石家庄市大气污染对儿童呼吸系统疾病门诊量影响的时间序列分析

发布时间：2018-08-19 09:10

【摘要】：目的描述石家庄市大气污染现状及大气污染物(PM_(2.5))的污染特征;分析大气污染对儿童呼吸系统等各等级门诊指标就诊人次的影响;探讨大气污染对儿童产生的急性影响,为采取有效干预措施、保护儿童健康提供科学依据。方法收集2013-2015年石家庄市气象、环保及某儿童医院门诊资料;描述性分析石家庄市大气污染现状及大气污染物(PM_(2.5))的污染特征与某儿童医院各等级门诊就诊情况;通过Spearman相关性分析探讨大气污染物与气象因素、大气污染物与门诊量、气象因素与门诊量之间的相关关系;分析不同大气污染物在不同浓度等级下对某儿童医院各等级门诊指标的影响;应用时间序列分析方法建立广义相加(GAM)模型,分析大气污染物对儿童呼吸系统疾病门诊量的影响及污染物的滞后效应,定量描述、评价大气污染对儿童健康的影响。结果1石家庄市大气污染特征分析:2013-2015年石家庄市大气污染物PM_(10)、PM_(2.5)、NO_2、SO_2日均浓度分别为221.18μg/m3、118.14μg/m3、55.09μg/m3、70.28μg/m3,均超过国家《环境空气质量标准》(GB3095-2012),其中PM_(2.5)超标倍数最多;四种污染物的日均浓度变化具有一定的季节性,最高值分布在1、12月,最低值分布在7-9月;在对大气污染物(PM_(2.5))的成分分析中显示,2015年PM_(2.5)中多环芳烃年均浓度由高到低依次为:苯并[g,h,i]傒苯并[a]蒽芘荧蒽苯并[b]荧蒽屈茚并[1,2,3-cd]芘苯并[a]芘;PM_(2.5)中7种重金属元素的浓度范围是1.00×10-8~3.05×10-4mg/m3,平均浓度由高到低依次为PbMnAsCrCdNiHg,参考《环境空气质量标准》(GB3095-2012),苯并[a]芘、金属As的平均浓度超过国家标准限值。2石家庄市大气污染对某儿童医院就诊情况的影响:门诊总量与4种污染物(PM_(2.5)、PM_(10)、SO_2、NO_2)呈现负相关(P0.01);呼吸系统疾病门诊量与PM_(2.5)、SO_2、NO_2存在明显的正相关;J00-J06每日入诊人次与4种大气污染物呈显著正相关(P0.01);通过GAM模型分析,NO_2、PM_(2.5)、PM_(10)每升高10μg/m3,分别使当天超额入诊风险增加0.44%(95%CI:0.18,0.71)、0.17%(95%CI:0.08,0.25)、0.1%(95%CI:0.04,0.15),SO_2浓度的增加对儿童呼吸系统疾病门诊量的影响主要在当天和滞后的1-3天,尤其是当天的影响较大。结论1 2013-2015年石家庄市大气污染较严重且呈现季节性变化,表现为冬季高于夏季;对比PM_(10)、SO_2、NO_2,大气污染物PM_(2.5)的污染最重,PM_(2.5)的成分中苯并[a]芘及金属As的污染较重。2石家庄市大气污染物PM_(2.5)、SO_2、NO_2浓度增高可能会致使儿童呼吸系统疾病门诊量和J00-J06的每日入诊人次增加,PM_(10)浓度的增高可能使J00-J06每日入诊人次增加;通过时间序列分析可知大气污染物SO_2对儿童呼吸系统疾病门诊量的影响可能存在1-3天的滞后效应。
[Abstract]:Objective to describe the present situation of air pollution in Shijiazhuang City and the pollution characteristics of atmospheric pollutants (PM2.5), to analyze the effects of air pollution on children's respiratory system and other outpatient visits, and to explore the acute effects of air pollution on children. To provide scientific basis for taking effective intervention measures and protecting children's health. Methods the data of meteorological, environmental protection and outpatient clinic of a children's hospital in Shijiazhuang city from 2013 to 2015 were collected, and the status quo of air pollution in Shijiazhuang city, the pollution characteristics of atmospheric pollutants (PM2.5) and the outpatient visits of each grade in a children's hospital were analyzed. The correlation between atmospheric pollutants and meteorological factors, between atmospheric pollutants and outpatient quantities, and between meteorological factors and outpatient quantities was discussed by Spearman correlation analysis. This paper analyzes the influence of different atmospheric pollutants on the outpatient index of each grade in a children's hospital under different concentration levels, and establishes a generalized additive (GAM) model by using time series analysis method. The effects of air pollutants on children's respiratory diseases were analyzed. The effects of air pollutants on children's health were described quantitatively and the effects of air pollutants on children's health were evaluated. Results 1 the analysis of air pollution characteristics in Shijiazhuang City from 2013 to 2015 showed that the average daily concentration of PM10 / PM2.5 and no _ 2 / so _ 2 in Shijiazhuang was 221.18 渭 g/m3118.14 / m ~ (3) and 55.09 渭 g / m ~ (3) / m ~ (3), respectively, which exceeded the National Environmental Air quality Standard (GB3095-2012), among which PM_ (2. 