深圳市龙岗区大气污染物与医院呼吸系统疾病门诊量的广义相加模型分析

目的 探讨深圳市龙岗区主要大气污染物(SO2、NO2、PM10与PM2.5)与医院呼吸系统疾病门诊量的关系。 方法 收集2013年1月1日-2015年12月31日深圳市龙岗区2家公立医院呼吸系统疾病逐日门诊量资料,深圳市龙岗区逐日大气污染物浓度及逐日气象资料分别来自深圳市环境监测站及气象局,运用时间序列分析广义相加模型对大气污染物日均浓度与呼吸系统疾病门诊量的关系及滞后效应进行分析。 结果 深圳市龙岗区2013-2015年SO2 、NO2 、PM10 与PM2.5浓度中位数分别为8.08、38.08、46.05 μg/m3及31.04 μg/m3。2家医院三年呼吸系统门诊总量为549 169人次,日门诊量中位数为499人次/d。广义相加模型分析结果表明,除NO2对呼吸系统疾病门诊量影响差异无统计学意义外,其余三种污染物对呼吸系统疾病门诊量影响均存在滞后效应,污染物每升高10 μg/m3,滞后2 d时SO2对门诊量影响最强(相对危险度RR为1.030 7,95%CI:1.015 7~1.045 9),滞后3 d时PM10与PM2.5浓度对呼吸系统疾病门诊量影响最强(PM10:RR=1.005 4,95%CI:1.002 8~1.008 0,PM2.5:RR=1.006 0, 95%CI:1.002 7~1.009 4)。 结论 深圳市龙岗区大气SO2、PM10与PM2.5浓度对医院呼吸系统疾病门诊量影响存在滞后效应。

Using a generalized additive model to study the relationship between air pollution and outpatient visits for respiratory diseases in Longgang District of Shenzhen City

Objective To explore the relationship between air pollution (including SO₂, NO₂, PM₁₀ and PM_2.5) and outpatient visits for respiratory diseases in Longgang District of Shenzhen City. Methods We collected the data regarding daily outpatient visits for respiratory diseases in two hospitals in Longgang District of Shenzhen City, daily air pollution data from Shenzhen Meteorological Bureau and daily meteorological data from Shenzhen Environmental Protection Bureau from January 1, 2013 to December 31, 2015. We performed time-series analysis using a generalized additive model (GAM), and then assessed the association and the lag effect between air pollution and hospital outpatient visits for respiratory diseases. Results The medians of SO₂, NO₂, PM₁₀ and PM_2.5 concentration were 8.08 μg/m³, 38.08 μg/m³, 46.05 μg/m³ and 31.04 μg/m³ respectively. The total outpatient visits of the involved hospitals during this three-year period were 549,169, with the median of 499 persons per day. The Results of GAM-based analysis indicated a positive association between three air pollutants (SO₂, PM₁₀ and PM_2.5) and hospital outpatient visits for respiratory diseases. The effect of SO₂ was the largest on lag two days (RR=1.030,7, 95%CI:1.015,7-1.045,9) and the ones of PM₁₀ and PM_2.5 were the largest on lag three days (PM₁₀:RR=1.005,4, 95%CI:1.002, 8-1.008,0, PM_2.5:RR=1.006,0, 95%CI:1.002,7-1.009,4). Conclusions The concentration of SO₂, PM₁₀ and PM_2.5 was positively associated with hospital outpatient visits for respiratory diseases in Longgang District in this three-year period, and a lag effect was found in these associations.