您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (11): 98-104.doi: 10.6040/j.issn.1671-7554.0.2017.1268

• • 上一篇    

2014~2016年济南市历城区大气气态污染物对社区人群门诊就诊影响的时间序列分析

满金宇1,岳克三2,崔亮亮3,李新伟3,韩联宇2,吴兴彬2,刘守钦3   

  1. 1. 山东大学公共卫生学院流行病学系, 山东 济南250012;2.济南市历城区疾病预防控制中心公共卫生科, 山东 济南 250199;3.济南市疾病预防控制中心环境健康所, 山东 济南 250021
  • 发布日期:2022-09-27
  • 通讯作者: 刘守钦. E-mail:liushouqin@sina.com
  • 基金资助:
    山东省医药卫生科技发展计划(2015WS0435)

Time series analysis of the impacts of gaseous air pollutants on community residents outpatient visits in Licheng District of Jinan City during 2014 and 2016

MAN Jinyu1, YUE Kesan2, CUI Liangliang3, LI Xinwei3, HAN Lianyu2, WU Xingbin2, LIU Shouqin3   

  1. 1. Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Public Health, Jinan Licheng District Center for Disease Control and Prevention, Jinan 250199, Shandong, China;
    3. Department of Environmental Health, Jinan Center for Disease Control and Prevention, Jinan 250021, Shandong, China
  • Published:2022-09-27

摘要: 目的 评估济南市空气污染严重区域大气气态污染物对社区人群内科门诊就诊的急性效应。 方法 收集2014年1月1日至2016年12月31日济南市重污染区域某综合医院逐日内科门诊就诊个案记录、空气污染物浓度及气象信息,并进行描述性分析。采用广义线性模型,定量评估逐日大气气态污染物浓度与社区人群门诊就诊量之间的相关关系,并进行分性别、分年龄段(<65岁和≥65岁)、分系统疾病(呼吸系统疾病和循环系统疾病)的相关性分析。 结果 2014年1月1日至2016年12月31日间该综合医院内科门诊量合计241 574人次,日均就诊量220人次/d,NO2、SO2、CO日均浓度分别为53、58、1 506 μg/m3。仅发现NO2与内科门诊量存在关联。大气污染物NO2浓度每升高10 μg/m3,当日内科门诊量增加1.13%(95%CI:0.55%~1.70%),lag02时增加1.47%(95%CI:0.72%~2.22%)。总门诊量及分年龄、分性别、分疾病门诊量均与NO2浓度存在统计学关联。不同性别、年龄组循环系统疾病的当日滞后效应模式与总体一致,呼吸系统疾病的当日滞后效应模式与总体略有不同。效应值男性高于女性、≥65岁人群高于<65岁人群。 结论 济南市空气污染严重区域大气气态污染物中仅NO2对社区人群的内科门诊量以及不同性别、不同年龄段、不同系统疾病存在广泛的急性效应,且男性较女性敏感、≥65岁人群较<65岁人群敏感。

关键词: 空气污染, 气态污染物, 内科门诊, 时间序列分析, 广义线性模型

Abstract: Objective To investigate the short-term effects of gaseous air pollutants on residents outpatient visits in the heavily polluted Licheng District of Jinan City. Methods The daily number of outpatients in a general hospital, daily air pollution and meteorological data in Licheng District during Jan. 1, 2014 and Dec. 31, 2016 were collected for 山 东 大 学 学 报 (医 学 版)56卷11期 -满金宇,等.2014~2016年济南市历城区大气气态污染物对社区人群门诊就诊影响的时间序列分析 \=-descriptive analysis. The relationship between the daily concentrations of gaseous air pollutants and the number of outpatients was analyzed with generalized linear model(GLM). The correlations between the concentrations of pollutants and different gender groups, age groups(<65 years and ≥65 years), respiratory diseases and cardiovascular diseases were evaluated. Results The total number of outpatients was 241 574, averaged 220 per day. The average daily concentrations of NO2, SO2 and CO were 53 μg/m3, 58 μg/m3 and 1 506 μg/m3, respectively. The concentration of NO2 was related to the number of outpatients. An increase of 10 μg/m3 in the concentration of NO2 meant the number of outpatients would increase by 1.13%(95%CI: 0.55%-1.70%)on lag0 and by 1.47%(95%CI:0.72%-2.22%)on lag02. There was correlation between the daily concentration of NO2 and the total number of outpatients, different gender groups and age groups, respiratory diseases and cardiovascular diseases. The same lag pattern was observed in different gender groups, age groups, and cardiovascular diseases. The pattern of respiratory diseases was different. The male had a higher risk than female, and the ≥65 group had a higher risk than the <65 group. Conclusion Our findings indicate that NO2 has posed a considerable risk to residents outpatient visits, and the elderly population(≥ 65 years)and males are more vulnerable.

