廖青, 胡雪姣, 薛琦, 王蕾, 刘建华, 王思嘉, 宫雅琪, 聂绍发. 宜昌市大气污染物对流感样病例的短期效应[J]. 环境与职业医学, 2018, 35(10): 879-884, 891. DOI: 10.13213/j.cnki.jeom.2018.18182
引用本文: 廖青, 胡雪姣, 薛琦, 王蕾, 刘建华, 王思嘉, 宫雅琪, 聂绍发. 宜昌市大气污染物对流感样病例的短期效应[J]. 环境与职业医学, 2018, 35(10): 879-884, 891. DOI: 10.13213/j.cnki.jeom.2018.18182
LIAO Qing, HU Xue-jiao, XUE Qi, WANG Lei, LIU Jian-hua, WANG Si-jia, GONG Ya-qi, NIE Shao-fa. Short-term impact of air pollutants on influenza-like illness in Yichang City[J]. Journal of Environmental and Occupational Medicine, 2018, 35(10): 879-884, 891. DOI: 10.13213/j.cnki.jeom.2018.18182
Citation: LIAO Qing, HU Xue-jiao, XUE Qi, WANG Lei, LIU Jian-hua, WANG Si-jia, GONG Ya-qi, NIE Shao-fa. Short-term impact of air pollutants on influenza-like illness in Yichang City[J]. Journal of Environmental and Occupational Medicine, 2018, 35(10): 879-884, 891. DOI: 10.13213/j.cnki.jeom.2018.18182

宜昌市大气污染物对流感样病例的短期效应

Short-term impact of air pollutants on influenza-like illness in Yichang City

  • 摘要: 目的 定量分析宜昌市大气污染物对流感样病例(ILI)数的短期影响,为该地区流感防控提供参考依据。

    方法 收集2014—2016年间宜昌市大气污染物(PM2.5、PM10、SO2、CO、NO2和O3)日均浓度、日均气温及同期2家哨点医院上报的每日ILI监测数据。用分布滞后非线性模型分析污染物对人群ILI发病数的影响和滞后效应,并进行年龄和季节亚组分析,用地理探测器q统计对季节分层进行检验。

    结果 2014—2016年间,宜昌市共报告了30 090例ILI。PM2.5、PM10和CO均在当天对ILI发病数的效应最大,ER及95% CI分别为0.78%(0.31%~1.26%)、0.56%(0.20%~0.92%)和1.08%(0.29%~1.88%);NO2和O3在滞后1 d时效应最强,ER及95% CI分别为2.29%(0.34%~4.25%)和0.45%(0.03%~0.88%)。PM2.5、PM10、NO2和O3每增加10 μg/m3,CO浓度每增加0.1 mg/m3,对人群的ILI累积发病数分别增加1.08%、0.82%、4.95%、1.44%和1.95%。其中,仅SO2对5~14岁的人群ILI发病数的影响有统计学意义(累积ER=11.86%,95% CI:5.06%~19.11%);PM2.5、NO2和O3每增加10 μg/m3,CO每增加0.1 mg/m3,将使25~59岁人群5 d内ILI发病数分别增加1.41%、6.29%、2.38%和2.88%;PM2.5、PM10、NO2每增加10μg/m3,CO每增加0.1mg/m3,会使60岁及以上人群ILI发病数分别增加1.56%、1.24%、8.02%和4.24%。春季时,PM2.5和PM10每升高10μg/m3将分别使ILI累积发病数增加3.66%和2.02%;夏季时,O3每升高10μg/m3,ILI累积发病数将增加3.25%;秋季时,PM2.5和PM10每升高10μg/m3将使ILI累积发病数降低3.15%和2.92%;各污染物在冬季的影响均无统计学意义。

    结论 宜昌市大气污染物对人群ILI的发病均有短期影响,对不同季节及不同年龄组人群的影响有差异。

     

    Abstract: Objective To quantify the short-term impact of air pollutants on influenza-like illness (ILI) occurrence in Yichang, and to provide scientific reference for the prevention and control of influenza in the area.

    Methods The daily data of air pollutants (PM2.5, PM10, SO2, CO, NO2, and O3), temperature, and ILI from two sentinel hospitals in Yichang during 2014 and 2016 were collected. A distributed lag non-linear model (DLNM) was used to analyze the excess risk (ER) and lag effect of various air pollutants on the incidence of ILI. Moreover, stratified analyses by age and season subgroups were conducted; the seasonal stratification was tested by q values in geographical detector.

    Results There were totally 30 090 ILI cases reported in Yichang from 2014 to 2016. For PM2.5, PM10, and CO, the strongest effects on daily ILI cases were observed on lag 0 day, with ER (95%CI) of 0.78% (0.31%-1.26%), 0.56% (0.20%-0.92%), and 1.08% (0.29%-1.88%), respectively; and the effects of NO2 and O3 were strongest on lag 1 day with ER (95%CI) of 2.29% (0.34%-4.25%) and 0.45% (0.03%-0.88%), respectively. A 10 μg/m3 increase in PM2.5, PM10, NO2, and O3 and a 0.1 mg/m3 increase in CO were associated with 1.08%, 0.82%, 4.95%, 1.44% and 1.95% increases of cumulative ILI cases, respectively. SO2 only statistically affected the incidence of the group of 5-14 years with a cumulative ER of 11.86% (95% CI:5.06%-19.11%); a 10 μg/m3 increase in PM2.5, NO2, and O3 and a 0.1 mg/m3 increase in CO were associated with 1.41%, 6.29%, 2.38%, and 2.88% increases of cumulative ILI cases in residents aged 25-59 years, respectively; a 10 μg/m3 increase in PM2.5, PM10, and NO2 and a 0.1 mg/m3 increase in CO were associated with 1.56%, 1.24%, 8.02%, and 4.24% increases in cumulative ILI cases in the residents with age ≥ 60 years, respectively. In spring, a 10μg/m3 increase in PM2.5 and PM10 was associated with 3.66% and 2.02% increases of cumulative ILI cases, respectively. In summer, a 10μg/m3 increase in O3 was associated with 3.25% increase of cumulative ILI cases. In autumn, a 10μg/m3 increase in PM2.5 and PM10 were associated with 3.15% and 2.92% decreases of cumulative ILI cases, respectively. In winter, the effects of various air pollutants on ILI cases were not statistically significant.

    Conclusion All the air pollutants studied have short-term effects on the occurrence of ILI, which is varied by age groups and seasons.

     

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