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2007—2018年上海市非职业性一氧化碳中毒事件的流行病学特征及影响因素

Epidemiological characteristics and influencing factor of non-occupational carbon monoxide poisoning during 2007—2018 in Shanghai

    摘要
  • 摘要:
    背景 非职业性一氧化碳中毒是严重影响居民健康和生命的公共卫生问题。
    目的 了解2007—2018年上海市非职业性一氧化碳中毒事件的发生状况，分析中毒事件的流行病学特征及其影响因素，并探讨切实有效的防控措施。
    方法 收集2007—2018年上海市每日气象和非职业性一氧化碳中毒病例资料，采用描述性流行病学的方法对中毒事件特征进行描述，并采用分布滞后非线性模型分析气温与中毒病例发病的关联。
    结果 2007—2018年上海市共报告本地非职业性一氧化碳中毒事件2264起，中毒人数3866人，其中死亡59人。中毒病例多为女性（56.3%），青壮年人群居多（54.8%）。中毒病例冬季（每年12月至次年2月）高发，近年来夏季中毒病例有所增加。中毒事件多集中在夜间（20：00—24：00）发生。中毒事件发生地点以家中（85.2%）和餐厅（8.0%）为主，中毒首要原因为燃气热水器使用不当（36.9%）。非职业性一氧化碳中毒发病与当日日平均气温的效应曲线呈非线性，气温低于9.6℃时，中毒发生风险随气温降低而增加；9.7~26.0℃时，中毒发生风险随气温升高而增加。
    结论 冬季是上海非职业性一氧化碳中毒的高发季节，近年来夏季中毒事件多发也值得关注。应加强市场监管，禁售违规燃气热水器，多途径宣教一氧化碳中毒防治知识，以减少中毒事件的发生。

     

    Abstract:
    Background Non-occupational carbon monoxide (CO) poisoning is a public health problem that seriously affect people’s health and lives.
    Objective To describe the prevalence of non-occupational CO poisoning during 2007—2018 in Shanghai, analyze its epidemiological characteristics and potential influencing factors, and explore effective prevention and control measures.
    Methods Daily reported non-occupational CO poisoning cases and meteorological factors from 2007 to 2018 were collected in Shanghai, epidemiological characteristics were analyzed by descriptive epidemiology methods, and a distributed lag nonlinear model was used to assess the association between temperature and non-occupational CO poisoning.
    Results A total of 2264 non-occupational CO poisoning events and 3866 cases from 2007 to 2018 were reported in Shanghai, including 59 death cases. More than half of the poisoning cases were female (56.3%), and young adults accounted for more cases than any other age group (54.8%). The poisoning events mainly occurred in winter (from December to next February); however, cases reported in summer increased in recent years. The peak period of the events was from 20:00 to 24:00. Households (85.2%) and restaurants (8.0%) were the common places of non-occupational CO poisoning events, and the main cause was improper use of gas water heater (36.9%). A nonlinear curve was found between daily average temperature of current day and the occurrence of non-occupational CO poisoning. Temperature was negatively associated with the risk of non-occupational CO poisoning when the temperature was lower than 9.6 ℃, while a positive association was found during 9.7-26.0 ℃.
    Conclusion Winter is a high season for non-occupational CO poisoning in Shanghai, rising cases reported in summer is also worthy of attention. Supervision should be strengthened to ban sales of unqualified gas water heaters, and health education on CO poisoning prevention and control should be conducted through multiple channels, in order to reduce the incidence of CO poisoning.

     

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