Differential effects of size-specific particulate matter on emergency department visits for respiratory and cardiovascular diseases in Guangzhou, China
Differential effects of size-specific particulate matter on emergency department visits for respiratory and cardiovascular diseases in Guangzhou, China
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中国广州特定粒径颗粒物对呼吸系统和心血管疾病急诊就诊的不同影响
DOI：
10.1016/j.envpol.2018.08.068
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发表时间：
2018-12-01
影响因子：
8.9
通讯作者：
Zhong, Nanshan
中科院分区：
文献类型：
--
作者：
Ge, Erjia;Lai, Kefang;Zhong, Nanshan
背景资料：区分PM2.5、PM10和PM2.5（类似于10）（即粗颗粒物或PMc）对心肺疾病影响的研究仍然有限且不一致。目的：估计暴露于三种特定尺寸PM对心肺疾病发病率的急性、累积和收获效应及其浓度-反应关系。方法：从2012年1月1日至2015年12月31日，广州市16家公立教学医院共收集了6，727，439次急诊（艾德）就诊，其中哮喘超过210万次，COPD、肺炎、呼吸道感染（RTI）、高血压、中风和冠心病（CHD）。使用分布滞后非线性模型（DLNM）来估计三种尺寸特定PM与心血管疾病艾德访视之间的关联。长期趋势，季节性，流感流行，气象因素和其他气体污染物，包括SO2，NO2和O-3，进行了调整。结果：PM2.5和PM10的升高与肺炎、RTI和CHD的艾德就诊率在滞后期（0）和滞后期（0-3）均显著相关。据估计，PMc增加10 μ g/m3（滞后（0-14）），肺炎和RTI的艾德就诊率分别增加6.32%（95% CI，4.19，8.49）和4.72%（95% CI，3.81，5.63）。PMc对儿童哮喘的累积作用强于老年人。我们观察到三种特定尺寸PM对呼吸系统的显著收获效应（即发病率位移），但对心血管艾德访视的影响很小。浓度-反应曲线表明暴露于三种不同尺寸的PM和呼吸incidence.Conclusions：总体而言，这三种尺寸的特定PM表现出明显的急性和累积效应的心肺疾病之间的非线性关系。PM2.5和PMc对肺炎和呼吸道感染有显著影响。应考虑进一步降低环境PM2.5和PMc水平的策略。(C)2018爱思唯尔有限公司版权所有
Background: Studies differentiating the cardiorespiratory morbidity effects of PM2.5, PM10, and PM2,5 similar to 10 (i.e. coarse PM or PMc) are still limited and inconsistent. Objective: To estimate the acute, cumulative, and harvesting effects of exposure to the three size-specific PM on cardiorespiratory morbidity, and their concentration-response relations.Methods: A total of 6,727,439 emergency department (ED) visits were collected from 16 public teaching hospitals in Guangzhou, from January 1st 2012 to December 31st 2015, among which over 2.1 million were asthma, COPD, pneumonia, respiratory tract infection (RTI), hypertension, stroke, and coronary heart disease (CHD). Distributed lag non-linear models (DLNM) was used to estimate the associations between the three size-specific PM and ED visits for the cardiovascular diseases. Long-term trends, seasonality, influenza epidemics, meteorological factors, and other gas pollutants, including SO2, NO2, and O-3, were adjusted. We stratified the analyses by gender and age.Results: Elevated PM2.5 and PM10 were significantly associated with increased ED visits for pneumonia, RTI, and CHD at both lag(0) and lag(0-3). A 10 mu g/m(3) increment of PMc (at lag(0-14)) was estimated to increase ED visits for pneumonia by 6.32% (95% CI, 4.19, 8.49) and for RTI by 4.72% (95% CI, 3.81, 5.63), respectively. PMc showed stronger cumulative effects on asthma in children than elderly. We observed significant harvesting effects (i.e. morbidity displacements) of the three size-specific PM on respiratory but very little on cardiovascular ED visits. The concentration-response curves suggested non-linear relations between exposures to the three different sizes of PM and respiratory morbidity.Conclusions: Overall, the three size-specific PM demonstrated distinct acute and cumulative effects on the cardiorespiratory diseases. PM2.5 and PMc would have significant effects on pneumonia and RTI. Strategies should be considered to further reduce levels of ambient PM2.5 and PMc. (C) 2018 Elsevier Ltd. All rights reserved.