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    2021—2023年攀枝花市大气PM2.5与心脑血管、呼吸系统疾病急救人次的时间序列分析

    Time series analysis of atmospheric PM2.5 and emergency visits due to cardiovascular, cerebrovascular, and respiratory diseases in Panzhihua, China, 2021—2023

      摘要
    • 摘要:
      目的 探究攀枝花市大气细颗粒物(fine particulate matter, PM2.5)的质量浓度对居民心脑血管和呼吸系统疾病急救人次的影响，以期为攀枝花市大气环境治理策略的制定提供技术支撑。
      方法 收集攀枝花市2021年1月1日—2023年12月31日期间大气污染物数据、气象资料以及当地居民每日心脑血管疾病、呼吸系统疾病急救人次，利用广义相加模型(generalized additive model，GAM)分析PM2.5与心脑血管日均急救人次、呼吸系统日均急救量间的相关性及其滞后效应。
      结果 2021—2023年攀枝花市PM2.5日均质量浓度中位数为25.14 μg/m3。相关性分析结果表明，PM2.5与心脑血管疾病日均急救人数(rs=0.083，P<0.001)和呼吸系统日均急救人数(rs=0.107，P<0.001)均呈正相关关系。单日滞后效应结果表明，PM2.5暴露对心脑血管系统疾病急救量的影响在lag6 d和lag7 d均产生危害效应，且在lag7 d影响最为显著，PM2.5质量浓度每升高10 μg/m3，心脑血管疾病急救人次增加的超额危险值(excess risk, ER)和相应的95%置信区间(confidence interval, CI)值为3.45%(1.03%，5.87%)；PM2.5暴露对呼吸系统疾病急救量的影响在lag0 d出现危害效应，PM2.5浓度每升高10 μg/m3，呼吸系统疾病急救患者数增加的ER(95%CI)值为2.78%(0.24%，5.34%)。累积滞后效应结果表明，PM2.5暴露对呼吸系统疾病急救量的影响在lag01~lag05 d的健康效应具有统计学意义(P＜0.05)，且在lag04 d时健康风险值增加最大，ER(95%CI)值为5.18%(1.21%, 9.15%)。而在双污染物模型下，分别引入SO2、CO、O3-8 h后，心脑血管系统疾病日均急救量增加的ER(95%CI)值分别为2.92%(0.28%，5.57%)、5.00%(2.29%，7.71%)、3.99%(1.46%，6.52%)，呼吸系统疾病日均急救量增加的ER(95%CI)值分别为2.89%(0.16%，5.62%)、4.27%(1.43%，7.12%)、2.19%(-0.61%，5.01%)；同时引入3种污染物的多污染物模型分析，PM2.5对心脑血管和呼吸系统疾病影响的日均急救量的增加ER(95%CI)值分别为5.46%(2.37%，8.57%)和3.48%(0.29%，6.68%)。
      结论 攀枝花市大气污染物PM2.5浓度升高可增加当地居民心脑血管系统疾病和呼吸系统疾病的发病风险。

       

      Abstract:
      Objective To explore the effect of the mass concentration of atmospheric fine particulate matter (PM2.5) on the emergency visits due to cardiovascular, cerebrovascular, and respiratory diseases in residents in Panzhihua, China, and to provide practical technical support for the formulation of air pollution prevention and control strategies in Panzhihua.
      Methods The data on air pollutants, meteorological data, and daily emergency visits of cardiovascular, cerebrovascular, and respiratory diseases among local residents in Panzhihua were collected from January 1, 2021 to December 31, 2023. The generalized additive model was used to analyze the correlation and lag effect between PM2.5 levels and mean daily emergency visits due to cardiovascular, cerebrovascular, and respiratory diseases.
      Results The median of daily mass concentrations of PM2.5 in Panzhihua from 2021 to 2023 was 25.14 μg/m3. The results of the correlation analysis showed that PM2.5 levels were significantly positively correlated with the mean daily emergency visits due to cardiovascular and cerebrovascular diseases (rs=0.083, P<0.001) and respiratory diseases (rs=0.107, P<0.001). The results of one-day lag effect indicated that the hazard effect of PM2.5 exposure on emergency visits due to cardiovascular and cerebrovascular diseases was observed on lag6 d and lag7 d, and the most significant effect was observed on lag7 d. For each 10 μg/m3 increase in the mass concentration of PM2.5, excess risk(ER) of emergency visits due to cardiovascular and cerebrovascular diseases increased by 3.45% 95% confidence interval (CI): 1.03%-5.87%. While the hazard effect of PM2.5 exposure on emergency visits due to respiratory diseases was observed on lag0 d, and for each 10 μg/m3 increase in PM2.5 concentration, the number of emergency patients with respiratory diseases increased by 2.78%(95%CI: 0.24%-5.34%). The results of cumulative lag effect showed that the PM2.5 exposure on emergency visits due to respiratory diseases was statistical on lag 01-05 d (P<0.05), and the maximum increase in the health risk value, 5.18%(95%CI: 1.21%-9.15%), was observed on lag04 d. Under the two-pollutant model, after the introduction of SO2, CO and O3-8 h, the ER of increased mean daily emergency visits due to PM2.5-related cardiovascular and cerebrovascular diseases was 2.92% (95%CI: 0.28%-5.57%), 5.00% (95%CI: 2.29%-7.71%), and 3.99% (95%CI: 1.46%-6.52%), respectively, while that due to PM2.5-related respiratory diseases increased by 2.89%(95%CI: 0.16%-5.62%), 4.27%(95%CI: 1.43%-7.12%), and 2.19%(95%CI: -0.61%-5.01%), respectively. Under the multi-pollutant model that introduced three pollutants simultaneously, the ER values of increased mean daily emergency visits due to PM2.5-related cardiovascular and cerebrovascular diseases and respiratory diseases were 5.46%(95%CI: 2.37%-8.57%) and 3.48%(95%CI: 0.29%-6.68%), respectively.
      Conclusion The increase in the concentration of atmospheric PM2.5 raises the risks of cardiovascular and cerebrovascular diseases and respiratory diseases in local residents in Panzhihua.

       

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