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目的评价大气污染物的短期暴露对居民缺血性心脏病(IHD)死亡的影响及其影响的季节差异。方法收集湖北省武汉市江岸区2002年1月1日—2010年12月31日IHD死亡监测资料和同期环境监测中心大气污染物浓度数据,应用基于广义相加模型的时间序列分析方法,分别构建全季节模型和分季节模型,定量评价大气污染对居民IHD死亡的影响。结果 4个季节中,大气污染水平和IHD死亡人数均在冬季达到最高,冬季可吸入颗粒物PM10、SO2和NO2年均浓度分别为(143.8±70.9)、(71.0±42.4)和(66.5±25.6)μg/m3,IHD日均死亡1.64人。全季节模型中,1 d滞后(Lag1)的PM10浓度每升高10μg/m3,IHD死亡率增加0.86%(95%CI=0.22%~1.51%),其他气态污染物SO2、NO2与全季节IHD死亡无统计学关联;分季节建模后,PM10、SO2和NO2对IHD死亡的影响均出现在冬季,其他季节的影响均无统计学意义;其中,1 d滞后的PM10、SO2和NO2浓度每升高10μg/m3,冬季IHD死亡率分别增加1.40%(95%CI=0.58%~2.23%)、1.65%(95%CI=0.28%~3.05%)和3.05%(95%CI=0.92%~5.23%)。结论武汉市大气污染的短期暴露会引起IHD死亡风险增加,且大气污染对IHD死亡的作用效应呈现一定的季节差异,冬季的影响表现更为明显。
Objective To evaluate the effects of short-term exposure to atmospheric pollutants on residents with ischemic heart disease (IHD) and their seasonal differences. Methods Data of IHD death monitoring and air pollutant concentration data of Environmental Monitoring Center of the same period collected from Jan. 1, 2002 to Dec. 31, 2010 in Jiang’an District, Wuhan City, Hubei Province were collected. The time series analysis method based on generalized additive model was used to construct All-season model and sub-seasonal model to quantitatively evaluate the impact of air pollution on residents of IHD death. Results During the four seasons, the average level of air pollution and the number of IHD deaths reached the highest in winter. The average annual concentrations of PM10, SO2 and NO2 in winter were (143.8 ± 70.9), (71.0 ± 42.4) and (66.5 ± 25.6) μg / m3, the average daily death of IHD 1.64 people. In the all-season model, the mortality of IHD increased by 0.86% (95% CI = 0.22% -1.51%) for every 10 μg / m3 increase of PM10 concentration at 1 d lag, and all the other gaseous pollutants, SO2 and NO2, There was no significant correlation between death and mortality of IHD after PM10, SO2 and NO2 were observed in the winter season, but there was no significant difference in the other seasons. Among them, the PM10, SO2 and NO2 concentrations (95% CI = 0.28% ~ 3.05%) and 3.05% (95% CI = 0.92% ~ 95% CI) in the winter increased by 1.40% (95% CI 0.58% -2.23% 5.23%). Conclusion Short-term exposure to air pollution in Wuhan City will cause an increased risk of death from IHD. Seasonal effects of air pollution on the death of IHD show seasonal differences, especially in winter.