张家口市PM2.5浓度与某医院呼吸科门诊人数的相关性分析  

Relationship Between the Concentration of PM2.5 in Ambient Air and the Number of Daily Outpatients in Respiratory Deparment of A Hospital in Zhangjiakou City

作　　者：马丽 陈红艳 MA Li;CHEN Hongyan(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《预防医学情报杂志》2020年第5期614-618,共5页Journal of Preventive Medicine Information

摘　　要：目的探讨张家口市PM2.5浓度对某院呼吸科日均门诊人数的影响。方法收集2016-01/2018-12河北北方学院附属第一医院呼吸科门诊患者资料及同期张家口地区气象监测和环境检测数据,对气象指标、环境污染指标、呼吸科门诊日均人数进行描述性分析。将泊松回归模型引入广义加性模型(GAM模型)中,利用样条平滑函数对时间趋势、日均温度及日均湿度进行拟合,控制星期几效应(DOW)建立PM2.5浓度与某院呼吸科门诊量的单污染模型,得出当天及滞后1~5 d的累积滞后效应值,以最大效应值(ER)作为PM2.5浓度对呼吸科门诊量影响的暴露风险估计值,并计算95%置信区间(95%CI)。结果该医院区域2016-01/2018-12的PM2.5和SO2年平均浓度均高于中国《环境空气质量标准》(GB3095-2012)二级限值标准,PM10年平均浓度高于三级限值标准,NO2年平均浓度高于一级限值标准;该院呼吸科日均门诊量最高值出现在2017-06,拟合该月气象指标、环境污染指标后发现,该院呼吸科日均门诊量在PM2.5滞后第4天达到最大值,且PM2.5浓度每增加10μg/m3,该院呼吸科门诊量增加0.56%(95%CI:0.16~0.64)。结论本研究发现PM2.5对呼吸科日均门诊量具有一定影响,当PM2.5浓度增加时,呼吸科日均门诊量会明显增加。Objective To investigate how the concentration of PM2.5 in ambient air affected the numbers of daily outpatients for respiratory diseases in a hospital of Zhangjiakou. Methods The case data of the outpatients in respiratory department of First Affiliated Hospital of Hebei North University in Zhangjiakou from January 2016 to December 2018 were selected, and meteorological and environmental monitoring data during the same period were collected. Correlation between meteorological factors,environmental PM2.5 pollutant concentration and the daily average number of outpatients in respiratory department was analyzed. Poisson regression model was introduced into the generalized additive model(GAM). The natural spline smoothing function was used to control the effects of time trends, temperature, relative humidity, and "day of the week"(DOW) in the model. The accumulative effects(lag1-lag5) of PM2.5 were estimated as the extra risk(ER and95% CI). Results Between January 2016 to December 2018, the average concentrations of PM2.5 and SO2 exceeded the Grade 2 of National Ambient Air Quality Standards(GB3095-2012), the average concentrations of PM10 was higher than the standard of third grade, the average concentrations of NO2 was higher than the first grade standard. The maximum daily outpatient volume of the respiratory department of the hospital occurred in June 2017. The average daily outpatient volume in the respiratory department reached the maximum value on the fourth day after PM2.5 lag. For every 10μg/m3 increase in PM2.5 concentration, the number of outpatients in the lag4 respiratory department increased by 0.56(95% CI: 0.16~0.35). Conclusion The concentration of PM2.5 in ambient air was positively associated with the daily number of outpatients for respiratory diseases in First Affiliated Hospital of Hebei North University.

关 键 词：呼吸系统疾病 日均门诊量 PM2.5浓度 空气污染 时间序列分析 

分 类 号：R56[医药卫生—呼吸系统]