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目的探索大气颗粒物对苏州市居民心脏病死亡影响的程度和特点,确定滞后时间,评估健康效应。方法收集2010年1月1日至2013年12月31日苏州市、区两级疾病预防控制中心死因监测部门实时上报国家人口死亡信息登记管理系统的居民心脏病死亡资料,大气颗粒物和气象数据,采用时间序列的广义相加模型,在控制长期趋势、星期几效应和气象因素的影响后,定量分析单污染物模型和双污染物模型中,大气颗粒物对心脏病死亡人数的影响。结果单污染物模型中,滞后3 d的PM10(lag3)和两日移动平均滞后的PM2.5(lag01)对心脏病日均死亡数的影响效应有统计学意义(P<0.05),PM10、PM2.5浓度每升高10μg/m3,心脏病日均死亡数分别增加0.305%(95%CI:0.043%~0.568%)和0.533%(95%CI:0.030%~1.036%);两日移动平均滞后模型中,PM10、PM2.5浓度每升高10μg/m3,冠心病日均死亡数增加0.520%(95%CI:0.011%~1.028%)和1.054%(95%CI:0.255%~1.853%)。双污染物模型结果显示,PM10可能是心脏病死亡影响的独立因素,但与其他大气污染物相互作用才影响冠心病死亡发生。PM2.5不是心脏病死亡的独立危险因素,对冠心病死亡数的影响也需要和PM10、NO2相互作用才能发挥效应。结论苏州市心脏病,特别是冠心病死亡人数随着大气颗粒物浓度的增加而呈上升趋势。其中,PM10对居民心脏病的影响存在滞后性,是心脏病死亡影响的独立影响因素;PM2.5对心脏病和冠心病死亡的影响更直接,不存在滞后性,但是需要其他污染物的联合作用才能发挥效应。
Objective To explore the extent and characteristics of atmospheric particulate matter in the death of heart disease in Suzhou residents, to determine the lag time and assess the health effects. Methods From January 1, 2010 to December 31, 2013, CDC’s death cause monitoring department of Suzhou CDC and CDCIC reported real-time cardiac death data, atmospheric particulates and meteorological data to residents of the national population death information registration management system in real time, The effects of atmospheric particulate matter on the number of deaths from heart disease were quantitatively analyzed using the generalized time-series additive model after controlling for long-term trends, day-of-the-week effects and meteorological factors in a single-pollutant model and a double-pollutant model. Results In single-pollutant model, the effect of PM10 (lag3) lagged 3 days and PM2.5 (lag01) lagged by two-day moving average lag on the average daily death rate of heart disease were statistically significant (P <0.05) For each 10 μg / m3 increase in PM2.5 concentration, the average daily deaths from heart disease increased by 0.305% (95% CI: 0.043% to 0.568%) and 0.533% (95% CI: 0.030% to 1.036% In the average lag model, the average daily deaths of coronary heart disease increased by 0.520% (95% CI: 0.011% ~ 1.028%) and 1.054% (95% CI: 0.255% ~ 1.853) for every 10μg / m3 increase of PM10 and PM2.5 concentrations %). Double-pollutant model results showed that PM10 may be an independent factor of cardiac death, but the interaction with other air pollutants affect the death of coronary heart disease. PM2.5 is not an independent risk factor for cardiac death, the impact on the number of coronary heart disease death also need to interact with PM10, NO2 to play an effect. Conclusion The death rate of heart disease, especially coronary heart disease in Suzhou City is on the rise with the increase of atmospheric particulate matter concentration. Among them, the impact of PM10 on residents with heart disease lags behind, is an independent factor affecting the death of heart disease; PM2.5 on heart disease and coronary heart disease death more direct, there is no lag, but the need for other pollutants Effect to play an effect.