2016—2020年江西省南昌市大气污染物与儿童呼吸疾病门诊病例数的时间序列关联研究  

Time-series study on association between air pollution and the number of outpatient visits for respiratory diseases among children in Nanchang city,Jiangxi Province,2016—2020

作　　者：宋孝光[1] 武昊 付俊杰[1] 鲁柯柯 何文鑫 卢飞豹[1] 江文斌 谢丽丽[1] 何加芬[1] SONG Xiao-guang;WU Hao;FU Jun-jie;LU Ke-ke;HE Wen-xin;LU Fei-bao;JIANG Wen-bin;XIE Li-li;HE Jia-fen(Institute of Environmental Health,Jiangxi Provincial Center for Disease Control and Prevention,Nanchang,Jiangxi 330029,China)

机构地区：[1]江西省疾病预防控制中心环境健康所,江西南昌330029 [2]南昌大学江西医学院公共卫生学院,江西南昌330006

出　　处：《现代预防医学》2022年第14期2539-2545,2552,共8页Modern Preventive Medicine

基　　金：江西省卫生健康委科技计划(20204847)。

摘　　要：目的探讨江西省南昌市6种常规监测大气污染物对儿童呼吸疾病的影响。方法选取2016-2020年江西省南昌市大气污染物、气象数据和江西省儿童医院呼吸系统日门诊量,采用时间序列Poisson分布的广义相加模型(GAM),定量分析大气污染物与儿童呼吸系统疾病门诊病例数的相关性。结果研究期间大气污染物SO_(2)、NO_(2)、O_(3)-8h、CO、PM_(2.5)、PM_(10)的日均浓度分别为11.35μg/m^(3)、32.80μg/m^(3)、91.80μg/m^(3)、0.89 mg/m^(3)、37.42μg/m^(3)、68.22μg/m^(3)。PM_(2.5)、PM_(10)、SO_(2)、CO、NO_(2)的浓度升高对儿童呼吸系统疾病日门诊量的增加存在统计学意义,均在当日(lag0)和累积滞后第7 d(lag07)效应最强,其中SO_(2)在累积滞后(lag07)的浓度值对儿童呼吸系统疾病门诊病例数的超额危险度(ER=9.47%,95%CI:6.78%~12.22%)最大。双污染物模型中,调整其他5种污染物后,O_(3)-8h对儿童呼吸系统疾病门诊量的增加无统计学意义;将O_(3)-8h引入双污染物模型后,均一定程度的增加了其他污染物的效应,SO_(2)在O_(3)-8h的影响下,对儿童呼吸系统疾病门诊数影响效应值最大;PM_(2.5)、PM_(10)、O_(3)-8h引入双污染模型后,SO_(2)和NO_(2)的效应值均扩大。结论2016-2020年大气污染物对南昌市儿童呼吸系统疾病有统计学影响,污染物浓度的升高导致儿童呼吸系统门诊量就诊人数增加,其中SO_(2)对门诊量影响最大。Objective To evaluate the effects of six routine monitoring pollutants on childhood respiratory disorders in Nanchang city,Jiangxi Province.Methods Data of the concentration of air pollutants,the corresponding meteorological data,and the daily outpatient visits for childhood respiratory disorders from Jiangxi Provincial Children’s Hospital between 2016 and 2020 were collected,and the correlation between air pollution and daily outpatient visits of childhood respiratory disorders were quantitatively assessed using generalized additive model(GAM)based on Poisson distribution.Results The average concentrations of SO_(2),NO_(2),O_(3)-8h,CO,PM_(2.5),and PM_(10) during study period were 11.35μg/m^(3),32.80μg/m^(3),91.80μg/m^(3),0.89 mg/m^(3),37.42μg/m^(3),and 68.22μg/m^(3),respectively.There was an obvious lag effect between the increase of air pollutants and the outpatient visits for childhood respiratory disorders,which was the strongest on the day(lag0)and the seventh day of cumulative lag(lag07).The concentration of SO_(2)in the cumulative lag(lag07)was the largest excess risk for childhood respiratory disorders(ER=9.47%,95%CI:6.78%-12.22%).The results of double-pollutant model showed that after adjusting the other five pollutants,O_(3)-8h had no significant effect on the increase of outpatient number in childhood respiratory disorders.After the introduction of O_(3)-8h into the model,the effect of other pollutants was increased to a certain extent.Under the influence of O_(3)-8h,the effect of SO_(2)on the outpatient number of respiratory diseases in children was particularly obvious.After introducing PM_(2.5),PM_(10),O_(3)-8h into the double-pollutant model,the effects of both SO_(2)and NO_(2)increased.Conclusion Air pollution has a significant impact on childhood respiratory disorders in Nanchang from 2016 to 2020,and the concentration of air pollutants could increase the number of daily outpatient visits for childhood respiratory disorders,among which SO_(2)has the strongest effect.

关 键 词：大气污染物 儿童呼吸系统疾病 日门诊量 时间序列方法 

分 类 号：X503.1[环境科学与工程—环境工程] R122.2[医药卫生—环境卫生学]