张家口市大气污染物与居民COPD入院人数之间的关系研究

发布时间：2018-02-01 03:48

  本文关键词： 大气污染物 COPD 时间序列分析 广义相加模型 PM_(2.5)　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解张家口市2013-2015年大气污染基本情况,定量评价张家口市大气污染物(PM_(2.5)、PM10、CO、SO_2、NO_2、O_3)对人群COPD发病情况及入院人数的影响。方法:1对张家口市2013.1.1-2015.12.31期间大气污染物测量数据(PM_(2.5)、PM10、CO、SO_2、NO_2、O_3)以及气象数据(主要包括日均气温以及相对湿度)进行搜集。2对张家口市某医院2013.1.1-2015.12.31期间人群COPD入院人数信息进行搜集。3通过基于时间序列Poisson分布的广义可加模型对获得的资料数据(张家口市大气污染和人群COPD入院人数)展开回归分析,通过平滑样条函数清除各种潜在的混杂因素,比如温度和长期趋势等,基于AIC最小原则,对模型应用变量及其立方平滑样条函数的自由度进行最终明确。结果:1在2013-2015年期间,张家口市的大气污染物中PM_(2.5)的年均浓度依次是35.54±22.34μg/m~3、34.9±39.08μg/m~3、34.04±20.45μg/m~3,PM10的年均浓度分别为86.57±53.49μg/m~3、77.47±70.28μg/m~3、77.66±52.12μg/m~3,CO的年均浓度分别为0.77±0.33mg/m~3、1.07±0.59mg/m~3、0.8±0.47mg/m~3,NO_2年均浓度分别为27.89±11.64μg/m~3、28.61±14.64μg/m~3、26.4±14.12μg/m~3,SO_2年均浓度分别为38.71±27.03μg/m~3、53.1±38.55μg/m~3、31.38±20.93μg/m~3,O_3年均浓度分别为109.1±46.33μg/m~3、84.12±37.09μg/m~3、97.15±44.84μg/m~3;2在滞后效应单污染模型中,在对多种气象因素及长期趋势所产生的影响进行有效管控后,在滞后0天(lag0)时,PM_(2.5)每增加10μg/m~3,患者群体每天COPD入院率增加1.7%(95%CI:0.6%~2.8%);PM10每升高10μg/m~3,人群每日COPD入院率增加1%(95%CI:0.5%~1.5%);co每升高10μg/m~3,人群每日copd入院率增加0.14%(95%ci:0.07%~0.21%);no2每升高10μg/m~3,人群每日copd入院率增加6.4%(95%ci:3.7%~9.2%);so2每升高10μg/m~3,人群每日copd入院率增加2.6%(95%ci:1.4%~3.9%);在滞后5天(lag5)时,o3每升高10μg/m~3,人群每日copd入院率增加1.2%(95%ci:0.2%~2.2%)。3在累积效应单污染物模型中,在对多种气象因素及长期趋势所产生的影响进行有效管控后,在滞后7天(avg7)时,pm2.5每增加10μg/m~3,患者群体每天copd入院率增加2.3%(95%ci:0.6%~4.1%);pm10每升高10μg/m~3,人群每日copd入院率增加1.9%(95%ci:1%~2.7%);co每升高10μg/m~3,人群每日copd入院率增加0.2%(95%ci:0.1%~0.3%);no2每升高10μg/m~3,人群每日copd入院率增加10.2%(95%ci:5.9%~14.7%);so2每增加10μg/m~3,患者群体每天因copd入院的患者数量风险就会提高4.6%(95%ci:2.7%~6.6%)。在滞后5天(avg5)时,o3每增加10μg/m~3,患者群体每天因copd入院的患者数量风险就会提高0.8%(95%ci:-0.6%~2.2%),不过不具备统计学价值。4滞后效应双污染模型中,仅发现pm2.5在控制了o3的影响时对copd每日入院人数的影响具有统计学意义(p0.05),人群copd每日入院率相应增加1.7%(95%ci:0.6%~2.9%)。发现pm10在控制了pm2.5、so2、o3的影响时对copd每天入院人数所产生的影响具有统计学价值(p0.05),在不受pm2.5影响的情况下,pm10每增加10μg/m~3,患者群体copd每日入院率增加1.02%(95%ci:0.03%~2.01%)。在不受so2影响的情况下,pm10每增加10μg/m~3,因copd每天入院的患者数量风险就会提高1%(95%ci:0.5%~1.5%)。在不受o3影响的情况下,pm10每增加10μg/m~3,因copd每天入院的患者数量风险就会提高0.06%(95%ci:0%~1.3%)。5累积效应双污染模型中,仅发现pm2.5在控制了o3的影响时对copd每日入院人数的影响具有统计学意义(p0.05),人群copd每日入院率相应增加2.3%(95%ci:0.6%~4.1%)。发现pm10在控制了pm2.5、so2、o3的影响时对copd每天入院人数所产生的影响具有统计学价值(p0.05)。在不受pm2.5影响的情况下,pm10每增加10μg/m~3,患者群体copd每日入院率增加2.8%(95%ci:1.1%~4.6%)。在不受so2影响的情况下,PM10每增加10μg/m~3,因COPD每天入院的患者数量风险就会提高1.9%(95%CI:1%~2.8%)。在不受O_3影响的情况下,PM10每增加10μg/m~3,因COPD每天入院的患者数量风险就会提高1.3%(95%CI:0.2%~2.4%)。结论:1 2013-2015年张家口市PM_(2.5)、PM10年均浓度均接近或高于国家年均浓度二级标准,污染水平不算太高;而CO、SO_2、NO_2和O_3皆达到了国家年均浓度二级标准,其污染性较小。2本研究发现,滞后效应中张家口市大气污染物PM_(2.5)、PM10、CO、SO_2、NO_2、O_3与COPD入院人数之间有统计学关联,且PM_(2.5)、PM10、CO、SO_2、NO_2对COPD入院的最大滞后效应出现在当日(lag0),而O_3的最大滞后效应出现在滞后第5天(lag5)。得出结论:PM_(2.5)、PM10、CO、SO_2、NO_2对COPD入院人数有一定的影响。3本研究发现,累积效应中张家口市大气污染物PM_(2.5)、PM10、CO、SO_2、NO_2与COPD入院人数之间有统计学关联,未发现O_3与COPD入院人数之间有统计学关联,且PM_(2.5)、PM10、CO、SO_2、NO_2对COPD入院的最大滞后效应出现在累积滞后第7天时(avg7)。得出结论:PM_(2.5)、PM10、CO、SO_2、NO_2对COPD入院人数有一定的影响。
