Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
Environ Sci Pollut Res Int. 2021 Jun;28(23):29820-29830. doi: 10.1007/s11356-021-12828-7. Epub 2021 Feb 10.
Ambient air pollutants have been linked to adverse health outcomes, but evidence is still relatively rare in college students. Upper respiratory tract infection (URTI) is a common disease of respiratory system among college students. In this study, we assess the acute effect of air pollution on clinic visits of college students for URTI in Wuhan, China. Data on clinic visits due to URTI were collected from Wuhan University Hospital, meteorological factors (including daily temperature and relative humidity) provided by Wuhan Meteorological Bureau, and air pollutants by Wuhan Environmental Protection Bureau. In the present study, generalized additive model with a quasi-Poisson distribution link function was used to examine the association between ambient air pollutants (fine particulate matter (PM), particulate matter (PM), sulfur dioxide (SO), nitrogen dioxide (NO), and ozone (O)) and the daily number of clinic visits of college students for URTI at Wuhan University Hospital in Wuhan, China. In the meantime, the model was adjusted for the confounding effects of long-term trends, seasonality, day of the week, public holidays, vacation, and meteorological factors. The best degrees of free in model were selected based on AIC (Akaike Information Criteria). The effect modification by gender was also examined. A total of 44,499 cases with principal diagnosis of URTI were included from January 1, 2016, to December 31, 2018. In single-pollutant models, the largest increment of URTI visits were found at lag 0 day in single-day lags, and the effect values in cumulative lags were greater than those in single-day lags. PM (0.74% (95%CI: 0.05, 1.44)) at lag 0 day, PM (0.61% (95%CI: 0.12, 1.11)) and O (1.01% (95%CI: 0.24, 1.79)) at lag 0-1 days, and SO (9.18% (95%CI: 3.27, 15.42)) and NO (3.40% (95% CI:1.64, 5.19)) at lag 0-3 days were observed to be strongly and significantly associated with clinic visits for URTI. PM and NO were almost still significantly associated with URTI after controlling for the other pollutants in our two-pollutant models, where the effect value of SO after inclusion of O appeared to be the largest and the effects of NO were also obvious compared with the other pollutants. Subgroups analysis demonstrated that males were more vulnerable to PM and O, while females seemed more vulnerable to exposure to SO and NO. This study implied that short-term exposure to ambient air pollution was associated with increased risk of URTI among college students at Wuhan University Hospital in Wuhan, China. And gaseous pollutants had more negative health impact than solid pollutants. SO and NO were the major air pollutants affecting the daily number of clinic visits on URTI, to which females seemed more vulnerable than males.
大气污染物与不良健康后果有关，但在大学生中，相关证据仍然相对较少。上呼吸道感染（URTI）是大学生常见的呼吸系统疾病。本研究评估了空气污染对中国武汉大学生URTI 就诊的急性影响。URTI 就诊数据来自武汉大学医院，气象因素（包括日温度和相对湿度）由武汉气象局提供，空气污染物由武汉环境保护局提供。在本研究中，使用具有拟泊松分布链接函数的广义加性模型来检验环境空气污染物（细颗粒物（PM）、颗粒物（PM）、二氧化硫（SO）、二氧化氮（NO）和臭氧（O））与中国武汉武汉大学医院大学生 URTI 每日就诊次数之间的关联。同时，该模型还调整了长期趋势、季节性、星期几、节假日、假期和气象因素的混杂影响。根据 AIC（Akaike 信息准则）选择模型的最佳自由度。还检查了性别对模型的修饰作用。2016 年 1 月 1 日至 2018 年 12 月 31 日，共纳入了 44499 例主要诊断为 URTI 的病例。在单污染物模型中，在单日滞后中发现 URTI 就诊次数的最大增量出现在滞后 0 天，累积滞后的效应值大于单日滞后的效应值。PM（滞后 0 天 0.74%（95%CI：0.05，1.44））、PM（滞后 0-1 天 0.61%（95%CI：0.12，1.11））和 O（滞后 0-1 天 1.01%（95%CI：0.24，1.79））和 SO（滞后 0-3 天 9.18%（95%CI：3.27，15.42））和 NO（滞后 0-3 天 3.40%（95%CI：1.64，5.19））与 URTI 就诊明显相关。在我们的双污染物模型中控制其他污染物后，PM 和 NO 仍与 URTI 显著相关，而纳入 O 后 SO 的效应值似乎最大，与其他污染物相比，NO 的影响也很明显。亚组分析表明，男性对 PM 和 O 更敏感，而女性对 SO 和 NO 的暴露似乎更敏感。本研究表明，短期暴露于环境空气污染与中国武汉武汉大学医院大学生 URTI 风险增加有关。气态污染物比固体污染物对健康的负面影响更大。SO 和 NO 是影响 URTI 每日就诊人数的主要空气污染物，女性似乎比男性更易受其影响。
