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

doi:10.13217/j.scjpm.2019.0115

华南预防医学 ›› 2019, Vol. 45 ›› Issue (2): 115-118.doi: 10.13217/j.scjpm.2019.0115

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

石同幸¹, 梁自勉², 朱克京³, 关绮华², 宁婷³, 马文军⁴, 刘涛⁴, 肖建鹏⁴, 古羽舟¹, 曾韦霖⁴, 郭凌川⁴, 李杏⁴

1.广州市疾病预防控制中心,广东广州 510440;
2.佛山市疾病预防控制中心; 3珠海市疾病预防控制中心;
4. 广东省疾病预防控制中心广东省公共卫生研究院

收稿日期:2018-12-28 出版日期:2019-04-20 发布日期:2019-05-15
通讯作者: 李杏,E-mail：lixing.echo@foxmail.com
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

Interactions of fine particle matter and ozone on outpatient visits for circulatory system diseases in Pearl River Delta urban areas

SHI Tong-xing¹, LIANG Zi-mian², ZHU Ke-jing³, GUAN Yi-hua², NING Ting³, MA Wen-jun⁴, LIU Tao⁴, XIAO Jian-peng⁴, GU Yu-zhou¹, ZENG Wei-lin⁴, GUO Ling-chuan⁴, LI Xing⁴

1.Guangzhou Center for Disease Control and Prevention,Guangzhou 510440,China;
2.Foshan Center for Disease Control and Prevention;
3.Zhuhai Center for Disease Control and Prevention;
4. Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention

Received:2018-12-28 Online:2019-04-20 Published:2019-05-15

摘要/Abstract

摘要： 目的了解珠江三角洲地区城市大气细颗粒物（PM_2.5）与臭氧（O₃）对循环系统疾病就诊情况的影响,并进一步探讨PM_2.5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PM_2.5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PM_2.5和O₃平均浓度上升10 μg/m³引起的超额风险（ER）及PM_2.5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PM_2.5浓度每增加10 μg/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PM_2.5和O₃浓度每增加10 μg/m³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PM_2.5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PM_2.5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PM_2.5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PM_2.5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。

关键词: 空气污染, 细颗粒物, 臭氧, 时间序列研究

Abstract: Objective To investigate the impact of fine particle matter （PM_2.5） 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 PM_2.5 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/m³ increment in PM_2.5 and ozone_, concentrations and further to explore the potential interactions between PM_2.5 and ozone. Additionally, a meta-analysis was conducted to quantitatively combine the ERs of the three cities. Results During 2015- 2017, a 10 μg/m³ increment in PM_2.5 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 PM_2.5 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 PM_2.5and the daily outpatient visits for circulatory system diseases. Specifically, when ozone concentration was lowest, the ER for PM_2.5 on daily outpatient visits for circulatory system diseases was highest （ER=4.19%,95%CI：1.82%-6.56%）. However, the modification effect of PM_2.5 on the association between ozone and outpatient visits for circulatory system diseases was not statistically significant. Conclusion Atmospheric PM_2.5could increase the risk of outpatient visits for circulatory system diseases in the Pearl River Delta urban area, and ozone had a modification effect on it.

Key words: Air pollution, Fine particle matter, Ozone, Time-series study

中图分类号:

R122.7

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. 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[J]. 华南预防医学, 2019, 45(2): 115-118.

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. Interactions of fine particle matter and ozone on outpatient visits for circulatory system diseases in Pearl River Delta urban areas[J]. South China Journal of Preventive Medicine, 2019, 45(2): 115-118.

参考文献 13

[1]	Brook RD, Rajagopalan S, Pope CA, et al.Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association[J]. Circulation, 2010,121(21):2331-2378.
[2]	刘晓环. 我国典型地区大气污染特征的数值模拟[D].济南:山东大学,2010.
[3]	Atkinson RW, Kang S, Anderson HR,et al.Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis[J]. Thorax, 2014,9(7): 660-665.
[4]	Green R, Broadwin R, Malig B, et al.Long-and short-term exposure to air pollution and inflammatory/hemostatic markers in midlife women[J]. Epidemiology, 2016, 27(2): 211-220.
[5]	Arjomandi M, Wong H, Donde A,et al.Exposure to medium and high ambient levels of ozone causes adverse systemic inflammatory and cardiac autonomic effects[J]. Am J Physiol Heart Circ Physiol, 2015, 308(12): 1499-1509.
[6]	Hampel R, Breitner S, Zareba W,et al.Immediate ozone effects on heart rate and repolarisation parameters in potentially susceptible individuals[J]. Occup Environ Med, 2012, 69(6): 428-436.
[7]	Newell K, Kartsonaki C, Lam KBH,et al.Cardiorespiratory health effects of gaseous ambient air pollution exposure in low and middle income countries: a systematic review and meta-analysis[J]. Environ Health, 2018,17(1): 41.
[8]	Gu Y, Lin H, Liu T,et al.The interaction between ambient PM10 and NO2 on mortality in Guangzhou, China[J]. Int J Environ Res Public Health,2017 ,14(11):1381.
[9]	Buadong D, Jinsart W, Funatagawa I, et al.Association between PM10 and O3 levels and hospital visits for cardiovascular diseases in Bangkok, Thailand[J]. J Epidemiol,2009,19(4):182-188.
[10]	王广鹤. 臭氧和大气细颗粒物对大鼠心肺系统的影响及其机制研究[D]. 上海:复旦大学, 2013.
[11]	Breitner S, Schneider A, Devlin RB,et al.Associations among plasma metabolite levels and short-term exposure to PM2.5 and ozone in a cardiac catheterization cohort[J]. Environ Int, 2016,97: 76-84.
[12]	曾韦霖, 李光春, 肖义泽,等. 中国四城市温度对居民心脑血管疾病死亡影响的时间序列研究[J]. 中华流行病学杂志, 2012,33(10):1021-1025.
[13]	刘涛, 曾韦霖, 林华亮,等. 珠江三角洲地区大气臭氧引起居民死亡风险的时空分布及其修饰因素[J]. 华南预防医学, 2016,42(3): 201-207.

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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