盐城市空气污染物对手足口病发生风险的影响研究  

Influence of air pollutants on occurrence risk of hand-foot-mouth disease in Yancheng City

作　　者：卢小敏[1,2] 储海燕 吴冬梅[1] 孙中友[3] LU Xiao min1,2 , CHU Hai-yan1 , WU Dong mei1 , SUN Zhong-you3(1.School of Public Health, Nanjing Medical University, Jiangsu Nanjing 211166, China ; 2.Jiangsu Vocational College of Medicine, Jiangsu Yancheng 224005, China ; 3.Yancheng Municipal Center for Disease Control and Prevention, Jiangsu Yancheng 224000, Chin)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]江苏医药职业学院,江苏盐城224005 [3]盐城市疾病预防控制中心,江苏盐城224000

出　　处：《中国妇幼健康研究》2018年第3期276-280,共5页Chinese Journal of Woman and Child Health Research

基　　金：江苏高校品牌专业建设工程资助项目(项目编号:PPZY2015A067);江苏省高校自然科学研究面上资助项目(15KJB330002);江苏高校优势学科建设工程资助项目

摘　　要：目的探讨盐城市各区县空气污染物可吸入颗粒物(PM_(10))、二氧化硫(SO_2)、二氧化氮(NO_2)对手足口病发病风险的影响。方法收集2005-2015年盐城市内9个区县手足口病的发病资料及同期空气污染物浓度、气象水平资料。采用广义相加模型(GAM),在控制气象因素、时间趋势及"星期几效应"的影响下,探索各区县不同时限内不同滞后天数(lag days)的空气污染物(PM_(10)、SO_2和NO_2)与手足口病发病之间的关系,最终对9个区县的结果进行Meta分析,进一步获取综合效应。结果 Spearman相关分析显示,9个区县中PM_(10)、SO_2、NO_2两两间存在正相关关系(r>0,P<0.05),总体上来说,三种污染物与平均温度和相对湿度存在负相关关系(r<0,P<0.05)。广义相加模型及Meta分析结果显示,滞后两天(lag 2)时,日均浓度每上升10μg/m^3,PM_(10)、SO_2和NO_2可分别导致盐城市居民手足口病发生风险增加0.38%(95%CI:0.03~0.73)、1.98%(95%CI:0.34~3.65)及1.59%(95%CI:0.53~2.66)。同时,多污染物模型结果表明,当一种或多种污染物引入模型后,NO_2对手足口病发病的影响差异始终存在统计学意义(双污染模型:调整PM_(10):Z=2.73,P=0.06;调整SO_2:Z=2.84,P=0.04;三污染模型:Z=2.64,P=0.08)。结论盐城市内空气污染物(PM_(10)、SO_2和NO_2)可能会导致手足口病的风险增加,应加强污染物的控制,降低手足口病的发病率。Objective To explore the influence of particulate matter （PM10）, sulfur dioxide （SO2） and nitrogen dioxide （NO2） on the occurrence risk of hand foot-mouth disease （HFMD） in every district and county of Yancheng City. Methods Incidence data of HFMD in 9 districts and counties of Yancheng during 2005--2015 as well as data of air pollutant concentrations and meteorological conditions in corresponding period were collected. Generalized additive model （GAM） was used to explore the relationship between occurrence of HFMD and air pollutants （PM10, SO2 and NO2） of different lag days in different time of each district and county, after adjusting effects of meteorological factors, long-term trend and ＂day of week＂. Finally, meta-analysis was performed on results of these 9 districts and counties to further obtain comprehensive effects. Results Spearman correlation analysis showed that there was a positive correlation between any two of PM10, SO2 and NO2 （r〉0, P〈0.05） in 9 districts and counties. As a whole, the three pollutants were negatively correlated with mean temperature and relative humidity （r〈0, P〈0.05）. Results of GAM and meta-analysis indicated that when lagging for 2 days, an increase of 10μg/m^3 in daily mean concentration of PM10, SO2 and NO2 could increase the occurrence risk of HFMD by 0.38% （95%CI：0.03%-0.73%）, 1.98% （95%CI： 0.34%-3.65%） and 1.59%（95%CI： 0.53%-2.66%）, respectively. Meanwhile, the results of multi-pollutant model showed that when one or more pollutants were introduced to the model, differences in the influence of NO2 on the occurrence of HFMD were always statistically significant （Double-pollutant model： Adjusting PM10 ： Z = 2.73, P = 0.06 ; Adiusting SO2 ： Z = 2.84, P = 0. 004; Three-pollutant model：Z=2.64, P = 0. 08）. Conclusion Air pollutants （PM10, SO2 and NO2 ） in Yancheng City may lead to an increase of occurrence risk of HFMD. Therefore, detection of these pollutants should be strengthened to reduce the inc

关 键 词：手足口病 广义相加模型 空气污染物可吸入颗粒物 二氧化硫 二氧化氮 

分 类 号：R725.1[医药卫生—儿科]