嘉兴市大气NO_(2)对呼吸系统疾病门诊量的影响分析  

Analysis on effect of air NO_(2) on hospital visits for respiratory diseases in Jiaxing

作　　者：洪伟伟 吴益康 朱泽[1] 王熙蓓 吴大明 周哲华[1] Hong Weiwei;Wu Yikang;Zhu Ze;Wang Xibei;Wu Daming;Zhou Zhehua(Department of Environmental Health(Department of Occupational Health and Radiation Protection),Jiaxing Center for Disease Control and Prevention,Jiaxing 314050,China)

机构地区：[1]嘉兴市疾病预防控制中心环境与健康科(职业健康与辐射防护科),浙江嘉兴314050

出　　处：《中国医院统计》2024年第3期189-192,196,共5页Chinese Journal of Hospital Statistics

基　　金：嘉兴市科技计划项目(2020AD30123,2023AY11008)。

摘　　要：目的 分析嘉兴市大气NO_(2)对呼吸系统疾病门诊量的影响。方法 收集2019—2021年嘉兴市每日大气NO_(2)监测资料、气象资料和呼吸系统疾病门诊量资料。分别应用Wilcoxon秩和检验和广义相加模型(GAM)2种统计方法,研究大气NO_(2)对呼吸系统疾病门诊量的急性效应。结果 期间大气NO_(2)日均浓度超标9 d。大气NO2超标日的呼吸系统疾病门诊总量和儿童呼吸系统疾病门诊量均高于达标日。单日滞后效应分析时,NO_(2)对呼吸系统疾病门诊总量和成人门诊量的滞后效应值均在lag4时达到最大,而儿童门诊量则在lag3时达到最大。NO2每增加10μg/m^(3),呼吸系统疾病门诊总量、成人和儿童门诊量分别增加2.23%(95%CI:1.52%~2.94%)、1.73%(95%CI:1.06%~2.41%)和2.73%(95%CI:1.73%~3.74%);累积滞后效应分析时,呼吸系统疾病门诊量效应值均在lag07时达到最大,NO2每增加10μg/m^(3),呼吸系统疾病门诊总量、成人和儿童呼吸系统疾病门诊量分别增加5.35%(95%CI:4.06%~6.66%)、3.47%(95%CI:2.25%~4.70%)和7.17%(95%CI:5.31%~9.07%);儿童门诊量的最大效应值高于成人。结论 嘉兴市大气NO_(2)浓度升高可能引起呼吸系统疾病门诊量增加,且具有滞后性,应特别加强儿童呼吸系统的健康防护。Objective To analyze the effect of nitrogen dioxide(NO_(2))on hospital visits for respiratory diseases in Jiaxing.Methods We collected daily air NO_(2) monitoring data,meteorological factors and hospital visits for respiratory diseases in Jiaxing from 2019 to 2021.We used Wilcoxon rank sum test and generalized addition model(GAM)to analyze the acute effects of air NO_(2) on hospital visits for respiratory diseases.Results The average daily concentration of NO_(2) exceeded the standard for 9 days.The daily hospital visits for respiratory diseases and childhood respiratory diseases on days when air NO_(2) exceeded the national standard were higher than those on qualified days.In the single-day lag effect analysis,the excess risk(ER)of daily hospital visits for respiratory diseases and adult respiratory diseases both reached the maximum on lag4,while the ER of daily hospital visits for childhood respiratory diseases reached the maximum on lag3 with ER(95%CI)being 2.23%(1.52%-2.94%),1.73%(1.06%-2.41%)and 2.73%(1.73%-3.74%)with NO_(2) concentration increase per 10μg/m^(3),respectively.In the cumulative lag effect analysis,the ER of daily hospital visits for respiratory diseases,adult and childhood respiratory diseases all reached the maximum on lag07,with ER(95%CI)being 5.35%(4.06%-6.66%),3.47%(2.25%-4.70%)and 7.17%(5.31%-9.07%)with NO_(2) concentration increase per 10μg/m^(3),respectively.The maximum ER of hospital visits for childhood respiratory diseases was higher than that for adults.Conclusion The increase of NO_(2) concentration in Jiaxing may lead to an increase in hospital visits for respiratory diseases with a lag effect,and the health protection of children′s respiratory system should be especially strengthened.

关 键 词：二氧化氮 呼吸系统疾病 门诊量 Wilcoxon秩和检验 广义相加模型 

分 类 号：X51[环境科学与工程—环境工程] R122[医药卫生—环境卫生学]