Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China.
School of Public Health, Lanzhou University, No.199, Donggang West Road, Lanzhou, 730000, Chengguan District, China.
Environ Sci Pollut Res Int. 2020 Jun;27(18):22843-22854. doi: 10.1007/s11356-020-08797-y. Epub 2020 Apr 22.
Until now, a number of epidemiological studies have focused on the association between ambient particulate matter pollution and chronic obstructive pulmonary disease (COPD), especially in developed countries. There are limited evidences on the association between short-term exposure to particulate matters (PM, PM, and PM) and overall hospital outpatient visits for COPD at the same time in China. Thus, a time-series analysis on the short-term association between three subtypes of PM (PM, PM, and PM) and daily hospital outpatients for COPD in Lanzhou, China was conducted, from 2014 to 2017.An over dispersed, generalized additive model was used to analyze the associations after controlling for time trend, weather conditions, day of the week, and holidays. Stratified analyses were also performed by age and gender. The results disclosed that a 10-μg/m increase in PM concentration at a lag of 0-7 days was associated with 1.190% (95% CI 0.1762.215%). For PM, therewere not statistically significant effects at any lag days, but we could find the greatest effect at lag07 that a 10-μg/m increase in concentration was associated with 0.014% (95% CI - 0.0650.093%). PM also exerted a high effect for COPD (0.185% increase; 95% CI - 0.0460.417%) when 6 days of exposures (lag6), however, no significance relationship could be found. For COPD among males, positive results were observed for PM with lags of 0-7 days, a 10-μg/m increase was 1.184% (95% CI 0.0952.284%). The effect of PM on females was also most significant at lag07, a 10-μg/m increase was 1.254% (95% CI 0.0532.469%). For those aged < 65 years old, PM was not statistically significant at all lag days, but it reached the maximum at lag07, a 10-μg/m increase was 0.978% (95% CI - 0.1392.108%). For those aged 65 ≥ years old and older, PM had a statistically significant lag effect at lag1, lag2, lag3, lag02, lag03, lag04, lag05, lag06, and lag07, and it was most significant at lag07; a 10-μg/m increase was 1.906% (95% CI 0.553~3.277%). Short-term exposure to PM was associated with increased risk of hospital visits for COPD. In particular, the elderly (aged ≥ 65 years old) and males were relatively more sensitive to PM, and were affected right away after the PM concentration went up.
截至目前，已有大量流行病学研究聚焦于大气颗粒物污染与慢性阻塞性肺疾病（COPD）之间的关联，尤其在发达国家。在中国，针对短期暴露于颗粒物（PM、PM 和 PM）与 COPD 患者同期的总门诊量之间的关联，目前仅有有限的证据。因此，本研究采用时间序列分析方法，分析了 2014 年至 2017 年期间中国兰州 PM 三种亚型（PM、PM 和 PM）与 COPD 患者每日门诊量之间的短期关联。在控制时间趋势、天气条件、星期几和节假日等因素后，采用过离散广义加性模型进行分析。同时还按年龄和性别进行了分层分析。结果显示，滞后 0-7 天 PM 浓度每增加 10μg/m，COPD 门诊就诊率增加 1.190%（95%CI：0.176-2.215%）。对于 PM，在任何滞后天数均无统计学意义，但我们发现滞后 07 天的影响最大，浓度每增加 10μg/m，COPD 门诊就诊率增加 0.014%（95%CI：-0.065-0.093%）。PM 对 COPD 的影响也很高（滞后 6 天，0.185%的增加；95%CI：-0.046-0.417%），但无统计学意义。对于男性 COPD，PM 在滞后 0-7 天存在阳性结果，浓度每增加 10μg/m，COPD 门诊就诊率增加 1.184%（95%CI：0.095-2.284%）。对于女性，PM 对 COPD 的影响在滞后 07 天最为显著，浓度每增加 10μg/m，COPD 门诊就诊率增加 1.254%（95%CI：0.053-2.469%）。对于年龄<65 岁的人群，PM 在所有滞后天数均无统计学意义，但在滞后 07 天达到最大值，浓度每增加 10μg/m，COPD 门诊就诊率增加 0.978%（95%CI：-0.139-2.108%）。对于年龄≥65 岁的老年人，PM 在滞后 1、2、3、02、03、04、05、06 和 07 天存在显著的滞后效应，在滞后 07 天最为显著；浓度每增加 10μg/m，COPD 门诊就诊率增加 1.906%（95%CI：0.553-3.277%）。短期暴露于 PM 与 COPD 患者门诊就诊风险增加相关。特别是老年人（年龄≥65 岁）和男性对 PM 更为敏感，且 PM 浓度升高后很快就会受到影响。
