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[目的]计算大气污染物浓度对社区上呼吸道疾病门诊就诊的相对危险度(RR),以评价不同污染物的效应差异。[方法]收集2011—2013年门诊病人资料及同期空气监测结果,采用分布滞后非线性模型(DLNM)计算空气污染物与上呼吸道疾病就诊量的RR值,并比较其滞后累积效应和剂量反应关系。[结果]各污染物水平与门诊量均有正相关性,且对上呼吸道疾病就诊量的影响随着浓度的增加而增加。SO2和PM2.5对上呼吸道门诊量的RR值在低浓度时效应增加较快,在高浓度时出现平台期或效应下降;NO2对上呼吸道门诊量的RR值在低浓度时相对较低,当天平台期效应不明显。SO2和NO2的最长滞后天数较短;PM2.5的累积效应更大,滞后天数更长。[结论]3种污染物均可增加上呼吸道门诊量,SO2和NO2的效应可能以急性为主,PM2.5的滞后效应更为明显。SO2在低浓度时就可以造成一定危害,而NO2在高浓度时效应增加更明显。
[Objective] To calculate the relative risk (RR) of air pollutant concentration in community outpatient upper respiratory disease clinics to evaluate the effect differences of different pollutants. [Methods] Outpatient data and air monitoring results during the same period from 2011 to 2013 were collected. The RR of air pollutants and upper respiratory diseases were calculated by using Distributed Lag Nonlinear Model (DLNM), and the relation between cumulative lag effect and dose response . [Results] There was a positive correlation between the levels of contaminants and the outpatient volume, and the influence on the amount of consultation on upper respiratory diseases increased with the increase of the concentration. RR of SO2 and PM2.5 in upper respiratory tract outpatients increased rapidly at low concentration, and plateau or decreased at high concentration. The RR of NO2 in upper respiratory tract was relatively low at low concentration, Platform effect of the day is not obvious. The longest lag days of SO2 and NO2 are shorter; the cumulative effect of PM2.5 is larger and the lag days are longer. [Conclusion] The three kinds of pollutants can increase the amount of outpatient upper respiratory tract, the effect of SO2 and NO2 may be mainly acute, and the hysteresis effect of PM2.5 is more obvious. SO2 at a low concentration can cause some harm, and NO2 at higher concentrations increased when the effect is more pronounced.