2015—2018年张家港市大气PM2.5对儿科门诊量影响的时间序列分析  

Effects of air PM2.5 on pediatric outpatient visits in Zhangjiagang,Jiangsu province in 2015-2018:a time-series analysis

作　　者：于颖慧[1] 夏威[1] 施惠军 陆逊[1] 王晓蕾[1] 邱海岩[1] YU Ying-hui;XIA Wei;SHI Hui-jun;LU Xun;WANG Xiao-lei;QIU Hai-yan(Zhangjiagang Municipal Center for Disease Control and Prevention,Zhangjiagang,Jiangsu 215600,China)

机构地区：[1]张家港市疾病预防控制中心卫生科,江苏215600

出　　处：《环境与健康杂志》2019年第11期950-953,共4页Journal of Environment and Health

基　　金：苏州市科技支撑计划项目[SYSD2016010];张家港市科技支撑计划项目[ZKS1635]。

摘　　要：目的探讨张家港市大气PM2.5污染对儿科日门诊量的影响。方法收集张家港市2015—2018年逐日气象资料、环保大气监测资料和某三级医院儿科门诊数据。采用基于Poisson回归的广义线性模型(GLM)控制时间趋势、温度和相对湿度、星期几效应、法定节假等因素后,进行PM2.5与儿科门诊量的单污染物模型、滞后效应(lag1~lag6)和累积滞后效应(lag0-1~lag0-6)分析,采用滞后天数最大效应值作为PM2.5对儿科门诊影响的暴露风险评估值。结果2015—2018年,张家港市某三级医院的儿科门诊量共438137人次,日均300人次,PM2.5年均值是48.0μg/m3(范围:38~59μg/m3);PM2.5污染对当天和滞后1~6 d的儿科总门诊量、当天和滞后1~5 d的呼吸系统疾病门诊量影响均有统计学意义,且分别在滞后第3天和第2天最强,PM2.5浓度每升高10μg/m3,门诊量分别增加0.51%(95%CI:0.20%~0.83%)和0.83%(95%CI:0.42%~1.23%);PM2.5对累积滞后1~6 d的儿科总门诊量和呼吸系统疾病门诊量影响均有统计学意义(P<0.05)。结论张家港市大气PM2.5浓度升高会导致儿科总门诊量和呼吸系统疾病门诊总量增加,应采取积极措施对儿童等重点人群开展有效防护。Objective To understand the effects of ambient PM2.5 on the pediatric outpatient visits in Zhangjiagang,Jiangsu province.Methods The data of daily meteorological and environmental monitoring,pediatric outpatients of a tertiary hospital in Zhangjiagang were collected from 2015 to 2018.Generalized linear model(GLM)based on Poisson regression was used to analyze the effect of PM2.5 on pediatric outpatients visits by controlling the factors of time trend,temperature,relative humidity,week of day and holiday.The analysis of lag effect(lag1-lag6)and cumulative lag effect(lag0-1-lag0-6)were also included.Results The total number of pediatric outpatient visits in the investigated hospital in Zhangjiagang in 2015-2018 was 438137 with an average daily number of 300.The annual average of PM2.5 daily value was 48.0μg/m3(range:38-59μg/m3).According to the results of GLM model analysis,statistical significance was found in the total pediatric outpatient visits during lag0-lag6 and pediatric respiratory diseases outpatient visits during lag0-lag5,with the highest extra risks(ER and 95%CI)on lag3 and lag2,which were 0.51%(95%CI:0.20%-0.83%)and 0.83%(95%CI:0.42%-1.23%)associated with an increase of 10μg/m3 PM2.5,respectively.Statistical significance was also found in the cumulative effects of PM2.5(lag0-1-lag0-6)on the total pediatric and respiratory disease outpatient visits(P<0.05).Conclusions In Zhangjiagang,ambient PM2.5 concentration increase may cause the total pediatric and respiratory diseases outpatient visits increase,and active measures should be taken to effectively protect the children health.

关 键 词：大气污染 PM2.5 儿科 门诊量 广义线性模型 

分 类 号：R181.3[医药卫生—流行病学]