[Abstract]:Objective: to understand the air pollution in Zhangjiakou city for 2013-2015 years the basic situation of atmospheric pollutants quantitative evaluation of Zhangjiakou city (PM_ (2.5), PM10, CO, SO_2, NO_2, O_3) influence on the population of COPD incidence and hospitalization. Methods: 1 2013.1.1-2015.12.31 in Zhangjiakou city during the air pollutant measurement data (PM_ (2.5), PM10 CO, SO_2, NO_2, O_3), and the meteorological data (including the average air temperature and relative humidity) were collected for.2 in a hospital of Zhangjiakou city during 2013.1.1-2015.12.31 crowd COPD admission information collected by.3 generalized additive model of data obtained from the Poisson distribution based on time series (Zhangjiakou City air pollution and the population of COPD hospital the number of expansion) regression analysis, by smoothing spline function to remove potential confounding factors, such as temperature and long-term trends, based on the principle of minimum AIC, the application of variable model and The cubic smoothing spline function of degree of freedom was finally clear. Results: 1 in a period of 2013-2015 years, air pollution in the city of Zhangjiakou, PM_ (2.5) the annual average concentration was 35.54 + 22.34 g/m~3,34.9 + 39.08 g/m~3,34.04 + 20.45 g/m~3, PM10 concentration was 86.57 + 53.49 g/m~3,77.47 + 70.28 g/m~3,77.66 + 52.12 g/m~3, annual average concentration of CO was 0.77 + 0.33mg/m~3,1.07 + 0.59mg/m~3,0.8 + 0.47mg/m~3, NO_2 annual average concentration was 27.89 + 11.64 g/m~3,28.61 + 14.64 g/m~3,26.4 + 14.12 g/m~3, annual average concentration of SO_2 was 38.71 + 27.03 g/m~3,53.1 + 38.55 g/m~3,31.38 + 20.93 g/m~3, O_3 annual average concentration was 109.1. 46.33 g/m~3,84.12 + 37.09 g/m~3,97.15 + 44.84 g/m~3; 2 in the lag effect of single pollution model, effectively control the impact on the long-term trend and various meteorological factors, at lag 0 Day (lag0), PM_ (2.5) for each additional 10 g/m~3 patients, COPD group daily admission rate increased by 1.7% (95%CI:0.6%~2.8%); PM10 increased 10 g/m~3, 1% COPD daily admission rate increased (95%CI:0.5%~1.5%); CO increased 10 g/m~3, 0.14% COPD daily admission rate increased (95%ci:0.07%~0.21%); NO2 