College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 73000, China.
School of Public Health, Gansu University of Chinese Medicine, Lanzhou, 73000, China.
Environ Geochem Health. 2023 Mar;45(3):941-959. doi: 10.1007/s10653-022-01256-2. Epub 2022 Apr 6.
The aim of this study was to assess the effects of air pollutants on hospital admissions for respiratory disease (RD) by using distributed lag nonlinear model (DLNM) in Lanzhou during 2014-2019. In this study, the dataset of air pollutants, meteorological, and daily hospital admissions for RD in Lanzhou, from January 1st, 2014 to December 31st, 2019, were collected from three national environmental monitoring stations, China meteorological data service center, and three large general hospitals, respectively. A time-series analysis with DLNM was used to estimate the associations between air pollutants and hospital admissions for RD including the stratified analysis of age, gender, and season. The key findings were expressed as the relative risk (RR) with a 95% confidence interval (CI) for single-day and cumulative lag effects (0-7). A total of 90, 942 RD hospitalization cases were identified during the study period. The highest association (RR, 95% CI) of hospital admissions for RD and PM (1.030, 1.012-1.049), and PM (1.009, 1.001-1.015), and NO (1.047, 1.024-1.071) were observed at lag 07 for an increase of 10 μg/m in the concentrations, and CO at lag07 (1.140, 1.052-1.236) for an increase of 1 mg/m in the concentration. We observed that the RR estimates for gaseous pollutants (e.g., CO and NO) were larger than those of particulate matter (e.g., PM and PM). The harmful effects of PM, PM, NO, and CO were greater in male, people aged 0-14 group and in the cold season. However, no significant association was observed for SO, O8h, and total hospital admissions for RD. Therefore, some effective intervention strategies should be taken to strengthen the treatment of the ambient air pollutants, especially gaseous pollutants (e.g., CO and NO), thereby, reducing the burden of respiratory diseases.
本研究旨在使用分布式滞后非线性模型(DLNM)评估 2014-2019 年兰州地区空气污染物对呼吸系统疾病(RD)住院的影响。本研究分别从国家环境监测站、中国气象数据服务中心和三家大型综合医院收集了 2014 年 1 月 1 日至 2019 年 12 月 31 日期间的兰州地区空气污染物、气象和每日 RD 住院数据。采用 DLNM 时间序列分析方法,估计了空气污染物与 RD 住院的关联,包括年龄、性别和季节的分层分析。主要发现以单日和累积滞后效应(0-7)的相对风险(RR)表示,置信区间(CI)为 95%。在研究期间共确定了 90942 例 RD 住院病例。与 RD 住院相关性最高的(RR,95%CI)为 PM(1.030,1.012-1.049)、PM(1.009,1.001-1.015)和 NO(1.047,1.024-1.071),浓度增加 10μg/m,CO 在滞后 07 时(1.140,1.052-1.236),浓度增加 1mg/m。我们发现气态污染物(如 CO 和 NO)的 RR 估计值大于颗粒物(如 PM 和 PM)的 RR 估计值。PM、PM、NO 和 CO 的有害影响在男性、0-14 岁组和寒冷季节更大。然而,SO、O8h 和总 RD 住院之间没有观察到显著关联。因此,应采取一些有效的干预策略来加强对环境空气污染物的治疗,特别是气态污染物(如 CO 和 NO),从而降低呼吸系统疾病的负担。