石家庄市大气PM2.5对儿童下呼吸道疾病门诊量的影响  

Impacts of PM2.5 on outpatient visits of children with lower respiratory tract diseasesin Shijiazhuang

作　　者：刘毅刚[1] 郝海燕[1] 袁树华[1] 赵春香[1] 张瑞琦[1] 王刚[1] 李伟 李云飞[2] LIU Yi-gang;HAO Hai-yan;YUAN Shu-hua;ZHAO Chun-xiang;ZHANG Rui-qi;WANG Gang;LI Wei;LI Yun-fei(Institute for Environmental Health Monitoring and Evaluation,Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang,Hebei 050021,China;不详)

机构地区：[1]河北省疾病预防控制中心环境卫生监测与评价所,河北石家庄050021 [2]保定市中心血站

出　　处：《环境与健康杂志》2019年第10期880-884,共5页Journal of Environment and Health

基　　金：河北省卫生计生委2017年河北省医学研究重点课题计划(20170052)

摘　　要：目的了解河北省石家庄市区空气污染现状,探讨PM2.5对儿童急性下呼吸道感染、慢性下呼吸道疾病急性发作门诊就诊量的影响。方法收集2014—2016年河北省儿童医院儿童急性下呼吸道感染和慢性下呼吸道疾病急性发作急性发作日门诊量,并获取同期PM2.5与气象资料,采用时间序列广义相加模型(GAM)控制时间、季节、星期几、节假日等效应及温度、相对湿度等混杂因素分析PM2.5与门诊量的暴露-反应关系,并分析滞后(lag1-lag7)效应以及累积滞后(lag0-1~lag0-7)效应。结果2014—2016年石家庄市PM2.5超标天数最多,PM2.5、PM10、NO2、SO2、CO超标情况不一致,5种污染物浓度的年度变化趋势基本一致,均为冬季较高。PM2.5对儿童急性下呼吸道感染、慢性下呼吸道疾病急性发作最强影响效应均出现于滞后2 d,暴露-反应关系为非线性相关。PM2.5浓度每升高10μg/m3,急性下呼吸道感染患者每日就诊人次上升0.988%(95%CI:0.046%~1.939%),慢性下呼吸道疾病急性发作急性发作患者就诊人次上升0.407%(95%CI:0.212%~0.603%)。结论石家庄市大气PM2.5对儿童急性下呼吸道感染具有急性效应,还能引起慢性下呼吸道疾病急性发作。Objective To understand the current air pollution in Shijiazhuang,Hebei province,and to clarify the impact of PM2.5 on the outpatient visits of children with acute and chronic lower respiratory tract diseases.Methods The daily outpatients of children with acute and chronic lower respiratory tract diseases in Hebei Province Children’s Hospital from 2014 to 2016 were collected,and PM2.5 and meteorological data were obtained in the same period.Time series generalized additive model(GAM)was used to control time,season,day of the week and holidays effects,temperature,humidity and other confounding factors,and to describe the lag(lag1-lag7)effect and cumulative lag(from lag0-1 to lag0-7)effects of PM2.5 on daily outpatients.Results During 2014-2016,the concentrations of ambient PM2.5,PM10,NO2,SO2 and CO in Shijiazhuang exceeded the national standard in different degrees,the number of days with higher daily PM2.5 concentrations exceeded the national standard was the highest,the daily concentrations of the five air pollutants presented basically the same variation trends,all of which increased in winter.The maximum effects of PM2.5 on daily outpatients of acute lower respiratory tract infection and acute attack of chronic lower respiratory tract diseases occurred at lag 2 days,and the exposure-response relationship was nonlinear and had a threshold effect.With an increase of 10μg/m3 PM2.5,the daily outpatients increased by 0.988%(95%CI:0.046%-1.939%)for acute lower respiratory tract infection,as well as 0.407%(95%CI:0.212%-0.603%)for acute attack of chronic lower respiratory tract disease among children respectively.Conclusion Ambient PM2.5 in Shijiazhuang not only has an acute effect on the lower respiratory tract infection,but also acute attack of chronic lower respiratory tract diseases among children.

关 键 词：PM2.5 儿童 下呼吸道疾病 广义相加模型 石家庄 

分 类 号：R725.6[医药卫生—儿科] X513[医药卫生—临床医学]