Key words: Air pollution, Gaseous pollutants, Hospital visit, Time series analysis, Generalized linear model

中图分类号: 

  • R181.3+4
[1] 孙贵范. 职业卫生与职业医学[M]. 7版. 北京: 人民卫生出版社, 2015:89-90,103.
[2] Sun J, Barnes AJ, He D, et al. Systematic review and meta-analysis of the association between ambient nitrogen dioxide and respiratory disease in China[J]. Int J Environ Res Public Health, 2017, 14(6): 646.
[3] Luo K, Li R, Li W, et al. Acute effects of nitrogen dioxide on cardiovascular mortality in Beijing: an exploration of spatial heterogeneity and the district-specific predictors[J]. Sci Rep, 2016, 6: 38328. doi: 10.1038/srep38328.
[4] 屈芳. 环境气象因素对呼吸系统疾病影响的研究进展[J]. 气象科技进展, 2013, 34(6): 35-44. QU Fang. Research progress on associations of environmental meterorological factors with humans' respiratory diseases[J]. Advances in Meteorological Science and Technology, 2013, 34(6): 35-44.
[5] 马洪群,崔莲花. 大气污染物(SO2、NO2)对中国居民健康效应影响的Meta分析[J]. 职业与健康, 2016, 32(8): 1038-1044. MA Hongqun, CUI Lianhua. Meta-analysis on health effects of air pollutants(SO2 and NO2)in the Chinese population[J]. Occupation and Health, 2016, 32(8): 1038-1044.
[6] Costa S, Ferreira J, Silveira C, et al. Integrating health on air quality assessment-review report on health risks of two major European outdoor air pollutants: PM and NO2[J]. J Toxicol Environ Health B Crit Rev, 2014, 17(6): 307-340.
[7] 李玉荣. 2014-2015年合肥市空气污染物与某儿童医院0-14岁儿童上呼吸道感染日门诊量的时间序列研究[D]. 合肥: 安徽医科大学, 2017.
[8] 钱旭君, 李国星, 贺天锋, 等. 宁波市大气污染物一氧化碳及臭氧对人群心肌梗死死亡的急性效应研究[J]. 中华流行病学杂志, 2017, 38(3): 297-302. QIAN Xujun, LI Guoxing, HE Tianfeng, et al. Acute effect of air pollutants(carbon monoxide and ozone)on myocardial infarction mortality in Ningbo[J]. Chinese Journal of Epidemiology, 2017, 38(3): 297-302.
[9] 刘楠媚, 莫运政, 刘利群,等. 大气二氧化硫与居民每日呼吸系统疾病死亡相关性的时间序列分析[J]. 环境与健康杂志, 2013, 30(5): 385-388. LIU Nanmei, MO Yunzheng, LIU Liqun, et al. Relationship between ambient level of sulfur dioxide and daily population mortality of respiratory disease: a timeseries analysis[J]. Journal of Environment & Health, 2013, 30(5): 385-388.
[10] 王德征, 江国虹, 张辉, 等. 天津市2001-2009年空气污染物二氧化硫、二氧化氮和可吸入颗粒物对冠心病死亡影响的时间序列分析[J]. 中华流行病学杂志, 2013, 34(5): 478-483. WANG Dezheng, JIANG Guohong, ZHANG Hui, et al. Effect of air pollution on coronary heart disease mortality in Tianjin, 2001-2009: a time-series study[J]. Chinese Journal of Epidemiology, 2013, 34(5): 478-483.
[11] Geddes JA, Martin RV, Boys BL, et al. Long-term trends worldwide in ambient NO2 concentrations inferred from satellite observations[J]. Environ Health Perspect, 2016, 124(3): 281-289.
