RR = 1.073, 95% CI, 1.016, 1.133). In the stratified analysis, we found that the association between ambient PM and COPD was stronger during the warm season (April to September) than that during the cold season (October to March), but we did not observe statistically significant differences in age groups (< 60 years and ≥ 60 years) or gender groups (male and female) related to the effects of PM. The associations between ambient PM and COPD became partially attenuated after the adjustment for gaseous pollutants in subgroups. Our findings could provide evidence that regulations for controlling both PM and gaseous pollutants should be implemented to protect the overall population.

摘要

环境颗粒物是发展中国家慢性阻塞性肺疾病(COPD)的主要危险因素之一。然而,在中国,关于细颗粒物(PM;直径≤2.5μm 的颗粒物)对 COPD 住院的健康影响的研究很少。我们应用广义加性模型(GAM)计算了 2016 年至 2018 年鄞州区环境 PM 浓度每增加一个四分位距(24.50μg/m)与 COPD 住院的相对风险(RR)及其 95%置信区间(CI)。环境 PM 浓度与 COPD 住院的相关性呈正相关,滞后时间为 0-7 天(RR=1.073,95%CI,1.016,1.133)。在分层分析中,我们发现环境 PM 与 COPD 之间的相关性在暖季(4 月至 9 月)比冷季(10 月至 3 月)更强,但我们没有观察到与 PM 效应相关的年龄组(<60 岁和≥60 岁)或性别组(男性和女性)之间存在统计学差异。在亚组中调整气态污染物后,环境 PM 与 COPD 之间的相关性部分减弱。我们的研究结果为控制 PM 和气态污染物的综合法规的实施提供了证据,以保护全体人群。

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