Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Huayun Sounding Meteorology Technology Corporation, Beijing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Nanjing University of Information Science & Technology, Nanjing, China.
Environ Pollut. 2023 Dec 1;338:122665. doi: 10.1016/j.envpol.2023.122665. Epub 2023 Oct 6.
The co-occurrence of fine particulate matter (PM) and ozone (O) pollution during the warm season has become a growing public health concern. The interaction between PM and O and its contribution to disease burden associated with co-pollution has not been thoroughly examined. We collected data on hospital admissions for respiratory diseases from a city-wide hospital discharge database in Beijing between 2013 and 2019. City-wide 24-h mean PM and daily maximum 8-h mean O were averaged from 35 monitoring stations across Beijing. Conditional Poisson regression was employed to estimate the interaction between warm-season PM and O on respiratory admissions. A model incorporating a tensor product term was used to fit the non-linear interaction and estimate the number of respiratory admissions attributable to PM and O pollution. From January 18, 2013 to December 31, 2019, 1,191,308 respiratory admissions were recorded. We observed multiplicative interactions between warm-season PM and O on upper respiratory infections (P = 0.004), pneumonia (P = 0.002), chronic obstructive pulmonary disease (P = 0.041), and total respiratory disease (P < 0.001). PM-O co-pollution during warm season exhibited a super-additive effect on respiratory admissions, with a relative excess risk due to interaction of 1.65% (95%CI: 0.46%-2.84%). There was a non-linear pattern of the synergistic effect between PM and O on respiratory admissions. Based on the World Health Organization global air quality guidelines, 12,421 respiratory admissions would be reduced if both daily PM and O concentrations had not exceeded the target (PM 15 μg/m, O 100 μg/m). The number of respiratory admissions attributable to either PM or O pollution decreased by 48.7% from 2013 to 2019. Prioritizing O control during the warm season is a cost-effective strategy for Beijing. These findings underscore the significance of concurrently addressing both PM pollution and O pollution during the warm season to alleviate the burden of respiratory diseases.
在暖季，细颗粒物（PM）和臭氧（O）污染的同时出现已成为日益严重的公共卫生问题。PM 和 O 之间的相互作用及其对与共污染相关的疾病负担的贡献尚未得到彻底研究。我们从北京市一家全市范围的医院出院数据库中收集了 2013 年至 2019 年期间因呼吸道疾病住院的数据。从北京市 35 个监测站平均得出了全市 24 小时平均 PM 和每日最大 8 小时平均 O。采用条件泊松回归估计了暖季 PM 和 O 对呼吸道疾病住院的相互作用。采用张量积项的模型拟合了非线性相互作用，并估计了归因于 PM 和 O 污染的呼吸道疾病住院人数。从 2013 年 1 月 18 日至 2019 年 12 月 31 日，共记录了 1191308 例呼吸道疾病住院。我们观察到，上呼吸道感染（P = 0.004）、肺炎（P = 0.002）、慢性阻塞性肺疾病（P = 0.041）和总呼吸道疾病（P < 0.001）中，暖季 PM 和 O 之间存在着乘法相互作用。PM-O 共污染对呼吸道疾病住院具有超相加效应，交互作用的相对超额风险为 1.65%（95%CI：0.46%-2.84%）。PM 和 O 对呼吸道疾病住院的协同作用呈非线性模式。根据世界卫生组织全球空气质量指南，如果每日 PM 和 O 浓度均未超过目标值（PM 15μg/m，O 100μg/m），那么将减少 12421 例呼吸道疾病住院。2013 年至 2019 年，归因于 PM 或 O 污染的呼吸道疾病住院人数减少了 48.7%。在暖季优先控制 O 是北京的一项具有成本效益的策略。这些发现强调了在暖季同时应对 PM 污染和 O 污染以减轻呼吸道疾病负担的重要性。
