可吸入颗粒物对银川市呼吸系统疾病影响分析

Study on the Impact of Inhalable Particulate Matter on Respiratory Diseases in Yinchuan City

摘要:

本文利用2015—2022年银川市逐日气象观测资料和呼吸系统疾病门诊就诊人数资料，基于广义相加模型（GAM）和分布滞后非线性模型（DLNM），以银川市可吸入颗粒物浓度作为主要影响因子，选取NO2、SO2、CO、风速、平均温度和最高温度作为协变量因子，定量评价了银川市可吸入颗粒物浓度对呼吸疾病门诊就诊人数影响的滞后及累积效应。结果表明：（1）2015—2022年呼吸系统疾病门诊就诊人数呈现波动上升态势，随着可吸入颗粒物浓度的升高，就诊人数增加，二者呈显著正相关，且均在冬、春季达到峰值。（2）2015—2022年PM2.5和PM10浓度均呈现微弱下降趋势；PM2.5轻度污染及以上等级的占比在10~40%，均出现在春、冬两季，PM10轻度污染及以上污染等级的占比在10~30%。（3）可吸入颗粒物浓度对呼吸疾病门诊就诊人数影响具有滞后性和累积效应。在发病当天，呼吸系统发病危险度随着PM10浓度的升高而升高；且在滞后2天内，呼吸系统疾病风险仍维持RR>1。（4）对不同性别的人群，可吸入颗粒物浓度与呼吸系统就诊人数的暴露—反应关系总体差异较小；对不同年龄段，其敏感性和滞后效应有所不同：65岁以上老年人对于颗粒物浓度的敏感性更强。PM2.5低于175 μg /m3时，所有人群的发病风险均在当日达到峰值，老年人的疾病暴露风险可持续到第10天，小于65岁的人群，持续到第4天。

Abstract:

This research employed daily meteorological observations and outpatient visit records for respiratory ailments in Yinchuan from 2015 to 2022. By utilizing the Generalized Additive Model (GAM) and the Distributed Lag Nonlinear Model (DLNM), with inhalable particulate matter concentration in Yinchuan serving as the primary exposure variable and NO?, SO?, CO, wind speed, mean temperature, and maximum temperature as covariates, it quantitatively assessed the lagged and cumulative impacts of inhalable particulate matter concentration on outpatient visits for respiratory diseases in Yinchuan. The findings are as follows:(1) Between 2015 and 2022, the number of outpatient consultations for respiratory diseases exhibited a fluctuating yet upward trend. A notable positive correlation was observed between the concentration of inhalable particulate matter and the number of outpatient visits, with both reaching their zenith during winter and spring.(2) During the same period, both PM?.? and PM?? concentrations demonstrated a marginal decline. The proportion of days categorized as "mild pollution" or worse for PM2.5 ranged from 10% to 40%, predominantly occurring in spring and winter. For PM??, this proportion varied between 10% and 30%.(3) The concentration of inhalable particulate matter exerted both lagged and cumulative effects on the number of outpatient visits for respiratory diseases. On the day of disease onset, the likelihood of respiratory illness escalated with increasing PM?? levels. Furthermore, the risk persisted above baseline (RR > 1) within a two-day lag period.(4) The exposure-response relationship between inhalable particulate matter concentration and outpatient visits for respiratory diseases displayed minimal overall variance across genders. However, variations in sensitivity and lagged effects were evident among different age groups: individuals aged 65 and above exhibited heightened susceptibility to particulate matter concentrations. When PM?.? remained below 175 μg/m3, the risk of disease onset peaked on the same day for all demographic groups. For the elderly, this risk persisted until the tenth day post-exposure, whereas for those under 65, it lasted until the 4th day.