2013—2018年北京市大气PM2.5持续高暴露对居民因病入院的急性影响

为探讨以细颗粒物（PM_2.5）持续高浓度暴露为特征的大气污染事件对于人群因病入院的急性影响，收集2013—2018年北京市大气PM_2.5浓度、气象因素数据和人群因病入院数据，以PM_2.5浓度〔75.0 μg/m3、150.0 μg/m3、第95百分位数（205.8 μg/m3）〕和持续时间（≥2 d、≥3 d）联合定义6种持续高暴露情景，采用基于quasi-Poisson回归的广义相加模型开展时间序列分析，获得不同情景下PM_2.5对人群因病入院的急性影响.结果表明:①对于全人群研究发现，相较于非持续高暴露情景，持续2 d及以上的重污染（PM_2.5浓度>150.0 μg/m3）情景引起非意外总疾病和心脑血管系统疾病的发病风险均显著增加，增幅分别为5.0%（95% CI，1.2%~9.0%）和5.6%（95% CI，1.8%~9.5%）.②亚组人群分层分析发现，持续2 d及以上的重污染情景下，男性、女性、0~64岁、65~74岁、75岁及以上等亚组人群的非意外总疾病和心脑血管系统疾病的发病风险均显著增加；当出现极端PM_2.5暴露浓度（>205.8 μg/m3）且持续3 d以及上时，女性和0~64岁、65~74岁人群的非意外总疾病和心脑血管系统疾病的发病风险均显著增加.③因呼吸系统疾病入院分析发现，仅在PM_2.5浓度>150 μg/m3且持续时间≥2 d的情景下，观察到0~64岁人群的发病风险显著增加，增幅为3.4%（95% CI，0.2%~6.6%）.研究显示，以PM_2.5持续高暴露为特征的大气污染事件对人群因病入院有显著影响. 

Impact of Persistent High Ambient Fine Particulate Matters Exposures on Hospitalization in Beijing from 2013 to 2018

In order to investigate the impact of air pollution episode characterized by persistent high PM_2.5 exposure on people's hospitalization in Beijing, we collected data of air pollutants, meteorological factors and hospital admissions in Beijing from 2013 to 2018. Under six persistent PM_2.5-polluted scenarios defined by PM_2.5 concentration (75.0 μg/m3, 150.0 μg/m3, P₉₅ (205.8 μg/m3)) and duration (≥2 d, ≥3 d), generalized additive models (GAM) based on quasi-Poisson regression were used to carry out time series analyses to obtain the impact of air pollution episode characterized by persistent high exposure to PM_2.5 on hospitalizations of the entire population and subgroups. The results showed that: (1) For the entire population, relative to non-specified pollution scenarios, when the PM_2.5 exposure concentration was >150 μg/m3 and lasted for two days or more, the hospitalization risk for non-accidental diseases and cardio-cerebrovascular diseases increased by 5.0% (95%CI, 1.2% to 9.0%) and 5.6% (95%CI, 1.8% to 9.5%), respectively. (2) A stratified analysis of subgroup populations found that under heavy PM_2.5-pollution scenarios that lasted for two days or more, non-accidental and cardio-cerebrovascular hospitalizations significantly increased in the subgroups of men, women, people 0-64 years old, people 65-74 years old, and people 75 years or older. In the extreme PM_2.5-pollution concentration (>205.8 μg/m3) that lasted for three days or more, non-accidental and cardio-cerebrovascular hospitalizations significantly increased in only the subgroups of women, people 0-64 years old and people 65-74 years old. (3) For respiratory admissions, we only detected statistical significance when PM_2.5 exposure concentration was greater than 150.0 μg/m3 and lasted for two days or more in the 0-64 years old population, and the risk increased by 3.4% (95%CI, 0.2% to 6.6%). This study shows that air pollution episode characterized by persistent high exposure to PM_2.5 had a significant impact on hospital admissions.