北京市延庆区大气污染物对呼吸系统疾病门急诊量的影响

  目的  探讨北京市延庆区大气污染对人群呼吸系统疾病门急诊量影响。  方法  收集2014-2017年北京市延庆区二级医疗机构的呼吸系统疾病每日门急诊量数据和同期气象数据资料以及大气污染数据资料，运用时间序列的广义相加模型，在控制混杂因素的基础上，分析大气污染物浓度与呼吸系统门急诊量的关系以及滞后效应。  结果  研究表明，大气中空气动力学直径当量直径≤ 2.5 μm的颗粒物（particulate matter 2.5，PM_2.5）每增加10 μg/m3，呼吸系统门急诊量增加0.11%（RR=0.11，95%CI:0.09~0.14，P=0.001）；大气中空气动力学直径当量直径≤ 10 μm的颗粒物（particulate matter 10，PM₁₀）每增加10 μg/m3，呼吸系统门急诊量增加0.17%（RR=0.17，95%CI:0.15~0.19，P=0.001；二氧化氮（nitrogen dioxide，NO₂）每增加10 μg/m3，呼吸系统门急诊量增加0.44%（RR=0.44，95%CI:0.37~0.50，P=0.001）；一氧化碳（carbon monoxide，CO）每增加10 μg/m3，呼吸系统门急诊量增加3.34%（RR=3.34，95%CI:1.57~5.15，P=0.001），且最强效应期均在第0 d。二氧化硫（sulfur ioxide，SO₂）每增加10 μg/m3呼吸系统门急诊量增加-1.69%（RR=-1.69，95%CI:-1.80~-1.57，P=0.001），且在第1 d达到最强效应值。臭氧（ozone，O₃）每增加10 μg/m3呼吸系统门急诊量增加-0.12%（RR=0.12，95%CI:-0.15~-0.10，P=0.001），且在第5 d达到最强效应值。双污染物模型分析中，CO在SO₂的影响下，对呼吸系统疾病门急诊人数影响尤为明显。  结论  本研究结果提示延庆区PM_2.5、PM₁₀、NO₂、CO浓度的增加均会导致呼吸系统门急诊量的增加，且不同污染物之间存在相互作用。

Effects of air pollutants on outpatient and emergency number of respiratory diseases in Yanqing District of Beijing

  Objective  To explore the association between air pollutants and the number of outpatient and emergency visits for respiratory diseases in Yanqing District, Beijing.  Methods  Data from 2014-2017 of the number of outpatient and emergency visits for respiratory diseases was collected from secondary medical institutions in Yanqing District of Beijing, and data of meteorological monitoring and atmospheric pollution were also collected. On the basis of controlling confounding factor, a generalized additive model was used to analyze the relationship between air pollutant concentration and the number of outpatient and emergency visits for respiratory diseases, and lag effect.  Results  The results showed that, Particulate Matter 2.5 (PM_2.5) increased by 10 μg/m3, the number of respiratory outpatient and emergency visits would increase 0.11% (95% CI: 0.09-0.14, P=0.001); Particulate Matter 10 (PM10) increased by 10 μg/m3, the number of respiratory outpatient and emergency visits would increase 0.17% (95% CI: 0.15-0.19, P=0.001); Nitrogen dioxide(NO₂) increased by 10 μg/m3, the number of respiratory outpatient and emergency visits would increase 0.44% (95% CI: 0.37-0.50, P=0.001); carbon monoxide (CO) increased by 10 μg/m3, the number of respiratory outpatient and emergency visits would increase 3.34% (95% CI: 1.57-5.15, P=0.001), and the most effective period was on the Zeroth day. The number of respiratory outpatient and emergency visits would increase -1.69%(95% CI: -1.80--1.57, P=0.001) with sulfur ioxide (SO₂) increased 10 μg/m3, and the most effective period was on the 1th day. The number of respiratory outpatient and emergency visits would increase -0.12% (95% CI: -0.15--0.10, P=0.001) with O₃ increased 10 μg/m3, and the most effective period was on the 5th day. In the analysis of double pollutant model, under the influence of SO₂, CO had a significant effect on the number of outpatient and emergency visits with respiratory diseases.  Conclusion  The results of this study suggest that in Yanqing District, increasing concentrations of PM_2.5, PM₁₀, NO₂ and CO will cause an increase in the number of outpatient and emergency visits for respiratory diseases, and there are interactions between different pollutants.