台风登陆前后气象因素对广州市儿科门诊就诊情况的影响
Influence of meteorological factors on pediatric outpatient visits in Guangzhou before and after typhoons
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摘要:
背景 气候变化导致极端天气事件频发，极端天气事件对人群健康存在一定影响，尤其是敏感群体。台风登陆期间气象因素的变化会对人群健康产生影响。
目的 观察广州市某医院儿科门诊就诊量在台风登陆前后的变化趋势以及疾病构成的变化，探讨台风登陆前后气象因素变化与儿科疾病间的关系。
方法 收集2015年3次台风登陆前后两周（“莲花”，6月24日至7月24日；“苏迪罗”，7月26日至8月29日；“彩虹”，9月19日至10月19日）气象数据以及该院儿科门诊在此3个时间段的就诊数据，比较分析3次台风登陆前后儿科门诊就诊人数及疾病构成的变化；运用Spearman相关分析法探索台风登陆前后气象因素变化与儿科门诊就诊量排名第一位的疾病之间的关系。
结果 所研究的3次台风期间，日最高温度中位数（以下指标均同）分别为33.7、33.5、30.4℃，日最低温度分别为25.4、24.3、23.3℃，日平均温度分别为28.8、28.1、25.2℃；日平均风速分别为2.6、1.6、2.3 m/s，日平均气压分别为994.2、993.3、1004.4hpa，相对湿度分别为73%、76%、77%；日门诊就诊人数分别为1 344、1 189、1 286，其中呼吸系统疾病就诊人数分别为954、815、929。3次台风登陆前儿科门诊就诊人数高于登陆后门诊就诊人数；3次台风登陆前后儿科门诊疾病构成均以呼吸系统疾病为第一位，且台风登陆前呼吸系统疾病构成比均高于台风登陆后呼吸系统疾病构成比；台风“莲花”“苏迪罗”“彩虹”登陆前儿科门诊呼吸系统疾病就诊量分别占73.5%、69.2%、72.5%，登陆后分别占70.5%、67.9%和70.5%。Spearman相关分析结果表明，台风“莲花”登陆前及登陆后儿科门诊呼吸系统疾病就诊人数与日最高温度、日平均温度呈正相关，与平均气压呈负相关（P < 0.05）；台风“苏迪罗”登陆前及登陆后儿科门诊呼吸系统疾病就诊人数与日最低温度、平均气压均呈负相关（P < 0.05）；台风“彩虹”登陆前及登陆后儿科门诊呼吸系统疾病就诊人数与日平均温度、平均气压呈负相关（P < 0.05），与相对湿度呈正相关（P < 0.05）；3次台风登陆前后平均气压与呼吸系统疾病就诊人数均呈负相关，台风登陆前的平均气压与呼吸系统疾病就诊人数的Spearman相关系数分别为-0.305、-0.402、-0.749。
结论 台风登陆前儿科门诊就诊量相较登陆后高，平均气压的变化与儿科呼吸系统疾病就诊人数相关。
Abstract:Background Climate change leads to frequent extreme weather events, which may have a certain health impact, especially on vulnerable groups. Changes in meteorological factors during typhoon landfall can affect the health of people.
Objective The purpose of this study is to observe the trends of pediatric outpatient visits before and after typhoons and the changes of disease composition in a hospital in Guangzhou, and to explore the relationship between meteorological factors and pediatric disease categories during typhoons.
Methods Meteorological data and pediatric outpatient visits of the hospital in two weeks before and after the landfalls of three typhoons in 2015 were collected (Lotus:from June 24 to July 24, Soudelor:from July 26 to August 29, Rainbow:from September 19 to October 19). The changes of the number of pediatric outpatient visits and disease composition before and after the three typhoons were compared. Spearman correlation analysis was used to explore the relationship between changes in meteorological factors and the disease category with most pediatric outpatient visits before and after typhoons.
Results During the three typhoon events, the daily maximum temperature (median, thereafter) 33.7, 33.5, and 30.4℃, respectively; the medians of daily minimum temperature was 25.4, 24.3, and 23.3℃, respectively; the average daily temperature was 28.8, 28.1, and 25.2℃, respectively; the average daily wind speed was 2.6, 1.6, and 2.3 m/s, respectively; the average daily air pressure was 994.2, 993.3, and 1 004.4 hpa, respectively; the relative humidity was 73%, 76%, and 77%, respectively; the daily outpatient number was 1 344, 1 189, and 1 286, respectively, among which the number of patients visiting respiratory outpatients was 954, 815, and 929, respectively. The numbers of pediatric outpatient visits before the three typhoons were higher than those after landfall. The proportions of respiratory outpatient visits to total pediatric outpatient visits before and after the three typhoons were all the highest, and the proportion before the typhoons was higher than that after. Specifically, before the landing of typhoons Lotus, Soudelor, and Rainbow, the proportions of respiratory outpatient visits to the total pediatric outpatient visits were 73.5%, 69.2%, and 72.5%, respectively; and the proportions after the landing were 70.5%, 67.9%, and 70.5%, respectively. The Spearman correlation analysis results showed that for typhoon Lotus, the numbers of patients visiting the pediatric respiratory outpatient department before and after its landing were positively correlated with average daily maxmum temperature and average daily temperature, and negatively correlated with average air pressure (P < 0.05); for typhoon Soudelor, the numbers were negatively correlated with average daily minimum temperature and average air pressure (P < 0.05); for typhoon Rainbow, the numbers were negatively correlated with average daily temperature and average air pressure, and positively correlated with relative humidity (P < 0.05). Before and after the landfalls of the three typhoons, average air pressure was all negatively correlated with respiratory outpatient volume, and the correlation coefficients before their landing were -0.305, -0.402, and -0.749, respectively.
Conclusion Before typhoon landfall, the number of pediatric outpatient visits would be higher than after the landfall; meanwhile, the change of average air pressure is correlated with the number of pediatric respiratory outpatient visits.
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