天津市大气颗粒物对健康影响的季节性差异研究
Seasonal variation in health effects of particulate matter in Tianjin
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摘要:
背景 大气颗粒物对健康的不良影响已得到证实，但关于健康影响季节性模式的研究结果并不一致。
目的 探讨天津市大气颗粒物（PM2.5和PM10）对每日非意外死亡率和相应寿命损失年（YLL）影响的季节性变化。
方法 收集天津市2014—2019年的逐日死亡资料、大气污染资料和气象资料，采用分层分析和时间序列分析相结合的方法。通过构建广义相加模型定量地评估PM2.5和PM10与每日非意外死亡和YLL之间的关系，模型中控制气温、相对湿度、长期趋势、星期几效应和节假日效应等混杂因素。
结果 全年、春季、夏季和秋季时PM2.5和PM10对每日非意外死亡率和相应YLL的影响有统计学意义（除了春季PM10对非意外死亡YLL的影响无统计学意义外），冬季时的影响均无统计学意义。全年及春、夏、秋季的PM2.5和PM10质量浓度每增加10 µg·m−3，非意外死亡率及其95%CI的增加值分别为：全年0.28%（0.11%~0.44%）和0.24%（0.11%~0.36%），春季0.44%（0.11%~0.77%）和0.17%（0.00%~0.33%），夏季1.32%（0.50%~2.16%）和2.15%（1.54%~2.76%），秋季0.68%（0.30%~1.06%）和0.57%（0.28%~0.87%）；相应的YLL及其95%CI的增加值 分别为：全年7.41（2.42~13.07）和5.75（1.94~9.57）人年，春季13.11（3.00~23.22）和2.88（−2.82~8.59）人年，夏季34.66（11.92~57.40）和48.12（31.48~64.75）人年，秋季16.13（4.57~27.70）和12.60（3.56~21.65）人年。以全球空气质量指南（2021）中的限值为参考时，夏季PM2.5和PM10暴露导致的超额死亡人数和超额YLL最大，平均每日由PM2.5和PM10暴露导致的超额死亡人数及其95%CI分别为5.38（5.08~5.69）、8.62（7.95~9.28），超额YLL及其95%CI分别为112.23（105.79~118.67）、156.94（144.99~168.89）人年。
结论 天津市大气颗粒物对非意外死亡的影响存在明显的季节性差异，其中夏季的不良健康影响最强，提示夏季更应该加强大气颗粒物相关健康防护。
Abstract:Background Adverse health effects associated with particulate matter have been demonstrated, but findings on seasonal variation in the health impacts are inconsistent.
Objective To explore potential seasonal variation in particulate matter (PM2.5 and PM10) associated daily non-accidental mortality and corresponding years of life loss (YLL) in Tianjin.
Methods The daily data of non-accidental deaths, air pollution, and meteorological factors in Tianjin from 2014 to 2019 were collected. A generalized additive model, with adjusting selected confounding factors such as temperature, relative humidity, long-term trends, day of the week, and holiday, was used to quantitatively evaluate the relationships of PM2.5 and PM10 with daily non-accidental deaths and YLL.
Results The effects of PM2.5 and PM10 on daily non-accidental mortality and corresponding YLL were statistically significant in full year, spring, summer, and autumn (except for the effect of PM10 on non-accidental YLL in spring), but not statistically significant in winter. The non-accidental mortality and it's 95%CI increased by 0.28% (0.11%-0.44%) and 0.24% (0.11%-0.36%) in full year, 0.44% (0.11%-0.77%) and 0.17% (0.00%-0.33%) in spring, 1.32% (0.50%-2.16%) and 2.15% (1.54%-2.76%) in summer, and 0.68% (0.30%-1.06%) and 0.57% (0.28%-0.87%) in autumn for every 10 µg·m−3 increase in PM2.5 and PM10 concentrations, respectively; the corresponding YLL and it's 95%CI increased by 7.41 (2.42-13.07) and 5.75 (1.94-9.57), 13.11 (3.00-23.22) and 2.88 (−2.82-8.59), 34.66 (11.92-57.40) and 48.12 (31.48-64.75), and 16.13 (4.57-27.70) and 12.60 (3.56-21.65) person-years, respectively. When adopting the limits in the Global Air Quality Guidelines (2021) as the reference, excess deaths and YLL caused by PM2.5 and PM10 exposure were the greatest in summer. The excess deaths and it's 95%CI were 5.38 (5.08-5.69) and 8.62 (7.95-9.28), and the excess YLL and it's 95%CI were 112.23 (105.79-118.67) and 156.94 (44.99-168.89) person-years, respectively.
Conclusion The effects of particulate matter on non-accidental mortality and corresponding YLL may vary seasonally in Tianjin with the greatest effects in summer, suggesting that the health protection related to particulate matter should be strengthened in summer.
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