2015年长三角地区三城市大气污染对成人急性呼吸系统疾病及症状的影响
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摘要
目的了解长三角地区大气污染对成人急性呼吸系统疾病及症状的影响。方法 2015年9—11月,在长三角地区的上海、苏州和南京三个城市的4个调查点随机整群抽取4144名年龄大于18岁的常住居民进行问卷调查,同时收集距离调查点最近的环保监测站点的每日PM_(2.5)、NO_2、O_3、CO、SO_2等5种大气污染物的浓度数据,采用Logistic回归模型分析排除了其他因素的影响后大气污染对成人急性呼吸系统疾病及症状的影响。结果成人近两周急性呼吸系统疾病患病率为0.99%,近两周呼吸系统症状发生率较患病率高,为3.88%。家里使用跟空气污染相关的化学品(OR=2.339,95%CI 1.156～4.734)、过敏(OR=4.857,95%CI 2.279～10.350)是成人近两周急性呼吸系统疾病患病的危险因素;从事的岗位存在有毒化学品、高温等职业有害因素(OR=1.796,95%CI 1.220～2.644)、有呼吸系统疾病家族史(OR=2.670,95%CI 1.865～3.823)、过敏(OR=3.703,95%CI 2.395～5.725)是成人近两周呼吸系统症状发生的危险因素。此外,在排除其他因素的影响后发现,近两周PM_(2.5)的平均暴露水平既是成人近两周患急性呼吸系统疾病患病的危险因素(OR=1.014,95%CI 1.000～1.028),也是成人近两周呼吸系统症状发生的危险因素(OR=1.025,95%CI 1.018～1.033)。结论长三角地区大气污染可能会使成人近两周急性呼吸系统患病和症状的发生风险增加。
OBJECTIVE To understand the effects of ambient air pollution on the prevalence of acute respiratory diseases and symptoms among adults in three cities in the Yangtze River Delta. METHODS During September to November 2015, 4144 permanent residents aged 18 years and above from four investigation sites in three cities in the Yangtze River Delta were randomly surveyed by questionnaire. Daily concentrations of air pollutants, including PM_(2.5), NO_2、O_3、CO and SO_2 nearest to the investigation sites were collected from the department of environmental protection. Logistic regression was used to analyze the association between air pollution and acute respiratory diseases and symptoms after other risk factors were adjusted. RESULTS The prevalence of acute respiratory diseases and symptoms in two weeks among adults were 0.99% and 3.88%, respectively. Chemicals related to air pollution(OR=2.339,95%CI 1.156-4.734) and allergy(OR=4.857,95%CI 2.279-10.350) were the risk factors of acute respiratory diseases in two weeks among adults while occupational hazards such as toxic chemicals and high temperature(OR=1.796,95%CI 1.220-2.644), family history of respiratory diseases(OR=2.670,95%CI 1.865-3.823) and allergy(OR=3.703,95%CI 2.395-5.725) were the risk factor of respiratory symptoms in two weeks among adults. In addition, the average exposure level of PM_(2.5)in two weeks was associated with acute respiratory diseases(OR=1.014, 95%CI 1.000-1.028) and symptoms(OR=1.025, 95%CI 1.018-1.033) in two weeks among adults. CONCLUSION The increases of the prevalence of acute respiratory diseases and symptoms among adults are associated with ambient air pollution in three cities in the Yangtze River Delta.
OBJECTIVE To understand the effects of ambient air pollution on the prevalence of acute respiratory diseases and symptoms among adults in three cities in the Yangtze River Delta. METHODS During September to November 2015, 4144 permanent residents aged 18 years and above from four investigation sites in three cities in the Yangtze River Delta were randomly surveyed by questionnaire. Daily concentrations of air pollutants, including PM_(2.5), NO_2、O_3、CO and SO_2 nearest to the investigation sites were collected from the department of environmental protection. Logistic regression was used to analyze the association between air pollution and acute respiratory diseases and symptoms after other risk factors were adjusted. RESULTS The prevalence of acute respiratory diseases and symptoms in two weeks among adults were 0.99% and 3.88%, respectively. Chemicals related to air pollution(OR=2.339,95%CI 1.156-4.734) and allergy(OR=4.857,95%CI 2.279-10.350) were the risk factors of acute respiratory diseases in two weeks among adults while occupational hazards such as toxic chemicals and high temperature(OR=1.796,95%CI 1.220-2.644), family history of respiratory diseases(OR=2.670,95%CI 1.865-3.823) and allergy(OR=3.703,95%CI 2.395-5.725) were the risk factor of respiratory symptoms in two weeks among adults. In addition, the average exposure level of PM_(2.5)in two weeks was associated with acute respiratory diseases(OR=1.014, 95%CI 1.000-1.028) and symptoms(OR=1.025, 95%CI 1.018-1.033) in two weeks among adults. CONCLUSION The increases of the prevalence of acute respiratory diseases and symptoms among adults are associated with ambient air pollution in three cities in the Yangtze River Delta.
引文
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[19] 陈涛, 黄红, 田英. 室内、外环境因素与儿童白血病关系的研究进展[J]. 环境与职业医学, 2009, 26(1):89-92.
[20] 李继忠, 边毓尧, 郭文有,等. PM2.5与呼吸系统疾病发病率关系流行病学调查研究[J]. 陕西医学杂志, 2018,47(6):805-808.
