空气污染对心脑血管疾病门诊量影响的Poisson广义可加模型分析

摘要

目的 定量研究潍坊市大气污染对居民心脑血管日门诊量的影响,探讨大气污染与门诊量之间的关系,为心脑血管疾病的预防控制提供依据.方法 通过潍坊市社保系统收集每日心脑血管疾病门诊量,从中国气象局收集气象资料,大气污染资料来源于潍坊市环境监测站.采用Poisson广义可加模型对潍坊市大气污染与心脑血管疾病门诊量进行回归分析,同时控制气象因素、时间趋势、周日效应混杂因素的影响.结果 2015年潍坊市空气中PM 2.5、PM 10、SO2、NO2的日均浓度分别为75.33μg/m3、126.25 μg/m3、41.25 μg/m3、38.17μg/m3;潍坊市心脑血管疾病日门诊量586人次/天;Spearman相关分析结果表明,温度和降雨量与空气污染指标存在较强相关性.单因素广义可加模型(GAM)时序分析结果显示,温度、降雨量、PM 2.5、PM 10、SO2、NO2对心脑血管疾病门诊量有影响;多因素分析显示,PM 2.5、PM10、SO2、NO2日均浓度每增加10μg/m3,心脑血管疾病门诊量的风险RR值分别增加0.27％(0.20％～0.53％)、0.35％(0.10％～0.61％)、0.69％(0.50％ ～0.89％)、0.39％ (0.04％ ～0.75％).结论 潍坊市大气污染能增加心脑血管疾病门诊量的风险,温度和降雨量与大气污染物相关性较高,提示采暖期污染程度明显加重,有必要开展相应的治理措施.%Objective To study the effect of air pollution on the daily outpatient amount of cardiovascular and cerebrovascular diseases and the relationship between air pollution and outpatient amount,in order to provide basis for prevention and control of cardiovascular and cerebrovascular diseases.Methods Collecting the outpatient volume of cardiovascular and cere brovascular diseases from Weifang social security system.Meteorological data were collected from the China Meteorological Administration,and the air pollution data were collected from Weifang environmental monitoring station.The Poisson generalized additive model was used to analyze the air pollution and cardiovascular and cerebrovascular diseases in Weifang,and the effects of meteorological factors,time trend,and Sunday effect were controlled.Results The air daily average concentrations of PM2.5 and PM10,SO2,NO2 were 75.33 μg/m3,126.25 μg/m3 and 41.25 μg/m3 and 38.17 μg/m3 of 2015 in weifang;the outpatient volume of cardiovascular and cerebrovascular diseases was 590 people per day in Weifang;Spearman correlation analysis results showed that temperature,rainfall and air pollution index had strong correlations.Single factor GAM time-series analysis results showed that temperature,rainfall,PM2.5,PM10,SO2,and NO2 had an impact on the outpatient amount of cardiovascular and cerebrovascular diseases.Multiple factors analysis showed that the concentration of PM2.5 and PM10,SO2,NO2average daily by 10 ug/m3,the risk of RR value were increased by 0.27％ (0.20％ 0.53％),0.27％ (0.10％ 0.61％),0.69％ (0.50％ 0.89％),0.50％ (0.04％ 0.75％).Conclusion The atmospheric contamination can increase the risk of the outpatient volume of cardiovascular and cerebrovascular diseases in Weifang.There are correlations between the air pollutants and temperature and rainfall.Prompting that the winter heating and other factors can lead to serious air pollution.It is necessary to carry out corresponding measures.