Effects of ozone concentration on allergic skin disease visits in summer in Hefei from 2015 to 2018
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摘要:
目的 探讨夏季臭氧(ozone, O3)浓度与过敏性皮肤病(allergic skin disease, ASD)就诊的关系。 方法 收集安徽医科大学第一附属医院和中国科学技术大学附属第一医院自2015年1月1日-2018年12月31日的夏季(每年的6月1日-8月31日)ASD就诊数据，并收集同期空气污染物和气象数据，利用分布滞后非线性模型(distributed lag non-linear model, DLNM)评估O3浓度与ASD就诊的暴露-滞后-反应关系，模型中对混杂因素、时间趋势、周天数和节假日进行了调整。 结果 共收集研究期间ASD就诊总人次31 741例。O3浓度与ASD就诊呈正相关，与慢性荨麻疹就诊也呈正相关，而与特应性皮炎就诊的相关性差异无统计学意义。O3浓度每增加10 μg/m3，单日滞后效应表现为ASD就诊风险最大为1.007(RR=1.007, 95% CI: 1.003~1.011, 滞后7 d)，累积滞后效应表现为ASD就诊风险最大为1.078(RR=1.078, 95% CI: 1.028~1.131, 累积滞后0~14 d)。在男性、 < 18岁和18~< 65岁ASD患者中，O3浓度增加10 μg/m3对ASD就诊单日滞后效应和累积滞后效应均有统计学意义(均有P＜0.05)。 结论 合肥地区夏季高浓度O3是ASD发生的重要危险因素且存在滞后效应。有关部门应强化夏季O3污染防治，加强患者医疗服务和保护易感人群。 Abstract:Objective To investigate the relationship between ozone (O3) concentration and allergic skin disease (ASD) visits in summer. Methods The daily counts of ASD admissions from January 1, 2015, to December 31, 2018 in summer (every year from June 1st to August 31st) were collected from the First Affiliated Hospital of Anhui Medical University and the First Affiliated Hospital of University of Science and Technology of China, and air pollutants and meteorological data were gathered during the same period. The exposure-lag-response relationship between O3 concentration and ASD admissions was evaluated using the distributed lag non-linear model (DLNM), in which confounding factors, time trend, day of week, and holiday were adjusted. Results A total of 31 741 ASD admissions were collected during the study period. O3 concentration was positively correlated with ASD admissions and chronic urticaria admissions but had no statistical significance with atopic dermatitis admissions. When O3 concentration increased by 10 μg/m3, the maximum single-day lagged effect of ASD admissions was 1.007 (RR=1.007, 95% CI: 1.003-1.011, lag 7 d), and the maximum cumulative lagged effect of ASD admissions was 1.078 (RR=1.078, 95% CI: 1.028-1.131, lag 0-14 d). In males, < 18 years and 18- < 65 years ASD patients, the single-day and cumulative lagged effects of O3 concentration increased by 10 μg/m3 on ASD admissions were statistically significant (all P < 0.05). Conclusions High concentration O3 is an important risk factor with lagged effect for ASD in summer in Hefei. The relevant departments should intensify the prevention and control of O3 pollution in summer, strengthen the medical service for ASD patients and protect the susceptible population. -
Key words:
- Ozone /
- Allergic skin disease /
- Summer /
- Distributed lag non-linear model
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图 1 O3浓度对ASD及其亚型的暴露-滞后-反应等高线图
Figure 1. Contours charts of exposure-lag-response about ASD and its subtypes with O3 concentration
图 2 O3浓度对ASD及其亚型的总体暴露效应曲线
Figure 2. Overall exposure effect curves of ASD and its subtypes with O3 concentration
图 3 O3浓度每增加10 μg/m3对ASD就诊的单日滞后效应和累积滞后效应
Figure 3. Single-day and cumulative lagged effects of ASD admissions with per 10 μg/m3 increments in O3 concentration
表 1 2015-2018年合肥市夏季ASD就诊数、空气污染物与气象因素的基本情况
Table 1. Basic information of ASD visits, air pollutants and meteorological factors in summer in Hefei from 2015 to 2018
变量 (x±s) Min P25 P50 P75 Max 总体(N=31 741) 86.25±17.89 37.00 74.00 86.00 99.00 136.00 分型 慢性荨麻疹(n=30 443) 82.72±16.75 31.00 71.00 83.00 95.00 132.00 特应性皮炎(n=1 298) 3.53±2.97 0.00 1.00 3.00 5.00 17.00 性别 男性(n=14 097) 38.31±9.63 13.00 32.00 38.00 43.00 66.00 女性(n=17 644) 47.95±10.70 12.00 40.00 48.00 55.00 81.00 年龄(岁) <18(n=12 332) 33.51±9.86 11.00 27.00 34.00 40.00 67.00 18~＜65(n=12 583) 47.67±10.04 19.00 40.00 48.00 55.00 83.00 ≥65(n=6 826) 18.55±5.65 4.00 14.00 18.00 22.00 36.00 空气污染物浓度 O3(μg/m3) 107.30±40.48 36.00 77.00 105.00 131.25 241.00 PM10(μg/m3) 54.71±21.85 10.00 39.00 52.50 69.00 116.00 M2.5(μg/m3) 32.63±14.72 6.00 21.00 31.00 41.25 91.00 NO2(μg/m3) 29.00±8.19 9.00 22.00 29.00 34.00 60.00 SO2(μg/m3) 7.95±2.53 3.00 6.00 8.00 10.00 17.00 CO(mg/m3) 0.71±0.16 0.40 0.60 0.70 0.80 1.30 气象因素 日均温度(℃) 27.50±3.20 18.90 25.30 27.30 30.20 34.80 日均相对湿度(%) 79.75±9.00 51.20 73.38 80.10 86.23 98.00 
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表 2 2015-2018年合肥市夏季ASD就诊数、空气污染物与气象因素的Spearman相关性分析结果
Table 2. Spearman correlation analysis results of the number of ASD visits, air pollutants and meteorological factors in summer in Hefei City from 2015 to 2018
变量 日就诊数 O3 SO2 NO2 PM10 PM2.5 CO 温度 O3 0.144 a SO2 -0.191 a 0.190 a NO2 0.012 0.450 a 0.498 a PM10 -0.200 a 0.582 a 0.422 a 0.580 a PM2.5 -0.204 a 0.458 a 0.332 a 0.507 a 0.862 a CO -0.240 a 0.195 a 0.265 a 0.519 a 0.559 a 0.702 a 温度 0.120 a 0.338 a -0.010 -0.042 0.246 a -0.009 -0.190 a 相对湿度 0.095 -0.652 a -0.266 a -0.258 a -0.596 a -0.294 a 0.063 -0.510 a 注：aP < 0.05。
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