2005-2012年武汉市大气污染对呼吸系统疾病日住院人数的影响

摘要

目的 探讨武汉市大气污染对居民呼吸系统疾病日住院人数的影响.方法 收集2005年1月1日-2012年12月31日武汉市每日空气污染指数(API)、气象(平均气压、气温、气湿)资料,以及武汉市某三甲医院呼吸系统疾病住院数据,选用广义相加模型(GAM)的Poisson回归,研究大气污染对居民呼吸系统疾病日住院人数的影响.结果 API每上升一个四分位间距(37个单位),在累积滞后01天(lag01)总呼吸系统疾病住院人数增加最大,为6%(RR=1.06,95%CI:1.015~1.107).男性比女性对空气污染更敏感,男性在API上升累积滞后01天(lag01)RR值最大,为1.069(1.016~1.125),女性则在当天RR值最大,为1.048(0.975~1.127).≥65岁人群较0~64岁人群更为易感.≥65岁和0~64岁人群在API上升累积滞后01天(lag01)RR值最大,分别为1.075(1.012~1.141)和1.046(0.982~1.115).慢性阻塞性肺疾病(COPD)患者日住院人数在API上升累积滞后01天(lag01)RR值最大,为1.095(1.004~1.194),肺炎患者日住院人数增幅在滞后1天(lag1)最大,RR为1.019(0.951~1.092).API对呼吸系统疾病住院人数的影响冷季节>暖季节.结论 大气污染可增加居民呼吸系统疾病日住院人数,并对不同性别、年龄、呼吸系统疾病类型和季节的影响存在差异.%Objectives To investigate the association between ambient air pollution and daily hospital admissions for respiratory diseases in Wuhan.Methods The air pollution data(air pollution index,API),meteorological data(average air pressure,temperature and humidity)and the data of hospital admissions in a first grade general hospital in Wuhan were collected from January 1,2005 to December 31,2012.A semi-parametric generalized additive model(GAM)was used to evaluate the specific influences of air pollutants(API)on daily hospital admissions with different lag structures.Results It was found that a range interquartile(37 units)increment in API at cumulative lag days 0-1(lag01)was associated with a highest increment of 6%(RR=1.06,95%CI:1.015-1.107)in overall daily hospital admissions.Statistic analysis showed males were more vulnerable to air pollution.The Relevant Risk(RR)had reached its highest rate of 1.069(1.016-1.125)among the male residents at lag01 day,whereas that for female reached its highest of 1.048(0.975-1.127)at present day(lag0).It was more likely for people ≥65 years of age to be affected.When API increased 37 units,the increased risk of hospitalization for people ≥65 years and 0-64 years of age reached their highest at lag01 day,with their RR levels going up to 1.075(1.012-1.141)and 1.046(0.982-1.115)at lag01 day,respectively.The maximum RR of daily hospital admissions for COPD was 1.075(1.012-1.141)at lag01 day,whereas that for pneumonia was 1.019(0.951-1.092)at lag day 1(lag1).The effects of air pollutants were more evident in the cold season than in the warm season.Conclusions Ambient air pollution was associated with increased risk of daily hospital admissions for respiratory diseases in Wuhan.And it differed in sex,age,types ofrespiratory diseases and seasons.