2017年广州市空气污染物对急救人数的影响分析

目的了解空气污染物浓度对广州市居民的急救就诊影响情况,为有效提高空气污染相关疾病的早期预防和控制能力提供科学依据。方法采用时间序列的半参数广义相加模型(GAM),控制每日急救人次的长期趋势、气象因素"、星期几效应"等混杂因素后,分析广州市2017年1月1日至12月31日大气中逐日的SO_2、NO_2、CO、PM_2.5、PM₁₀、O_3-1h、O_3-8h浓度与居民急救人数的关系。结果 2017年广州市空气中主要污染物为CO,全年空气中PM_2.5、PM₁₀、NO_2、CO浓度12月最高,6月最低;O_3(O_3-1h、O_3-8h)8月份浓度最高,1月最低;SO_212月最高,1月最低。2017年日均急救人数为405.08例,呼吸系统疾病日均急救人数为26.57例,循环系统疾病日均急救人数38.44例。GAM模型分析结果显示,SO_2、NO_2、CO浓度每上升10个单位,当天及滞后3 d内日均急救总人数相应增加。SO_2浓度升高的当天及滞后第3天时对呼吸系统疾病急救人数影响最大,每上升10个单位,呼吸系统疾病急救人数分别增加8.01%、9.62%。逐日空气污染物浓度对循环系统疾病急救人数的影响无统计学意义。结论广州市空气污染物对居民健康存在急性影响,尤其对呼吸系统产生影响,应做好污染物控制,在中、重污染天气下做好敏感人群的健康防护。

Impact of air pollutants on emergency department visits due to first aid in Guangzhou, 2017

Objective To understand effect of air pollutant concentration on first aid visits of residents in Guangzhou, so as to improve the ability and control of early prevention of air pollution related diseases. Methods A semi-parametric generalized additive model （GAM） was used to examine the relationship between the concentrations of SO₂, NO₂, CO, PM_2.5, PM₁₀, O_3-1h and O_3-8h in the atmosphere and emergency department visits due to the first aid from January 1 to December 31, 2017 in Guangzhou after controlling long time trend, the “day of the week” effect and confounding meteorological factors. Results In 2017, the main pollutants in the air was CO in Guangzhou. The concentrations of PM_2.5, PM₁₀, NO₂ and CO in the air were highest in December and lowest in June, concentrations of O₃ （O_3-1h and O_3-8h） were highest in August and lowest in January, and concentration of SO₂ was highest in December and lowest in January. In 2017, the daily average number of first aid cases was 405.08, and the daily number of first aid cases was 26.57 for respiratory diseases and 38.44 for cardiovascular diseases. GAM analysis showed that each 10-unit increment in SO₂, NO₂, and CO concentrations was associated with an increment in the total number of first aid cases at the same day and within lag3 days. The increase in SO₂ concentration at the same day and three-day lag time had the greatest impact on the number of emergency department visits due to first aid for respiratory diseases, for every 10-unit increment in SO₂ concentration, the number of first aid cases for respiratory diseases increased by 8.01% and 9.62%, respectively. Conclusion Air pollution was associated with increased risk of emergency visits due to the first aid, especially for the respiratory diseases in Guangzhou. The health protection for the sensitive population should be emphasized in moderate and heavy pollution weather.