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    长春市大气PM2.5对呼吸系统疾病住院及其相关经济损失的影响研究

    Impacts of ambient PM2.5 on hospitalizations for respiratory diseases and associated economic losses in Changchun, China

      摘要
    • 摘要:
      目的 本研究旨在量化长春市PM2.5短期暴露导致的呼吸系统疾病住院健康损害及社会经济成本损失, 为制定基于健康效益和经济可行性的精准空气污染防控策略提供科学依据。
      方法 收集长春市4所综合性医院2019—2023年住院病案、环境空气质量(包括PM2.5、PM10、SO2、NO2、O3、CO)、气象、经济、人口等数据。采用病例交叉分析的方法, 评估大气PM2.5暴露对人群呼吸系统疾病住院的影响, 通过计算归因分值和归因人数评估PM2.5暴露对人群入院产生的归因风险, 采用疾病成本法评估PM2.5污染导致的住院经济负担。
      结果 2019—2023年长春市4所综合医院呼吸系统疾病住院病例24 362人次, 平均每天住院量中位数12人次, PM2.5平均浓度为35 μg/m3。单日滞后最大效应值出现在滞后1天, PM2.5浓度每增加10 μg/m3, RR值为1.017(1.013, 1.021), 随滞后期延长呈递减趋势; 移动平均滞后效应RR值随累积暴露时间窗口扩大而逐渐上升, lag07天RR升至最高的1.029(1.022, 1.035)。女性各滞后点RR值普遍高于男性, ≥60岁组风险效应最高。三组参考浓度(35、15、0 μg/m3)下, 2019—2023年间, 归因于PM2.5暴露的呼吸系统疾病住院归因分值分别为2.86%、5.46%、9.05%, 归因人数分别为1.95、3.72、6.16万人, 经济损失分别为2.68、5.12、8.48亿元。当调整O3和CO时, PM2.5与呼吸系统疾病住院的相关性升高。
      结论 大气PM2.5可能会增加人群呼吸系统疾病住院风险, 尤其是女性和老年人, 由PM2.5导致的呼吸系统疾病住院量及经济损失不容忽视, 加强PM2.5等空气污染物的综合治理尤为重要。

       

      Abstract:
      Objective To quantify the health impacts of short-term PM2.5 exposure on hospitalizations for respiratory diseases and associated socioeconomic losses in Changchun, and to provide a scientific basis for formulating precise air pollution prevention and control strategies based on health benefits and economic feasibility.
      Methods Data on hospitalizations from four general hospitals, ambient air quality (PM2.5, PM10, SO2, NO2, O3, CO), meteorology, economy, and population in Changchun between 2019 and 2023 were collected. A case-crossover analysis was employed to assess the impacts of ambient PM2.5 exposure on hospitalizations for respiratory diseases. Attributable fractions and attributable numbers were calculated to assess the attributable risk of PM2.5 exposure on hospitalizations. The cost-of-illness method was used to estimate the economic burden of PM2.5 pollution-induced hospitalizations.
      Results From 2019 to 2023, 24 362 hospitalizations for respiratory diseases were recorded across the four hospitals, with a daily average admission of 12 cases and a mean PM2.5 concentration of 35 μg/m3. Single-day lag effect peaked at lag1 day, where each 10 μg/m3 increase in PM2.5 concentration was associated with a relative risk of 1.017 (1.013, 1.021), declining thereafter. The relative risk of moving average lag effect increased with the expansion of cumulative exposure window, peaking at 1.029 (1.022, 1.035) at lag07 day. The relative risks were generally higher for females than for males, and the ≥60 age group showed the highest risk effects. Under three reference concentrations (35, 15, 0 μg/m3), the attributable fractions for PM2.5-attributable respiratory disease hospitalizations from 2019 to 2023 were 2.86%, 5.46%, and 9.05%, respectively, corresponding to attributable numbers of 19 500, 37 200, and 61 600 individuals, and economic losses of RMB 268 million, 512 million, and 848 million, respectively. Adjustments for O3 and CO strengthened the association between PM2.5 and respiratory disease hospitalizations.
      Conclusion Ambient PM2.5 may increase the risk of hospitalization for respiratory diseases in the population, particularly females and older adults. The hospitalizations and economic losses attributable to PM2.5-induced respiratory diseases cannot be ignored, highlighting the importance of comprehensive management of PM2.5 and other air pollutants.

       

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