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山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (11): 42-47.doi: 10.6040/j.issn.1671-7554.0.2018.309

• • 上一篇    

淄博市大气污染物浓度与急救人次关联的时间序列分析

刘晓利,刘芳盈,孟超,李平,张殿平,殷茂荣,翟慎永   

  1. 淄博市疾病预防控制中心, 山东 淄博 255026
  • 发布日期:2022-09-27
  • 通讯作者: 翟慎永. E-mail:zhaishenyong@126.com
  • 基金资助:
    山东省医药卫生科技发展计划(2014WS0231);淄博市科技发展计划(2017kj010092)

Time series analysis on the relationship between air pollution and daily emergency room visits in Zibo City

LIU Xiaoli, LIU Fangying, MENG Chao, LI Ping, ZHANG Dianping, YIN Maorong, ZHAI Shenyong   

  1. Zibo Center for Disease Control and Prevention, Zibo 255026, Shandong, China
  • Published:2022-09-27

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摘要： 目的 探讨淄博市大气污染物［SO2、NO2、细颗粒物(PM2.5)］浓度对急救人次的影响。 方法 收集2016年1月1日至2017年12月31日淄博市的急救医疗数据,按照WHO国际疾病分类(ICD-10)统计每日因非意外总急救及呼吸系统疾病急救的人次,结合同期逐日空气污染数据和气象数据,利用广义相加模型(GAM)控制长期趋势、季节趋势、星期几效应及气象因素的影响后,分析SO2、NO2、PM2.5日均浓度与非意外、呼吸系统疾病急救人次的关系。 结果 淄博市2016年至2017年SO2日均浓度52.6 μg/m3,NO2日平均浓度57.0 μg/m3,PM2.5日平均浓度70.4 μg/m3。2016年至2017年日平均急救366.78人次,其中日均非意外急救63.98人次,日均呼吸系统急救8.04人次。相关性分析表明,日均非意外急救及呼吸系统急救人次均与PM2.5、SO2、NO2、CO浓度呈正相关。时间序列分析单污染物模型显示,SO2和NO2浓度均对非意外急救人次的影响存在滞后效应,滞后1 d健康效应最强,其中SO2浓度每增加10 μg/m3,非意外急救人次增加0.423%(95%CI:0.253%~0.601%),NO2浓度每增加10 μg/m3,非意外急救人次增加0.412%(95%CI:0.218%~0.621%);PM2.5浓度均对呼吸系统疾病急救人次的影响存在滞后效应,滞后3 d健康效应最强,其中PM2.5浓度每增加10 μg/m3,呼吸系统疾病急救人次增加0.314%(95%CI:0.178%~0.533%)。双污染物模型中,在分别引入PM2.5和O3后,SO2浓度每升高10 μg/m3,非意外总急救人次的超额危险度(ER)分别为0.286%(95%CI:0.061%~0.519%)、0.389%(95%CI:0.229%~0.671%),NO2浓度每升高10 μg/m3,非意外总急救人次的ER分别为0.176%(95%CI:0.117%~0.561%)、0.427%(95%CI:0.287%~0.663%)。双污染物模型中,分别引入SO2和NO2后,PM2.5浓度每升高10 μg/m3,呼吸系统疾病急救人次的ER分别为0.219%(95%CI:0.128%~0.456%)、0.193%(95%CI:0.101%~0.429%)。 结论 大气中SO2或NO2浓度的升高可能增加居民非意外急救的风险,PM2.5浓度的升高可能增加居民呼吸系统疾病急救的风险,应加强环保整治力度,加快能源改革,发展清洁能源,减少大气污染物的排放,促进居民身体健康。

