大气臭氧对北京某城区居民焦虑状况的影响
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摘要
目的探讨空气污染物O_3与城市人群焦虑的关系,为开展空气污染现状下人群心理健康干预工作提供基础。方法采用国际标准化焦虑自评量表(SAS)收集北京市某区居民的焦虑状况,并构建大气污染物O_3与焦虑的非条件Logistic回归模型,分析O_3暴露与人群焦虑状况之间的关系。结果共调查北京某区居民991名,获得有效问卷962份,有效率为97. 07%;检出有焦虑症状者122名,检出率12. 68%。调查期间O_3平均浓度为102. 21μg/m~3。结果显示,O_3暴露与焦虑风险增加显著相关;不仅调查当天的O_3暴露浓度升高(每10μg/m~3)增加焦虑发生风险(OR:1. 08,95%CI:1. 03～1. 14),滞后1 d(lag1)和累积滞后(1～4) d(lag01～lag04)也均能显著增加焦虑的发生风险,其中lag04对焦虑发生风险的影响最大(OR:1. 30,95%CI:1. 09～1. 56)。结论大气臭氧暴露可能是人群焦虑的危险因素之一,空气重污染区域人群的精神健康应引起关注。
Objectives To explore the relationship between air ozone and anxiety in urban residents,and to provide a basis for carrying out mental health intervention. Methods A Self-Rating Anxiety Scale( SAS) was used to investigate the anxiety of residents in a district of Beijing. Monitoring data from the nearest environmental protection monitoring sites and meteorological data from the residential area were recorded during the investigation period.Binary logistic regression model was used to analyze the relationship between air ozone and anxiety in residents.Results A total of 991 residents in a district of Beijing were investigated. There were 962 effective questionnaires and the effective rate was 97. 07%. Anxiety was detected in 122 residents and the detection rate was 12. 68%. The result showed that the risk of anxiety increased( OR: 1. 08,95%CI: 1. 03 ～ 1. 14) with each increase of 10 mg/m~3 ozone in the day of exposure and lagged for( 1 ～ 4) days( lag01-lag04). The biggest effect of air ozone on anxiety was in the lag04 after exposure to ozone( OR: 1. 30,95%CI: 1. 09 ～ 1. 56). Conclusions The exposure to air O_3 might be one of risk factors for anxiety in people,but further investigation on the mechanism of anxiety caused by air O_3 was needed.
Objectives To explore the relationship between air ozone and anxiety in urban residents,and to provide a basis for carrying out mental health intervention. Methods A Self-Rating Anxiety Scale( SAS) was used to investigate the anxiety of residents in a district of Beijing. Monitoring data from the nearest environmental protection monitoring sites and meteorological data from the residential area were recorded during the investigation period.Binary logistic regression model was used to analyze the relationship between air ozone and anxiety in residents.Results A total of 991 residents in a district of Beijing were investigated. There were 962 effective questionnaires and the effective rate was 97. 07%. Anxiety was detected in 122 residents and the detection rate was 12. 68%. The result showed that the risk of anxiety increased( OR: 1. 08,95%CI: 1. 03 ～ 1. 14) with each increase of 10 mg/m~3 ozone in the day of exposure and lagged for( 1 ～ 4) days( lag01-lag04). The biggest effect of air ozone on anxiety was in the lag04 after exposure to ozone( OR: 1. 30,95%CI: 1. 09 ～ 1. 56). Conclusions The exposure to air O_3 might be one of risk factors for anxiety in people,but further investigation on the mechanism of anxiety caused by air O_3 was needed.
引文
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[13]Zanobetti A,Schwartz J.Temperature and mortality in nine UScities[J].Epidemiology,2008,19(4):563-570.
[14]Pun VC,Manjourides J,Suh H.Association of ambient air pollution with depressive and anxiety symptoms in older adults:results from the NSHAP study[J].Environ Health Perspect,2017,125(3):342-348.
