兰州市臭氧对儿童哮喘的短期影响及其季节性差异  

Short-term effects and seasonal variation of ozone on daily hospital outpatient visits for childhood asthma in Lanzhou

作　　者：张宏[1] 董继元[2] 王建军[3] 范临夏[3] 曲强[3] 刘洋 ZHANG Hong;DONG Ji-yuan;WANG Jian-jun;FAN Lin-xia;QU Qiang;LIU Yang(Asthma Center, Gansu Provincial Hospital, Lanzhou 730000, China;Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China;Department of Pediatrics, Gansu Provincial Hospital, Lanzhou 730000, China)

机构地区：[1]甘肃省人民医院哮喘防治中心,兰州730000 [2]兰州大学公共卫生学院劳动卫生与环境卫生学研究所,兰州730000 [3]甘肃省人民医院儿科,兰州730000

出　　处：《北京大学学报（医学版）》2022年第2期227-235,共9页Journal of Peking University:Health Sciences

基　　金：甘肃省人民医院院内科研基金(18GSSY4-24)。

摘　　要：目的:分析不同季节不同度量方式的臭氧(ozone,O_(3))浓度对儿童哮喘门诊就诊人次的影响,探讨该影响在不同类型人群中的差异。方法:收集兰州市三所三级甲等综合医院2014年1月1日至2017年12月31日儿童哮喘门诊的就诊资料,收集同期空气污染数据和气象数据,考虑到O_(3)浓度与儿童哮喘门诊就诊人次及气象因素之间的非线性关系,利用广义相加时间序列模型分析O_(3)浓度变化与儿童哮喘门诊就诊人次的短期关联性,同时进一步对性别、年龄进行分层分析,考虑到O_(3)在1 d内浓度变化情况,同时采用每日1 h最大值浓度(O_(3)max1h)、每日8 h最大值浓度(O_(3)8h)以及每日24 h均值浓度(O_(3)24h)这三种O_(3)暴露的不同度量方式作为O_(3)短期暴露指标,并分别开展模型分析。结果:夏季时,O_(3)短期暴露水平的升高对于儿童哮喘门诊就诊人次的增加有显著影响。在滞后当天(lag0)的情况下,大气O_(3)max1h浓度每增加10μg/m^(3),儿童哮喘门诊就诊人次增加3.351%(95%CI:1.231%~5.516%);O_(3)8h浓度每增加10μg/m^(3),儿童哮喘门诊就诊人次增加3.320%(95%CI:0.197%~3.829%);O_(3)24h浓度每增加10μg/m^(3),夏季儿童哮喘门诊就诊人次增加6.600%(95%CI:0.914%~12.607%);此外,O_(3)max1h暴露增加也会引起0~5岁儿童及男性哮喘门诊就诊人次的显著增加。结论:兰州市夏季时O_(3)短期暴露水平的升高对于儿童哮喘门诊就诊风险的增加有显著影响,O_(3)max1h与儿童哮喘门诊就诊人次增加的关联更密切。Objective:To analyze the effects of ozone(O_(3))concentrations measured with different approaches across different seasons on the total number of childhood asthma-related clinical visits,as well as the differentiation of such effects across different groups of patients.Methods:The outpatient data of three grade A tertiary hospitals in Lanzhou City spanning from 1 January 2014 to 31 December 2017,as well as air pollution and meteorological data during the same period were collected.Considering the nonlinear relationship between O_(3) concentrations and the total number of childhood asthma-related clinical visits and meteorological factors,a generalized additive temporal sequence model was employed to analyze the short-term association between changes in O_(3) concentrations and the total number of childhood asthma-related clinical visits.Taking into account of the variations in O_(3) concentrations within 1 day,this study adopted different measurement approaches to address the three types of O_(3) exposures,namely,the maximum 1 h daily concentration(O_(3)max1h),the maximum 8 h daily concentration(O_(3)8h)and the mean 24 h daily concentration(O_(3)24h)as the short term exposure indicators to O_(3),followed by a model-based analysis.Results:The increase in short-term exposure levels to O_(3) in summer had a significant effect on the increase in the total number of childhood asthma-related clinical visits.With lag0 for the current day,every 10μg/m^(3) increase in atmospheric concentration of O_(3)max1h was associated with an increase in the total number of childhood asthma-related clinical visits by 3.351%(95%CI:1.231%-5.516%);for every 10μg/m^(3) increase in O_(3)8h concentration,the total number of childhood asthma-related clinical visits increased by 3.320%(95%CI:0.197%-3.829%);for every 10μg/m^(3)increase in O_(3)24h concentration,the total number of childhood asthma-related clinical visits in summer increased by 6.600%(95%CI:0.914%-12.607%);moreover,an increase in exposure to O_(3)max1h also led to a signific

关 键 词：臭氧 空气污染物 儿童 哮喘 门诊病人 

分 类 号：R725.6[医药卫生—儿科]