文章摘要
张良,冯伟,陆蓓蓓,李宁,李辉,谷少华,葛挺,许国章.宁波市大气PM2.5污染对城区居民慢性阻塞性肺疾病门诊量影响研究[J].中华流行病学杂志,2019,40(6):686-691
宁波市大气PM2.5污染对城区居民慢性阻塞性肺疾病门诊量影响研究
The impact of ambient PM2.5 on daily outpatient visits due to chronic obstructive pulmonary disease, among the urban residents of Ningbo city
投稿时间:2018-12-28  
DOI:10.3760/cma.j.issn.0254-6450.2019.06.016
中文关键词: 大气PM2.5;慢性阻塞性肺疾病;广义相加模型
英文关键词: Ambient PM2.5;Chronic obstructive pulmonary disease;Generalized additional model
基金项目:国家重点研发计划(2018YFC1315305);浙江省医学重点学科“现场流行病学”(07-013);宁波市市级医疗卫生品牌学科(PPXK2018-10);宁波市医学科技计划(2016A02)
作者单位E-mail
张良 宁波市疾病预防控制中心 315010  
冯伟 奉化区疾病预防控制中心慢性病与社区卫生服务科, 宁波 315500  
陆蓓蓓 宁波市疾病预防控制中心 315010  
李宁 宁波市疾病预防控制中心 315010  
李辉 宁波市疾病预防控制中心 315010  
谷少华 宁波市疾病预防控制中心 315010  
葛挺 宁波市医疗中心李惠利医院呼吸内科 315010  
许国章 宁波市疾病预防控制中心 315010 xugz@nbcdc.org.cn 
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中文摘要:
      目的 探讨宁波市大气PM2.5污染对城区居民COPD门诊量短期影响。方法 基于宁波市全民健康信息平台,收集宁波市4家综合性医院2014-2016年城区居民COPD逐日就诊资料、同期气象及大气污染数据,采用泊松回归广义相加模型,分析宁波市大气PM2.5污染与居民COPD门诊量的关系及滞后效应。结果 宁波市大气PM2.5每升高10 μg/m3在全年、冷季(11月至次年4月)和暖季(5-10月)条件下分别可造成COPD门诊就诊人次升高1.87%(95% CI:0.98%~2.76%)、2.09%(95% CI:1.11%~3.08%)和2.56%(95% CI:0.56%~4.59%),冷季滞后第4天效应最强,暖季当天效应值最大,未见滞后效应。大气PM2.5污染对不同人群就诊量影响均有统计学意义(P<0.05),且滞后第4天效应最强,其中≥65岁和女性人群中效应更明显。引入PM10、SO2和NO2后,PM2.5浓度对当天的COPD门诊就诊量效应ER值均无统计学意义(P>0.05),对滞后第4天COPD门诊量效应强度略有变化,差异均有统计学意义(P<0.05)。结论 宁波市大气PM2.5浓度升高与居民COPD门诊就诊量增加相关,应采取有效预防措施加强对脆弱人群的保护,降低COPD发病风险。
英文摘要:
      Objective To explore the short-term effects of ambient PM2.5 on the outpatient visits of chronic obstructive pulmonary disease (COPD) in Ningbo city. Methods Through the regional health information platform, number of daily COPD outpatients from the four general hospitals in Ningbo was gathered. Related data on meteorological and air pollution from 2014 to 2016 was also collected. Generalized additive model (GAM) of Possion regression was used to estimate the impact of PM2.5 pollution on COPD outpatients and the lagging effects. Results In cold (November- April) or warm seasons (May-October), an 10 μg/m3 increase of PM2.5 would result in the excessive number of COPD outpatients as 1.87% (95%CI:0.98%-2.76%), 2.09% (95%CI:1.11%-3.08%) and 2.56% (95%CI:0.56%-4.59%), respectively. In terms of the short-term effects of PM2.5 the strongest was seen in the days of warm season but without delay (P<0.05). The strongest effect appeared at day 4 in cold season and the effect was particularly significant seen in the over 65 year-old group or in the female population. After the introduction of PM10, SO2 and NO2, the concentration of PM2.5, did not show significant effect on the number of hospital visits due to COPD on the same day (P>0.05). The effect of COPD on the fourth day showed a slight change after the lagging, and the effect was statistically significant (P<0.05). Conclusion The increase of PM2.5 concentration in Ningbo was related to the increase of COPD outpatient numbers. Effective prevention measures should be taken to protect the vulnerable population and to reduce the risk of COPD.
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