2018-2020年河南省安阳市不同气温下PM_(2.5)对医院门诊量的影响  

Modification Effects of Temperature on the correlation of PM_(2.5) and outpatient visits of general hospitals in Anyang of Henan,2018-2020

作　　者：张杰[1] 杨似玉 张书芳[1] 闫晓娜 ZHANG Jie;YANG Siyu;ZHANG Shufang;YAN Xiaona(Department of Public Health,Henan provincial Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心公共卫生研究所,河南郑州450016

出　　处：《现代疾病预防控制》2023年第11期827-831,884,共6页MODERN DISEASE CONTROL AND PREVENTION

摘　　要：目的 探讨安阳市不同温度条件下PM_(2.5)对医院门诊量的影响,为制定人群健康防护措施提供科学依据。方法建立2018~2020年安阳市大气PM_(2.5)、气象资料与综合医院内科疾病门诊量及呼吸系统疾病、循环系统疾病门诊量时间序列数据库,利用广义相加模型获得PM_(2.5)与门诊量暴露-反应关系,进一步通过张量积相互作用函数检验PM_(2.5)与温度之间交互作用对不同门诊量影响,最后利用广义相加温度分层模型分析高、中、低不同温度层中PM_(2.5)对不同门诊量的影响。结果2018-2020年安阳市综合医院内科疾病、呼吸系统疾病、循环系统疾病日门诊量总计为2 911 611、163 473、412 958人次,日均值分别为2 657、149、377人次;PM_(2.5)的日平均浓度为68.95μg/m^(3)。与不同滞后时间相比PM_(2.5)当天浓度每上升10μg/m3,内科疾病门诊量、呼吸系统疾病门诊量及循环系统门诊量上升超额危险度(excessive risk,ER)最大,分别为0.44%(95%CI:0.19%~0.69%)、1.28%(95%CI:0.97%~1.60%)及0.66%(95%CI:0.30%~1.02%)。PM_(2.5)与气温交互作用对相关门诊就诊人次的影响均具有统计学意义(P<0.05)。仅低温层和中温层时PM_(2.5)对综合医院内科疾病门诊量、循环系统疾病门诊量影响具有统计学意义(P<0.05);而低、中、高温层PM_(2.5)对综合医院呼吸系统疾病门诊量影响均具有统计学意义(P<0.05)。低温层PM_(2.5)对综合医院内科及呼吸系统门诊量影响均高于中温层,差异均具有统计学意义(P<0.05)。结论气温与PM_(2.5)对医院内科、呼吸系统门诊量的影响存在交互作用,且PM_(2.5)在不同温度层对不同门诊影响不同,呈现曲线变化。低温在PM_(2.5)对内科及呼吸系统疾病影响中可能起到一定促进作用。Objective To explore the modification effects of temperature on the correlation of PM_(2.5) and outpatient visits of general hospitals in Anyang city,and provide scientific evidence for the development of protective measures on the population health.Methods The time series datasets of PM_(2.5),meteorology and the internal medicine,respiratory system and circulatory system outpatient visits of general hospitals in Anyang from 2018 to 2020 were established.The generalized additive model was used to obtain the expose-response coefficient between PM_(2.5) and the outpatient visit volume.Further,the tensor product interaction function was used to test the interaction between PM_(2.5) and temperature on outpatient visit volume.Finally,the generalized additive temperature stratification model was used to analyze the influence of PM_(2.5) in high,medium,and low temperature layers on different outpatient visit volume.Results The total number of outpatient visits of internal medicine,respiratory system and circulatory system in Anyang general hospitals were 2911611,163473 and 412958,and the average daily visits were 2657149 and 377,respectively.The average daily concentration of PM_(2.5) was 68.95μg/m^(3).Compared with diferent lag time,an increase of 10μg/m'in PM25 concentration on the day of lagO would result in the largest ER for the outpatient visits of internal medicine,respiratory system and circulatory system,which were 0.44%(95%CI:0.19%-0.69%),1.28%(95%CI:0.97%-1.60%)and 0.66%(95%CI:0.30%-1.02%),respectively.The interaction between PM_(2.5) and the air temperature had statistically significant influence on the number of outpatient visits(P<0.05).When it was in low and medium temperature layer,the influences of PM_(2.5) on the outpatient volume of internal medicine and circulatory system were both statistically significant(P<0.05);the influence of PM_(2.5) in low,medium and high temperature layer on the respiratory system outpatient volume were also statistically significant(P<0.05).The influence of PM_(2.5) in th

关 键 词：PM_(2.5) 气温 交互作用 医院门诊 

分 类 号：R181.3[医药卫生—流行病学]