济南市2013―2019年大气臭氧暴露对居民超额应急呼叫的风险评估

常会云; 王丽珩; 黄珂; 李明君; 崔亮亮

doi:10.16462/j.cnki.zhjbkz.2024.04.017

济南市2013―2019年大气臭氧暴露对居民超额应急呼叫的风险评估

doi: 10.16462/j.cnki.zhjbkz.2024.04.017

1.
济南市疾病预防控制中心科研教育部，济南 250021
2.
济南市疾病预防控制中心环境健康所，济南 250021
3.
济南市急救中心急救部，济南 250021

基金项目:

济南市卫生健康委员会科技计划项目 2021-public-02

济南市卫生健康委员会科技计划项目 2022-public-10

详细信息

通讯作者:
崔亮亮，E-mail: cll602@163.com

中图分类号: R122
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- 被引次数: 0
出版历程
- 收稿日期: 2023-05-07
- 修回日期: 2023-09-19
- 网络出版日期: 2024-05-17
- 刊出日期: 2024-04-10

Effects analysis and excess risk assessment on O₃ related emergency calls in Jinan City, 2013-2019

1.
Department of Research and Education, Jinan Center for Disease Control and Prevention, Jinan 250021, China
2.
Environmental Health Institute, Jinan Center for Disease Control and Prevention, Jinan 250021, China
3.
Emergency Department, Jinan Medical Emergency Center, Jinan 250021, China

Funds:

Science and Technology Development Plan of Jinan Health Commission 2021-public-02

Science and Technology Development Plan of Jinan Health Commission 2022-public-10

More Information

Corresponding author: CUI Liangliang, E-mail: cll602@163.com

摘要

摘要: 目的探讨济南市2013―2019年臭氧(Ozone, O₃)暴露对居民超额应急呼叫风险的影响。方法收集济南市2013―2019年每日的居民应急呼叫事件信息，以及同期每日的空气污染物(O₃、PM_2.5、PM₁₀、NO₂、SO₂、CO)浓度和气象因素(日均温度、日均相对湿度和日均风速)资料，采用病例交叉设计方法确定暴露-反应系数，Cox比例风险回归模型进行健康风险评估；对呼吸、循环和神经系统疾病进行分层分析，同时比较冬春季和夏秋季O₃暴露造成的超额应急呼叫风险是否具有差异。结果 2013―2019年济南市共发生应急呼叫事件653 473件，平均每日应急呼叫总量为250人次。通过总应急呼叫的影响效应分析和超额风险评估发现，O₃浓度每升高10 μg/m³，居民总应急呼叫的风险增加0.375%(95% CI：0.288%~0.461%)，造成的超额应急呼叫总量为7 226人次。疾病分层分析发现，研究期间O₃暴露仅对增加神经系统疾病应急呼叫的超额风险差异有统计学意义(P＜0.001)，影响效应估计值为0.471%(95% CI：0.250%~0.692%)，进而造成的超额应急呼叫量为1 371人次。另外，O₃暴露造成的超额应急呼叫量有季节差异，表现为夏秋季>冬春季。结论济南市O₃暴露增加居民的超额应急呼叫风险，且夏秋季O₃暴露造成的超额应急呼叫风险高于冬春季，特别是神经系统疾病受其影响更为显著。
- 臭氧 /
- 应急呼叫 /
- 风险评估
Abstract: Objective To explore the effect of Ozone (O₃) exposure on the risk of excess emergency calls of residents in Jinan City from 2013 to 2019. Methods The daily emergency calling event information of residents, as well as the average concentration of air pollutants (O₃, PM_2.5, PM₁₀, NO₂, SO₂, CO) and meteorological factors (daily average temperature, average relative humidity and average wind speed) in Jinan City from January 1st to December 31st of 2013 to 2019, were collected. The case-cross design method was used to determine the expose-response relationship coefficient, which was introduced into the proportional risk model for health risk assessment. Further, stratified analysis was conducted by respiratory system diseases, circulatory system diseases and neurological diseases, and the differences in excess emergency call risk caused by O₃ exposure in different seasons were compared. Results There were 653 473 emergency call incidents in Jinan from 2013 to 2019, and average daily emergency calls volume were 250. Impact analysis and excess risk assessment on total emergency calls found that for every 10 μg/m³ increase in O₃ concentration, the risk of emergency calls increased by 0.375% (95% CI: 0.288%-0.461%), resulting in excess emergency calls of 7 226. Disease-stratified analyses found that the effect estimate of O₃ exposure on emergency calls was statistically significant only for neurologic disorders during the study period, with a corresponding effect estimate of 0.471% (95% CI: 0.250%-0.692%), and resulted in excess emergency calls of 1 371. In addition, the excess emergency calls caused by O₃ exposure had seasonal differences, which were higher in summer and autumn than in winter and spring. Conclusions In Jinan City, exposure of O₃ increases the risk of excess emergency calls of residents, and manifests as higher in summer and autumn than in winter and spring. Especially, neurological diseases are significantly affected.
- Ozone /
- Emergency call /
- Risk assessment