5) exceeded the national air quality standard (GB3095-2012), and the average daily concentration was 221.18 渭 g/m3118.14 / m ~ (3) / m ~ (3), 70.28 渭 g / m ~ (3) above the national ambient air quality standard (GB3095-2012). The daily average concentration of the four pollutants varied seasonally, with the highest value distributed in January, December and the lowest in July-September. An analysis of the composition of atmospheric pollutants (PM2.5) shows that the average annual concentrations of polycyclic aromatic hydrocarbons (PAHs) in PM2.5 in 2015 are seven heavy metal elements in benzo [gaphani] benzo [a] pyrene fluoranthracene [b] fluorinine [1o 23-cd] benzo [a] pyrene PPM _ (2.5) in order of which the average annual concentration of polycyclic aromatic hydrocarbons (PAHs) in PM2.5 is in the order of high to low. The range of concentration is 1.00 脳 10-8, 3.05 脳 10-4 mg / m3, the average concentration is PbMnAsCrCdNiHg from high to low, referring to ambient air quality standard (GB3095-2012), benzo [a] pyrene, The average concentration of as in Shijiazhuang is higher than the national standard. 2. The influence of air pollution on the visit to a children's hospital in Shijiazhuang City: the total amount of outpatient service is negatively correlated with the four kinds of pollutants (PM2.5 / PM10) and so _ 2 / no _ 2 (P0.01); the number of outpatients with respiratory diseases and the presence of PM2.5 / so _ 2no _ 2 are obviously negative (P0.01). There was a significant positive correlation between the number of visits per day and the four kinds of atmospheric pollutants (P0.01), and the analysis of each 10 渭 g / m ~ (3) increase of 10 渭 g / m _ (10) of no _ 2 PM_ (2.5) / PM10 by GAM model increased the risk of over-admission by 0.44% (95: 0.180.71) 0.17% (95CI: 0.08 ~ 0.25) by 0.1% (95: 0.040.15) by the increase of SO2 concentration in children's respiratory diseases. The effects are mainly on the same day and 1 to 3 days behind, In particular, the impact of the day is greater. Conclusion (1) the air pollution in Shijiazhuang from 2013 to 2015 is serious and seasonal, which is higher in winter than in summer. Comparing PM10 with SO2NO2, the most polluted components of atmospheric pollutant PM2.5 are benzo [a] pyrene and heavy pollution of as. 2 the higher concentration of PM2.5 and metal as in Shijiazhuang may lead to the outpatient consultation of respiratory diseases in children and the daily visit to J00-J06. The increase of PM10 concentration may increase the daily visits of J00-J06. Time series analysis showed that there might be a lag effect of 1-3 days in the effect of air pollutant SO_2 on the outpatient volume of respiratory diseases in children.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.6

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