冬季颗粒物暴露对大学生1s最大呼气量及呼吸道症状的急性影响  

Acute effects of particulate matter on FEV1 and respiratory symptoms of college students in winter

作　　者：张云权[1] 马露[1] 朱耀辉[1] 龙璇[1] 李锐[2] 王素青[2] 田村宪治 岛正之 

机构地区：[1]武汉大学公共卫生学院流行病与卫生统计学系,430071 [2]武汉大学公共卫生学院营养与食品卫生学系 [3]日本国立环境研究所环境健康研究综合影响评价研究室 [4]日本兵库医科大学公共卫生学系

出　　处：《中华预防医学杂志》2015年第4期350-355,共6页Chinese Journal of Preventive Medicine

基　　金：湖北省卫计委一般项目（JX6859）

摘　　要：目的：研究冬季室内外空气中细颗粒物（PM2.5）、可吸入颗粒物（PM10）的短期暴露对大学生呼吸道症状以及1 s最大呼气量（FEV1）的影响。方法整群选取武汉市某大学2年级37名学生作为调查对象，采用固定群组追踪研究的方法，于2009年12月23日—2010年1月5日连续14 d，测定其早晚FEV1，并记录每日是否出现咳嗽、咳痰、流鼻涕等呼吸道症状，同时监测室内外PM2.5、PM10浓度和温湿度变化。构建广义估计方程（GEE）模型定量评价颗粒物暴露对学生呼吸道症状以及FEV1的影响。结果调查期间室内、外PM2.5日均浓度分别为（110.6±42.3）、（143.5±51.2）μg/m3，PM10日均浓度分别为（148.2±43.2）、（239.1±71.3）μg/m3。研究未发现当日（lag 0 d）室外PM2.5的暴露对晚上FEV1有急性影响，室外PM2.5浓度每升高10μg/m3，其滞后1 d（lag 1 d）、滞后0～1 d（lag 0～1 d）、滞后0～2 d（lag 0～2 d）的FEV1分别改变-0.28%（95%CI：-0.52%～-0.03%）、-0.45%（95%CI：-0.81%～-0.08%）和-0.63%（95%CI：-1.15%～-0.11%）。在出现的咳嗽、咳痰和流鼻涕等症状中，咳痰的发生风险随室内外颗粒物浓度升高而增加，其中，室内、室外当日PM2.5浓度升高10μg/m3，咳痰症状发生的风险分别增加为1.18（95%CI：1.02~1.36）、1.08（95%CI：0.97～1.19）。并且，随着室内外PM2.5、PM10滞后时间和累积时间的增加，发生咳痰症状的风险均呈上升趋势。结论武汉市冬季颗粒物的短期暴露对大学生呼吸道症状和FEV1存在急性影响，并伴随滞后和累积的天数增加其影响呈现加重趋势。Objective To evaluate the acute effects of indoor and outdoor particulate matter on lung function and respiratory symptoms of college students in winter. Methods A panel of 37 college students aged 19-21 in Wuhan were included and the investigation was carried out from 12/23/2009 to 01/05/2010. Daily morning/evening forced expiratory volume in one second（FEV1） and respiratory symptoms （cough, phlegm and runny） were measured and reported by subjects, respectively. Meanwhile, daily data of indoors and outdoors PM10, PM2.5, temperature, and relative humidity were collected. Generalized Estimating Equations（GEEs） were used to estimate the association between particulate matters exposure and respiratory symptoms and FEV1. Results Average daily concentrations of indoor, outdoor PM2.5 during the study period were（110.6 ± 42.3）,（143.5 ± 51.2） μg/m3,（148.2 ± 43.2） and（239.1 ± 71.3） μg/m3 for indoor, outdoor PM10, respectively. Outdoor exposure to PM2.5 on lag 0 had little effect on evening FEV1. However, researchers observed a significant lagging effect（lag 1 d） and accumulative effect（lag 0-1 d and lag 0-2 d）. A rise in the PM2.5 concentration of 10μg/m3 resulted in the change of evening FEV1 of-0.28%（95%CI：-0.52%,-0.03%）,-0.45%（95%CI：-0.81%,-0.08%） and-0.63%（95%CI：-1.15%,-0.11%）, respectively. For respiratory symptoms of coughing up phlegm, 10 mg/m3 increase of indoor/outdoor PM2.5 concentration were associated with odds ratio of 1.18（95%CI：1.02-1.36） and 1.08（95%CI：0.97-1.19）, respectively. Moreover, risk of coughing up phlegm increased with lagging time, and accumulative time of indoor and outdoor PM2.5 and PM10. Conclusion Our study suggested that short-term exposure to particulate matters in winter was significantly associated with acute changes of respiratory symptoms and FEV1 of college students in Wuhan. Moreover, the effects of particulate matters tended to be larger as the increase of lagged and accumulative days.

关 键 词：颗粒物 呼吸功能试验 呼吸道症状 大学生 

分 类 号：R56[医药卫生—呼吸系统]