摘要
目的探讨气温与大气细颗粒物(fine particulate matter,PM_(2.5))协同作用对肺炎住院人数的影响,为大气污染防治和敏感人群主动健康防护提供依据。方法采用广义相加模型(generalized additive model,GAM)、平滑曲线阈值效应和饱和效应的方法,在控制了时间序列长期趋势、季节效应、节假日效应、平均风速和污染物PM_(10)、SO_(2)、NO_(2)、O_(3)质量浓度等混杂因素影响后,分析2018—2022年兰州市气温与大气PM_(2.5)协同作用对肺炎住院人数影响的暴露-反应关系。结果急诊肺炎日均住院中位数为14人次,日均温度与肺炎住院人数间呈典型“单峰型”变化趋势,日平均气温阈值为9.9℃;温度日较差与肺炎住院人数呈线性正相关关系;PM_(2.5)与肺炎住院人数总体上呈波动递增趋势,且PM_(2.5)质量浓度每升高10μg/m^(3),肺炎住院人数增加的相对危险度为1.022(95%CI:1.013~1.035)。此外,PM_(2.5)质量浓度≥97μg/m^(3)时,温度日较差与PM_(2.5)存在着协同加强效应,温度日较差每增加1℃,肺炎住院发生风险将增加1.562%(95%CI:1.132%~1.965%)。结论气温骤变和空气污染可能是影响肺炎住院人数的重要因素,温度日较差越大,PM_(2.5)质量浓度越高时,对肺炎住院人数影响越显著,并有一定的协同效应。
Objective To explore the impact of synergistic effect of temperature and atmospheric fine particulate matter(PM_(2.5))on the number of pneumonia hospitalizations,and to provide a basis for air pollution prevention and proactive health protection of sensitive groups.Methods Using generalized additive model(GAM)and smooth curve along with threshold and saturation effect analysis,we analyzed the exposure-response relationship of impact of synergistic effect of temperature and atmospheric PM_(2.5)on the number of pneumonia hospitalizations in Lanzhou City from 2018 to 2022 after controlling for confounding factors such as time-series long-term trends,seasonal effects,holiday effects,average wind speed,and concentrations of PM_(10),SO_(2),NO_(2)and O_(3).Results The median daily hospitalizations for emergency pneumonia were 14 cases.The relationship between daily average temperature and the number of pneumonia hospitalizations showed a typical unimodal trend,with the daily average temperature threshold being 9.9℃.Diurnal temperature range(DTR)was positively linearly correlated with the number of pneumonia hospitalizations.PM_(2.5)and the number of pneumonia hospitalizations generally showed a fluctuating upward trend,with the relative risk of an increase in the number of pneumonia hospitalizations being 1.022(95%CI:1.013-1.035)for every 10μg/m^(3)increase in PM_(2.5)concentration.Moreover,significant synergistic enhancement effects were observed between DTR and PM_(2.5)when PM_(2.5)concentration≥97μg/m^(3).For every 1℃increase in DTR,the risk of pneumonia hospitalizations would increase by 1.562%(95%CI:1.132%-1.965%).Conclusion Sudden temperature changes and air pollution may be the important factors affecting the number of pneumonia hospitalizations.Larger DTR and higher PM_(2.5)concentration have more significant impacts on the number of pneumonia hospitalizations,with certain synergistic effects.
作者
宋全全
陈世强
孙武
王秀珍
马梅
李娟
罗鹏程
SONG Quanquan;CHEN Shiqiang;SUN Wu;WANG Xiuzheng;MA Mei;LI Juan;LUO Pengcheng(Guangyuan Mental Health Center,Guangyuan,Sichuan 628000,China;Lanzhou Municipal Center for Disease Control and Prevention,Lanzhou,Gansu 730000,China;Wushan County Center for Disease Control and Prevention,Tianshui,Gansu 741300,China)
出处
《实用预防医学》
2025年第7期795-800,共6页
Practical Preventive Medicine
基金
国家自然科学基金(41375121)
广元市科技局重点研发项目(23ZDYF0085)
四川省卫生健康委员会科技项目资助(24WSXT037)。
关键词
气温
细颗粒物
肺炎
协同作用
广义相加模型
temperature
fine particulate matter
pneumonia
synergistic effect
generalized additive model
