大气主要污染物与儿童呼吸系统疾病住院率关系调查研究

摘要

背景儿童呼吸系统疾病发病率呈上升趋势，大气污染对儿童健康的影响越来越受重视。目的比较兰州市2014年和2015年大气主要污染物对1~5岁儿童呼吸系统疾病住院率影响的差异。方法于2016年5—6月通过“中国空气质量在线监测平台”收集2014—2015年兰州市大气主要污染物〔PM2.5、PM10、二氧化硫（SO2）、二氧化氮（NO2）、臭氧（O3）〕每月平均污染水平的数据，并通过“甘肃省卫生系统疾控机构进医院信息平台”收集同时段兰州市1~5岁儿童呼吸系统疾病每月住院率数据。采用 Pearson 相关分析大气主要污染物与住院率及污染物之间的关系，并采用线性回归分析大气主要污染物对住院率的影响。结果2014年和2015年 PM2.5、PM10、SO2、O3水平比较，差异均无统计学意义（P >0.05）；2015年 NO2水平、儿童呼吸系统疾病住院率高于2014年（P <0.05）。2014年，PM2.5、PM10、SO2、NO2水平与住院率呈正相关（P <0.05），O3水平与住院率呈负相关（ P <0.05）。2015年， PM10和 NO2水平与住院率无直线相关性（P >0.05），PM2.5和 SO2水平与住院率呈正相关（P <0.05），O3水平与住院率呈临界负相关（P =0.050）。多元线性回归分析结果显示，2014年，PM2.5〔 t =3.79，P =0.004，方差膨胀因子（VIF）=1.45〕和 NO2（ t =2.64，P =0.027，VIF =1.45）是住院率的影响因素（ P <0.05）；2015年，SO2（ t =3.01，P =0.013，VIF =1.00）是住院率的影响因素（P <0.05）。结论兰州市2015年儿童呼吸系统疾病住院率高于2014年，可能是由于2015年影响住院率的因素（SO2）与2014年（PM2.5和 NO2）不同造成。%Background As the prevalence of respiratory diseases in children presents an upward trend,the influence of air pollution on children′s health is being taken more seriously. Objective To compare the influence of major air pollutants on the hospitalization rate of respiratory diseases among children aged 1 - 5 years between 2014 and 2015 in Lanzhou city. Methods From May to June 2016,we collected the data of monthly level of major air pollutants(PM2. 5 ,PM10 ,SO2 ,NO2 and O3 )of Lanzhou in 2014 and 2015 from China′s Air Pollution Online Monitoring Platform,and the data of hospitalization rate for respiratory diseases among children aged 1 - 5 years in Lanzhou during the same two years from the Information Platform of Health System from CDC into Hospital in Gansu province. The Pearson correlation was used to test the correlation of major air pollutants with hospitalization rate,and that between the major air pollutants. The linear regression was used to analyze the influence of major air pollutants on hospitalization rate. Results The differences in the levels of PM2. 5 ,PM10 ,SO2 and O3 in Lanzhou between 2014 and 2015 showed no statistical significance(P > 0. 05). The level of NO2 was significantly higher in 2015 than it in 2014(P < 0. 05),and the hospitalization rate of respiratory diseases among 1 - 5 years old children was significantly higher in 2015 than it in 2014(P < 0. 05). Results of Pearson correlation showed that in 2014,PM2. 5 ,PM10 ,SO2 ,NO2 were positively correlated with the hospitalization rate(P < 0. 05),while O3 was negatively correlated with it(P < 0. 05);in 2015, PM10 and NO2 had no linear correlation with hospitalization rate(P > 0. 05),PM2. 5 and SO2 were positively correlated with the hospitalization rate(P < 0. 05),and O3 was critically negatively correlated with hospitalization rate(P = 0. 050). The results of multivariate linear regression analysis showed that in 2014,PM2. 5 (t = 3. 79,P = 0. 004,VIF = 1. 45)and NO2 (t = 2. 64, P = 0. 027,VIF = 1. 45) were significant risk factors for hospitalization rate( P < 0. 05);in 2015,SO2 ( t = 3. 01,P =0. 013,VIF = 1. 00 ) was the significant risk factor for hospitalization rate( P < 0. 05 ). Conclusion The different air pollutants(PM2. 5 and NO2 in 2014,and SO2 in 2015)might lead to the higher hospitalization rate of respiratory diseases among children aged 1 - 5 in Lanzhou in 2015 than it in 2014.