[15]闫美霖,李湉湉,刘晓途,等.我国臭氧短期暴露的人群健康效应研究进展[J].环境与健康杂志,2012,29(8):752-761.(In English:Yan ML,Li TT,Liu XT,et al.Human health effects of short-term ozone exposure:a review of Chinese epidemiological evidence[J].J Environ Health,2012,29(8):752-761.)
[16]Baxter AJ,Scott KM,Vos T,et al.Global prevalence of anxiety disorders:a systematic review and meta-regression[J].Psychol Med,2013,43(5):897-910.
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[18]Kroenke K,Spitzer RL,Williams JBW,et al.The patient health questionnaire somatic,anxiety,and depressive symptom scales:a systematic review[J].Gen Hosp Psychiatry,2010,32(4):345-359.
[19]Szyszkowicz M,Kousha T,Kingsbury M,et al.Air pollution and emergency department visits for depression:a multicity casecrossover study[J].Environ Health Insights,2016,10:155-161.
[20]Cho J,Choi YJ,Suh M,et al.Air pollution as a risk factor for depressive episode in patients with cardiovascular disease,diabetes mellitus,or asthma[J].J Affect Disord,2014,157:45-51.
[21]Faustini A,Stafoggia M,Cappai G,et al.Short-term effects of air pollution in a cohort of patients with chronic obstructive pulmonary disease[J].Epidemiology,2012,23(6):861-879.
[22]周历媛,吴泉源,蔡东全,等.基于GIS的济南市典型大气污染物对哮喘病的时空影响研究[J].环境卫生学杂志,2015,5(3):211-214.(In English:Zhou LY,Wu QY,Cai DQ,et al.Typical air pollutants space-time effects on asthma in Jinan City[J].J Environ Hyg,2015,5(3):211-214.)
[23]满金宇,崔亮亮,于坤坤,等.济南市重污染区域大气污染物对循环系统疾病门诊量的急性效应[J].环境卫生学杂志,2018,8(1):12-17.(In English:Man JY,Cui LL,Yu KK,et al.Acute effect of air pollutants in heavy polluted areas on outpatients visit for cardiovascular diseases in Jinan[J].J Environ Hyg,2018,8(1):12-17.)
[24]刘晓波,杨丽,洪千淇,等.2015年哈尔滨市某地区空气污染物与呼吸系统疾病门诊量关系的时间序列研究[J].环境卫生学杂志,2017,7(4):279-283.(In English:Liu XB,Yang L,Hong QQ,et al.Time-series analysis on association between air pollutants and hospital outpatients for respiratoty diseases in a district,Harbin in 2015[J].J Environ Hyg,2017,7(4):279-283.)
[25]Power MC,Kioumourtzoglou MA,Hart JE,et al.The relation between past exposure to fine particulate air pollution and prevalent anxiety:observational cohort study[J].BMJ,2015,350:h1111.
[26]Araujo JA,Nel AE.Particulate matter and atherosclerosis:role of particle size,composition and oxidative stress[J].Part Fibre Toxicol,2009,6:24.
[27]Bell ML,Kim JY,Dominici F.Potential confounding of particulate matter on the short-term association between ozone and mortality in multisite time-series studies[J].Environ Health Perspect,2007,115(11):1591-1595.
[28]Salim S,Chugh G,Asghar M.Inflammation in anxiety[J].Adv Protein Chem Struct Biol,2012,88:1-25.
[29]Hou RH,Baldwin DS.A neuroimmunological perspective on anxiety disorders[J].Hum Psychopharmacol,2012,27(1):6-14.
[30]Maes M,Kubera M,Obuchowiczwa E,et al.Depression's multiple comorbidities explained by(neuro)inflammatory and oxidative&nitrosative stress pathways[J].Neuro Endocrinol Lett,2011,32(1):7-24.
[31]孙庆华,王情,陈晨,等.PM2.5个体暴露浓度与固定站点监测浓度的关系[J].环境与健康杂志,2015,32(12):1055-1057.(In English:Sun QH,Wang Q,Chen C,et al.Associations between personal exposures and fixed-site concentration of PM2.5[J].J Environ Health,2015,32(12):1055-1057.)
