| 京津冀及周边地区大气细颗粒物和臭氧对医院日门诊量的急性影响及季节性差异 |
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| 引用本文： | 陈晨,张梦雪,刘晶,方建龙,郭亚菲,李湉湉,施小明.京津冀及周边地区大气细颗粒物和臭氧对医院日门诊量的急性影响及季节性差异[J].气象学报,2022,80(3):366-374. |
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| 作者姓名： | 陈晨 张梦雪 刘晶 方建龙 郭亚菲 李湉湉 施小明 |
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| 作者单位： | 1.中国疾病预防控制中心环境与人群健康重点实验室，中国疾病预防控制中心环境与健康相关产品安全所，北京，100021 |
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| 基金项目： | 中国疾病预防控制中心环境所青年科学基金项目（2020YSRF_02）、国家重点研发计划项目（2016YFC0206500）、大气重污染成因与治理攻关项目（DQGG0401） |
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| 摘 要： | 探究京津冀及周边地区大气细颗粒物（PM2.5）和臭氧（O3）短期暴露对人群因病就诊的急性影响及其季节性差异，为区域性大气污染的协同治理提供流行病学证据。收集2013年1月1日—2018年12月31日京津冀及周边地区共14个城市100家医院门诊的日就诊量，以及大气PM2.5和O3日均浓度和气象因子数据，基于时间序列研究设计，采用二阶段统计分析策略（广义相加模型联合meta分析），在控制气象因子和时间趋势等混杂因素的基础上构建双污染物模型，分析大气PM2.5和O3短期暴露对人群因病就诊的影响。研究期间，大气PM2.5和O3日均浓度平均分别为 72.2±56.8 μg/m3和 58.2±36.9 μg/m3，医院门诊就诊量达6257万人 · 次。双污染物模型结果显示，移动平均滞后0—1 d的PM2.5和O3暴露浓度每升高10 μg/m3，医院门诊就诊量分别增加0.25%（95%置信区间（95%CI）:0.20%—0.29%）和0.15%（95%CI:0.07%—0.22%）；拟合季节分层模型发现，冷季PM2.5暴露对门诊就诊量的急性影响较强，而O3相关效应则呈现出暖季较强的特征。京津冀及周边地区大气PM2.5和O3短期暴露均增大人群因病就诊的风险，提示应采取积极措施协同治理大气PM2.5和O3复合污染，同时重视污染物冷、暖季风险的差异。
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| 关 键 词： | 细颗粒物 臭氧 短期暴露 因病就诊 季节模式 |
| 收稿时间： | 2021-12-27 |
| 修稿时间： | 2022-03-25 |
Acute impact of ambient fine particulate matter and ozone on daily outpatient visits and its seasonal differences in Beijing-Tianjin-Hebei and surrounding areas |
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| Institution: | 1.China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health，Chinese Center for Disease Control and Prevention，Beijing 100021，China2.School of Public Health，Nanjing Medical University，Nanjing 211166，China3.College of Public Health，Hebei University，Baoding 071002，China |
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| Abstract: | This study explores acute effects of short-term exposure to ambient fine particulate matter (PM2.5) and ozone (O3) on hospital visits in the Beijing-Tianjin-Hebei region and surrounding areas and provides epidemiological evidence for the coordinated management of regional air pollution. Daily outpatient visits at 100 hospitals in 14 cities across the Beijing-Tianjin-Hebei region and surrounding areas and daily mean concentrations of PM2.5 and O3 as well as meteorological factors for the period from 1 January 2013 to 31 December 2018 are collected. Based on time series studies, a two-stage statistical analysis strategy (generalized additive model combined with meta analysis) is adopted to construct a dual-pollutant model by adjusting confounding factors (such as meteorological factors and time trends) to analyze effects of short-term exposure to ambient PM2.5 and O3 on hospital visits. During the study period, the average daily concentrations of ambient PM2.5 and O3 are 72.2±56.8 μg/m3 and 58.2±36.9 μg/m3, respectively, and the number of outpatient visits is 62.57 million. The results of the dual-pollutant model show that per 10 μg/m3 increases in 2 d moving average PM2.5 and O3 concentrations are associated with excess risks of 0.25% (95%CI: 0.20%—0.29%) and 0.15% (95%CI: 0.07%—0.22%) for daily outpatient visits with 0 to 1 d lag, respectively. Fitting the model of seasonal stratification, the acute effect of PM2.5 exposure on outpatient visits is strong in cold season, while the O3-related effect shows a strong effect in warm season. It is found that short-term exposure to ambient PM2.5 and O3 in the Beijing-Tianjin-Hebei region and surrounding areas both can increase the risk of outpatient visits. It is recommended to take active measures to coordinately control the combined pollution of PM2.5 and O3, and pay attention to different risk characteristics of pollutants between the cold and warm seasons. |
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