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[目的]观察上海市冬季雾霾期大气污染状况及小学生肺功能的变化趋势。[方法]在上海市中心城区和郊区各选择一所小学(A校和B校),每所学校3~5年级各随机抽取一个班级学生为样本研究对象,共182名,于2013年12月测试其肺功能3次(每周1次,连续3周);另于次年6月测试第4次,以作为对照。同时收集2013年12月和2014年6月,A、B两校就近的环境监测国控点大气细颗粒物(PM2.5)、可吸入颗粒物(PM10)、二氧化硫(SO2)和二氧化氮(NO2)4种污染物的监测数据。采用两样本t检验和χ2检验比较组间差异,以一般线性模型(GLM)中重复测量方差分析的方法分析肺功能变化趋势。[结果]2013年12月两校所在监测点PM2.5、PM10和NO2平均浓度均超过GB 3095—2012《环境空气质量标准》二级标准,其中PM2.5超标严重;2014年6月4种污染物浓度已达到国家二级标准,且明显低于2013年12月(P<0.01)。所调查的182人中,完成4次肺功能检查的有160人,占87.91%。两校学生性别、年龄、身高、体重差异无统计学意义;A校第2次用力肺活量(FVC)和第3次的呼气流量峰值(PEF)高于B校(P<0.05);各肺功能指标均有随时间而变化的趋势(P<0.05或P<0.01),FVC值存在时间和学校中的交互作用(P<0.01);FVC、第一秒用力呼气量(FEV1)、50%肺活量最大呼气流量(MEF50%)、25%肺活量最大呼气流量(MEF25%)4次检查结果均呈线性降低(P<0.01);两校边际均值轮廓图显示,FVC、FEV1、MEF50%和MEF25%4次结果呈降低趋势,PEF、75%肺活量最大呼气流量(MEF75%)和用力呼气中段流量(FEF25%~75%)则前3次依次降低,第4次回升;经检验,2013年12月各指标的边际轮廓均值与2014年6月明显不同(P<0.01或P<0.05)。[结论]2013年12月冬季雾霾期上海市两监测点空气质量较差,周边小学生肺功能大气道和小气道功能指标均逐渐降低,雾霾期后仅部分指标回升,个别指标仍未完全恢复。
[Objective] To observe the change of air pollution in winter haze and the pupil’s pulmonary function in Shanghai. [Method] A primary school (A school and B school) was chosen in each of the downtown area and suburban districts of Shanghai. Each grade 3 ~ 5 grade was randomly selected as a sample of a total of 182 students. In December 2013 Test their lung function 3 times (once a week for 3 consecutive weeks); the other in June the fourth test in June, as a control. In December 2013 and June 2014, PM2.5, PM10, SO2 and NO2 (NO2) were collected from environmental monitoring stations near A and B in December 2013 and June 2014 respectively. ) 4 kinds of pollutants monitoring data. Two-sample t-test and χ2 test were used to compare the differences between groups. The change trend of lung function was analyzed by means of repeated measures analysis of variance (ANOVA) in general linear model (GLM). [Result] The average concentrations of PM2.5, PM10 and NO2 at the monitoring points where the two schools were located exceeded the Grade 2 standard of Ambient Air Quality Standard GB 3095-2012 in December 2013, of which PM2.5 exceeded the standard seriously. In June 2014, 4 species Pollutant concentration has reached the national secondary standard, and was significantly lower than in December 2013 (P <0.01). Of the 182 people surveyed, 160 completed 4 pulmonary function tests, accounting for 87.91%. There were no significant differences in sex, age, height and weight between the two schools. The second FCE and the third peak expiratory flow (PEF) of School A were higher than those of School B (P <0.05) (P <0.05 or P <0.01), the presence of FVC in school and the interaction in school (P <0.01); FVC, FEV1, 50 (MEF50%) and maximum expiratory flow (MEF25%) of25% of vital capacity all showed a linear decrease (P <0.01). The marginal mean contours of the two schools showed that FVC, FEV1, MEF50% (MEF75%) and forced expiratory midstream flow (FEF25% ~ 75%) decreased in the first three times and then rose again in the fourth. After the test, the PEF, the maximum expiratory flow of 75% In December 2013, the average of the marginal profiles of each indicator was significantly different from that of June 2014 (P <0.01 or P <0.05). [Conclusion] The air quality of two monitoring points in Shanghai in December 2013 haze was poor, the function of airway and small airway of pupils around the pupils decreased gradually, and only some indexes rose after the smog period, and some indicators were still incomplete restore.