广州市空气污染对居民每日急救病例影响的短期效应
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摘要
目的分析广州市空气污染物浓度与居民因不同疾病(循环系统疾病、消化系统疾病、神经系统疾病和呼吸系统疾病)而寻求急救服务人次的关系,探讨广州市空气污染对人群健康影响的短期效应。方法收集广州市2015-2017年空气污染物二氧化硫(sulfur dioxide,SO_2)、二氧化氮(nitrogen dioxide,NO_2)、一氧化碳(carbon monoxide,CO)、细颗粒物(fine particulate matter,PM_(2.5))的每日24 h平均浓度和臭氧(ozone,O_3)最大8 h浓度、日均气温、相对湿度和4大疾病别每日急救人次,采用时间序列分析的广义相加模型,分析空气中污染物浓度和居民4大疾病别急救人次的关系。结果研究期间空气中SO_2、NO_2、CO、O_3、PM_(2.5)的日平均浓度分别是13.24μg/m~3、45.96μg/m~3、0.97 mg/m~3、123.77μg/m~3、和36.22μg/m~3。经过单污染物模型分析,空气中SO_2每增加4.70μg/m~3,循环系统急救量增加2.91%(95%CI:1.00%～4.85%),在多污染物模型中,循环系统急救量则增加4.39%(95%CI:1.22%～7.67%)。结论大气SO_2污染可能增加居民循环系统疾病的风险,应采取防控措施降低SO_2排放。
Objective To understand the relationship between the concentration of air pollutants and daily emergency department visits for different diseases(circulatory system disease,digestive system disease,nervous system disease and respiratory system disease)in Guangzhou,Guangdong Province.Methods The daily average concentrations of sulfur dioxide(SO_2),nitrogen dioxide(NO_2,carbon monoxide(CO)and PM_(2.5)and the daily maximum 8-hour concentrations of O_3,the daily average temperature,the relative humidity and cause-specific emergency department visits of the four major diseases from 2015 to 2017 were collected in Guangzhou.Semi-parametric generalized additive model was used to analyze the relationship between the concentration of pollutants and daily cause-specific emergency department visits.Results The daily average concentrations of SO_2,NO_2,CO,O_3 and PM_(2.5)during the study period were 13.24μg/m~3,45.96μg/m~3,0.97 mg/m~3,123.77μg/m~3and 36.22μg/m~3,respectively.For circulatory system disease,the independently significant associations of SO_2with emergency department visits in single-pollutant models(2.91%,95%CI:1.00%-4.85%),and multipollutant models(4.39%,95%CI:1.22%-7.67%)were observed.ConclusionThe ambient SO_2 increases the risk of emergency department visits due to circulatory diseases in Guangzhou.Comprehensive prevention and control measures should be taken to reduce the emission of SO_2.
Objective To understand the relationship between the concentration of air pollutants and daily emergency department visits for different diseases(circulatory system disease,digestive system disease,nervous system disease and respiratory system disease)in Guangzhou,Guangdong Province.Methods The daily average concentrations of sulfur dioxide(SO_2),nitrogen dioxide(NO_2,carbon monoxide(CO)and PM_(2.5)and the daily maximum 8-hour concentrations of O_3,the daily average temperature,the relative humidity and cause-specific emergency department visits of the four major diseases from 2015 to 2017 were collected in Guangzhou.Semi-parametric generalized additive model was used to analyze the relationship between the concentration of pollutants and daily cause-specific emergency department visits.Results The daily average concentrations of SO_2,NO_2,CO,O_3 and PM_(2.5)during the study period were 13.24μg/m~3,45.96μg/m~3,0.97 mg/m~3,123.77μg/m~3and 36.22μg/m~3,respectively.For circulatory system disease,the independently significant associations of SO_2with emergency department visits in single-pollutant models(2.91%,95%CI:1.00%-4.85%),and multipollutant models(4.39%,95%CI:1.22%-7.67%)were observed.ConclusionThe ambient SO_2 increases the risk of emergency department visits due to circulatory diseases in Guangzhou.Comprehensive prevention and control measures should be taken to reduce the emission of SO_2.
引文
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[3]陈浪,赵川,关茗洋,等.石家庄市大气颗粒污染物浓度与居民死亡率的时间序列分析[J].中华疾病控制杂志,2018,22(3):272-277.DOI:10.16462/j.cnki.zhjbkz.2018.03.014.Chen L,Zhao C,Guan MY,et al.Time-series analysis of the relationship between particulate matter and mortality in Shijiazhuang[J].Chin J Dis Control Prev,2018,22(3):272-277.DOI:10.16462/j.cnki.zhjbkz.2018.03.014.
