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京津冀及周边地区大气细颗粒物和臭氧对医院日门诊量的急性影响及季节性差异

陈晨 张梦雪 刘晶 方建龙 郭亚菲 李湉湉 施小明

陈晨,张梦雪,刘晶,方建龙,郭亚菲,李湉湉,施小明. 2022. 京津冀及周边地区大气细颗粒物和臭氧对医院日门诊量的急性影响及季节性差异. 气象学报,80(3):366-374 doi: 10.11676/qxxb2022.040
引用本文: 陈晨,张梦雪,刘晶,方建龙,郭亚菲,李湉湉,施小明. 2022. 京津冀及周边地区大气细颗粒物和臭氧对医院日门诊量的急性影响及季节性差异. 气象学报,80(3):366-374 doi: 10.11676/qxxb2022.040
Chen Chen, Zhang Mengxue, Liu Jing, Fang Jianlong, Guo Yafei, Li Tiantian, Shi Xiaoming. 2022. Acute impact of ambient fine particulate matter and ozone on daily outpatient visits and its seasonal differences in Beijing-Tianjin-Hebei and surrounding areas. Acta Meteorologica Sinica, 80(3):366-374 doi: 10.11676/qxxb2022.040
Citation: Chen Chen, Zhang Mengxue, Liu Jing, Fang Jianlong, Guo Yafei, Li Tiantian, Shi Xiaoming. 2022. Acute impact of ambient fine particulate matter and ozone on daily outpatient visits and its seasonal differences in Beijing-Tianjin-Hebei and surrounding areas. Acta Meteorologica Sinica, 80(3):366-374 doi: 10.11676/qxxb2022.040

京津冀及周边地区大气细颗粒物和臭氧对医院日门诊量的急性影响及季节性差异

doi: 10.11676/qxxb2022.040
基金项目: 中国疾病预防控制中心环境所青年科学基金项目(2020YSRF_02)、国家重点研发计划项目(2016YFC0206500)、大气重污染成因与治理攻关项目(DQGG0401)
详细信息
    作者简介:

    陈晨,主要从事环境流行病学研究。E-mail:chenchen3@nieh.chinacdc.cn

    通讯作者:

    施小明,主要从事慢性病流行病学研究。E-mail:shixm@chinacdc.cn

  • 中图分类号: P49

Acute impact of ambient fine particulate matter and ozone on daily outpatient visits and its seasonal differences in Beijing-Tianjin-Hebei and surrounding areas

  • 摘要: 探究京津冀及周边地区大气细颗粒物(PM2.5)和臭氧(O3)短期暴露对人群因病就诊的急性影响及其季节性差异,为区域性大气污染的协同治理提供流行病学证据。收集2013年1月1日—2018年12月31日京津冀及周边地区共14个城市100家医院门诊的日就诊量,以及大气PM2.5和O3日均浓度和气象因子数据,基于时间序列研究设计,采用二阶段统计分析策略(广义相加模型联合meta分析),在控制气象因子和时间趋势等混杂因素的基础上构建双污染物模型,分析大气PM2.5和O3短期暴露对人群因病就诊的影响。研究期间,大气PM2.5和O3日均浓度平均分别为 72.2±56.8 μg/m3和 58.2±36.9 μg/m3,医院门诊就诊量达6257万人 · 次。双污染物模型结果显示,移动平均滞后0—1 d的PM2.5和O3暴露浓度每升高10 μg/m3,医院门诊就诊量分别增加0.25%(95%置信区间(95%CI):0.20%—0.29%)和0.15%(95%CI:0.07%—0.22%);拟合季节分层模型发现,冷季PM2.5暴露对门诊就诊量的急性影响较强,而O3相关效应则呈现出暖季较强的特征。京津冀及周边地区大气PM2.5和O3短期暴露均增大人群因病就诊的风险,提示应采取积极措施协同治理大气PM2.5和O3复合污染,同时重视污染物冷、暖季风险的差异。

     

  • 图 1  京津冀及周边地区大气细颗粒物短期暴露对医院门诊每日就诊量的急性影响

    Figure 1.  Acute effects of short-term exposure to ambient fine particulate matter on daily outpatient visits in Beijing-Tianjin-Hebei and surrounding areas