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图 1 不同季节O₃浓度增加对居民应急呼叫的超额危险度

A：应急呼叫总量；B：呼吸系统疾病呼叫量；C：循环系统疾病呼叫量；D：神经系统疾病呼叫量。

Figure 1. Excess risk of resident emergency calls due to increased seasonal O₃ concentration

A: Total emergency calls; B: Calls for respiratory diseases; C: Calls for circulatory diseases; D: Calls for neurologic disorders.

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表 1 2013―2019年济南市居民应急呼叫事件和环境指标的基本情况描述

Table 1. Basic situation description of resident emergency call events and environmental indicators in Jinan City, 2013-2019

指标Index	最小值Min	P₂₅	M	P₇₅	最大值Max
空气污染物/(μg·m^-3)Air pollutants /(μg·m^-3)
O₃-8h	5	61	102	154	266
PM_2.5	3	42	62	93	443
PM₁₀	5	94	129	178	693
NO₂	9	34	45	59	165
SO₂	6	18	33	56	429
CO	363	824	1 049	1 403	6 555
气象因素Meteorological factors
日均温度/℃ Daily average temperature/℃	-12.4	6.1	16.9	24.6	33.8
日均相对湿度/% Daily average relative humidity/%	15.0	40.0	54.0	69.0	100.0
日均风速/(m·s^-1)Daily average wind /(m·s^-1)	0.2	1.7	2.1	2.9	8.4
应急呼叫事件/(人次·d^-1) Emergency call incidents/(calls·day^-1)
呼叫总量Total calls	56	225	250	281	395
呼吸系统疾病呼叫量Calls for respiratory diseases	2	13	20	28	63
循环系统疾病呼叫量Calls for circulatory disease	4	30	39	47	86
神经系统疾病呼叫量Calls for neurologic disorders	5	33	39	46	78

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表 2 2013―2019年O₃浓度增加对居民应急呼叫的超额危险度

Table 2. Excess risk of resident emergency calls due to increased O₃ concentration, 2013-2019

