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目的了解珠江三角洲地区城市大气臭氧(O3)对居民死亡风险的影响及其时空分布情况,并进一步探讨影响时空分布的修饰因素。方法采用时间序列研究方法。选择广州、东莞、佛山、江门和肇庆市为研究点,从广东省疾病预防控制中心获得2013—2014年期间每日非意外死亡数据,从广东省环境监测中心获得每日大气O3浓度,从广东省气象局获得每日气象数据。采用广义相加模型(GAM)分别分析全年、冷季(11月至次年4月)和暖季(5—10月)中Lag 02(滞后2 d)期间O3平均浓度上升(10μg/m3)引起的超额死亡风险(ER),采用Meta分析对多城市的结果进行合并,并采用Meta回归探讨年平均O3浓度、老年人口(>65岁)比例和人均收入水平等因素对不同城市之间O3效应差异的影响。结果 2013—2014年期间广州、东莞、佛山、江门和肇庆市每日平均非意外死亡人数分别为136.2、29.5、9.3、77.2和18.9例;大气O3日平均浓度分别为57.0、71.9、53.9、53.9和64.6μg/m3。全年分析发现,广州、东莞、佛山、江门和肇庆市大气O3浓度每增加10μg/m3引起居民死亡风险的ER分别为0.37%(95%CI:0.07%~0.66%)、0.44%(95%CI:-0.11%~0.99%)、-0.05%(95%CI:-1.08%~0.99%)、0.21%(95%CI:-0.23%~0.66%)和0.65%(95%CI:-0.09%~1.40%)。Meta分析合并的ER值为0.35%(95%CI:0.14%~0.56%),并且冷季(ER=0.51%,95%CI:0.20%~0.83%)的合并效应高于暖季(ER=0.22%,95%CI:-0.07%~0.51%)。Meta回归分析发现O3的死亡效应与各城市的日平均O3浓度和老年人的比例呈正相关,与人均年收入和开支水平呈负相关,但是均没有统计学意义。结论珠江三角洲地区大气O3可增加居民的死亡风险,冷季效应高于暖季,且不同城市间的O3健康效应差别明显,大气O3平均浓度、老年人比例和收入水平对O3效应的修饰效应尚不明确,有待进一步研究。
Objective To understand the impact of atmospheric ozone (O3) on the residents’ risk of death and its temporal and spatial distribution in the Pearl River Delta region, and to further explore the modification factors that affect the temporal and spatial distribution. Methods using time series research methods. Choosing Guangzhou, Dongguan, Foshan, Jiangmen and Zhaoqing as research sites, we obtained daily non-accidental death data from Guangdong Provincial Center for Disease Control and Prevention from 2013 to 2014. Daily atmospheric O3 concentration was obtained from Guangdong Environmental Monitoring Center. Provincial Meteorological Bureau to obtain daily weather data. The generalized additive model (GAM) was used to analyze the increase of average O3 concentration (10 μg / m3) during the whole year, in the cooling season (November to April) and in the warm season (May to October) (ER). Meta-analysis was used to combine the results of multiple cities. Meta-regression was used to explore the effect of annual average O3 concentration, the proportion of elderly population (> 65 years old) and per capita income on different cities O3 effects of the difference. Results The average number of non-accidental deaths in Guangzhou, Dongguan, Foshan, Jiangmen and Zhaoqing was 136.2, 29.5, 9.3, 77.2 and 18.9 respectively during 2013-2014. The average concentration of O3 in the atmosphere was 57.0, 71.9, 53.9 and 53.9 And 64.6 μg / m3. The annual analysis showed that the ER of inhabitants for each 10 μg / m3 increase of O3 concentrations in Guangzhou, Dongguan, Foshan, Jiangmen and Zhaoqing was 0.37% (95% CI: 0.07% -0.66%) and 0.44% (95% CI: -0.11% -0.99%), -0.05% (95% CI -1.08% -0.99%), 0.21% (95% CI -0.23% -0.66%) and 0.65% % ~ 1.40%). The pooled ER values were 0.35% (95% CI: 0.14% -0.56%) in the Meta-analysis and were higher in the cold (ER = 0.51%, 95% CI: 0.20% -0.83% 0.22%, 95% CI: -0.07% -0.51%). Meta-regression analysis found that the death effect of O3 was positively correlated with the daily average O3 concentration in each city and the proportion of elderly people, but negatively correlated with the annual per capita income and expenditure level, but no statistical significance. Conclusion O3 in the Pearl River Delta may increase residents’ risk of death, the cold season effect is higher than that of the warm season, and the O3 effect is obviously different among different cities. The O3 effect is also modified by the average O3 concentration, the elderly proportion and the income level Not clear, pending further study.