[4]Kim H,Kim J,Kim S,et al.Cardiovascular effects of long-term exposure to air pollution:a population-based study with 900 845person-years of follow-up[J].J Am Heart Assoc,2017,6(11):e007170.DOI:10.1161/JAHA.117.007170.
[5]Fiordelisi A,Piscitelli P,Trimarco B,et al.The mechanisms of air pollution and particulate matter in cardiovascular diseases[J].Heart Fail Rev,2017,22(3):337-347.DOI:10.1007/s10741-017-9606-7.
[6]丁亚萍,虞明星,郝海燕,等.石家庄市空气PM2.5浓度与儿童呼吸系统疾病门诊量的关系[J].中华疾病控制杂志,2018,22(7):672-676.DOI:10.16462/j.cnki.zhjbkz.2018.07.005.Ding YP,Yu MX,Hao HY,et al.The relationship between fine particulate matter and hospital outpatients with pediatric respiratory diseases in Shijiazhuang City[J].Chin J Dis Control Prev,2018,22(7):672-676.DOI:10.16462/j.cnki.zhjbkz.2018.07.005.
[7]Macintyre H,Heaviside C,Neal L,et al.Mortality and emergency hospitalizations associated with atmospheric particulate matter episodes across the UK in spring 2014[J].Environ Int,2016,97:108-116.DOI:10.1016/j.envint.2016.07.018.
[8]Neuberger M,Moshammer H,Rabczenko D.Acute and subacute effects of urban air pollution on cardiopulmonary emergencies and mortality:time series studies in Austrian cities[J].Int J Environ Res Public Health,2013,10(10):4728-4751.DOI:10.3390/ijerph10104728.
[9]Pun VC,Yu IT,Qiu H,et al.Short-term associations of causespecific emergency hospitalizations and particulate matter chemical components in Hong Kong[J].Am J Epidemiol,2014,179(9):1086-1095.DOI:10.1093/aje/kwu026.
[10]Song Q,Christiani D,Wang XR,et al.The global contribution of outdoor air pollution to the incidence,prevalence,mortality and hospital admission for chronic obstructive pulmonary disease:a systematic review and meta-analysis[J].Int J Environ Res Public Health,2014,11(11):11822-11832.DOI:10.3390/ijerph111111822.
[11]Huang F,Luo Y,Guo Y,et al.Particulate matter and hospital admissions for stroke in Beijing,China:modification effects by ambient temperature[J].J Am Heart Assoc,2016,5(7).DOI:10.1161/JAHA.116.003437.
[12]Vodonos A,Novack V,Zlotnik Y,et al.Ambient air pollution,weather and daily emergency department visits for headache[J].Cephalalgia,2015,35(12):1085-1091.DOI:10.1177/0333102415570300.
[13]Alimohammadi H,Fakhri S,Derakhshanfar H,et al.The effects of air pollution on ischemic stroke admission rate[J].Chonnam Med J,2016,52(1):53-58.DOI:10.4068/cmj.2016.52.1.53.
[14]Brook R,Kousha T.Air pollution and emergency department visits for hypertension in Edmonton and Calgary,Canada:a case-crossover study[J].Am J Hypertens,2015,28(9):1121-1126.DOI:10.1093/ajh/hpu302.
[15]Guo Y,Tong S,Li S,et al.Gaseous air pollution and emergency hospital visits for hypertension in Beijing,China:a time-stratified case-crossover study[J].Environ Health,2010,9:57.DOI:10.1186/1476-069X-9-57.
[16]Guo Y,Jia Y,Pan X,et al.The association between fine particulate air pollution and hospital emergency room visits for cardiovascular diseases in Beijing,China[J].Sci Total Environ,2009,407(17):4826-4830.DOI:10.1016/j.scitotenv.2009.05.022.
[17]Meng Z,Qin G,Zhang B,et al.Oxidative damage of sulfur dioxide inhalation on lungs and hearts of mice[J].Environ Res,2003,93(3):285-292.
[18]Zheng X,Ding H,Jiang L,et al.Association between air pollutants and asthma emergency room visits and hospital admissions in time series studies:a systematic review and meta-analysis[J].PLo S One,2015,10(9):e138146.DOI:10.1371/journal.pone.0138146.
[19]Phung D,Hien TT,Linh HN,et al.Air pollution and risk of respiratory and cardiovascular hospitalizations in the most populous city in Vietnam[J].Sci Total Environ,2016,557-558:322-330.DOI:10.1016/j.scitotenv.2016.03.070.
[20]Winterton DL,Kaufman J,Keener CV,et al.Genetic polymorphisms as biomarkers of sensitivity to inhaled sulfur dioxide in subjects with asthma[J].Ann Allergy Asthma Immunol,2001,86(2):232-238.DOI:10.1016/S1081-1206(10)62697-X.