2016-2021年河南省某工业区大气污染对居民精神和行为障碍就诊人次的影响  

Impact of ambient air pollution on hospital visits for mental and behavioral disorders among residents in an industrial area in Henan Province from 2016 to 2021

作　　者：陈宇航 张文强[2] 刘俊伟 张积睿 刘正阳 张文君 张庆鑫 刘金婵 李萌 Chen Yuhang;Zhang Wenqiang;Liu Junwei;Zhang Jirui;Liu Zhengyang;Zhang Wenjun;Zhang Qingxin;Liu Jinchan;Li Meng(College of Public Health,Zhengzhou University,Zhengzhou 450001,China;The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China;Medical Department,Staff General Hospital of Anyang Iron and Steel Group Co.,Ltd.,Anyang 455004,China;School of Physics,Henan Normal University,Xinxiang 453007,China;Sanquan College,Xinxiang Medical University,Xinxiang 453003,China)

机构地区：[1]郑州大学公共卫生学院,郑州450001 [2]郑州大学第二附属医院,郑州450003 [3]安钢总医院医务科,安阳455004 [4]河南师范大学物理学院,新乡453007 [5]新乡医学院三全学院,新乡453003

出　　处：《中华预防医学杂志》2025年第1期39-52,共14页Chinese Journal of Preventive Medicine

基　　金：国家重点研发计划项目(2022YFC3803201);河南省重点研发与推广专项(科技攻关)(232102310496)。

摘　　要：目的探讨2016—2021年河南省某工业区大气污染对居民精神和行为障碍就诊人次的影响。方法收集2016年1月至2021年12月安阳市安钢工业区的安钢总医院每日精神和行为障碍疾病门诊就诊数据和同期的大气污染物及气象数据,使用广义相加模型进行时间序列分析,分析二氧化氮(NO_(2))、二氧化硫(SO_(2))、细颗粒物(PM_(2.5))、可吸入颗粒物(PM_(10))、一氧化碳(CO)日均浓度和臭氧(O 3)日最大8 h平均浓度滞后0到7 d对居民精神和行为障碍就诊人次的关系单日滞后效应(lag0~lag7 d)和累积滞后效应(lag01~lag07 d)。利用平滑立方样条函数拟合暴露-反应关系,并将数据按不同性别、季节和年龄进行亚组分析。结果共收集2016—2021年该工业区26268人次的精神和行为障碍门诊就诊数据,SO_(2)、NO_(2)、PM_(2.5)、PM_(10)和CO的日均浓度分别为(27.50±27.33)、(43.11±18.33)、(73.87±60.30)、(134.01±83.81)μg/m^(3)和(1.72±1.03)mg/m^(3),O 3日最大8 h平均浓度为(82.18±53.70)μg/m^(3)。广义相加模型分析结果显示,在控制了长期趋势、温度、相对湿度、星期几效应和节假日效应后,NO_(2)在lag0 d、lag2 d和lag01~lag05 d与CO在lag0~lag3 d和lag01~lag06 d对精神和行为障碍就诊人次的影响有统计学意义(均P<0.05);NO_(2)在lag02~lag04 d与CO在lag0~lag2 d和lag01~lag04 d对神经衰弱就诊人次的影响有统计学意义(均P<0.05);NO_(2)在lag03~lag04 d、PM_(2.5)在lag3 d和lag03~lag04 d、PM_(10)在lag3 d和lag03 d与CO在lag3 d和lag01~lag05 d时对广泛性焦虑障碍就诊人次的影响有统计学意义(均P<0.05)。FDR校正后结果显示,NO_(2)每增加10μg/m^(3)和CO每增加0.1 mg/m^(3)精神和行为障碍就诊人次增加百分比及其95%置信区间(95%CI)分别为3.38%(0.95%~5.87%)和0.78%(0.38%~1.17%);CO每增加0.1 mg/m^(3)神经衰弱就诊人次增加0.78%(0.27%~1.29%);PM_(2.5)每增加10μg/m^(3)和CO每增加0.1 mg/m^(3)广泛性焦虑障碍就诊人次分别增加Objective To explore the impact of air pollution on hospital visits for mental and behavioral disorders among residents in an industrial area in Henan Province from 2016 to 2021.Methods Daily outpatient visits data for mental and behavioral disorders were collected from Angang General Hospital in Angang Industrial Area at Anyang City between January 2016 and December 2021.And air pollutants and meteorological data during the same period were also collected.A generalized additive model was used for time-series analysis to examine the relationship between daily average concentrations of nitrogen dioxide(NO_(2)),sulfur dioxide(SO_(2)),fine particulate matter(PM_(2.5)),inhalable particulate matter(PM_(10)),carbon monoxide(CO),and ozone(O 3)with a lag of 0 to 7 days on the number of visits for mental and behavioral disorders among residents.The single-day lag effect(lag0-lag7 d)and cumulative lag effect(lag01-lag07 d)were analyzed.The smooth cubic spline function was used to fit the exposure-response relationship,and subgroup analysis was performed according to different genders,seasons and ages.Results A total of 26268 hospital visits for mental and behavioral disorders were collected from the industrial area between 2016 and 2021.The daily average concentrations of SO_(2),NO_(2),PM_(2.5),PM_(10),and CO were(27.50±27.33),(43.11±18.33),(73.87±60.30),(134.01±83.81)μg/m^(3),and(1.72±1.03)mg/m^(3),respectively.The daily maximum 8-hour average concentration of O 3 was(82.18±53.70)μg/m^(3).After controlling for long-term trends,temperature,relative humidity,day of the week effects,and holiday effects,the generalized additive model analysis showed that NO_(2)had a statistically significant impact on the hospital visits for mental and behavioral disorders at lag0 d,lag2 d and lag01-lag05 d and CO had a statistically significant impact at lag0-lag3 d and lag01-lag06 d(all P<0.05).NO_(2)at lag02-lag04 d and CO at lag0-lag2 d and lag01-lag04 d had statistically significant effects on the visits for neurasthenia(both P<0

关 键 词：大气污染 精神和行为障碍 时间序列分析 神经衰弱 广泛性焦虑障碍 

分 类 号：X51[环境科学与工程—环境工程] X503.1[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]