    图 2  京津冀及周边地区大气臭氧短期暴露对医院门诊每日就诊量的急性影响

    Figure 2.  Acute effects of short-term exposure to ambient ozone on daily outpatient visits in Beijing-Tianjin-Hebei and surrounding areas

    图 3  京津冀及周边地区大气细颗粒物和臭氧短期暴露对医院门诊就诊影响的滞后效应

    Figure 3.  Lagged effect of short-term exposure to ambient fine particulate matter and ozone on hospital outpatient visits in Beijing-Tianjin-Hebei and surrounding areas

    表  1  京津冀及周边地区纳入研究的100家医院类型

    Table  1.   Type of 100 hospitals in Beijing-Tianjin-Hebei and surrounding areas

    省/直辖市医院类型(家)
    三级综合医院
    二级及社区综合医院
    儿童医院
    北京市461
    天津市461
    河北省6101
    山西省482
    山东省7133
    河南省8133
    下载: 导出CSV

    表  2  2013—2018年京津冀及周边地区100家医院每日门诊就诊量、大气污染物浓度和气象因子统计

    Table  2.   Summary statistics of daily outpatient visits at 100 hospitals and air pollutants and meteorological factors across the Beijing-Tianjin-Hebei region and surrounding areas from 2013 to 2018

    2013—2018年冷季暖季
    Mean±SDMedian (P25,P75)Mean±SDMean±SD
    每日门诊就诊量(人·次)282±463103(24,347)287±477277±449
    细颗粒物(μg/m372.2±56.856.0 (35.5,90.8)90.9±67.453.8±35.2
    臭氧(μg/m358.2±36.952.2 (28.6,81.5)39.6±26.376.4±36.7
    日均气温(℃)14.1±10.715.6 (4.5,23.7)5.5±7.122.7±5.3
    相对湿度(%)60.6±18.862.0 (47.0,75.0)54.8±19.666.2±16.1
     注:P25和P75分别为25%和75%分位数;Mean为平均值;Median为中位数;SD为标准差。
    下载: 导出CSV

    表  3  不同污染物模型对全年大气细颗粒物和臭氧短期暴露急性效应的影响

    Table  3.   Influences of different pollutant-models on acute effects of ambient fine particulate matter and ozone short-term exposure during the entire year

    污染物及暴露滞后门诊就诊人次增加百分比[%(95%CI)]
    双污染物模型单污染物模型
    细颗粒物 lag00.23 (0.20—0.27)0.24 (0.20—0.27)
    细颗粒物 lag10.12 (0.09—0.15)0.12 (0.09—0.15)
    细颗粒物 lag010.25 (0.20—0.29)0.25 (0.21—0.30)
    臭氧 lag00.08 (0.02—0.14)0.09 (0.03—0.16)
    臭氧 lag10.16 (0.10—0.23)0.17 (0.11—0.24)
    臭氧 lag010.15 (0.07—0.22)0.18 (0.10—0.26)
    下载: 导出CSV

    表  4  模型自由度调整对全年大气细颗粒物和臭氧移动平均滞后0—1 d暴露急性效应的影响

    Table  4.   Influences of degree of freedom adjustment on acute effects of annual ambient fine particulate matter and ozone exposure with 0 to 1 d lag

    自由度调整门诊就诊人次增加百分比[%(95%CI)]
    细颗粒物臭氧
    dftime=6,dftem=3,dfrh=30.25 (0.20—0.29)0.15 (0.07—0.22)
    dftime=7,dftem=3,dfrh=30.26 (0.21—0.30)0.11 (0.04—0.19)
    dftime=6,dftem=5,dfrh=50.24 (0.20—0.29)0.13 (0.06—0.20)
    dftime=7,dftem=5,dfrh=50.25 (0.21—0.30)0.11 (0.03—0.18)
    下载: 导出CSV
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  • 收稿日期:  2021-12-27
  • 录用日期:  2022-04-21
  • 修回日期:  2022-03-25
  • 网络出版日期:  2022-04-12

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