济南市供暖季空气污染对儿童肺功能的急性影响

吴兴彬; 岳克三; 曹萌; 潘荣建; 王创新; 崔亮亮

doi:10.13421/j.cnki.hjwsxzz.2020.04.010

济南市供暖季空气污染对儿童肺功能的急性影响

Acute Effects of Air Pollution on Lung Function of Schoolchildren during Heating Season in Jinan, China

摘要

摘要:
目的分析集中供暖后大气污染加重对儿童肺功能的急性影响。
方法 2014—2017年期间，选择济南市空气污染严重地区范围内的一所小学作为研究现场。在每年供暖季采用分层整群随机抽样的方法，分别从三至五年级各单纯随机抽取1个班，对班内所有学生进行身高、体重和肺功能检测。比较分析供暖前后PM_2.5、PM₁₀、SO₂、NO₂、CO浓度差异，儿童肺功能指标差异性。采用多元线性回归模型分析大气污染物与肺功能指标的相关性。
结果较集中供暖前，集中供暖后济南市空气PM_2.5、PM₁₀、SO₂、NO₂和CO浓度明显增高（P < 0.05）；集中供暖前后共对484名小学生进行了1194人次的肺功能检测，结果显示，呼气流速峰值（PEF）（t=3.19，P < 0.01）、75%用力呼气流量FEF75（t=2.28，P < 0.05）、25%用力呼气流量（FEF25）（t=2.89，P < 0.01）在供暖前后差异存在统计学意义，供暖后低于供暖前；大气PM_2.5浓度每升高10 μg/m³，FVC（Lag2）可降低9.28（4.37~14.18）mL，FEV₁（Lag1）降低5.31（2.64~7.98）mL，PEF（Lag0）降低36.58（16.66~56.50）mL/s，FEF75（Lag1）降低6.09（2.07~10.11）mL/s，FEF75（Lag0）降低56.27（34.32~78.22）mL/s。
结论济南市供暖季空气污染加重后，对健康儿童肺功能具有急性效应影响。

Abstract:
Objective To investigate the acute effects of increased air pollution after central heating on the lung function of schoolchildren.
Methods A field investigation was conducted in a primary school in the severely air-polluted area of Jinan, Shandong province, China, during 2014 to 2017. One class each was randomly selected from grade three to grade five during heating season of every year using the stratified cluster random sampling method, and all students in the sample grades were tested for height, weight, and lung function. The authors compared the changes in pollutant concentrations (PM_2.5, PM₁₀, SO₂, NO₂, and CO) and children's lung function indices before and after central heating, and analyzed the association between the pollutants and lung function using a multiple linear regression model.
Results The concentrations of PM_2.5, PM₁₀, SO₂, NO₂, and CO significantly increased after central heating in Jinan (P < 0.05). A total of 1 194 lung function tests of 484 schoolchildren showed that there were significant decreases after heating in peak expiratory flow (PEF) (t=3.19, P < 0.01), forced expiratory flow at 75% (FEF75) (t=2.28, P < 0.05), and forced expiratory flow at 25% (t=2.89, P < 0.01). For every 10 μg/m³ increase in PM_2.5, there was an associated 9.28 (4.37~14.18) mL decrease in forced vital capacity (Lag2), an associated 5.31(2.64~7.98) mL decrease in forced expiratory volume in FEV₁ (Lag1), an associated 36.58(16.66~56.50) mL/s decrease in PEF (Lag0), an associated 6.09(2.07~10.11) mL/s decrease in FEF75 (Lag1), and an associated 56.27(34.32~78.22) mL/s decrease in FEF75 (Lag0).
Conclusion During heating season in Jinan, air pollution deteriorates and has acute effects on the lung function of healthy schoolchildren.

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