increased 10 g/m~3, 6.4% COPD daily admission rate increased (95%ci:3.7%~9.2%); SO2 increased 10 g/m~3, 2.6% COPD daily admission rate increased (95%ci:1.4%~3.9%); the lag of 5 days (lag5), O3 increased by 10 g/m~3, 1.2% COPD daily admission rate increased (95%ci:0.2%~2.2%) in.3 the cumulative effect of single pollutant model, effectively control the impact on the long-term trend and various meteorological factors, the lag of 7 days (avg7), each additional PM2.5 10 g/m~3, COPD group of patients daily admission rate increased by 2.3% (95%ci:0.6%~4.1%); PM10 increased 10 g/m~3, population COPD daily admission rate increased by 1.9% (95%ci:1%~2.7%); CO increased 10 g/m~3, 0.2% COPD daily admission rate increased (95%ci:0.1%~0.3%); NO2 increased 10 g/m~3, 10.2% COPD daily admission rate increased (95%ci:5.9%~14.7%); SO2 increased 10 g/m~3, group of patients every day because the number of patients with COPD hospitalized will risk 4.6% (95%ci:2.7%~6.6%). The lag of 5 days (avg5), O3 increased by 10 per mu g/m~3, groups of patients every day because the number of patients with COPD hospitalized risk will be increased by 0.8% (95%ci:-0.6%~2.2%), but does not have the effect of double pollution model lag value of.4 was found only in PM2.5, the effect of control effect on O3 COPD daily hospitalization was statistically significant (P0.05), group COPD daily admission rate increased 1.7% (95%ci:0.6%~2.9%). PM10 was found in the control of the PM2.5, SO2, COPD impact on the daily hospitalization O3 the influence of With statistical value (P0.05), was not affected by PM2.5 under the condition of PM10 for each additional 10 g/m~3 patients, group COPD daily admission rate increased by 1.02% (95%ci:0.03%~2.01%). In the case of not affected by SO2, each PM10 increase 10 g/m~3, because the number of patients with risk will be increased by 1% COPD every day of admission (95%ci:0.5%~1.5%). In the case of not affected by O3, each PM10 increase 10 g/m~3, because the number of patients with risk will be increased by 0.06% COPD per day of admission (95%ci:0%~1.3%.5) the cumulative effect of double pollution model, only found PM2.5 in effect control of O3 effect on COPD daily hospitalization was statistically significant (P0.05). The crowd COPD daily admission rate increased 2.3% (95%ci:0.6%~4.1%). PM10 was found in the control of the PM2.5, SO2, has significant influence on the COPD value of every admission number O3 (P0.05). The effect is not affected by PM2.5 in case of PM10 姣忓�炲姡�

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