[12] Song C, Wu L, Xie Y, et al. Air pollution in China: status and spatiotemporal variations[J]. Environ Pollut, 2017, 227: 334-347. doi: 10.1016/j.envpol.2017.04.075.
[13] 徐甜, 王志远, 张兵, 等. 中国环境保护重点城市空气质量指数时空变化特征[J]. 中国公共卫生, 2016, 32(8): 1027-1031. XU Tian, WANG Zhiyuan, ZHANG Bing, et al. Spatial-temporal variations of air quality indexes in key environmental protection cities of China[J]. Chinese Journal of Public Health, 2016, 32(8): 1027-1031.
[14] 徐红霞, 刘汝海, 王艳, 等. 2014~2016年山东省空气质量变化及典型城市污染天气污染物来源分析[J]. 中国人口·资源与环境, 2017, 27(11):132-135.
[15] He S, Mazumdar S, Arena VC. A comparative study of the use of GAM and GLM in air pollution research[J]. Environmetrics, 2006, 17(1): 81-93.
[16] 杨程, 杨兴堂, 沈先标.上海市某区2013-2015年大气污染物与医院门诊量的时间序列研究[J]. 环境与职业医学, 2017, 34(3): 235-238, 244. YANG Cheng, YANG Xingtang, SHEN Xianbiao, et al. A time-series study on association between ambient air pollutants and hospital outpatients in a district of Shanghai[J]. Journal of Environmental & Occupational Medicine, 2017, 34(3): 235-238, 244.
[17] 臧涛. 六安市大气部分空气质量指标与某医院总门诊量、呼吸内科和心血管内科门诊量关系的时间序列分析[D]. 合肥: 安徽医科大学, 2015.
[18] 赵越. 大气污染对城市居民的健康效应及经济损失研究[D]. 北京: 中国地质大学, 2007.
[19] 侯斌, 戴灵真, 王铮, 等. 西安市大气污染对城区居民每日死亡率影响的时间序列分析[J]. 环境与健康杂志, 2011, 28(12): 1039-1043. HOU Bin, DAI Lingzhen, WANG Zheng. Time-series analysis of acute mortality effects of air pollution in Xian[J]. Journal of Environment & Health, 2011, 28(12): 1039-1043.
[20] Vahedian M, Khanjani N, Mirzaee M, et al. Associations of short-term exposure to air pollution with respiratory hospital admissions in Arak, Iran[J]. J Environ Health Sci Eng, 2017, 15(1): 17.
[21] 张莹, 邵毅, 王式功, 等. 北京市空气污染物对呼吸系统疾病门诊人数的影响[J]. 中国环境科学, 2014, 34(9): 2401-2407. ZHANG Ying, SHAO Yi, WANG Shigong, et al. Relationship between air pollutant and respiratory diseases hospital outpatient visits in Beijing[J]. China Environmental Science, 2014, 34(9): 2401-2407.
[22] 陶燕, 羊德容, 兰岚, 等. 兰州市空气污染对呼吸系统疾病入院人数的影响[J]. 中国环境科学, 2013, 33(1): 175-180. TAO Yan, YANG Derong, LAN Lan, et al. Relationship between air pollutant and respiratory diseases hospitalization in Lanzhou[J]. China Environmental Science, 2013, 33(1): 175-180.
[23] 牟喆, 耿福海, 叶晓芳, 等. 上海市大气污染对不同特征居民呼吸疾病就诊人数影响[J]. 中国公共卫生, 2016, 32(4): 513-516. MOU Zhe, GENG Fuhai, YE Xiaofang, et al. Effects of air pollution on clinic visits of different gender and age respiratory outpatients in Shanghai, China[J]. Chinese Journal of Public Health, 2016, 32(4): 513-516.
[24] Zhao L, Liang HR, Chen FY, et al. Association between air pollution and cardiovascular mortality in China: a systematic review and meta-analysis[J]. Oncotarget, 2017, 8(39): 66438-66448.
