Abstract:Objective To explore season-specific association between ambient PM2.5 and outpatient visits for asthma in the urban areas of Ningbo. Methods Based on the platform of population health information,we collected daily outpatient visits for asthma in four general hospitals in the urban areas of Ningbo from 2014 to 2016. We also collected data of meteorological indicators and air pollutants during the same period from local weather bureau and environmental monitoring center. Generalized additive model(GAM)was applied to examining the relationship and lag effects between ambient PM2.5 and outpatient visits for asthma in different seasons. Results A total of 45 184 outpatients with asthma were reported from 2014 to 2016,with an average of 41.23 cases per day. The annual average concentration of PM2.5 in Ningbo was(43.12± 26.40)μg/m3 ,with the peak as(65.27± 34.51)μg/m3 in winter and the though as(27.34± 12.70)μg/m3 in summer. A 10 μg/m3 increase of PM2.5 were associated with 1.14%(95%CI:0.48%-1.81%),2.40%(95%CI:0.22%-4.63%)and 1.37%(95%CI:0.28%-2.48%)increase of outpatient volume for asthma on the day in the whole year,summer and winter,respectively. In summer,males were at higher risk compared to females(P< 0.05);in winter,people under 65 years old were at higher risk(P< 0.05). Including NO2,the effect of PM2.5 on the excess risk of outpatient visits for asthma in summer was enhanced in two-pollutant models(P< 0.05). Conclusion PM2.5 pollution might increase the outpatient volume for asthma in summer and winter. NO2 might have synergistic effect with PM2.5 on asthma.
葛挺, 张良, 王辉, 谷少华, 叶健魁, 王爱红, 褚梦迪, 陆蓓蓓. 宁波市城区大气PM2.5污染与哮喘门诊量的关联性研究[J]. 预防医学, 2019, 31(6): 568-572.
GE Ting, ZHANG Liang, WANG Hui, GU Shao-hua, YE Jian-kui, WANG Ai-hong, CHU Meng-di, LU Bei-bei. Association between ambient PM2.5 and outpatient visits for asthmain Ningbo. Preventive Medicine, 2019, 31(6): 568-572.
MATTHEW M,DENISE F,SHAUN H,et al.The global burden of asthma:executive summary of the GINA Dissemination Committee Report[J]. Allergy,2004,59:469-478.
[3]
VOS T,FLAXMAN A D,NAGHAVI M,et al.Years lived with disability(YLDs)for 1 160 sequelae of 289 diseases and injuries 1990-2010:a systematic analysis for the global burden of disease study 2010[J]. Lancet,2012,380(9859):2163-2196.
MENG Y Y,RULL R P,WILHELM M,et al.Outdoor air pollution and uncontrolled asthma in the San Joaquin Valley,California[J].J Epidemiol Community Health,2010,64(2):142-147.
[6]
ANDERSON H R,FAVARATO G,ATKINSON R W.Long-term exposure to air pollution and the incidence of asthma:meta-analysis of cohort studies[J]. Air Qual Atmos Health,2013,6:47-56.
MÖLTER A,SIMPSON A,BERDEL D,et al. A multicentre study of air pollution exposure and childhood asthma prevalence:the ESCAPE project[J]. Eur Respir J,2015,45(3):610-624.
[9]
SALIMII F,MORGAN G,ROLFE M,et al.Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases:a prospective cohort study in Australia[J]. Environ Int,2018,121(Pt 1):415-420.
STRICKLAND M J,DARROW L A,KLEIN M,et al.Short-term associations between ambient air pollutants and pediatric asthma emergency department visit[J]. Am J Respir Cirt Care Med,2010,182:307-316.
WINQUIST A,KLEIN M,TOLBERT P,et al.Comparison of emergency department and hospital admission data for air pollution time-series studies[J]. Environ Health:Clobal Access Sci Source,11(70):1-14.
[14]
GLEASON J A,BIELORY L,FAGLIANO J A.Associations between ozone,PM2.5 and four pollen types on emergency department pediatric asthma events during the warm seanson in New Jersey:a case-crossover study[J]. Environ Res,2014,132:421-429.
[15]
FAN J,LI S,FAN C,et al.The impact of PM2.5 on asthma emergency department visits:a systematic review and meta-analysis[J]. Environ Sci Pollut Res,2016,23:843-850.