中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2021, Vol. 43 ›› Issue (4): 521-530.doi: 10.3881/j.issn.1000-503X.13046

• 论著 • 上一篇    下一篇

空气污染物对兰州市特应性皮炎门诊人次的影响

何苑1,石春蕊2(),光奇3,骆志成4,郗群5,韩磊6   

  1. 1兰州大学第一临床医学院皮肤病与性病学,兰州 730000
    兰州大学第一医院 2皮肤科,兰州 730000
    3信息中心,兰州 730000
    兰州大学第二医院 4皮肤科,兰州 730000
    5信息中心,兰州 730000
    6河西学院附属张掖人民医院皮肤科,甘肃张掖 734000
  • 收稿日期:2020-06-02 出版日期:2021-08-30 发布日期:2021-09-03
  • 通讯作者: 石春蕊 E-mail:stone7207@126.com
  • 基金资助:
    甘肃省自然科学基金(18JR3RA337)

Effects of Air Pollutants on Outpatient Visits for Atopic Dermatitis in Lanzhou

HE Yuan1,SHI Chunrui2(),GUANG Qi3,LUO Zhicheng4,XI Qun5,HAN Lei6   

  1. 1Department of Dermatovenereology,The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China
    2Department of Dermatology,Lanzhou 730000,China
    3Information Center,The First Hospital of Lanzhou University,Lanzhou 730000,China
    4Department of Dermatology,Lanzhou 730000,China
    5Information Center,Lanzhou University Second Hospital,Lanzhou 730000,China
    6Department of Dermatology,Zhangye People’s Hospital Affiliated to Hexi University,Zhangye,Gansu 734000,China
  • Received:2020-06-02 Published:2021-08-30 Online:2021-09-03
  • Contact: SHI Chunrui E-mail:stone7207@126.com
  • Supported by:
    Natural Science Foundation of Gansu Province of China(18JR3RA337)

摘要:

目的 定量评估兰州地区空气污染物PM2.5、PM10、NO2和SO2浓度对特应性皮炎门诊人次的影响。方法 收集 2013年1月至2017年12 月特应性皮炎患者的门诊资料和同期气象及环境污染物资料。采用基于泊松分布广义相加模型在控制季节性和长期趋势、星期几效应基础上,研究PM2.5、PM10、NO2和SO2浓度对就诊人次影响的滞后效应。结果 在单污染物模型中,PM2.5、PM10均在滞后当日(lag0)时对特应性皮炎门诊人次的影响最明显,但无统计学意义;NO2也在lag0时影响最明显,并存在滞后效应,其浓度每增加10 μg/m3,特应性皮炎门诊人次的超额危险度(ER)及95%可信区间(95%CI)为1.95%(95%CI=1.09%~2.82%),具有统计学意义(P=0.01);SO2在滞后第6天(lag6)时影响最明显,SO2浓度每升高10 μg/m3,门诊人次增加1.52%(95%CI=0.48%~2.54%),具有统计学意义(P=0.02);对不同性别、年龄、季节分析后显示,女性比男性对PM10和SO2敏感,PM10和SO2每上升10 μg/m3,女性门诊人次分别增加0.02%和2.47%。而男性对PM2.5及NO2敏感,PM2.5和NO2每上升10 μg/m3,男性门诊人次分别增加0.47%和1.78%;气态污染物(NO2、SO2)影响≤2岁人群高于其余年龄人群,NO2和SO2每上升10 μg/m3,≤2岁人群门诊人次分别增加2.35%和1.57%,具有统计学意义(P=0.02)。13~59岁人群对NO2浓度的升高敏感,NO2每上升10 μg/m3,13~59岁人群门诊人次分别增加1.39%;NO2在冷暖季节时期对门诊人次有影响,ER值分别为2.35%和1.89%,具有统计学意义(P=0.01)。颗粒物(PM2.5、PM10)在冬季门诊人次影响明显,但均无统计学意义。PM2.5和NO2,PM10和NO2以及SO2和NO2对特应性皮炎总门诊人次的交互作用明显。在双污染物模型中,引入PM2.5、PM10和SO2,NO2对特应性皮炎门诊人次影响较单污染物模型明显增加,且具有统计学意义(P=0.01)。结论 兰州市空气污染物(PM2.5、PM10、NO2、SO2)与特应性皮炎门诊人次密切相关,并且NO2和SO2浓度升高更易增加特应性皮炎的发病风险。

关键词: 特应性皮炎, 空气污染物, 广义相加模型

Abstract:

Objective To quantitatively evaluate the associations of PM2.5,PM10,NO2,and SO2 concentrations with the outpatient visits for atopic dermatitis in Lanzhou. Methods The data of outpatient visits,together with meteorological data and air pollutant data,from January 2013 to December 2017 were collected.The generalized additive model based on Poisson distribution was employed to study the lag effects of PM2.5,PM10,NO2,and SO2 concentrations on the visits of outpatients,with the seasonal and long-term trends and day-of-the-week effect controlled. Results The results of the single pollutant model showed that PM2.5 and PM10 had the most obvious while still insignificant impact on the outpatient visits for atopic dermatitis on the current day(lag0).NO2 also had the most obvious impact in the case of lag0 and showed a lag effect.For each 10 μg/m3 increase in NO2 concentration,the excess risk(ER)of outpatient visits for atopic dermatitis was 1.95%(95% CI=1.09%-2.82%,P=0.01).SO2 had the most significant effect on lag6,and the outpatient visits increased by 1.55%(95% CI=0.48%-2.54%)for every 10 μg/m3 rise in SO2 concentration(P=0.02).Females were more sensitive to PM10 and SO2 than males.For every 10 μg/m3 increase in PM10 and SO2,the female outpatient visits increased by 0.02% and 2.47%,respectively.Males were sensitive to PM2.5 and NO2,and the every 10 μg/m3 rise in PM2.5 and NO2 increased male outpatient visits by 0.47% and 1.78%,respectively.Gaseous pollutants(NO2 and SO2)had more significant effect on people ≤2 years old than on those of other ages.Every 10 μg/m3 rise in NO2 and SO2 would increase the ≤2-year-old outpatient visits by 2.35% and 1.57%,respectively(P=0.02).People of 13-59 years old were sensitive to NO2 concentration,and every 10 μg/m3 rise in NO2 concentration increased their visits by 1.39%.NO2 affected the outpatient visits during the cold and warm seasons,with the ER values of 2.35% and 1.89%,respectively(P=0.01).Particulate matter(PM2.5 and PM10)had the most obvious yet insignificant association with the outpatient visits in winter.The interactions between PM2.5 and NO2,between PM10 and NO2,and between SO2 and NO2 affected the total outpatient visits for atopic dermatitis.The results of double pollutant model showed that in the presence of PM2.5,PM10,or SO2,the effect of NO2 on the outpatient visits for atopic dermatitis enhanced compared with that predicted by single pollutant model(P=0.01). Conclusion The air pollutants(PM2.5,PM10,NO2,and SO2)in Lanzhou were closely related to the outpatient visits for atopic dermatitis,and the increased concentrations of NO2 and SO2 was more likely to increase the risk of atopic dermatitis.

Key words: atopic dermatitis, air pollutants, generalized additive model

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