大气污染对呼吸系统疾病患儿肺功能的短期效应研究  

Short-term effects of air pollution on pulmonary function in children with respiratory diseases

作　　者：丁一辰 王宇虹 高剑晖[1] 石丽莎 许东[3] 凌利民[4] 彭丽[5] 张海云 张莉君 DING Yi-chen;WANG Yu-hong;GAO Jian-hui;SHI Li-sha;XU Dong;LING Li-min;PENG Li;ZHANG Hai-yun;ZHANG Li-jun(Department of Health Related Places Assessment,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Fenglin Street Community Health Service Center;Department of Environment Sanitation,Shanghai Xuhui District Center for Disease Control and Prevention;Department of Environment Sanitation,Shanghai Hongkou District Center for Disease Control and Prevention;Key Laboratory of Meteorology and Health,Shanghai Meteorological Service;Shanghai Center for Health Technology Assessment)

机构地区：[1]上海市疾病预防控制中心健康相关场所评价科,上海200336 [2]上海市枫林街道社区卫生服务中心 [3]上海市徐汇区疾病预防控制中心环境卫生科 [4]上海市虹口区疾病预防控制中心环境卫生科 [5]上海市气象局气象与健康重点实验室 [6]上海市卫生健康技术评价中心

出　　处：《环境卫生学杂志》2025年第4期294-302,共9页JOURNAL OF ENVIRONMENTAL HYGIENE

基　　金：上海市科技创新行动计划-自然科学基金资助项目(19 ZR1444300);国家环境保护新型污染物环境健康影响评价重点实验室项目(SEPKL-EHIAEC-202210);上海市加强公共卫生体系建设三年行动计划(2023—2025年)重点学科项目(GWVI-11.1-38);上海市疾病预防控制中心“青耕计划”(2022-48)。

摘　　要：目的分析上海市大气污染对呼吸系统疾病患儿肺功能的短期影响。方法在上海市虹口区、徐汇区环境监测点附近各选择一所学校,通过问卷筛选出80名患有呼吸系统疾病的四年级学生作为研究对象。采用定群追踪研究,分别于2020年和2021年开展4次肺功能检测,指标包括第1秒用力呼气量(forced expiratory volume in the first second,FEV1)、用力肺活量(forced vital capacity,FVC)、呼气流量峰值(peak expiratory flow,PEF)、用力呼气流量25%的呼气流速(forced expiratory flow at 25%of FVC,FEF25%)、用力呼气流量50%的呼气流速(forced expiratory flow at 50%of FVC,FEF50%)、用力呼气流量75%的呼气流速(forced expiratory flow at 75%of FVC,FEF75%)和用力呼气中段流量(forced expiratory flow between 25%and 75%of FVC,FEF25%~75%);同时收集检测当天到检测前三天(lag 0~lag 3 d)学校附近环境空气质量监测点的大气PM_(2.5)、O3、NO_(2)、SO_(2)以及PM_(10)等污染物浓度的监测数据。采用混合效应模型分析大气污染物对患病儿童肺功能的短期效应。结果单污染物模型结果显示,O3和PM_(10)对FVC的影响均发生在lag 2 d,浓度每升高一个四分位数间距(interquartile range,IQR),FVC分别下降8.78%和1.89%;O3在lag 2 d对FEF25%、NO_(2)在lag 3 d对FEF75%有影响,浓度每升高一个IQR,FEF25%和FEF75%分别下降12.67%和18.81%;PM_(2.5)、O3、NO_(2)、SO_(2)和PM_(10)对FEV1和PEF效应发生在lag 0~lag 3 d,浓度每升高一个IQR,FEV1最多分別降低5.50%、11.71%、7.16%、12.63%、3.75%,PEF分别下降11.06%、18.83%、23.46%、18.27%、9.90%,但O3对PEF的影响在lag 0~lag 1 d时为升高,在lag 2 d时为降低,变化较不稳定;5种大气污染物对患儿FEF50%和FEF25%~75%的影响均无统计学意义(P>0.05)。O3、NO_(2)、SO_(2)和PM_(10)对FEV1,PM_(2.5)、NO_(2)和PM_(10)对PEF存在累积滞后效应。双污染物模型分析显示,O3分别合并PM_(2.5)、NO_(2)、SO_(2)时,PM_(2.5)分别合并O3、SO_(2)、PM_(10)�Objective To analyze the short-term effects of air pollution on pulmonary function in children with respiratory diseases in Shanghai,China.Methods One school each was selected near the environmental monitoring sites in Hongkou District and Xuhui District of Shanghai.Eighty fourth-grade students with respiratory diseases were selected for the research through a questionnaire.U-sing a panel study,four repeated tests of pulmonary function were performed in 2020 and 2021.Pulmonary function indicators included forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory flow at 25%of FVC(FEF25%),forced expiratory flow at 50%of FVC(FEF50%),forced expiratory flow at 75%of FVC(FEF75%),and forced expiratory flow between 25%and 75%of FVC(FEF25%-75%).Meanwhile the monitoring data of concentrations of fine particulate matter(PM_(2.5)),ozone(O3),nitrogen dioxide(NO_(2)),sulfur dioxide(SO_(2)),and inhalable particulate matter(PM_(10))in the atmos-phere of the environmental air quality monitoring sites near the schools were collected from three days before the test to the day of the test(lag 0-lag 3 d).The mixed effect model was used to analyze the short-term effect of atmospheric pollutants on pulmonary function in sick children.Results Single-pollutant model results showed that the effects of O3 and PM_(10) on FVC both occurred on lag 2 d,and FVC decreased by 8.78%and 1.89%for each interquartile range(IQR)increase in pollutant concentration.Only O3 had an effect on FEF25%on lag 2 d,and only NO_(2) had an effect on FEF75%on lag 3 d;for each IQR increase in the concentration,FEF25%and FEF75%decreased by 12.67%and 18.81%,respectively.The effects of PM_(2.5),O3,NO_(2),SO_(2),and PM_(10) on FEV1 and PEF occurred from lag 0 d to lag 3 d;for each IQR increase in the concentration,the maximum decreases of FEV1 were 5.50%,11.71%,7.16%,12.63%,and 3.75%,respectively,and those of PEF were 11.06%,18.83%,23.46%,18.27%,and 9.90%,respectively.How-ever,the effect of O3 on PEF increa

关 键 词：大气污染 呼吸系统疾病患儿 肺功能 混合效应模型 

分 类 号：R122[医药卫生—环境卫生学] R179[医药卫生—公共卫生与预防医学]