大气污染对呼吸系统疾病日门诊量的时间序列分析  

Time Series Analysis of Association between Air Pollution and Daily Outpatient Visits for Respiratory Diseases

作　　者：陆雯雯 王兴甜 孟华 苏馨雅 梁沛枫[3] LU Wenwen;WANG Xingtian;MENG Hua;SU Xinya;LIANG Peifeng(School of Public Health and Management,Ningxia Medical University,Yinchuan 750004,China;Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia,Yinchuan 750004,China;Department of Statistics,People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏医科大学公共卫生与管理学院,银川750004 [2]宁夏环境因素与慢性病控制重点实验室,银川750004 [3]宁夏回族自治区人民医院病案统计科,银川750002

出　　处：《宁夏医科大学学报》2023年第3期309-314,共6页Journal of Ningxia Medical University

基　　金：宁夏回族自治区重点研发计划项目(2021BEG03099)。

摘　　要：目的 探究银川市大气污染物浓度对医院呼吸系统疾病日门诊量的影响。方法 收集2019年1月1日至2021年12月31日银川市多院区医院门诊逐日就诊资料、同期气象数据和大气污染物资料。采用Poisson分布的广义相加模型计算不同大气污染物对呼吸系统疾病日门诊量的单日滞后效应(lag0~lag7)和累计滞后效应(lag01~lag07),采用季节分层分析研究不同亚组大气污染与日门诊量的关系。结果 单污染模型中PM_(2.5)、PM_(10)、NO_(2)、O_(3)浓度每增加10μg·m^(-3),日门诊量分别增加1.398%(95%CI:1.229%~1.567%)、17.179%(95%CI:0.678%~36.384%)、2.940%(95%CI:2.470%~3.412%)和0.426%(95%CI:0.175%~0.677%),分别在lag01、lag06、lag07、lag04达到最大效应。季节分层分析显示,除去PM_(10)在冷、暖季最大效应值基本持平外,PM_(2.5)、NO_(2)和O_(3)最大效应值均出现在暖季,最佳滞后天数分别为lag1、lag7、lag2。结论 银川市大气污染物PM_(2.5)、PM_(10)、NO_(2)和O_(3)浓度升高均能增加呼吸系统疾病日门诊量,且具有滞后效应,其中污染物PM_(10)对日门诊量的影响最大。Objective To explore the influence of air pollutants concentration on daily outpatient visits for respiratory diseases in Yinchuan city.Methods The Daily outpatient visited to multi-branch hospital,simultaneous meteorological data,and air pollution data were collected in Yinchuan city from Jan.12019 to Dec.312021.The generalized additive model with Poisson regression was used to analyze the single-day lag effect(lag0-lag7)and cumulative lag effect(lag01-lag07)of different air pollution on daily outpatient visits for respiratory diseases.The season-stratified model was constructed to study the relationship between air pollution and daily outpatient visits in different subgroups.Results The concentration of PM_(2.5),PM_(10),NO_(2) and O_(3) in the single pollution model increased by 10μg·m^(-3),the daily outpatient volume of increased by 1.398%(95%CI:1.229%-1.567%),17.179%(95%CI:0.678%-36.384%),2.940%(95%CI:2.470%-3.412%)and 0.426%(95%CI:0.175%-0.677%),respectively.And the strongest effect was achieved in lag01,lag06,lag07,and lag04,respectively.Seasonal stratification analysis showed that,except for the fact that the maximum effect values of PM_(10) were basically the same in the cold and warm seasons,the maximum effect values of PM_(2.5),NO_(2),and O_(3) all occured in the warm season,with the best lag days being lag1,lag7,and lag2,respectively.The season-stratified analysis showed that the maximal effect of PM_(2.5),NO_(2) and O_(3) was higher in the cold season than in the warm season,and the optimum lag condition were lag1,lag7 and lag2,respectively.Except that the maximum effect of PM_(10) was basically the same in cold and warm seasons.Conclusion The increases in PM_(2.5),PM_(10),NO_(2) and O_(3) concentrations in Yinchuan city will increase the daily outpatient visits for respiratory diseases with a lag effect,with PM_(10) having the greatest impact on the daily outpatient volume.

关 键 词：大气污染 呼吸系统 日门诊量 时间序列分析 广义相加模型 

分 类 号：R122.2[医药卫生—环境卫生学]