[21] BENNETT C M, SIMPSON P, RAVEN J, et al. Associations between ambient PM2.5 concentrations and respiratory symptoms in Melbourne, 1998-2005[J]. J Toxicol Environ Health,2007,70(19):1613-1618.
[22] POPE C A, DOCKERY D W, SPENGLER J D, et al. Respiratory health and PM10 pollution. A daily time series analysis[J]. Am Rev Respir Disease, 1991, 144(3 Pt 1):668-674.
[23] MARTIN L D, KRUNKOSKY T M, DYE J A, et al. The role of reactive oxygen and nitrogen species in the response of airway epithelium to particulates[J].Environ Health Persp, 1997, 105 (Suppl 5):1301-1307.
[24] KUBESCH N J, DE N A, WESTERDAHL D, et al. Respiratory and inflammatory responses to short-term exposure to traffic-related air pollution with and without moderate physical activity[J]. Occup Environ Med, 2014, 72(4):284-293.
[2] SUN Q, HONG X, WOLD L E. Cardiovascular effects of ambient particulate air pollution exposure[J]. Circulation,2010,121(25):2755-2765.
[3] WONG T, TAM W, YU T, et al. Associations between daily mortalities from respiratory and cardiovascular diseases and air pollution in Hong Kong, China[J]. Occup Environ Med,2002,59(1):30-35.
[4] 李宁, 彭晓武, 张本延,等. 广州市居民呼吸系统疾病每日死亡人数与大气污染的时间序列分析[J]. 华中科技大学学报(医学版),2010, 39(6):863-867.
[5] NASCIMENTO L F, VIEIRA L C, MANTOVANI K C, et al. Air pollution and respiratory diseases: ecological time series[J]. Sao Paulo Med J,2016,134(4):315-321.
[6] 鲍玉星, 晓开题·依不拉音, 吴文华,等. 乌鲁木齐大气污染与呼吸系统疾病日住院人数的时间序列分析[J]. 新疆医科大学学报, 2013, 36(4):537-541.
[7] 李宁,彭晓武,张本延,等. 大气污染与呼吸系统疾病日门诊量的时间序列分析[J]. 环境与健康杂志, 2009, 26(12):1077-1080.
[8] GOUVEIA N, FLETCHER T. Respiratory diseases in children and outdoor air pollution in S?o Paulo, Brazil: a time series analysis[J]. Occup Environ Med,2000,57(7):477-483.
[9] VIGOTTI M A, SERINELLI M, MARCHINI L. Urban air pollution and children respiratory hospital admissions in Pisa (Italy): a time series and a case-crossover approach [J]. Epidemiol Prev,2010,34(4):143-149.
[10] 国家环境保护部.2015中国环境状况公报[M].北京:国家环境保护部,2016.
[11] 国家统计局, 环境保护部. 中国环境统计年鉴 2013[M]. 北京:中国统计出版社, 2013.
[12] 国家统计局, 环境保护部. 中国环境统计年鉴 2014[M]. 北京:中国统计出版社, 2014.
[13] 国家统计局, 环境保护部. 中国环境统计年鉴 2015[M]. 北京:中国统计出版社, 2015.
[14] 刘世炜, 周脉耕, 王黎君,等. 1990年与2010年中国归因于室外空气污染的疾病负担分析[J]. 中华预防医学杂志, 2015,49(4):327-333.
[15] 侯俊, 王含婧, 董玲,等. 大气可吸入颗粒物对河南省城市人群呼吸系统疾病的影响[J]. 郑州大学学报(医学版),2008,43(6):1246-1248.
[16] 黄意府, 黄鲜华, 何英鸾,等. 低浓度氟对工人呼吸系统影响的调查[J]. 中国职业医学, 2005, 32(1):62-63.
[17] 洪志强, 童智敏, 施健. 甲醛对作业工人呼吸系统及肺功能影响[J]. 中国公共卫生, 2007, 23(7):849-850.
[18] 潘行杰, 阎西革. 玻璃制品业高温作业对工人生理功能的影响[J]. 中国工业医学杂志, 2007, 20(5):325-326.
[19] 陈涛, 黄红, 田英. 室内、外环境因素与儿童白血病关系的研究进展[J]. 环境与职业医学, 2009, 26(1):89-92.
[20] 李继忠, 边毓尧, 郭文有,等. PM2.5与呼吸系统疾病发病率关系流行病学调查研究[J]. 陕西医学杂志, 2018,47(6):805-808.
[21] BENNETT C M, SIMPSON P, RAVEN J, et al. Associations between ambient PM2.5 concentrations and respiratory symptoms in Melbourne, 1998-2005[J]. J Toxicol Environ Health,2007,70(19):1613-1618.
[22] POPE C A, DOCKERY D W, SPENGLER J D, et al. Respiratory health and PM10 pollution. A daily time series analysis[J]. Am Rev Respir Disease, 1991, 144(3 Pt 1):668-674.
[23] MARTIN L D, KRUNKOSKY T M, DYE J A, et al. The role of reactive oxygen and nitrogen species in the response of airway epithelium to particulates[J].Environ Health Persp, 1997, 105 (Suppl 5):1301-1307.
[24] KUBESCH N J, DE N A, WESTERDAHL D, et al. Respiratory and inflammatory responses to short-term exposure to traffic-related air pollution with and without moderate physical activity[J]. Occup Environ Med, 2014, 72(4):284-293.