广州市灰霾天气对城区居民心血管疾病影响的时间序列分析

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目的探讨灰霾天气(haze)和PM10、PM2.5、SO2、NO2浓度对心血管疾病日门诊量的影响,为进一步制定有效的环境法规、保护易感人群提供依据。方法收集广州市中心城区某医院心血管疾病日门诊量资料及同时期大气污染物浓度、气象监测资料,采用时间序列的自回归模型,在控制了长期趋势、短期趋势、气象因素等混杂因素的基础上,分析广州中心城区2006年1月1日—2008年12月31日灰霾天气及空气污染物与居民心血管疾病发病的关系。结果自回归模型显示,2008年的门诊量水平高于2006年,每年4和12月的门诊量高于1月,工作日都高于休息日;灰霾的水平与医院心血管门诊病人量呈正相关,灰霾天气每增加1d,医院门诊病人量就上升2.12个单位;前第2天的灰霾的水平(lag2)对当天的疾病水平是负影响。而残差部分表明前1d和前3d的疾病门诊残留量(AR1、AR3)对当天的门诊残留量是正影响(分别增加52.25%,26.1%),前2d的疾病门诊残留量(AR2)对当天的门诊残留量是负影响(下降17%)。另外,各种空气污染物(PM10、PM2.5、SO2、NO2)之间呈现一定正相关性,并且具有滞后现象。结论由悬浮颗粒物、气象因素和气体污染物产生的灰霾天气是心血管疾病发病的环境病因,而单个空气污染物指标对心血管门诊病人量的影响被灰霾污染的综合效应所弱化。 Objective To investigate the effect of haze and PM10, PM2.5, SO2 and NO2 concentrations on the daily outpatient visits of cardiovascular diseases in order to provide evidences for further developing effective environmental regulations and protecting susceptible populations. Methods The data of daily outpatient visits of cardiovascular disease in a downtown area of ​​Guangzhou and the data of atmospheric pollutant concentrations and meteorological monitoring during the same period were collected. The autoregressive model of time series was used to control the long-term trend, short-term trend and meteorological factors Based on the analysis of Guangzhou downtown from January 1, 2006 -2008 on December 31, the relationship between haze weather and air pollutants and residents of cardiovascular disease. Results The autoregressive model showed that the outpatient amount in 2008 was higher than that in 2006, and the outpatient amount in April and December was higher than that in January and the working day was higher than the rest day. The level of haze was positively correlated with the number of hospital outpatient cardiovascular patients For each 1 day increase in haze weather, the number of outpatients in the hospital increased by 2.12 units; the level of haze before the second day was negatively affected by the level of disease on that day. While the residuals showed that the outpatient visits (AR1, AR3) of the first and last days were positive for the outpatient visits (52.25% and 26.1% respectively), and the outpatient visits for the first 2 days (AR2) Outpatient clinic residuals were negative (down 17%). In addition, a variety of air pollutants (PM10, PM2.5, SO2, NO2) showed a certain positive correlation between, and with hysteresis. Conclusions The haze weather caused by suspended particles, meteorological factors and gaseous pollutants is the environmental cause of cardiovascular disease. The impact of individual air pollutants on the volume of cardiovascular outpatients is weakened by the combined effect of haze pollution.
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