[32]董小艳,吴亚西.空气污染外暴露监测技术及暴露现状[J].环境卫生学杂志,2017,7(1):64-68,74.(In English:Dong XY,Wu YX.Monitoring techniques and exposure status for external exposure of air pollution[J].J Environ Hyg,2017,7(1):64-68,74.)
[33]Craske MG,Stein MB,Eley TC,et al.Anxiety disorders[J].Nat Rev Dis Primers,2017,3:17024.
[2]王占山,张大伟,李云婷,等.北京市夏季不同O3和PM2.5污染状况研究[J].环境科学,2016,37(3):807-815.(In English:Wang ZS,Zhang DW,Li YT,et al.Different air pollution situations of O3and PM2.5during summer in Beijing[J].Environ Sci,2016,37(3):807-815.)
[3]De Almeida SP,Casimiro E,Calheiros J.Short-term association between exposure to ozone and mortality in Oporto,Portugal[J].Environ Res,2011,111(3):406-410.
[4]Thomson EM,Pal S,Guénette J,et al.Ozone inhalation provokes glucocorticoid-dependent and-independent effects on inflammatory and metabolic pathways[J].Toxicol Sci,2016,152(1):17-28.
[5]Lim YH,Kim H,Kim JH,et al.Air pollution and symptoms of depression in elderly adults[J].Environ Health Perspect,2012,120(7):1023-1028.
[6]Szyszkowicz M,Rowe BH,Colman I.Air pollution and daily emergency department visits for depression[J].Int J Occup Med Environ Health,2009,22(4):355-362.
[7]胡强,万玉美,苏亮,等.中国普通人群焦虑障碍患病率的荟萃分析[J].中华精神科杂志,2013,46(4):204-211.(In English:Hu Q,Wan YM,Su L,et al.Prevalence of anxiety disorder among mainland residents in China:a meta-analysis[J].Chin J Psychiatry,2013,46(4):204-211.)
[8]王爱芹,孟明珠,孔丽娜,等.我国医学类大学生焦虑症状检出率的meta分析[J].中国卫生统计,2015,32(5):841-843,847.
[9]王立鑫,姚旭辉,贾海燕,等.某高校大学生焦虑抑郁与空气污染的关系[J].中国学校卫生,2016,37(7):1036-1038.(In English:Wang LX,Yao XH,Jia HY,et al.Correlation between air pollution and anxiety and depression for university students[J].Chin J Sch Health,2016,37(7):1036-1038.)
[10]中国环境监测总站.全国城市空气质量实时发布平台[EB/OL].(2016-10-01).[2017-04-20].http://106.37.208.233:20035/.
[11]National Centers for Environmental Information.Climate data online:dataset discovery[EB/OL].(2016-10-01).[2017-04-18].https://www.ncdc.noaa.gov/cdo-web/datasets.
[12]张明园.精神科评定量表手册[M].2版.长沙:湖南科学技术出版社,1998:39-42.(In English:Zhang MY.Handbook of Rating Scales in Psychiatry[M].2nd ed.Changsha:Hunan Science and Technology Press,1998:39-42.)
[13]Zanobetti A,Schwartz J.Temperature and mortality in nine UScities[J].Epidemiology,2008,19(4):563-570.
[14]Pun VC,Manjourides J,Suh H.Association of ambient air pollution with depressive and anxiety symptoms in older adults:results from the NSHAP study[J].Environ Health Perspect,2017,125(3):342-348.
[15]闫美霖,李湉湉,刘晓途,等.我国臭氧短期暴露的人群健康效应研究进展[J].环境与健康杂志,2012,29(8):752-761.(In English:Yan ML,Li TT,Liu XT,et al.Human health effects of short-term ozone exposure:a review of Chinese epidemiological evidence[J].J Environ Health,2012,29(8):752-761.)
[16]Baxter AJ,Scott KM,Vos T,et al.Global prevalence of anxiety disorders:a systematic review and meta-regression[J].Psychol Med,2013,43(5):897-910.
[17]Brauer M.Air pollution,stroke,and anxiety[J].BMJ,2015,350:h1510.
