美国的乔治亚州儿科急诊就诊与PM2.5的短期浓度变化的关系
2016/07/28
摘要
背景：儿科急诊(ED)就诊和粒径≤2.5μm的颗粒物浓度（PM2.5）之间的关系已有报道，虽然很少是在非大都市地区进行的研究。
目的：我们使用一个两阶段模型，包括土地使用的参数和卫星测量大气气溶胶光学厚度在1公里的分辨率, 来评估每日PM2.5的浓度与通过过城市化分类选出美国乔治亚州六个儿科疾病急诊就诊之间的关系。
方法：我们获得了儿科急诊就诊信息，我们对这些就诊者都进行地理编码到居住地的邮政编码，居住地均有PM2.5评估信息。患者就诊时间在2002年1月1日到2010年6月30日期间 2岁至18岁的哮喘或喘息患者（n = 189816）、0到18岁的支气管炎患者（n = 76243）、慢性鼻窦炎患者（n = 15745）、中耳炎患者（n = 237833）、肺炎患者（n = 52946），和上呼吸道感染患者（n = 414556）。
用邮政编码边界区域的平均浓度计算每日邮政编码评估的24小时PM2.5平均值。我们用时间分层的病例交叉模型对邮政编码边界、年和月进行分层，来评估急诊就诊和当天和前一天邮政编码水平的PM2.5浓度之间的比值比（OR），并利用县级城市化来研究效应修正。
结果：当天10μg/m3PM2.5浓度的增加与哮喘或喘息的儿科急诊就诊相关（OR=1.013；95%可信区间：1.003，1.023）、与上呼吸道感染的急诊就诊相关（OR= 1.015；95%可信区间：1.008，1.022）；与前一天PM2.5浓度的相关性较低。在城市化水平的关系评估的差异无统计学意义。
结论：在Georgia，哮喘或喘息和上呼吸道感染的儿科急诊就诊与PM2.5浓度有关。
（杨冬 审校）
Environ Health Perspect. 2016 May;124(5):690-6. doi: 10.1289/ehp.1509856. Epub 2015 Oct 9.
Pediatric Emergency Visits and Short-Term Changes in PM2.5 Concentrations in the U.S. State of Georgia.
Strickland MJ1, Hao H, Hu X, Chang HH, Darrow LA, Liu Y.
Author information
Abstract
BACKGROUND:Associations between pediatric emergency department (ED) visits and ambient concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) have been reported in previous studies, although few were performed in nonmetropolitan areas.
OBJECTIVE:We estimated associations between daily PM2.5 concentrations, using a two-stage model that included land use parameters and satellite aerosol optical depth measurements at 1-km resolution, and ED visits for six pediatric conditions in the U.S. state of Georgia by urbanicity classification.
METHODS:We obtained pediatric ED visits geocoded to residential ZIP codes for visits with nonmissing PM2.5 estimates and admission dates during 1 January 2002-30 June 2010 for 2- to 18-year-olds for asthma or wheeze (n = 189,816), and for 0- to 18-year-olds for bronchitis (n = 76,243), chronic sinusitis (n = 15,745), otitis media (n = 237,833), pneumonia (n = 52,946), and upper respiratory infections (n = 414,556). Daily ZIP code-level estimates of 24-hr average PM2.5 were calculated by averaging concentrations within ZIP code boundaries. We used time-stratified case-crossover models stratified on ZIP code, year, and month to estimate odds ratios (ORs) between ED visits and same-day and previous-day PM2.5 concentrations at the ZIP code level, and we investigated effect modification by county-level urbanicity.
RESULTS:A 10-μg/m3 increase in same-day PM2.5 concentrations was associated with ED visits for asthma or wheeze (OR = 1.013; 95% CI: 1.003, 1.023) and upper respiratory infections (OR = 1.015; 95% CI: 1.008, 1.022); associations with previous-day PM2.5 concentrations were lower. Differences in the association estimates across levels of urbanicity were not statistically significant.
CONCLUSION:Pediatric ED visits for asthma or wheeze and for upper respiratory infections were associated with PM2.5 concentrations in Georgia.
CITATION:Strickland MJ, Hao H, Hu X, Chang HH, Darrow LA, Liu Y. 2016. Pediatric emergency visits and short-term changes in PM2.5 concentrations in the U.S. state of Georgia. Environ Health Perspect 124:690-696; http://dx.doi.org/10.1289/ehp.1509856.
Environ Health Perspect. 2016 May;124(5):690-6. doi: 10.1289/ehp.1509856. Epub 2015 Oct 9.
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