石家庄市空气PM2.5浓度与儿童呼吸系统疾病门诊量的关系

目的 分析石家庄市PM_2.5浓度与儿童呼吸系统疾病日门诊量的关系。方法 收集石家庄市2014-2016年气象、污染物及河北省儿童医院内科门诊呼吸系统门诊量数据，采用Poisson广义相加模型分析PM_2.5与儿童呼吸系统疾病日门诊量的关系。根据暴露-反应关系曲线进行分段危险度评估。结果 石家庄市2014-2016年PM_2.5年均值为104.93 μg/m³，该医院儿童呼吸系统疾病日门诊量均值为690例。PM_2.5与日门诊量的暴露-反应关系为非线性，且在低剂量范围时影响较大，在滞后1 d时效应最强，日均浓度每升高10 μg/m³，其儿童呼吸系统疾病日门诊量增加0.26%（95%CI：0.14%~0.38%）。分析PM_2.5累积滞后效应时发现，PM_2.5对儿童呼吸系统日门诊量有累积滞后效应，在累积滞后7 d时效应最强。多污染物分析显示：PM_2.5在只引入SO₂时对呼吸系统疾病日门诊量的效应下降，且差异具有统计学意义。引入其他污染物时，差异均无统计学意义（均有P>0.05）。结论 石家庄市空气PM_2.5会导致儿童呼吸系统疾病门诊量增加。

The relationship between fine particulate matter and hospital outpatients with pediatric respiratory diseases in Shijiazhuang City

Objective To analyze the relationship between fine particulate matter and hospital daily outpatients with pediatric respiratory diseases in Shijiazhuang. Methods The data of meteorology, air pollution and the daily outpatients with pediatric respiratory diseases were collected during 2014-2016 in Shijiazhuang. Generalized additive model (GAM) extended Poisson distribution was used to examine the relationship between fine particulate matter and hospital outpatients with pediatric respiratory diseases in Shijiazhuang. According to the exposure-response relationship curve, piecewise linear regression was used for risk analysis. Results During the study period, the average annual concentration of PM_2.5 in Shijiazhuang was 104.93 μg/m3 and the average number of daily hospital outpatients was 690 to the pediatric respiratory diseases. The exposure-response relationship suggested a nonlinear between PM_2.5 and daily hospital outpatient visits. A larger increase in daily hospital outpatient visits was observed at lower concentration of PM_2.5. An increase of 10 μg/m3 of PM_2.5 (lag1)was significantly related to hospital outpatients with respiratory diseases and could increase the excess risk of 0.26%(0.14%-0.38%). By moving average concentration analysis, there was a cumulative lag effect between PM_2.5 concentrations pediatric respiratory visits. The highest influence between PM_2.5 and accumulative effects for pediatric respiratory diseases visits was occurred in lag 0-7. The analysis of multiple pollutants model showed that the effect of PM_2.5 on the outpatient respiratory diseases decreased when only SO₂ was introduced, and it was statistically significant. But there was no statistical significance when introducing other pollutants(all P>0.05). Conclusion The PM_2.5 in Shijiazhuang may lead to the increase in hospital outpatients with pediatric respiratory diseases.