Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University/Hebei Key Laboratory of Respiratory Critical Care, No. 215 Heping West Road, Shijiazhuang, 050000, China.
Department of Biological Pharmacy, Hebei Medical University, Shijiazhuang, 050000, China.
Sci Rep. 2022 May 24;12(1):8711. doi: 10.1038/s41598-022-12791-4.
Epidemiological evidence of the effect of high-level air pollution and its interaction with meteorological factors on the risk of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is limited. Daily data on AECOPD cases, air pollutants and meteorological factors were collected from 2015 to 2018 in Shijiazhuang. A distributed lag non-linear model (DLNM) was used to explore the lag and cumulative effect of PM on the risk of AECOPD. The effect of the interaction between PM and meteorological factors on AECOPD was estimated by a generalized additive model (GAM) and a stratification model. A total of 4766 patients with AECOPD were enrolled. After controlling for confounders, each 10 μg/m increase in PM led to a 5.8% increase in the risk of AECOPD on day lag 0. The cumulative effect of PM on AECOPD risk showed an increasing trend after 3 days. Similar results were observed in both smoking and non-smoking patients. There was an interaction between PM and meteorological factors, and the risk of AECOPD was higher in cold and lower humidity conditions than in other conditions. High-level PM exposure is positively associated with the risk of AECOPD onset, and the effect of PM can be modified by the temperature and relative humidity. Public health guidelines should pay close attention to AECOPD risk under the condition of high-level PM with low temperature or low humidity.
大气污染水平及其与气象因素相互作用对慢性阻塞性肺疾病急性加重（AECOPD）风险的影响的流行病学证据有限。本研究于 2015 年至 2018 年在石家庄市收集了每日 AECOPD 病例、空气污染物和气象因素数据。采用分布滞后非线性模型（DLNM）来探讨 PM 对 AECOPD 风险的滞后和累积效应。采用广义相加模型（GAM）和分层模型来估计 PM 与气象因素相互作用对 AECOPD 的影响。共纳入 4766 例 AECOPD 患者。在控制混杂因素后，PM 每增加 10μg/m，AECOPD 的风险增加 5.8%（lag 0）。PM 对 AECOPD 风险的累积效应在 3 天后呈上升趋势。在吸烟和非吸烟患者中均观察到类似结果。PM 与气象因素之间存在交互作用，在寒冷和低湿度条件下，AECOPD 的风险更高。高水平 PM 暴露与 AECOPD 发病风险呈正相关，PM 的作用可通过温度和相对湿度来修饰。在低温或低湿度的高水平 PM 条件下，公共卫生指南应密切关注 AECOPD 风险。
