摘要
[背景]空气质量健康指数(AQHI)将人群流行病学观察到的多个污染物健康效应指数化,能更好地反映空气污染与健康效应间广泛存在的线性无阈值关系。[目的]探索上海市儿童呼吸系统疾病AQHI(AQHI_(r))的建立方法并探讨其适用性。[方法]收集2015—2019年上海市徐汇、宝山、虹口、金山和崇明区5家综合医院儿科呼吸系统疾病日门诊人次数,收集距离医院最近的5个空气质量监测点大气污染物(PM_(2.5)、PM_(10)、SO_(2)、NO_(2)和O_(3))监测资料、空气质量指数(AQI)和气象监测资料(温度、相对湿度、气压和风速),采用基于泊松分布的广义相加模型(GAM),分析大气污染与儿科呼吸系统疾病门诊人次数之间的关联,依据GAM分析结果构建AQHI_(r)。比较AQHI_(r)、AQI与徐汇、虹口和崇明区的3家医院儿科呼吸系统疾病门诊人次数之间的关联性,评价AQHI_(r)的预测效果。[结果]大气污染物对儿科呼吸系统疾病门诊人次数有不同程度的影响:PM_(2.5)、NO_(2)和O_(3)效应在滞后当天(lag0)最显著,污染物质量浓度每升高10μg·m^(-3),超额就诊风险分别为1.27%(95%CI:0.88%~1.66%)、0.75%(95%CI:0.40%~1.11%)和3.61%(95%CI:2.71%~4.51%);PM_(10)和SO_(2)在滞后3 d(lag3)效应最显著,污染物每升高10μg·m^(-3),超额就诊风险分别为0.81%(95%CI:0.51~1.12)和5.64%(95%CI:3.37%~7.96%)。除PM_(10)+NO_(2)、SO_(2)+PM_(2.5)和SO_(2)+NO_(2)外,其余污染物两两叠加,对健康影响均有意义(P<0.05)。依据单污染物和双污染物分析结果,选择PM_(2.5)、NO_(2)、SO_(2)和O_(3)建立AQHI_(r)。比较结果显示,AQHI_(r)每升高一个四分位数间距,儿童超额就诊风险高于AQI相应的指标值。[结论]上海市大气污染物对儿科呼吸系统疾病门诊人次数有影响。依据儿童呼吸系统疾病就诊风险建立的AQHI_(r)能够较好地预测空气污染对儿童呼吸系统的健康影响。
[Background]Air quality health index(AQHI)has been widely used to quantify the health effects of multiple pollutants observed in population-based epidemiological studies,and can better reflect the widespread linear non-threshold between air pollution and health effects.[Objective]To explore an AQHI for pediatric respiratory diseases(AQHI_(r))in Shanghai and evaluate its feasibility.[Methods]The daily numbers of hospital outpatient visits for pediatric respiratory diseases from 2015 to 2019 were obtained from five general hospitals in Xuhui,Baoshan,Hongkou,Jinshan,and Chongming Districts of Shanghai.Monitoring data on air pollutants(PM_(2.5),PM_(10),SO_(2),NO_(2),and O_(3)),air quality index(AQI),and meteorological variables(temperature,relative humidity,air pressure,and wind speed)were collected from five air quality monitoring sites nearest to selected hospitals.Time-series analysis using generalized additive model(GAM)was conducted to estimate the associations between respiratory-related pediatric outpatient visits and the concentrations of air pollutants.The sum of excess risk(ER)of hospital outpatient visits was used to construct AQHI_(r).To assess the predictive power of AQHI_(r),the associations of AQHI_(r) and AQI with the number of pediatric respiratory outpatient visits in three hospitals in Xuhui,Hongkou,and Chongming districts were compared.[Results]Air pollutants had various effects on respiratory diseases outpatient visits.PM_(2.5),NO_(2),and O_(3) had most significant impacts on lag0 day and the associated ERs of hospital outpatient visits for each 10μg·m−3 increase in pollutant concentration were 1.27%(95%CI:0.88%-1.66%),0.75%(95%CI:0.40%-1.11%),and 0.36%(95%CI:0.10%-0.62%),respectively.PM_(10) and SO_(2) had most significant impacts on lag3 day and the associated ERs of hospital outpatient visits for each 10μg·m−3 increase in pollutant concentration were 0.81%(95%CI:0.51%-1.12%)and 5.64%(95%CI:3.37%-7.96%),respectively.There were significant effects of combinations of two pollutants among
作者
张莉君
许慧慧
朱凤鸣
东春阳
许东
沈先标
凌利民
许明佳
张标
陈健
苏瑾
ZHANG Lijun;XU Huihui;ZHU Fengming;DONG Chunyang;XU Dong;SHEN Xianbiao;LING Limin;XU Mingjia;ZHANG Biao;CHEN Jian;SU Jin(Division of Public Health Service and Safety Assessment,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Institutes of Preventive Medicine,Shanghai 200336,China;Shanghai University of Medicine&Health Science,Shanghai 201318,China;Environmental Health Department,Shanghai Xuhui District Center for Disease Control and Prevention,Shanghai 200237,China;Environmental Health Department,Shanghai Baoshan District Center for Disease Control and Prevention,Shanghai 201901,China;Environmental Health Department,Shanghai Hongkou District Center for Disease Control and Prevention,Shanghai 200082,China;Environmental Health Department,Shanghai Jinshan District Center for Disease Control and Prevention,Shanghai 201500,China;Environmental Health Department,Shanghai Chongming District Center for Disease Control and Prevention,Shanghai 202150,China)
出处
《环境与职业医学》
CAS
CSCD
北大核心
2022年第7期730-736,共7页
Journal of Environmental and Occupational Medicine
基金
上海市科技创新行动计划-自然科学基金资助项目(19 ZR1444300)
国家空气污染对人群健康影响监测项目(无编号)
国家环境保护新型污染物环境健康影响评价重点实验室项目(无编号)。
