武汉市颗粒物污染对呼吸系统健康影响及经济损失分析

目的评估颗粒物(particulate matter,PM)污染对呼吸系统疾病(respiratory disease,RD)住院人数的影响,估计降低PM水平可避免的经济损失,为评估空气污染治理的成本-效益提供依据。方法收集武汉市2015—2019年两家三甲医院RD住院患者资料、同期武汉市PM浓度和气象数据。采用广义相加模型(generalized additive model,GAM)估计PM对RD住院人数的影响,采用疾病成本法(cost of illness approach,COI)估算PM浓度降低带来的可避免经济损失。结果PM污染造成RD住院人数增加,PM_(2.5)和PM_(10)浓度每上升10μg/m^(3),分别导致RD住院人数上升1.71%和0.71%。其中男性和0~14岁人群受影响较大,PM_(2.5)浓度每上升10μg/m^(3),男性和0~14岁住院人数分别上升1.97%和2.65%;PM_(10)浓度每上升10μg/m^(3),男性和0~14岁住院人数分别上升0.87%和0.88%。2015—2019年PM污染造成武汉市6.33万人住院和12.14亿元经济损失。若PM浓度降低至同期世界卫生组织建议值,武汉市每年可避免1.94亿元经济损失和1.01万人住院。结论PM暴露可导致沉重的疾病负担和经济损失,采取有效的措施控制PM浓度,将带来较大的经济效益。

Analysis on respiratory health effects and economic losses ofparticulate matter pollution in Wuhan

Objective To evaluate the impact of particulate matter(PM)pollution on the hospitalization for respiratory diseases(RD),to estimate the avoidable economic loss by reducing the level of PM pollution,and to provide a basis for evaluating the cost-effectiveness of air pollution control.Methods The data of RD inpatients in two class-A tertiary hospitals in Wuhan from 2015 to 2019,PM concentration and meteorological data in Wuhan in the same period were collected.The generalized additive model(GAM)was used to estimate the impact of PM on the number of RD inpatients,and the cost of illness approach(COI)was used to estimate the avoidable economic loss caused by the reduction of PM concentration.Results PM pollution caused an increase in the number of RD inpatients.Each 10(μg/m³ increase in PM_2.5 and PM₁₀ concentrations resulted in an increase of 1.71%and 0.71%in the number of RD inpatients,respectively.Among them,men and children aged 0-14 years were more affected.For every 10(μg/m³ increase in PM_2.5 concentration,the number of hospitalized men and children aged 0-14 years increased by 1.97%and 2.65%,respectively.For every 10(μg/m³ increase in PM₁₀ concentration,the number of hospitalized men and children aged 0-14 years increased by 0.87%and 0.88%,respectively.PM pollution caused 63300 hospitalizations and 1.214 billion yuan of economic losses in 2015-2019,Wuhan.If the PM concentration is reduced to the recommended value of the World Health Organization in the same period,194 million yuan of economic loss and 10100 hospitalizations could be avoided every year in Wuhan.Conclusion PM exposure can lead to heavy disease burden and economic loss.Taking effective measures to control PM concentration will bring great economic benefits.