北京市大气PM2.5污染对某医院儿科门诊量影响的时间序列研究

目的 探讨北京市大气PM2.5对医院儿科门诊量的影响。方法 采用基于泊松回归的广义线性模型(GLM),控制时间的长期趋势、季节趋势、星期几效应、节假日效应、流感、气象因素等混杂因素后,分析2013-2015年北京市大气PM2.5对某医院儿科门诊量的影响。结果 单污染物模型分析显示PM2.5对儿科总门诊量、儿科呼吸系统疾病门诊量和儿科其他疾病门诊量的影响均有统计学意义,且以当天的效应最强,PM2.5浓度每升高10μg/m³,上述门诊量分别增加0.525%(95%CI:0.428%~0.622%)、0.589%(95%CI:0.473%~0.706%)、0.393%(95%CI:0.218%~0.569%)。多污染物模型分析结果显示,引入其他污染物后,PM2.5对儿科总门诊量和呼吸系统疾病门诊量的影响仍有统计学意义,PM2.5浓度每升高10μg/m³,上述门诊量分别增加0.570(0.342~0.797)、0.697(0.421~0.973);PM2.5对儿科其他疾病门诊量的影响无统计学意义。结论 北京市PM2.5浓度升高可能会引起医院儿科呼吸系统疾病门诊量的增加。

Impact of PM2.5 on outpatient visit of pediatric department in Beijing:a time-series study

Objective To estimate the effect of PM2.5 on the outpatient visit of the pediatric department in Beijing.Methods All records of the daily outpatient visit of pediatric department and the number of influenza-like cases from 2013 to 2015 were collected from one tertiary hospital in Beijing.The air pollution data and meteorological data of the same period were also collected from Beijing Environmental Protection Bureau and Meteorological Bureau.Generalized linear model (GLM) based on the Poisson regression was conducted to analyse the effect of PM2.5 on outpatient visit of pediatric department,long-term and seasonal trends.Factors of the day of the week,holiday,flu,and meteorological were controlled in the model and the lag effect was also analyzed.Results The median of daily average values of PM2.5 were 90.6 g/m³ (daily range:5.6 g/m3-519.7 g/m³).Significant association were found between PM2.5 and total outpatient visit,outpatient visit of respiratory diseases and outpatient visit of other diseases of pediatric department (lag0),and the ERs were 0.525% (95%CI:0.428%-0.622%),0.589% (95%CI:0.473%-0.706%) and 0.393% (95%CI:0.218%-0.569%) individually associated with an increase of 10 g/m³ PM2.5.After controlling other pollutants (PM10,SO2,NO2,O3,CO) simultaneously,significant association were still found between PM2.5 and total outpatient visit and outpatient visit of respiratory diseases,and the ERs were 0.570 (0.342 0.797) and 0.697 (0.421 0.973) individually associated with an increase of 10 g/m³ PM2.5.Conclusion It is suggested that PM2.5 may increase the outpatient visit of respiratory diseases.