大气气态污染物对北京市某社区中老年人群血常规指标的影响  

Effects of gaseous air pollutants on blood routine indicators in elders from a community in Beijing

作　　者：王万州 陈俏 李宏宇[1] 刘琪思婧 吴少伟[1] WANG Wan-zhou;CHEN Qiao;LI Hong-yu;LIU Qi-si-jing;WU Shao-wei(School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院,北京100191

出　　处：《环境与职业医学》2020年第7期664-671,共8页Journal of Environmental and Occupational Medicine

基　　金：国家重点研发计划资助(2017YFC0211600,2017YFC0211601)。

摘　　要：[背景]近年来,大气气态污染物对人群健康的影响研究不断取得进展,但对外周血液学指标影响的证据仍然有限。[目的]探究大气首要气态污染物(CO、NO2、O3、SO2)对中老年人群血常规指标的影响。[方法]于2018年1月—2019年9月期间对北京市某社区427名50~78岁的中老年人群进行血常规检验、基本信息调查和环境暴露数据采集。利用单变量线性回归模型探究血常规指标的潜在影响因素后,建立单污染物多重线性回归模型分析气态污染物对血常规指标的估计效应,建立修饰作用及双污染物多重线性回归模型检验上述模型结果的稳定性。[结果]研究对象白细胞、红细胞、血小板数的M(IQR)分别为5.7×109(1.7×109)、4.6×1012(0.5×1012)、217.0×109(63.5×109)L-1。随SO2暴露水平的增加,中性粒细胞比例减少,淋巴细胞比例增加(P<0.05)。同时,随4种污染物暴露水平的增加,红细胞数、平均血红蛋白量及浓度的减少,以及平均红细胞体积与红细胞分布宽度标准差的增加均具有统计学意义(P<0.05)。4种污染物的90 d移动平均值每增加1个IQR(0.4 mg·m-3、24.4μg·m-3、67.1μg·m-3、3.4μg·m-3),平均血红蛋白浓度变化值的百分比及其95%CI分别为-2.6%(-3.7%^-1.4%)、-2.6%(-4.0%^-1.2%)、-3.2%(-4.8%^-1.5%)以及-2.9%(-3.9%^-1.9%),均P<0.01。而随CO、NO2及SO2暴露水平的增加,血小板数、平均血小板体积、血小板压积呈现下降趋势,而血小板分布宽度有增加的趋势。CO、NO2及SO2的90 d移动平均值每增加1个IQR,血小板压积的变化值的百分比及其95%CI分别为-21.2%(-29.3%^-12.2%)、-19.7%(-29.3%^-8.8%)以及-15.6%(-23.2%^-7.2%),均P<0.01。是否感冒、被动吸烟、患高血压/糖尿病等慢性病以及服用药物的修饰作用不具有统计学意义(P≥0.10)。在控制同时间窗其余3种气态污染物及大气细颗粒物的影响后,双污染物模型的结果仍然稳定。[结论]大气气态污染物暴露[Background]In recent years,research about effects of gaseous air pollutants on population health has continued to make progress,but evidence for the impacts on peripheral hematology is still limited.[Objective]This study is designed to investigate the effects of exposures to main gaseous air pollutants[carbon monoxide(CO),nitrogen dioxide(NO2),ozone(O3),and sulfur dioxide(SO2)]on blood routine indicators of elderly residents.[Methods]From January 2018 to September 2019,blood routine tests,basic information surveys,and environmental exposure data collection were performed on 427 people aged 50 to 78 years in a community of Beijing.Univariate linear regression models were used to explore the potential risk factors of blood routine indicators.Single-pollutant multivariate linear regression models were established to analyze the effects of gaseous pollutants on blood routine indicators.Effect modification models and two-pollutant multivariate linear regression models were conducted to explore the robustness of the results from the single-pollutant models.[Results]The medians[interquartile ranges(IQR)]of white blood cells,red blood cells,and platelets of the study subjects were 5.7×109(1.7×109),4.6×1012(0.5×1012),and 217.0×109(63.5×109)L-1,respectively.Along with the increases in SO2,neutrophils percentage showed significant decreases(P<0.05),while lymphocytes percentage showed significant increases(P<0.05).Red blood cells counts,mean corpuscular hemoglobin and its concentration showed significant decreases(P<0.05),whereas mean corpuscular volume and red cell distribution width standard deviation showed significant increases(P<0.05)along with increases of the four pollutants.An IQR increment in CO(0.4 mg·m-3),NO2(24.4μg·m-3),O3(67.1μg·m-3),and SO2(3.4μg·m-3)at 90-d moving average was significantly associated with percent changes of-2.6%(95%CI:-3.7%--1.4%),-2.6%(95%CI:-4.0%--1.2%),-3.2%(95%CI:-4.8%--1.5%),and-2.9%(95%CI:-3.9%--1.9%)(all P<0.01)in mean corpuscular hemoglobin concentration,respectively.Alon

关 键 词：大气污染 中老年人 一氧化碳 二氧化氮 臭氧 二氧化硫 血常规 

分 类 号：R12[医药卫生—环境卫生学]