德州市大气二氧化硫短期暴露与救护车紧急呼叫量的时间分层病例交叉研究  

A time-stratified case-crossover study on the association between short-term exposure to ambient sulfur dioxide and ambulance emergency call-outs in Dezhou City

作　　者：刘菲 曲一楠 郭富 赵琦 LIU Fei;QU Yinan;GUO Fu;ZHAO Qi(Department of Epidemiology,School of Public Health,Shandong University,Jinan 250012,China;Dezhou Centerfor Disease Control and Prevention,Dezhou 253016,Shandong,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院流行病学系,山东济南250012 [2]德州市疾病预防控制中心,山东德州253016

出　　处：《兰州大学学报(医学版)》2025年第1期68-74,81,共8页Journal of Lanzhou University(Medical Sciences)

基　　金：山东省自然科学基金青年项目(ZR2021QH318);山东省优秀青年基金(海外)资助项目(2022HWYQ-055)。

摘　　要：目的探讨山东省德州市大气二氧化硫(SO_(2))短期暴露与救护车紧急呼叫量(AECOs)的关联。方法收集2020年1月1日—2022年12月31日山东省德州市每日急救呼叫、空气污染和气象数据。基于时间分层的病例交叉设计,使用条件Logistic回归结合分布滞后非线性模型(DLNM)估计SO_(2)短期暴露的效应,利用分层分析确定脆弱人群和敏感疾病。结果在滞后3 d内,AECOs的相对风险(OR)与大气SO_(2)质量浓度呈正相关关系,SO_(2)每增加10μg/m^(3),累积OR值为1.06(95%CI:[1.04,1.08])。滞后分析结果表明,大气SO_(2)短期暴露的效应在滞后当天最大,而后迅速减小。35岁以下青壮年及65岁以上老年人群SO_(2)效应更大。在不同病因分层的分层分析中,呼吸系统疾病相关的AECOs与大气SO_(2)暴露的关联强度大于其他病因相关的AECOs(P<0.05)。结论山东省德州市人群SO_(2)短期暴露与AECOs显著相关,应重点关注年轻人群、老年人群和患呼吸系统疾病人群的SO_(2)效应。Objective To investigate the association between short-term exposure to ambient sulfur dioxide(SO_(2))and ambulance emergency call-outs(AECOs)in Dezhou City,Shandong Province.Methods Daily emergency call,air pollution and meteorological data were collected in Dezhou City from January 1,2020 to December 31,2022.Based on the time-stratified case-crossover design,conditional Logistic regression combined with distributed-lag nonlinear models was applied to assess the effect of short-term SO_(2)exposure,and stratified analysis used to identify susceptible populations and sensitive diseases.Results The odd ratio(OR)of AECOs was positively correlated with SO_(2)concentration,with a cumulative OR value of 1.06(95%CI:[1.04,1.08])for every 10 ug/m3 increase in SO_(2)over 0~3 lag days.The results of lag pattern analysis showed that the effect of short-term SO_(2)exposure was greatest on the lag 0 day,and then decreased rapidly.The SO_(2)effect was stronger in the population aged less than 35 years or more than 65 years old.In stratified analysis by causes,AECOs related to respiratory diseases were more strongly associated with SO_(2)exposure than others(P<0.05).Conclusion Short-term exposure to SO_(2)was significantly correlated with AECOs in Dezhou City,Shandong Province.Special attention should be paid to SO_(2)effects in the young population,the elderly population,and respiratory diseases.

关 键 词：二氧化硫 救护车紧急呼叫量 分层分析 时间分层的病例交叉研究 

分 类 号：R122.7[医药卫生—环境卫生学]