[18]Kroenke K,Spitzer RL,Williams JBW,et al.The patient health questionnaire somatic,anxiety,and depressive symptom scales:a systematic review[J].Gen Hosp Psychiatry,2010,32(4):345-359.
[19]Szyszkowicz M,Kousha T,Kingsbury M,et al.Air pollution and emergency department visits for depression:a multicity casecrossover study[J].Environ Health Insights,2016,10:155-161.
[20]Cho J,Choi YJ,Suh M,et al.Air pollution as a risk factor for depressive episode in patients with cardiovascular disease,diabetes mellitus,or asthma[J].J Affect Disord,2014,157:45-51.
[21]Faustini A,Stafoggia M,Cappai G,et al.Short-term effects of air pollution in a cohort of patients with chronic obstructive pulmonary disease[J].Epidemiology,2012,23(6):861-879.
[22]周历媛,吴泉源,蔡东全,等.基于GIS的济南市典型大气污染物对哮喘病的时空影响研究[J].环境卫生学杂志,2015,5(3):211-214.(In English:Zhou LY,Wu QY,Cai DQ,et al.Typical air pollutants space-time effects on asthma in Jinan City[J].J Environ Hyg,2015,5(3):211-214.)
[23]满金宇,崔亮亮,于坤坤,等.济南市重污染区域大气污染物对循环系统疾病门诊量的急性效应[J].环境卫生学杂志,2018,8(1):12-17.(In English:Man JY,Cui LL,Yu KK,et al.Acute effect of air pollutants in heavy polluted areas on outpatients visit for cardiovascular diseases in Jinan[J].J Environ Hyg,2018,8(1):12-17.)
[24]刘晓波,杨丽,洪千淇,等.2015年哈尔滨市某地区空气污染物与呼吸系统疾病门诊量关系的时间序列研究[J].环境卫生学杂志,2017,7(4):279-283.(In English:Liu XB,Yang L,Hong QQ,et al.Time-series analysis on association between air pollutants and hospital outpatients for respiratoty diseases in a district,Harbin in 2015[J].J Environ Hyg,2017,7(4):279-283.)
[25]Power MC,Kioumourtzoglou MA,Hart JE,et al.The relation between past exposure to fine particulate air pollution and prevalent anxiety:observational cohort study[J].BMJ,2015,350:h1111.
[26]Araujo JA,Nel AE.Particulate matter and atherosclerosis:role of particle size,composition and oxidative stress[J].Part Fibre Toxicol,2009,6:24.
[27]Bell ML,Kim JY,Dominici F.Potential confounding of particulate matter on the short-term association between ozone and mortality in multisite time-series studies[J].Environ Health Perspect,2007,115(11):1591-1595.
[28]Salim S,Chugh G,Asghar M.Inflammation in anxiety[J].Adv Protein Chem Struct Biol,2012,88:1-25.
[29]Hou RH,Baldwin DS.A neuroimmunological perspective on anxiety disorders[J].Hum Psychopharmacol,2012,27(1):6-14.
[30]Maes M,Kubera M,Obuchowiczwa E,et al.Depression's multiple comorbidities explained by(neuro)inflammatory and oxidative&nitrosative stress pathways[J].Neuro Endocrinol Lett,2011,32(1):7-24.
[31]孙庆华,王情,陈晨,等.PM2.5个体暴露浓度与固定站点监测浓度的关系[J].环境与健康杂志,2015,32(12):1055-1057.(In English:Sun QH,Wang Q,Chen C,et al.Associations between personal exposures and fixed-site concentration of PM2.5[J].J Environ Health,2015,32(12):1055-1057.)
[32]董小艳,吴亚西.空气污染外暴露监测技术及暴露现状[J].环境卫生学杂志,2017,7(1):64-68,74.(In English:Dong XY,Wu YX.Monitoring techniques and exposure status for external exposure of air pollution[J].J Environ Hyg,2017,7(1):64-68,74.)
[33]Craske MG,Stein MB,Eley TC,et al.Anxiety disorders[J].Nat Rev Dis Primers,2017,3:17024.