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珠江三角洲地区城市大气细颗粒物与臭氧对循环系统疾病就诊风险的交互作用

Interactions of fine particle matter and ozone on outpatient visits for circulatory system diseases in Pearl River Delta urban areas
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摘要 目的了解珠江三角洲地区城市大气细颗粒物(PM2.5)与臭氧(O3)对循环系统疾病就诊情况的影响,并进一步探讨PM2.5和O3的交互作用。方法采用时间序列研究方法,选择广州、佛山和珠海市为研究点,从广东省疾病预防控制中心获得2015-2017年3个城市3家三甲医院的每日循环系统疾病门诊就诊数据,从广东省环境监测中心获得每日大气PM2.5和O3浓度数据,从广东省气象局获得每日气象数据。采用广义相加模型(GAM)分别分析PM2.5和O3平均浓度上升10μg/m^3引起的超额风险(ER)及PM2.5和O3的交互作用,并采用Meta分析对多城市的结果进行合并。结果2015-2017年,广州、佛山和珠海市大气PM2.5浓度每增加10μg/m3引起循环系统疾病门诊就诊风险的ER分别为2.45%、0.64%和0.95%;3个城市大气PM2.5和O3浓度每增加10μg/m^3引起的合并ER分别为1.34%(95%CI:0.25%~2.43%)和-0.17%(95%CI:-0.47%~0.14%)。O3对PM2.5与循环系统疾病门诊就诊风险存在修饰效应,其中在O3浓度低时PM2.5导致的循环系统疾病门诊就诊风险最高,ER为4.19%(95%CI:1.82%~6.56%);而PM2.5对O3与循环系统疾病门诊就诊风险的修饰效应没有统计学意义。结论珠江三角洲地区城市大气PM2.5可增加居民的循环系统疾病门诊就诊风险,O3对其存在修饰效应。 Objective To investigate the impact of fine particle matter(PM2.5)and ozone on outpatient visits for circulatory system diseases and explore their interactions. Methods Time series research method was used in this study. Data on daily outpatient visits for circulatory system diseases of three Level-3 Class-A hospitals in cities of Guangzhou,Foshan,and Zhuhai were obtained from Guangdong Provincial Center for Disease Control and Prevention between 2015 and 2017. Daily ambient PM2.5 and ozone concentration data from Guangdong Environmental Monitoring Center and daily meteorological data from Guangdong Provincial Meteorological Bureau were collected in the same period. Generalized additive model(GAM)was used to estimate the excess risk(ER)for each 10 μg/m^3 increment in PM2.5 and ozone,concentrations and further to explore the potential interactions between PM2.5 and ozone. Additionally,a metaanalysis was conducted to quantitatively combine the ERs of the three cities. Results During 2015-2017,a 10 μg/m^3 increment in PM2.5 concentration was associated with an increment in the daily outpatient visits for circulatory system diseases by 2.45%,0.64%,and 0.95% of ER in Guangzhou,Foshan,and Zhuhai,respectively. And a 10 μg/m3 increment in PM2.5 and ozone concentrations was associated with an increment in the combined ER of three cities by 1.34%(95%CI:0.25%-2.43%)and-0.17%(95%CI:-0.47%-0.14%),respectively. Additionally,ozone modified the association between PM2.5 and the daily outpatient visits for circulatory system diseases. Specifically,when ozone concentration was lowest,the ER for PM2.5 on daily outpatient visits for circulatory system diseases was highest(ER=4.19%,95%CI:1.82%-6.56%). However,the modification effect of PM2.5 on the association between ozone and outpatient visits for circulatory system diseases was not statistically significant. Conclusion Atmospheric PM2.5 could increase the risk of outpatient visits for circulatory system diseases in the Pearl River Delta urban area,and ozone had a modification e
作者 石同幸 梁自勉 朱克京 关绮华 宁婷 马文军 刘涛 肖建鹏 古羽舟 曾韦霖 郭凌川 李杏 SHI Tong-xing;LIANG Zi-mian;ZHU Ke-jing;GUAN Yi-hua;NING Ting;MA Wen-jun;LIU Tao;XIAO Jian-peng;GU Yu-zhou;ZENG Wei-lin;GUO Ling-chuan;LI Xing(Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,China;FoshanCenter for Disease Control and Prevention;Zhuhai Center for Disease Control and Prevention;Guangdong Provincial Institute of Public Health,Guangdong Provincial Center for Disease Control and Prevention)
出处 《华南预防医学》 2019年第2期115-118,共4页 South China JOurnal of Preventive Medicine
关键词 空气污染 细颗粒物 臭氧 时间序列研究 Air pollution Fine particle matter Ozone Time-series study
作者简介 石同幸(1969-),男,硕士研究生,副主任医师,研究方向:环境卫生;通讯作者:李杏,E-mail:lixing.echo@foxmail.com.
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