Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
Shanghai Bluecross Medical Science Institute, Shanghai, China.
Front Public Health. 2021 Oct 26;9:749191. doi: 10.3389/fpubh.2021.749191. eCollection 2021.
There has been a recent worsening of air pollution in China, which poses a huge threat to public health by inducing and promoting circulatory and respiratory diseases. This study aimed to explore the association between the concentration of air pollution and daily internal medicine outpatient visits registered for the treatment of circulatory and respiratory symptoms in Zhoushan, China using a time-series method. We validated and acquired the daily internal medicine outpatient visits records between January 1, 2014, and December 31, 2019, from the Zhoushan Center for Disease Control and Prevention in Zhejiang, China. Further, we collected the daily average records of the ambient air pollutants from the Zhoushan Environmental Monitoring Centre within the same duration. A generalized additive model with the natural splines was constructed to explore the association between the ambient air pollutants and daily internal medicine outpatient visits. Further, we conducted a lag analysis by using the distributed lag non-linear model to estimate the time-delayed effects of the air pollutants on the daily internal medicine outpatient visits. A total of 2,190,258 daily internal medicine outpatient visits with a mean of 202.4 visits per day were recorded. The non-linear relationships were found among particulate matter (PM), sulfur dioxide (SO), and the daily internal medicine outpatient visits. Overall, PM was positively correlated with the daily internal medicine outpatient visits. Both ozone (O) and SO had significant delayed effects on the daily internal medical outpatient numbers; however, PM only showed a short-term risk. Short-term exposure to PM was associated with an increase in the daily internal medicine outpatient visits for circulatory and respiratory diseases/symptoms in Zhoushan, China. SO and O were shown to induce significant effects after a concentration-dependent time lag.
中国近期的空气污染情况有所恶化，这通过诱发和促进循环和呼吸系统疾病，对公众健康构成了巨大威胁。本研究旨在采用时间序列方法探讨中国舟山地区空气污染浓度与因循环和呼吸系统症状就诊的内科每日门诊量之间的关联。
我们验证并获取了中国浙江舟山疾病预防控制中心 2014 年 1 月 1 日至 2019 年 12 月 31 日的每日内科门诊就诊记录。此外，我们还收集了同期内舟山环境监测中心的每日环境空气污染物的平均记录。采用广义加性模型与自然样条构建了一个模型，以探讨环境空气污染物与每日内科门诊就诊量之间的关系。此外，我们通过使用分布式滞后非线性模型进行滞后分析，以估计污染物对每日内科门诊就诊量的时间延迟效应。
共记录了 2190258 例每日内科门诊就诊，平均每天就诊 202.4 例。发现颗粒物（PM）、二氧化硫（SO）与每日内科门诊就诊量之间存在非线性关系。总体而言，PM 与每日内科门诊就诊量呈正相关。臭氧（O）和 SO 对每日内科门诊就诊人数均有显著的滞后效应，而 PM 仅显示短期风险。
短期暴露于 PM 与中国舟山因循环和呼吸系统疾病/症状就诊的每日内科门诊就诊量增加有关。SO 和 O 在浓度相关的时间滞后后显示出显著的影响。
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