合肥市大气污染与肺炎门诊量的时间序列研究

目的探讨大气污染物SO_2、NO_2和PM_(2.5)浓度与合肥市滨湖医院肺炎日门诊量之间的关系。方法采用时间序列分析的广义相加Poisson回归模型,在控制长期趋势、星期几效应和气象因素等混杂因素的影响后,定量分析2014年安徽省合肥市大气污染物SO_2、NO_2、PM_(2.5)日均浓度与滨湖医院肺炎日门诊量的关系及滞后效应。结果单污染物模型中,在控制了长期趋势、星期几效应和气象因素的影响后,SO_2在滞后3、4、5 d(lag3、lag4、lag5)时对肺炎日门诊量的影响有统计学意义(P0.05),NO_2滞后2、3、4、5 d(lag2、lag3、lag4、lag5)时的影响有统计学意义(P0.01),PM_(2.5)滞后3、4 d(lag3、lag4)时的影响有统计学意义(P0.05);SO_2、NO_2、PM_(2.5)的滞后效应分别在lag3、lag2、lag4时最明显,当SO_2、NO_2、PM_(2.5)浓度每升高10μg/m~3时,肺炎日门诊量分别增加1.54%(95%CI:0.28%~2.81%),1.98%(95%CI:0.89%~3.08%)和0.28%(95%CI:0.06%~0.50%)。多污染物模型中,当模型中引入两种或两种以上的污染物后,各污染物对肺炎日门诊量的效应估计值均较单污染物模型降低,但并不改变各污染物与肺炎日门诊量之间的正向关联。结论合肥市大气污染物SO_2、NO_2、PM_(2.5)浓度升高可能引起医院肺炎日门诊量增加,且有一定的滞后效应。

Association between air pollution and daily outpatient visits for pneumonia in Hefei city: a time-series analysis

Objective To understand the relationship between air pollutants,such as sulfur dioxide (SO2),nitrogen dioxide (NO2) and fine particulate matter (PM2.5) and daffy outpatient visits for pneumonia in Hefei city,Anhui province.Methods The data analysis was conducted by using a Poisson generalized additive regression models to describe the air pollutants-pneumonia outpatient visits relationship and the lag effects.Long-term trends,day-of-week effect,and meteorological factors were adjusted to control the potential confounding effects.Results In the single-pollutant model,it had statistically significance between pneumonia daily outpatient visits and SO2 concentration(lag3,lag4,lag5) (P＜0.05),NOz concentration (lag2,lag3,lag4,lag5) (P＜0.01),PM2.5 concentration (lag4,lag5) (P＜0.05),respectively.The lag effects for SO2 (lag3),NO2 (lag2) and PM2.5 (lag4) showed the most significant influence,respectively.The excess relative risks of pneumonia daily outpatient visits for a 10 μg/m3 increment in SO2,NO2 and PM2.5 were 1.54％ (95％CI:0,28％-2.81％),1.98％ (95％CI:0.89％-3.08％) and 0.28％ (95％CI:0.06％-0.50％),respectively.In the mukiple-pollutant models,all pollutants effect estimates were lower compared with the results of the single-pollutant model when other pollutants were adjusted,but the positive correlations still existed between the pollutants and pneumonia daily outpatients.Conclusion The increase of air pollutants such as SO2,NO2 and PM2.5 may cause pneumonia daily outpatient visits increasing with lag effect in Hefei.