关键词: SO2, NO2, 细颗粒物, 急救, 时间序列分析

Abstract: Objective To explore the association between SO2, NO2, fine particulate matter(PM2.5)pollution and daily emergency room visits in Zibo City. Methods The data of emergency room visits during 2016 and 2017 were collected. The number of non-accidental emergencies and respiratory diseases emergencies were statistically analyzed according to the WHO International Classification of Diseases(ICD-10). After the confounding factors including time 山 东 大 学 学 报 (医 学 版)56卷11期 -刘晓利,等.淄博市大气污染物浓度与急救人次关联的时间序列分析 \=-trends, seasonal trends, day of week(DOW)and meteorological factors were controlled, the excess risk(ER)of daily emergency room visits associated with increased SO2, NO2, PM2.5 levels were analyzed with generalized addictive model(GAM)with Poisson regression. Results During 2016 and 2017, the average daily concentrations of SO2, NO2 and PM2.5 were 52.6 μg/m3, 57.0 μg/m3 and 70.4 μg/m3, respectively. The daily emergency room visits was 366.78, of which 63.98 and 8.04 were due to non-accidents and respiratory diseases. The correlation analysis showed that the number of daily emergency room visits was positively correlated with the concentrations of PM2.5, SO2, NO2 and CO. In the single-pollutant model, the SO2 and NO2 concentrations had lag effect on the number of non-accidental emergency visits, and lag1 factor had the most significant impact: a 10 μg/m3 increase of SO2 concentration was associated with a 0.423% ER(95%CI: 0.253%-0.601%), and a 10 μg/m3 increase of NO2 was associated with 0.412% ER(95%CI: 0.218%-0.621%). The PM2.5 concentration had lag effect on the number of respiratory diseases emergency visits, and lag3 factor had the most significant impact: a 10 μg/m3 increase of PM2.5 concentration was associated with a 0.314% ER(95%CI: 0.178%-0.533%). The dual-pollutant model indicated that for every 10 μg/m3 rise in SO2 concentration, the ER of non-accidental emergency visits was 0.286%(95%CI: 0.061%-0.519%)and 0.389%(95%CI: 0.229%-0.671%)when PM2.5 and O3 were introduced separately; and for every 10 μg/m3 rise in NO2 concentration, the ER was 0.176%(95%CI: 0.117%-0.561%)and 0.427%(95%CI: 0.287%-0.663%). The dual-pollutant model indicated that for every 10 μg/m3 rise in PM2.5 concentration, the ER of respiratory diseases emergency visits was 0.219%(95%CI:0.128%-0.456%)and 0.193%(95%CI:0.101%-0.429%)when SO2 and NO2 were introduced separately. Conclusion The rise of SO2 and NO2 concentrations in the air may increase the risk of non-accidental emergencies, and the rise of PM2.5 concentration may increase the risk of respiratory diseases emergencies. Efforts should be made to strengthen environmental protection, speed up energy reform, develop clean energies, reduce emissions of pollutants, and promote the health of residents.

Key words: SO2, NO2, fine particulate matter, Emergency visit, Time-series analysis

中图分类号: 

