济南市2013―2019年大气臭氧暴露对居民超额应急呼叫的风险评估  

Effects analysis and excess risk assessment on O_(3) related emergency calls in Jinan City,2013-2019

作　　者：常会云 王丽珩[2] 黄珂[3] 李明君[1] 崔亮亮[1] CHANG Huiyun;WANG Liheng;HUANG Ke;LI Mingjun;CUI Liangliang(Department of Research and Education,Jinan Center for Disease Control and Prevention,Jinan 250021,China;Environmental Health Institute,Jinan Center for Disease Control and Prevention,Jinan 250021,China;Emergency Department,Jinan Medical Emergency Center,Jinan 250021,China)

机构地区：[1]济南市疾病预防控制中心科研教育部,济南250021 [2]济南市疾病预防控制中心环境健康所,济南250021 [3]济南市急救中心急救部,济南250021

出　　处：《中华疾病控制杂志》2024年第4期479-485,共7页Chinese Journal of Disease Control & Prevention

基　　金：济南市卫生健康委员会科技计划项目(2021-公-02,2022-公-10)。

摘　　要：目的探讨济南市2013―2019年臭氧(Ozone,O_(3))暴露对居民超额应急呼叫风险的影响。方法收集济南市2013―2019年每日的居民应急呼叫事件信息,以及同期每日的空气污染物(O_(3)、PM_(2.5)、PM_(10)、NO_(2)、SO_(2)、CO)浓度和气象因素(日均温度、日均相对湿度和日均风速)资料,采用病例交叉设计方法确定暴露-反应系数,Cox比例风险回归模型进行健康风险评估;对呼吸、循环和神经系统疾病进行分层分析,同时比较冬春季和夏秋季O_(3)暴露造成的超额应急呼叫风险是否具有差异。结果2013―2019年济南市共发生应急呼叫事件653473件,平均每日应急呼叫总量为250人次。通过总应急呼叫的影响效应分析和超额风险评估发现,O_(3)浓度每升高10μg/m3,居民总应急呼叫的风险增加0.375%(95%CI:0.288%~0.461%),造成的超额应急呼叫总量为7226人次。疾病分层分析发现,研究期间O_(3)暴露仅对增加神经系统疾病应急呼叫的超额风险差异有统计学意义(P<0.001),影响效应估计值为0.471%(95%CI:0.250%~0.692%),进而造成的超额应急呼叫量为1371人次。另外,O_(3)暴露造成的超额应急呼叫量有季节差异,表现为夏秋季>冬春季。结论济南市O_(3)暴露增加居民的超额应急呼叫风险,且夏秋季O_(3)暴露造成的超额应急呼叫风险高于冬春季,特别是神经系统疾病受其影响更为显著。Objective To explore the effect of Ozone(O_(3))exposure on the risk of excess emergency calls of residents in Jinan City from 2013 to 2019.Methods The daily emergency calling event information of residents,as well as the average concentration of air pollutants(O_(3),PM_(2.5),PM_(10),NO_(2),SO_(2),CO)and meteorological factors(daily average temperature,average relative humidity and average wind speed)in Jinan City from January 1st to December 31st of 2013 to 2019,were collected.The case-cross design method was used to determine the expose-response relationship coefficient,which was introduced into the proportional risk model for health risk assessment.Further,stratified analysis was conducted by respiratory system diseases,circulatory system diseases and neurological diseases,and the differences in excess emergency call risk caused by O_(3) exposure in different seasons were compared.Results There were 653473 emergency call incidents in Jinan from 2013 to 2019,and average daily emergency calls volume were 250.Impact analysis and excess risk assessment on total emergency calls found that for every 10μg/m3 increase in O_(3) concentration,the risk of emergency calls increased by 0.375%(95%CI:0.288%-0.461%),resulting in excess emergency calls of 7226.Disease-stratified analyses found that the effect estimate of O_(3) exposure on emergency calls was statistically significant only for neurologic disorders during the study period,with a corresponding effect estimate of 0.471%(95%CI:0.250%-0.692%),and resulted in excess emergency calls of 1371.In addition,the excess emergency calls caused by O_(3) exposure had seasonal differences,which were higher in summer and autumn than in winter and spring.Conclusions In Jinan City,exposure of O_(3) increases the risk of excess emergency calls of residents,and manifests as higher in summer and autumn than in winter and spring.Especially,neurological diseases are significantly affected.

关 键 词：臭氧 应急呼叫 风险评估 

分 类 号：R122[医药卫生—环境卫生学]