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[空气污染物对兰州特应性皮炎门诊就诊率的影响]

[Effects of Air Pollutants on Outpatient Visits for Atopic Dermatitis in Lanzhou].

作者信息

He Yuan, Shi Chun-Rui, Guang Qi, Luo Zhi-Cheng, Xi Qun, Han Lei

机构信息

Department of Dermatovenereology,The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China.

Department of Dermatology,Lanzhou 730000,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Aug;43(4):521-530. doi: 10.3881/j.issn.1000-503X.13046.

Abstract

Objective To quantitatively evaluate the associations of PM,PM,NO,and SO concentrations with the outpatient visits for atopic dermatitis in Lanzhou. Methods The data of outpatient visits,together with meteorological data and air pollutant data,from January 2013 to December 2017 were collected.The generalized additive model based on Poisson distribution was employed to study the lag effects of PM,PM,NO,and SO concentrations on the visits of outpatients,with the seasonal and long-term trends and day-of-the-week effect controlled. Results The results of the single pollutant model showed that PM and PM had the most obvious while still insignificant impact on the outpatient visits for atopic dermatitis on the current day(lag0).NO also had the most obvious impact in the case of lag0 and showed a lag effect.For each 10 μg/m increase in NO concentration,the excess risk(ER)of outpatient visits for atopic dermatitis was 1.95%(95% =1.09%-2.82%,=0.01).SO had the most significant effect on lag6,and the outpatient visits increased by 1.55%(95% =0.48%-2.54%)for every 10 μg/m rise in SO concentration(=0.02).Females were more sensitive to PM and SO than males.For every 10 μg/m increase in PM and SO,the female outpatient visits increased by 0.02% and 2.47%,respectively.Males were sensitive to PM and NO,and the every 10 μg/m rise in PM and NO increased male outpatient visits by 0.47% and 1.78%,respectively.Gaseous pollutants(NO and SO)had more significant effect on people ≤2 years old than on those of other ages.Every 10 μg/m rise in NO and SO would increase the ≤2-year-old outpatient visits by 2.35% and 1.57%,respectively(=0.02).People of 13-59 years old were sensitive to NO concentration,and every 10 μg/m rise in NO concentration increased their visits by 1.39%.NO affected the outpatient visits during the cold and warm seasons,with the ER values of 2.35% and 1.89%,respectively(=0.01).Particulate matter(PM and PM)had the most obvious yet insignificant association with the outpatient visits in winter.The interactions between PM and NO,between PM and NO,and between SO and NO affected the total outpatient visits for atopic dermatitis.The results of double pollutant model showed that in the presence of PM,PM,or SO,the effect of NO on the outpatient visits for atopic dermatitis enhanced compared with that predicted by single pollutant model(=0.01). Conclusion The air pollutants(PM,PM,NO,and SO)in Lanzhou were closely related to the outpatient visits for atopic dermatitis,and the increased concentrations of NO and SO was more likely to increase the risk of atopic dermatitis.

摘要

目的 定量评估兰州市空气中PM、PM、NO和SO浓度与特应性皮炎门诊就诊量之间的关联。方法 收集2013年1月至2017年12月的门诊就诊数据、气象数据和空气污染物数据。采用基于泊松分布的广义相加模型,研究PM、PM、NO和SO浓度对门诊就诊量的滞后效应,并控制季节和长期趋势以及星期效应。结果 单污染物模型结果显示,PM和PM对当日(滞后0天)特应性皮炎门诊就诊量的影响最为明显但仍不显著。NO在滞后0天的情况下影响也最为明显且呈现滞后效应。NO浓度每升高10 μg/m,特应性皮炎门诊就诊的超额风险(ER)为1.95%(95%可信区间=1.09%-2.82%,P=0.01)。SO对滞后6天的影响最为显著,SO浓度每升高10 μg/m,门诊就诊量增加1.55%(95%可信区间=0.48%-2.54%,P=0.02)。女性对PM和SO比男性更敏感。PM和SO浓度每升高10 μg/m,女性门诊就诊量分别增加0.02%和2.47%。男性对PM和NO敏感,PM和NO浓度每升高10 μg/m,男性门诊就诊量分别增加0.47%和1.78%。气态污染物(NO和SO)对2岁及以下人群的影响比对其他年龄段人群更显著。NO和SO浓度每升高10 μg/m,2岁及以下人群的门诊就诊量分别增加2.35%和1.57%(P=0.02)。13-59岁人群对NO浓度敏感,NO浓度每升高10 μg/m,其门诊就诊量增加1.39%。NO在寒冷和温暖季节均影响门诊就诊量,ER值分别为2.35%和1.89%(P=0.01)。颗粒物(PM和PM)与冬季门诊就诊量的关联最为明显但不显著。PM与NO、PM与NO以及SO与NO之间的相互作用影响特应性皮炎的总门诊就诊量。双污染物模型结果显示,在存在PM、PM或SO的情况下,NO对特应性皮炎门诊就诊量的影响比单污染物模型预测的增强(P=0.01)。结论 兰州市空气污染物(PM、PM、NO和SO)与特应性皮炎门诊就诊量密切相关,NO和SO浓度升高更易增加患特应性皮炎的风险。

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