空气污染物和哮喘患者就诊：环境影响因素
2018/01/15
摘要
背景：空气污染是造成身体健康损害的重要因素。较少研究探索污染源影响及空气污染物与哮喘患者就诊次数的相关性。
目的：本研究旨在探索上海短期接触空气污染物与哮喘发病率的关系，进一步探究地域和水域造成空气污染的源头。
方法:普及化添加模式（GAM）被用于探索每日患者就诊次数和空气污染物之间的关系。通过R统计软件以mgcv包装形式进行计算。PSCF模型被用于定位空气污染浓度源头。
结果：研究发现，在哮喘患者随访中，土地来源的PM2.5, PM10, NO2, SO2, O3及CO平均IQR分别为6.63% (95% CI: -0.27%-14%), 6.48% (95% CI: 0.06%- 13.3%), 1.68% (95% CI: -2.68%- 6.24%), 2.81% (95% CI: -1.42%- 7.22%), -0.60% (95% CI: -5.94% -5.04%) 以及16.6% (95% CI: 8.68%- 25.2%)。海洋来源的PM2.5, PM10, NO2, SO2, O3及CO平均IQR分别为5.34% (95% CI: 0.42% -10.5%), 3.84% (95% CI: 0.08% -7.74%), 3.21% (95% CI: -0.92%- 7.52%), 2.58% (95% CI: -1.02%- 6.30%), 1.42% (95% CI: -3.10% -6.15%)以及 8.81% (95% CI: 2.56%- 15.4%). PSCF提示除O3外所有污染物主要来源于土地污染。此外，研究还发现除NO2外所有污染物与春季哮喘发病高风险显著相关。
结论：空气污染物会造成哮喘患者就诊增多，PM2.5, PM10, NO2, SO2及CO主要来源于土地污染，而O3主要来源于海洋污染。空气污染导致哮喘就诊呈季节相关性，尤其在春季。PM2.5和CO是导致上海地区哮喘就诊风险显著增加的主要污染物。
Air pollutants and asthma patient visits: Indication of source influence.
Sci Total Environ. 2017 Dec 28;625:355-362. doi: 10.1016/j.scitotenv.2017.12.298. [Epub ahead of print]
Guo H, Huang S,Chen M.
Abstract
BACKGROUND: Sources of air pollutants are significant factors for adverse health effect. Few current studies explored the linking of sources influence and ambient pollutants to asthma patient visits in Shanghai, China.
OBJECTIVES:This study explored the associations between short-term exposures to ambient pollutants and asthma morbidity with terrestrial and marine source influence in Shanghai.
METHODS:Generalized additive model (GAM) was used to explore the association of daily patient visits and ambient pollutants. These analyses were calculated in R statistical software in mgcv package. PSCF modeling was used to locate potential source areas contributing to the concentrations of pollutants.
RESULTS:We found that per IQR of in terrestrial source were associated with an increase of 6.63% (95% CI: -0.27% to 14%), 6.48% (95% CI: 0.06% to 13.3%), 1.68% (95% CI: -2.68% to 6.24%), 2.81% (95% CI: -1.42% to 7.22%), -0.60% (95% CI: -5.94% to 5.04%) and 16.6% (95% CI: 8.68% to 25.2%), respectively in asthma patient visits. Per IQR of PM2.5, PM10, NO2, SO2, O3 and CO in marine source were associated with an increase of 5.34% (95% CI: 0.42% to 10.5%), 3.84% (95% CI: 0.08% to 7.74%), 3.21% (95% CI: -0.92% to 7.52%), 2.58% (95% CI: -1.02% to 6.30%), 1.42% (95% CI: -3.10% to 6.15%) and 8.81% (95% CI: 2.56% to 15.4%). The PSCF show all of the pollutants except O3 mainly come from terrestrial during observation. We also found that all of the pollutants except NO2 displayed the highest effect in the spring for relative risk of asthma morbidity.
CONCLUSIONS:Ambient air pollutants that cause an increase in asthma patient visits, such as PM2.5, PM10, NO2, SO2 and CO are mainly produced from terrestrial sources, while O3 is primarily from marine sources. The association of ambient pollutants and asthma patient visits is closely related with seasons, especially with spring. PM2.5 and CO are major air pollutants increasing the relative risk of asthma patient visits in Shanghai.