[25] Wang KY, Chau TT. An association between air pollution and daily outpatient visits for respiratory disease in a heavy industry area[J]. PLoS One, 2013, 8(10): e75220[MJ7]. doi:10.1371/journal.pone.0075220.
[26] Clougherty JE. A growing role for gender analysis in air pollution epidemiology[J]. Cien Saude Colet, 2011, 16(4): 2221-2238.
[27] 朱嫒嫒,李士雪,吴敏,等.济南市≥65岁老人身体健康状况及影响因素分析[J]. 中国公共卫生, 2011, 27(4): 433-435. ZHU Yuanyuan, LI Shixue, WU Min. Physical health status and its influential factors among the elderly ≥65 years old in Jinan city[J]. Chinese Journal of Public Health, 2011, 27(4): 433-435.
[28] 王在翔, 赵晶, 牛泽亮, 等. 空气污染对心脑血管疾病门诊量影响的Poisson广义可加模型分析[J]. 中国卫生统计, 2017, 34(2): 232-235. WANG Zaixiang, ZHAO Jing, NIU Zeliang, et al. Influence of air pollution on the outpatient volume of cardiovascular and cerebrovascular diseases using the Poisson generalized additive models in Weifang[J]. Chinese Journal of Health Statistics, 2017, 34(2): 232-235.
[29] 王德征, 江国虹, 张辉,等.天津市2001-2009年空气污染物二氧化硫、二氧化氮和可吸入颗粒物对冠心病死亡影响的时间序列分析[J].中华流行病学杂志, 2013, 34(5): 478-483. DOI:10.3760/cma.j.issn.0254-6450.2013.05.015. WANG Dezheng, JIANG Guohong, ZHANG Hui, et al. Effect of air pollution on coronary heart disease mortality in Tianjin, 2001-2009: a time-series study[J]. Chin J Epidemiol, 2013, 34(5): 478-483.
[30] 王晓东. 二氧化氮及其衍生物对肺和脑一般毒性的研究[D]. 太原: 山西大学, 2014.
[31] 杨蕾. 气温、湿度对上海市流感样病例人次的影响[D]. 上海: 复旦大学, 2013.
[1] 刘军,李欢,张仕玉,张鹏,艾思奇,田飞,林华亮. 湖北省新型冠状病毒肺炎患者发生重型、危重型的影响因素[J]. 山东大学学报 (医学版), 2020, 58(10): 60-65.
[2] 齐畅,朱雨辰,李春雨,刘利利,张丹丹,王旭,佘凯丽,陈鸣,康殿民,李秀君. 基于地理加权广义线性模型探索山东省新型冠状病毒肺炎的影响因素[J]. 山东大学学报 (医学版), 2020, 58(10): 53-59.
[3] 曹若明,崔亮亮,姜超,景一鸣,周林,张琳,刘守钦. 济南市大气污染物O3与居民呼吸系统疾病死亡风险的时间序列分析[J]. 山东大学学报 (医学版), 2018, 56(11): 91-97.
[4] 贾晓倩,崔亮亮,岳克三,李新伟,韩联宇,吴兴彬,周敬文. 济南市大气颗粒物与儿童呼吸系统疾病就诊量的时间序列分析[J]. 山东大学学报 (医学版), 2018, 56(11): 84-90.
[5] 肖长春,唐静,李玉荣,翟金霞. 合肥市空气污染与某儿童医院肺炎门诊量关系的时间序列分析[J]. 山东大学学报 (医学版), 2018, 56(11): 76-83.
[6] 陈浪,赵川,陈凤格,白萍. 石家庄市大气颗粒污染物浓度对儿童呼吸系统疾病门诊量的影响[J]. 山东大学学报 (医学版), 2018, 56(11): 68-75.
[7] 满金宇,崔亮亮,韩联宇,于坤坤,吴兴彬,岳克三,周敬文. 2014~2016年济南市空气污染严重地区大气颗粒物对社区人群门诊就诊量的急性效应分析[J]. 山东大学学报 (医学版), 2018, 56(11): 61-67.
[8] 王志强,徐艳龙,肖长春,冯晓亮,郑莉,李飞,黄发源. 合肥市2014~2016年大气污染物PM2.5对居民循环系统疾病死亡效应的时间序列分析[J]. 山东大学学报 (医学版), 2018, 56(11): 48-52.
[9] 刘晓利,刘芳盈,孟超,李平,张殿平,殷茂荣,翟慎永. 淄博市大气污染物浓度与急救人次关联的时间序列分析[J]. 山东大学学报 (医学版), 2018, 56(11): 42-47.
[10] 崔亮亮,张萌,于坤坤,姜超,阮师漫. 济南市大气重点污染物对居民应急呼叫事件的急性影响[J]. 山东大学学报 (医学版), 2018, 56(11): 34-41.
[11] 马润美,张翼,王彦文,许丹丹,孙志颖,石婉荧,崔亮亮,李湉湉. 大气颗粒物污染与血糖关系的系统综述[J]. 山东大学学报 (医学版), 2018, 56(11): 27-33.
[12] 李润滋,章涛,梁玉民,罗成,蒋正,薛付忠,刘言训,刘静,李秀君. SARIMA模型在流行性腮腺炎发病预测中的应用[J]. 山东大学学报(医学版), 2016, 54(9): 82-86.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!