沈阳市PM2.5离子成分对呼吸疾病门诊数影响研究

采用时间序列的半参数广义相加模型，在控制了长期趋势、"星期几效应"和气象因素等混杂因素的基础上，分析沈阳市大气污染物及PM_2.5中水溶性离子对呼吸系统疾病门诊就诊人数的影响，并按性别和年龄分层建模.结果表明：PM_2.5及其各离子成分与呼吸系统疾病门诊人数之间存在关联，并有明显的滞后效应.受冬季供暖燃煤排放影响，PM_2.5、NO₃^-和NH₄⁺呈显著关联，在滞后累积2d后风险最大.最佳滞后时间下，PM_2.5的浓度每增加10µg/m³，对应呼吸系统疾病日门诊就诊人数增加百分比（ER）为1.31%（95% CI：1.2%~1.43%）；离子成分SO₄^2-、NO₃^-、NH₄⁺、Cl^-、K⁺、Mg²⁺、Ca²⁺和Na⁺的浓度每增加1个4分位间距（IQR），对应的呼吸系统疾病日门诊就诊人数增加百分比（ER）分别为3.22%（95% CI：2.81%~3.62%）、4.67%（95% CI：4.13%~5.22%）、5.41%（95% CI：4.49%~6.33%）、7.38%（95% CI：3.91%~10.96%）、0.14%（95% CI：-6.34%~7.07%）、7.64%（95% CI：-11.87%~31.47%）、3.57%（95% CI：-2.83%~10.39%）和0.46%（95% CI：-16.64%~21.06%）.PM_2.5、Cl^-、Mg²⁺、Ca²⁺和Na⁺对女性呼吸疾病门诊人数的影响比对男性的影响大.PM_2.5、SO₄^2-、Cl^-、Ca²⁺和Na⁺对≥65岁的老人门诊人数的影响比对15~65岁劳动年龄人群的影响大.表明不同性别、不同年龄由于生理结构和环境因素的不同而引起的差异不同.

Effect of the association between PM2.5 and its water-soluble ions and hospital outpatient visits for respiratory diseases in Shenyang City

A semi-parametric generalized additive model (GAM) was used to analyze the exposure-effect relationship between PM_2.5 and its water-soluble (WS) ions and daily respiratory hospital outpatient visits from 2015 to 2016 in Shenyang after a complex control of the long-term trend, the "day of the week" effect, and the meteorological parameter. The layering model was established for people with different sexes and ages. The results showed that PM_2.5 and its WS ions had a lag correlation with daily outpatient visits. Due to the coal burning emissions in winter, PM_2.5, NO₃^-and NH₄⁺ had a significantly positively correlative with outpatient visits. With the largest correlation coefficient of 2-days lags (avg01). Under the optimal lagging time, the excess risk (ER%) of daily outpatients was increased by 1.31% with a 95% confidence interval (CI) of 1.2%~1.43% when PM_2.5 concentration increased 10µg/m³. As ionic concentrations of SO₄^2-, NO₃^-, NH₄⁺, Cl^-, K⁺, Mg²⁺, Ca²⁺ and Na⁺ increased by 1interquartile range (IQR), the ER% of daily outpatients increased by 3.22% (with 95%CI:2.81%~3.62%), 4.67%(4.13%~5.22%), 5.41%(4.49%~6.33%), 7.38%(3.91%~10.96%), 0.14% (-6.34%-7.07%), 7.64% (-11.87%-31.47%), 3.57%(-2.83%-10.39%) and 0.46%(-16.64%-21.06%), respectively. PM_2.5, Cl^-, Mg²⁺, Ca²⁺, and Na⁺ had a greater effect on the number of respiratory disease female outpatients than on male ones. Compared with the population aged between 15 and 65, PM_2.5, SO₄^2-, Cl^-, Ca²⁺ and Na⁺ exerted a greater effect on the elderly population aged 65 and above. This indicated that there was difference among population of different sexes and ages due to the divergence in physiological structure and environmental factors.