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目的研究并描述高浓度PM_(10)与5岁以下儿童呼吸系统疾病日住院例数之间的浓度-反应关系及曲线特征。方法儿童呼吸系统疾病住院数据为2004—2006年临汾市主要的5所医院的电子病历首页,空气质量数据为市内5个空气监测点的PM_(10)、SO_2和NO_2日平均值,气象数据为当地的日平均气温和相对气湿。应用广义相加模型(GAM)建立浓度-反应关系;以多重结构断裂点检测法确定浓度-反应关系曲线上的拐点;以约束性分段线性函数估计相对危险度。结果临汾市大气PM_(10)的平均浓度为185.1μg/m~3(范围为45.3~1 109.2μg/m~3),PM_(10)与5岁以下儿童呼吸系统疾病日住院例数的浓度-反应关系曲线明显偏离线性,以J型为主。PM_(10)的影响主要表现为多日的累积影响,在141.8~676.0μg/m~3的浓度范围,全年中累积5 d(avg04)的PM_(10)浓度每升高10μg/m~3,5岁以下儿童呼吸系统疾病日住院例数增加2.03%(95%CI:1.28%~2.79%)。PM_(10)的影响主要发生于采暖期,在109.7~634.7μg/m3的浓度范围,累积7 d(avg06)的PM_(10)每升高10μg/m~3,5岁以下儿童呼吸系统疾病日住院例数增加2.24%(95%CI:1.29%~3.19%);在非采暖期未见明显影响。结论高浓度PM_(10)与5岁以下儿童呼吸系统疾病日住院例数的浓度-反应关系曲线呈J型,低浓度范围内的C型曲线无统计学意义。
Objective To study and describe the concentration-response relationship and curve characteristics of high-concentration PM_ (10) and hospitalized cases of respiratory diseases in children under 5 years of age. Methods The hospitalization data of children with respiratory diseases were the first page of electronic medical records of five major hospitals in Linfen City from 2004 to 2006. The air quality data were the daily average values of PM 10, SO 2 and NO 2 at five air monitoring stations in the city, For the local average temperature and relative humidity. The generalized additive model (GAM) was used to establish the concentration-response relationship. The inflection point on the concentration-response curve was determined by multiple structural breakpoint detection. The relative risk was estimated by the constrained piecewise linear function. Results The mean PM_ (10) concentration in Linfen City was 185.1μg / m ~ 3 (range 45.3-1 109.2μg / m ~ 3). The PM_ (10) - The response curve was significantly deviated from the linear, with J-based. The effect of PM_ (10) was mainly manifested as the cumulative effect of multiple days. With the concentration of 141.8 ~ 676.0μg / m3, the PM_ (10) concentration of 5 days (avg04) The number of hospitalizations for children under the age of 3,5 years with respiratory diseases increased by 2.03% (95% CI: 1.28% -2.79%). The effect of PM_ (10) mainly occurred in the heating period, and in the concentration range of 109.7 ~ 634.7μg / m3, the PM_ (10) accumulated for 7 days (avg06) increased for every 10μg / m ~ The number of daily hospitalizations increased by 2.24% (95% CI: 1.29% -3.19%); no significant effect was observed during non-heating period. Conclusion The concentration-response curve of high-concentration PM_ (10) and hospitalized children under 5 years of age with respiratory diseases was J-type. There was no significant difference in the C-curve in low concentration range.