临汾市大气PM_(10)与5岁以下儿童呼吸系统疾病住院的浓度-反应关系研究  

Concentration-response relationship between PM_(10) and respiratory disease hospital admissions of children in Linfen, China

作　　者：杨钊[1,2] 张燕萍[3] 桑田[1,2] 赵宝新[3] 张金良[2] 

机构地区：[1]山西医科大学公共卫生学院,山西太原030001 [2]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 [3]太原市疾病预防控制中心

出　　处：《环境与健康杂志》2015年第12期1042-1049,共8页Journal of Environment and Health

基　　金：国家重点实验室自由探索基金

摘　　要：目的研究并描述高浓度PM_(10)与5岁以下儿童呼吸系统疾病日住院例数之间的浓度-反应关系及曲线特征。方法儿童呼吸系统疾病住院数据为2004—2006年临汾市主要的5所医院的电子病历首页,空气质量数据为市内5个空气监测点的PM_(10)、SO_2和NO_2日平均值,气象数据为当地的日平均气温和相对气湿。应用广义相加模型(GAM)建立浓度-反应关系;以多重结构断裂点检测法确定浓度-反应关系曲线上的拐点;以约束性分段线性函数估计相对危险度。结果临汾市大气PM_(10)的平均浓度为185.1μg/m^3(范围为45.3~1 109.2μg/m^3),PM_(10)与5岁以下儿童呼吸系统疾病日住院例数的浓度-反应关系曲线明显偏离线性,以J型为主。PM_(10)的影响主要表现为多日的累积影响,在141.8~676.0μg/m^3的浓度范围,全年中累积5 d(avg04)的PM_(10)浓度每升高10μg/m^3,5岁以下儿童呼吸系统疾病日住院例数增加2.03%(95%CI:1.28%~2.79%)。PM_(10)的影响主要发生于采暖期,在109.7~634.7μg/m3的浓度范围,累积7 d(avg06)的PM_(10)每升高10μg/m^3,5岁以下儿童呼吸系统疾病日住院例数增加2.24%(95%CI:1.29%~3.19%);在非采暖期未见明显影响。结论高浓度PM_(10)与5岁以下儿童呼吸系统疾病日住院例数的浓度-反应关系曲线呈J型,低浓度范围内的C型曲线无统计学意义。Objective To determine the shape of concentration-response function between PM_（10） and pediatric respiratory hospital admissions within a high concentration range of PM_（10）. Methods Medical abstract records were collected from five major hospitals in Taiyuan during the period from 2004 to 2006. Air pollution data（24-hour average of PM_（10）, SO_2, and NO_2）were collected from five local environmental monitoring points, and the weather data（24-hour average of temperature and humidity） were from Shanxi Meteorology Agency. Generalized additive models（GAM） with log link and Poisson error was used to estimate the shape of the concentration response function. Constrained piecewise linear function was used to estimate the relative risks, with change points dynamically estimated by structural-change-detection algorithm. Results The average concentration of PM_（10） was 185.1 μg/m^3（range：45.3-1 109.2 μg/m3）, and we identified the shape of concentration-response function between PM_（10） and pediatric respiratory hospital admissions mainly in J shape. The influence of PM_（10） mainly for the cumulative effect, within the concentration range of 141.8-676.0 μg/m3, a 10 μg/m3 increase in PM_（10） was associated with 2.03%increase（95% CI： 1.28%-2.79%; avg04）. For season analysis, the influence of PM_（10） mainly in heating period, within the concentration range of 109.7-634.7 μg/m3, a 10 μg/m3 increase in PM_（10） was associated with 2.24% increase（95%CI： 1.29%-3.19%; avg06）. In non-heating period, there was no significant influence. Conclusion The shape of concentration-response function between high concentration PM_（10） and pediatric respiratory admissions is in J shape.

关 键 词：PM10 儿童 呼吸系统疾病 住院 浓度-反应关系 

分 类 号：R181.3[医药卫生—流行病学]