滞后日 Lag days	应急呼叫总量 Total emergency calls		呼吸系统疾病呼叫量 Calls for respiratory diseases		循环系统疾病呼叫量 Calls for circulatory disease		神经系统疾病呼叫量 Calls for neurologic disorders
滞后日 Lag days	ER	95% CI	ER	95% CI	ER	95% CI	ER	95% CI
Lag0	0.375 ^①	(0.288~0.461)	0.179	(-0.131~0.490)	0.122	(-0.105~0.350)	0.471 ^①	(0.250~0.692)
Lag1	0.179 ^①	(0.099~0.260)	0.203	(-0.086~0.493)	-0.093	(-0.302~0.117)	0.073	(-0.131~0.277)
Lag2	0.079 ^①	(0.002~0.156)	0.236	(-0.043~0.517)	-0.167	(-0.368~0.035)	-0.031	(-0.227~0.166)
Lag3	0.071	(-0.005~0.148)	0.059	(-0.219~0.338)	-0.210	(-0.410~0.008)	-0.080	(-0.276~0.116)
Lag4	0.018	(-0.057~0.094)	0.049	(-0.228~0.326)	-0.224	(-0.424~0.024)	0.016	(-0.179~0.211)
Lag5	0.012	(-0.063~0.088)	0.129	(-0.147~0.405)	-0.114	(-0.314~0.086)	-0.168	(-0.361~0.026)
Lag01	0.372 ^①	(0.279~0.445)	0.265	(-0.087~0.617)	0.007	(-0.251~0.266)	0.358 ^①	(0.107~0.608)
Lag02	0.339 ^①	(0.234~0.444)	0.349	(-0.030~0.729)	-0.100	(-0.377~0.177)	0.254	(-0.015~0.524)
Lag03	0.328 ^①	(0.216~0.440)	0.330	(-0.075~0.735)	-0.199	(-0.495~0.097)	0.174	(-0.113~0.462)
Lag04	0.304 ^①	(0.185~0.423)	0.321	(-0.108~0.750)	-0.289	(-0.603~0.025)	0.165	(-0.140~0.469)
Lag05	0.289 ^①	(0.163~0.415)	0.357	(0.097~0.811)	-0.321	(-0.653~0.010)	0.078	(-0.244~0.340)
注：ER，超额危险度。 ① P < 0.05。 Note: ER, excess risk. ① P < 0.05.

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表 3 2013―2019年济南市O₃暴露造成的居民超额应急呼叫量

Table 3. Excess emergency call volume caused by O₃ exposure in Jinan City, 2013-2019

年份 Year	超额应急呼叫总量 Excess total emergency calls		超额神经系统疾病呼叫量 Excess calls for neurologic disorders
年份 Year	WHO标准 WHO standard	中国标准 Chinese standard	WHO标准 WHO standard	中国标准 Chinese standard
2013	715(709~721)	136(132~140)	138(137~139)	27(26~28)
2014	953(946~960)	230(226~234)	179(178~180)	44(43~45)
2015	1 008(1 001~1 015)	243(238~248)	194(192~196)	48(47~49)
2016	893(887~ 899)	224(220~228)	179(178~180)	45(44~46)
2017	934(927~941)	245(240~250)	198(196~200)	52(51~53)
2018	1 056(1 049~1 063)	289(285~293)	186(185~187)	51(50~52)
2019	1 667(1 657~1 677)	553(546~560)	297(295~299)	99(98~100)
2013―2019	7 226(7 218~7 234)	1 920(1 915~1 925)	1 371(1 369~1 373)	366(365~367)

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表 4 2013―2019年济南市不同季节O₃暴露造成的居民超额应急呼叫量

Table 4. Excess emergency call volume caused by seasonal O₃ exposure in Jinan City, 2013-2019

年份 Year	超额应急呼叫总量 Excess total emergency calls		超额神经系统疾病呼叫量 Excess calls for neurologic disorders
年份 Year	冬春季 Winter and spring	夏秋季 Summer and autumn	冬春季 Winter and spring	夏秋季 Summer and autumn
2013	34(31~37)	1 002(994~1 010)	7(6~8)	284(282~286)
2014	124(119~129)	1 234(1 224~1 244)	27(26~28)	338(335~341)
2015	94(88~100)	1 351(1 341~1 362)	20(18~22)	382(379~385)
2016	155(151~160)	1 104(1 095~1 113)	34(33~35)	325(323~328)
2017	111(107~115)	1 221(1 211~1 232)	27(26~28)	379(375~382)
2018	201(195~207)	1 285(1 275~1 295)	38(27~39)	334(331~337)
2019	207(201~213)	2 167(2 153~2 182)	45(44~46)	551(547~555)
2013-2019	929(924~935)	9 368(9 356~9 379)	202(201~204)	2 605(2 602~2 608)

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