新冠疫情前后成都市臭氧和呼吸系统疾病死亡之间的关联分析  

Association between ozone and respiratory mortality before and during the COVID-19 epidemic,Chengdu

作　　者：张燚 曾晶[2] 杜仟仟 张华东[3] 邓颖[2] 殷菲[1] ZHANG Yi;ZENG Jing;DU Qian-qian;ZHANG Hua-dong;DENG Ying;YIN Fin(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院,成都610041 [2]四川省疾病预防控制中心 [3]重庆市疾病预防控制中心

出　　处：《现代预防医学》2023年第8期1365-1371,共7页Modern Preventive Medicine

基　　金：国家自然科学基金(81872713,81803332);四川省科学技术厅重点研发项目(2021YFS0181);重庆市科技局资助(cstc2020jscx-cylhX0003)。

摘　　要：目的分析不同时间段成都市臭氧浓度和呼吸系统疾病死亡人数之间的关联。方法成都市2018—2021年呼吸系统疾病的每日死亡数来自于四川省疾病预防控制中心,以新冠为断点描述两个时期呼吸系统疾病死亡数和臭氧浓度的变化,采用分布滞后非线性模型进行断点前后对比分析臭氧和呼吸道死亡风险之间的暴露-滞后-反应关联。结果新冠发生前,成都市呼吸系统疾病死亡总数为41465人,新冠疫情期间死亡总数为39300人,除了臭氧,其余空气污染物浓度在新冠疫情期间有所下降。新冠发生前,臭氧与呼吸系统疾病死亡的关系曲线总体呈上升趋势,低浓度的RR值为0.4776(95%CI:0.2821~0.8085),各浓度下均存在滞后效应,中位浓度下滞后1天的RR值为0.9745(95%CI:0.9573~0.9921)。在新冠疫情管控期间,臭氧与呼吸系统疾病死亡的暴露关联曲线总体呈下降趋势,低浓度对应的RR值为1.9464(95%CI:1.2177~3.1111),仅高浓度臭氧存在滞后效应,滞后1天的RR为0.9994(95%CI:0.9990~0.9998)。结论成都市的臭氧与呼吸系统疾病死亡之间存在关联,而且在新冠疫情前后两者的关联形式和滞后效应存在差异。Objective To analyze the relationship between ozone concentration and death of respiratory diseases in Chengdu before and during the COVID-19 epidemic.Methods The daily respiratory mortality data in Chengdu from 2018 to 2021 was collected from the Sichuan Center for Disease Control and Prevention.Statistical indexes were calculated to describe the change of respiratory disease deaths and ozone concentration before and during the COVID-19 epidemic.The distributed-lag nonlinear models were established to compare the exposure-lag-response associations between ozone and respiratory mortality at the different period.Results Before the COVID-19 epidemic,41465 deaths of respiratory diseases were reported in Chengdu,while 39300 deaths were reported during the COVID-19 epidemic.Except for ozone,the concentrations of other air pollutants decreased during the COVID-19 epidemic.Before the COVID-19 epidemic,the risk curve between ozone and death of respiratory diseases showed an overall upward trend.The RR of low concentrations was 0.4776(95%CI:0.2821-0.8085).Lag effect was observed at all concentrations.The RR of lag 1 day at the median concentration was 0.9745(95%CI:0.9573-0.9921).During the COVID-19 epidemic,the risk curve between ozone and death of respiratory diseases showed an overall downward trend.The RR of the low concentration was 1.9464(95%CI:1.2177-3.1111).Lag effect was observed only at the high ozone concentrations,and the RR of lag 1 was 0.9994(95%CI:0.9990-0.9998).Conclusion There was a significant association between ozone concentration and death of respiratory diseases in Chengdu.Before and after COVID-19,the differences of association pattern and lag effect were observed.

关 键 词：环境臭氧 呼吸系统疾病 暴露滞后反映关联 新冠疫情 

分 类 号：R122[医药卫生—环境卫生学] R56[医药卫生—公共卫生与预防医学]