2013年初灰霾期间中国三城市空气污染对呼吸内科和儿科门诊量的影响  

Respiratory and pediatric outpatient visits associated with 2013 smog episode in China

作　　者：张金良[1] 闫崴[2] 刘惠卿[3] 柴发合[1] 李立杰[3] 刘喆[1] 田兆兴[2] 王芬芬[1,4] 桑田[1,4] 王慢想[1] 邹天森[1] 张燕萍[1] 

机构地区：[1]中国环境科学研究院环境基准和风险评估国家重点实验室,北京100012 [2]北京大学第三医院 [3]河北省人民医院 [4]山西医科大学公共卫生学院

出　　处：《环境与健康杂志》2014年第10期847-852,共6页Journal of Environment and Health

基　　金：中国环境科学研究院中央级公益性科研院所基本科研业务专项(2013-YSKY-03)

摘　　要：目的观察石家庄、北京和太原灰霾期间呼吸内科、儿科每日门诊量的变化趋势,确定门诊量的增加是否与空气污染相关。方法选择石家庄、北京和太原作为研究区域,并在每个城市选择1所三甲综合性医院,收集呼吸内科、儿科每日门诊量数据,API数据来自当地环保局网站,气温数据来自天气网;数据包括两个时间序列,即2012年10月—2013年1月(T1序列)和2011年10月—2012年1月(T2序列)。在去除了门诊增量的增长趋势以后,比较T1和T2两个序列,获得门诊量的百分增量;采用Poisson回归分析研究空气污染与呼吸内科和儿科门诊量的相关性。结果2013年1月7—17日(灰霾期间),石家庄和北京某三甲医院呼吸内科和儿科门诊的百分增量达到高峰,石家庄某医院呼吸内科和儿科门诊的百分增量分别为55.5%和44.0%,北京市某医院分别为38.4%和34.1%。太原市医院相关科室的门诊量未见明显增加。Poisson回归分析显示,2013年1月,API每升高1个四分位数间距,石家庄市医院呼吸内科和儿科门诊量分别增加13.6%和13.8%,北京市医院相关科室的门诊量分别增加8.4%和8.7%,明显高于2012年1月和2012年10—12月,差异具有统计学意义(P<0.05)。太原市某医院2013年1月相关科室门诊量的增加与API的关系无统计学意义(P>0.05),而10—12月期间API增加1个四分位数间距,分别增加10.6%(lag5)和10.8%(lag3),与北京市和石家庄市的变化不同。结论 2013年1月灰霾期间,石家庄、北京市医院呼吸内科和儿科门诊量明显升高,且门诊量的增加与空气污染相关。Objective The aim of this study was to investigate whether hospital outpatient visits increased during haze event and to determine whether such increase was associated with air pollution. Methods Shijiazhuang, Beijing and Taiyuan were selected as study areas. The observation period was from Oct.2012 to Jan.2013, and the same period from earlier year. The event period was defined as Jan.2013, and the others were control periods. Daily outpatient visits records were collected from one comprehensive hospital in each city, API data were from three local Environmental Protection Agencies, and temperature data were from China Weather website. We first calculated percent increase in daily hospital visits of Oct. 2012-Jan. 2013 against Oct. 2011-Jan. 2012 with weather, weekends, and holiday effect controlled to identify the existence of haze effect. We later used Poisson regression, similarly with weather, weekends, and holiday effect controlled to estimate the relative risks both in event and control periods. Results During 7-17 Jan.2013, respiratory and pediatric outpatient visits increased significantly in Shijiazhuang and Beijing, and their percentage increase reached 55.5% and 44.0% in Shijiazhuang, and 38.4% and 34.1% in Beijing. No similar increase was observed in Taiyuan. Poisson regression suggested the higher risks in event period than in control periods both in Shijiazhuang and Beijing, but not in Taiyuan. For an interquartile range increase in API, respiratory and pediatric outpatient visits increased 13.6% and 13.8% in Shijiazhuang,8.4% and 8.7% in Beijing. The results were statistically significant. Conclusion Respiratory and pediatric outpatient visits increase significantly in the haze influenced areas, and the increase is associated with the unusually high level of air pollution during the episode period.

关 键 词：灰霾事件 空气污染 每日门诊量 呼吸内科 儿科 

分 类 号：R181.3[医药卫生—流行病学]