2016—2018年河南洛阳市主要大气污染物对心脑血管疾病门诊量的影响  

Influence of main air pollutants on hospital outpatient visits for cardiovascular and cerebrovascular diseases in Luoyang of Henan Province in 2016-2018

作　　者：郭恒亮[1,2,4] 王孟飞 龚喜云 魏海涛[2,4] GUO Hengliang;WANG Mengfei;GONG Xiyun;WEI Haitao(Henan Province Supercomputing Center,Zhengzhou University,Zhengzhou,Henan 450001,China;The School of the Geo-Science&Technology,Zhengzhou University,Zhengzhou,Henan 450001,China;College of Chemistry,Zhengzhou University,Zhengzhou,Henan 450001,China;Joint Laboratory of Eco-meteorology,Chinese Academy of Meteorological Sciences and Zhengzhou University,Zhengzhou University,Zhengzhou,Henan 450001,China;The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450001,China)

机构地区：[1]郑州大学河南省超级计算中心,河南郑州450001 [2]郑州大学地球科学与技术学院,河南郑州450001 [3]郑州大学化学学院,河南郑州450001 [4]郑州大学中国气象科学研究院郑州大学生态气象联合实验室,河南郑州450001 [5]郑州大学第一附属医院,河南郑州450001

出　　处：《环境与职业医学》2021年第4期389-396,共8页Journal of Environmental and Occupational Medicine

基　　金：国家重点研发计划资助项目(2018YFB0505004-03);河南省重点研发与推广专项(科技攻关)项目(192102210124)。

摘　　要：[背景]心脑血管疾病占我国居民死因首位,但目前的研究更侧重于经济发达或污染严重地区,且不同地区研究结果存在差异。[目的]探究河南省洛阳市主要大气污染物(PM_(2.5)、PM_(10)、SO_(2)、NO_(2)、CO、O_(3))对洛阳市心脑血管疾病门诊量的影响。[方法]收集洛阳市2016年1月1日—2018年12月31日的心脑血管疾病门诊信息以及同期大气污染物浓度数据和气象数据。利用广义相加模型分别建立单污染物模型、双污染物模型,以及年龄、性别和季节的分层模型,并计算单日滞后(lag0~lag7)和累积滞后(lag0~lag07)的相对危险度(RR)及95%置信区间(CI)。[结果]2016—2018年洛阳市的心脑血管疾病门诊量共208355例。同期PM_(10)、PM_(2.5)分别超标277、82 d,NO_(2)、CO、O_(3)分别超标48、9、8 d,SO_(2)日均浓度不超标。单污染物模型结果显示,PM_(2.5)、PM_(10)、SO_(2)、NO_(2)、CO、O_(3)最佳滞后时间分别是lag0、lag3、lag6、lag2、lag0、lag04,对应的RR及95%CI分别为1.0024(1.0011~1.0037)、1.0017(1.0010~1.0025)、0.9767(0.9696~0.9840)、1.0277(1.0236~1.0319)、1.0006(1.0004~1.0007)、1.0041(1.0014~1.0069)。双污染物模型中,各污染物引入其余污染物前后结果基本都有统计学意义(P<0.05)。性别分层和年龄分层结果均显示NO_(2)是危害性最大的污染物:NO_(2)对男性和女性心脑血管疾病门诊量影响的最佳滞后时间分别为lag2、lag01,对应的RR及95%CI分别为1.0293(1.0235~1.0351)、1.0277(1.0218~1.0335),对0~40、41~65、65岁以上人群心脑血管疾病门诊量影响的最佳滞后时间为分别为lag4、lag3、lag2,对应的RR及95%CI分别为1.0359(1.0009~1.0720)、1.0277(1.0215~1.0339)、1.0311(1.0255~1.0367)。季节分层结果显示:PM_(2.5)、SO_(2)、NO_(2)和CO最大效应值出现在春季,对应的RR及其95%CI分别为1.0220(1.0188~1.0253)、1.0733(1.0570~1.0899)、1.0626(1.0531~1.0721)、1.0015(1.0011~1.0019);PM_(10)和O_(3)的最大效应出现在夏季,对�[Background]Cardiovascular and cerebrovascular diseases top the general causes of death among Chinese residents.However,current research focuses more on economically developed or heavily polluted areas,and the research results are inconsistent across regions.[Objective]This study investigates the impact of major atmospheric pollutants(PM_(2.5),PM_(10),SO_(2),NO_(2),CO,and O_(3))on the number of hospital outpatient visits for cardiovascular and cerebrovascular diseases in Luoyang of Henan Province from 2016 to 2018.[Methods]Outpatient information of cardiovascular and cerebrovascular diseases,atmospheric pollutant concentration data,and meteorological data in Luoyang from January 1,2016 to December 31,2018 were collected.Generalized additive models(GAMs)were chosen to construct single-pollutant models,double-pollutant models,and stratified models of age,gender,and season.The relative risks(RRs)and 95% confidence intervals(CIs)of single-day and cumulative lag effects were estimated.[Results]There were a total of 208355 cardio-cerebrovascular disease outpatient visits in Luoyang from 2016 to 2018.PM_(2.5)and PM_(10)daily concentrations exceeded the national standard limits for 277 and 82 d respectively,followed by NO_(2),CO,and O_(3)which were unqualified for 48,9,and 8 d,respectively,and SO_(2)did not exceed the standard.The single-pollutant models showed that the best lag days for PM_(2.5),PM_(10),SO_(2),NO_(2),CO,and O_(3)were lag0,lag3,lag6,lag2,lag0,and lag04,and the corresponding RRs and 95%CIs were 1.0024(1.0011-1.0037),1.0017(1.0010-1.0025),0.9767(0.9696-0.9840),1.0277(1.0236-1.0319),1.0006(1.0004-1.0007),and 1.0041(1.0014-1.0069),respectively.In the double pollutant models,there was no significant difference in the effect values of each pollutant before and after the introduction of other pollutants(P>0.05).The results of gender stratification and age stratification analyses showed that NO_(2)was the most affecting pollutant.The best lag days of NO_(2)on the outpatient volume of cardio-cerebrovascular disea

关 键 词：大气污染物 心脑血管疾病 日门诊量 广义相加模型 时间序列分析 

分 类 号：R12[医药卫生—环境卫生学]