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目的探讨空气污染对济南市某医院呼吸系统疾病的短期影响及在人群中的差异。方法收集济南市某医院2010年1月1日至2012年12月31日呼吸系统疾病门诊资料、同期气象及空气污染数据,采用分布滞后非线性模型和温度分层等方法研究空气污染的滞后效应及其与气温的交互作用。结果空气污染当日即可引起呼吸系统门诊量升高,且效应可持续18 d;空气污染指数每升高10时,14 d累积效应可使呼吸系统门诊量增加4.26%(95%CI:1.89%~6.69%);将日最高气温按照P10和P90分为低、中、高3个水平后,空气污染指数每升高10可使呼吸系统疾病门诊量分别增加0.24%(95%CI:-4.65%~5.39%),2.54%(95%CI:0.55%~4.57%)和11.24%(95%CI:4.69%~18.20%),其中高温与空气污染的交互作用有统计学意义(P<0.05),且在0~14岁人群中效应更明显。结论空气污染加重会导致呼吸系统疾病门诊人数升高且持续时间较长,并与高温有交互作用。提示高温天气时更应加强对空气污染的防护,尤其应关注儿童等脆弱人群。
Objective To investigate the short-term effects of air pollution on respiratory diseases in a hospital in Jinan City and the differences in the population. Methods The data of outpatient respiratory diseases from January 1, 2010 to December 31, 2012 in Jinan City were collected. The meteorological and air pollution data of the same period were collected. The lagged effect of air pollution was studied by the method of distributed lag nonlinear model and temperature stratification And its interaction with temperature. Results On the day of air pollution, the respiratory outpatient volume increased and the effect lasted for 18 days. For every 10-day increase in air pollution index, the cumulative effect on 14-day cumulative respiratory output increased by 4.26% (95% CI: 1.89% ~ 6.69%). After the daily maximum temperature was divided into three levels of low, medium and high according to P10 and P90, the increase of out-patient respiratory disease by 0.24% for every 10-point increase in air pollution index (95% CI: -4.65 (95% CI: 0.55% ~ 4.57%) and 11.24% (95% CI: 4.69% ~ 18.20%). The interaction between high temperature and air pollution was statistically significant (P <0.05 ), And in 0 ~ 14-year-old crowd effect more obvious. Conclusion The increase of air pollution will cause the number of outpatients with respiratory diseases to rise and last longer, and interact with high temperature. Prompt high temperature weather should be more protection against air pollution, with particular attention to vulnerable groups such as children.