  • X510.2
[1] 陈娟, 崔淑卿. 空气中二氧化硫对人体的危害及相关问题探讨[J]. 内蒙古水利, 2012(3): 174-175.
[2] 王慧文, 潘秀丹. 沈阳市大气二氧化硫污染对呼吸系统疾病死亡率的影响[J]. 环境与健康杂志, 2007, 24(10): 762-765. WANG Huiwen, PAN Xiudan. Effect of ambient air SO2 on mortality of respiratory diseases in Shenyang[J]. Journal of Environment and Health, 2007, 24(10): 762-765.
[3] 刘昌景, 黄飞, 杨志洲, 等. 我国空气污染物与人群呼吸系统疾病死亡急性效应的Meta分析[J]. 中华流行病学杂志, 2015, 36(8): 889-895. LIU Changjing, HUANG Fei, YANG Zhizhou, et al. A meta analysis on the associations between air pollution and respiratory mortality in China.[J]. Chinese Journal of Epidemiology, 2015, 36(8): 889-895.
[4] 张雅婧. 城市交通性污染研究及其对成人呼吸系统健康的影响分析[D]. 天津:天津大学, 2012.
[5] 刘晓莉. 大气污染物对大鼠不同器官的毒作用及对人体健康的危害[D]. 太原: 山西大学, 2006.
[6] Brunekreef B, Beelen R, Hoek G, et al. Effects of long-term exposure to traffic-related air pollution on respiratory and cardiovascular mortality in the Netherlands: the NLCS-AIR study[J]. Res Rep Health Eff Inst, 2009, 578(139): 5-71.
[7] Zanobetti A, Schwartz J. The effect of fine and coarse particulate air pollution on mortality: a national analysis[J]. Environ Health Perspect, 2009, 117(6): 898-903.
[8] 吴一峰, 赵凤敏, 钱旭君, 等.宁波市江北区大气二氧化硫浓度与上呼吸道疾病门诊量的关系[J]. 卫生研究, 2015, 44(4): 565-569. WU Yifeng, ZHAO Fengmin, QIAN Xujun, et al. Relationship between sulfur dioxide pollution and upper respiratory outpatients in Jiangbei, Ningbo[J]. Journal of Hygiene Research, 2015, 44(4): 565-569.
[9] 刘楠媚, 刘利群, 胥美美, 等. 北京市大气二氧化氮水平与居民呼吸系统疾病死亡的关系[J]. 环境与健康杂志, 2014, 31(7): 565-568. LIU Nanmei, LIU Liqun, XU Meimei, et al. Relationships between ambient nitrogen dioxide and population mortality of respiratory disease in Beijing[J]. Journal of Environment and Health, 2014, 31(7): 565-568.
[10] 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.
[11] Mustafic H, Jabre P, Caussin C, et al. Main air pollutants and myocardial infarction: a systematic review and meta-analysis[J]. JAMA, 2012, 307(7): 713-721.
[12] 孟紫强, 李君灵. 二氧化硫生物学研究进展:从毒理学到生理学[J]. 生理学报, 2011, 63(6): 593-600. MENG Ziqiang, LI Junling. Progress in sulfur dioxide biology: from toxicology to physiology[J]. Acta Physiologica Sinica, 2011, 63(6): 593-600.
[13] 白剑英, 孟紫强. 短期二氧化硫吸入的肝脏毒性研究[J]. 肝脏, 2002, 7(4): 243-245. BAI Jianying, MENG Ziqiang. Study of hepatic toxicity of short-term inhalation of sulfur dioxide[J]. Chinese Hepatology, 2002, 7(4): 243-245.
[14] 王丽娜. 二氧化硫污染对机体呼吸系统、免疫系统的影响[D]. 重庆:重庆医科大学, 2001.
[15] 张丽, 赵梦迪, 胡天鹏, 等. 2006-2012年黄石城区大气污染物变化特征及评价[J]. 湖北理工学院学报, 2015, 31(2): 16-21. ZHANG Li, ZHAO Mengdi, HU Tianpeng, et al. Variation characteristics and assessment of atmospheric pollutants in Huangshi from 2006 to 2012.[J]. Journal of Hubei Polytechnic University, 2015, 31(2): 16-21.
[16] 刘玉香. SO2的危害及其流行病学与毒理学研究[J]. 生态毒理学报, 2007, 2(2): 225-231. LIU Yuxiang. Damage effects of SO2 and its epidemiology and toxicology research[J]. Asian Journal of Ecotoxicology, 2007, 2(2): 225-231.
[17] 李君灵, 孟紫强. 我国大气环境毒理学研究新进展[J]. 生态毒理学报, 2012, 7(2): 133-139. LI Junling, MENG Ziqiang. Current progress in atmospheric environmental toxicology in China[J]. Asian Journal of Ecotoxicology, 2012, 7(2): 133-139.
[18] 周晨虹. 大气臭氧和二氧化氮的变化及其影响因素[D]. 南京:南京信息工程大学, 2013.
[19] 张莹, 刘丽伟, 宁贵财, 等. 兰州市大气污染物的分布特征及其对人体健康的影响[J]. 卫生研究, 2015, 44(5): 723-729. ZHANG Ying, LIU Liwei, NING Guicai, et al. Distribution characteristics of atmospheric pollutants and their effects on human health in Lanzhou[J]. Journal of Hygiene Research, 2015, 44(5): 723-729.
[20] Zanobetti A, Franklin M, Koutrakis P, et al. Fine particulate air pollution and its components in association with cause-specific emergency admissions[J]. Environ Health, 2009, 8: 58. doi: 10.1186/1476-069X-8-58.
[21] Bravo MA, Ebisu K, Dominici F, et al. Airborne fine particles and risk of hospital admissions for understudied populations: effects by urbanicity and short-term cumulative exposures in 708 U.S. counties[J]. Environ Health Perspect, 2017, 125(4): 594-601.
[22] Turner MC, Krewski D, Pope CA, et al. Long-term ambient fine particulate matter air pollution and lung cancer in a large cohort of never-smokers[J]. Am J Respir Crit Care Med, 2011, 184(12): 1374-1381.
[23] 胡悦, 关茗洋, 赵冬, 等. 石家庄市大气SO2和NO2浓度与急救人次关联的时间序列分析[J]. 中华预防医学杂志, 2017, 51(4): 358-361. HU Yue, GUAN Mingyang, ZHAO Dong, et al. Time-series analysis of association between SO2, NO2 pollution and daily emergency room visits in Shijiazhuang[J]. Chinese Journal of Preventive Medicine, 2017, 51(4): 358-361.
[24] 刘迎春, 龚洁, 杨念念, 等. 武汉市大气污染与居民呼吸系统疾病死亡关系的病例交叉研究[J]. 环境与健康杂志, 2012, 29(3): 241-244. LIU Yingchun, GONG Jie, YANG Niannian, et al. Association between air pollution and mortality of respiratory diseases in wuhan: a case-crossover[J]. Journal of Environment and Health, 2012, 29(3): 241-244.
[25] 王灵菇. 北京市部分医院门急诊就诊人次与大气污染物浓度相关性的时间序列分析[D].北京:北京大学, 2002.
[26] Fischer PH, Marra M, Ameling CB, et al. Air pollution and mortality in seven million adults: the dutch environmental longitudinal study(DUELS)[J]. Environ Health Perspect, 2015, 123(7): 697-704.
[27] 张衍粜, 周脉耕, 贾予平, 等. 天津市大气气态污染物与居民每日死亡关系的时间序列分析[J]. 中华流行病学杂志, 2010, 31(10): 1158-1162. ZHANG Yansang, ZHOU Maigeng, JIA Yuping, et al. Time-series analysis on the association between gaseous air pollutants and daily mortality in urban residents in Tianjin[J]. Chinese Journal of Epidemiology, 2010, 31(10): 1158-1162.
[28] 刘金一. 杭州市大气污染的健康效应时间序列研究[D]. 杭州:杭州电子科技大学, 2014.
[29] Qiao L, Cai J, Wang H, et al. PM2.5 constituents and hospital emergency-room visits in Shanghai, China[J]. Environ Sci Technol, 2014, 48(17): 10406-10414.
[30] Strickland MJ, Hao H, Hu X, et al. Pediatric emergency visits and short-term changes in pm2.5 concentrations in the U.S. state of Georgia[J]. Environ Health Perspect, 2016, 124(5): 690-696.
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