背景：空气污染是造成身体健康损害的重要因素。较少研究探索污染源影响及空气污染物与哮喘患者就诊次数的相关性。
目的：本研究旨在探索上海短期接触空气污染物与哮喘发病率的关系，进一步探究地域和水域造成空气污染的源头。
方法:普及化添加模式（GAM）被用于探索每日患者就诊次数和空气污染物之间的关系。通过R统计软件以mgcv包装形式进行计算。PSCF模型被用于定位空气污染浓度源头。
结果：研究发现，在哮喘患者随访中，土地来源的PM2.5, PM10, NO2, SO2, O3及CO平均IQR分别为6.63% (95% CI: -0.27%-14%), 6.48% (95% CI: 0.06%- 13.3%), 1.68% (95% CI: -2.68%- 6.24%), 2.81% (95% CI: -1.42%- 7.22%), -0.60% (95% CI: -5.94% -5.04%) 以及16.6% (95% CI: 8.68%- 25.2%)。海洋来源的PM2.5, PM10, NO2, SO2, O3及CO平均IQR分别为5.34% (95% CI: 0.42% -10.5%), 3.84% (95% CI: 0.08% -7.74%), 3.21% (95% CI: -0.92%- 7.52%), 2.58% (95% CI: -1.02%- 6.30%), 1.42% (95% CI: -3.10% -6.15%)以及 8.81% (95% CI: 2.56%- 15.4%). PSCF提示除O3外所有污染物主要来源于土地污染。此外，研究还发现除NO2外所有污染物与春季哮喘发病高风险显著相关。
结论：空气污染物会造成哮喘患者就诊增多，PM2.5, PM10, NO2, SO2及CO主要来源于土地污染，而O3主要来源于海洋污染。空气污染导致哮喘就诊呈季节相关性，尤其在春季。PM2.5和CO是导致上海地区哮喘就诊风险显著增加的主要污染物。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Sci Total Environ. 2017 Dec 28;625:355-362. doi: 10.1016/j.scitotenv.2017.12.298. [Epub ahead of print]）
（Sci Total Environ. 2017 Dec 28;625:355-362. doi: 10.1016/j.scitotenv.2017.12.298. [Epub ahead of print]）
Air pollutants and asthma patient visits: Indication of source influence.
Sci Total Environ. 2017 Dec 28;625:355-362. doi: 10.1016/j.scitotenv.2017.12.298. [Epub ahead of print]
Guo H, Huang S,Chen M.
Abstract
BACKGROUND: Sources of air pollutants are significant factors for adverse health effect. Few current studies explored the linking of sources influence and ambient pollutants to asthma patient visits in Shanghai, China.
OBJECTIVES:This study explored the associations between short-term exposures to ambient pollutants and asthma morbidity with terrestrial and marine source influence in Shanghai.
METHODS:Generalized additive model (GAM) was used to explore the association of daily patient visits and ambient pollutants. These analyses were calculated in R statistical software in mgcv package. PSCF modeling was used to locate potential source areas contributing to the concentrations of pollutants.
RESULTS:We found that per IQR of in terrestrial source were associated with an increase of 6.63% (95% CI: -0.27% to 14%), 6.48% (95% CI: 0.06% to 13.3%), 1.68% (95% CI: -2.68% to 6.24%), 2.81% (95% CI: -1.42% to 7.22%), -0.60% (95% CI: -5.94% to 5.04%) and 16.6% (95% CI: 8.68% to 25.2%), respectively in asthma patient visits. Per IQR of PM2.5, PM10, NO2, SO2, O3 and CO in marine source were associated with an increase of 5.34% (95% CI: 0.42% to 10.5%), 3.84% (95% CI: 0.08% to 7.74%), 3.21% (95% CI: -0.92% to 7.52%), 2.58% (95% CI: -1.02% to 6.30%), 1.42% (95% CI: -3.10% to 6.15%) and 8.81% (95% CI: 2.56% to 15.4%). The PSCF show all of the pollutants except O3 mainly come from terrestrial during observation. We also found that all of the pollutants except NO2 displayed the highest effect in the spring for relative risk of asthma morbidity.
CONCLUSIONS:Ambient air pollutants that cause an increase in asthma patient visits, such as PM2.5, PM10, NO2, SO2 and CO are mainly produced from terrestrial sources, while O3 is primarily from marine sources. The association of ambient pollutants and asthma patient visits is closely related with seasons, especially with spring. PM2.5 and CO are major air pollutants increasing the relative risk of asthma patient visits in Shanghai.
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