Study On The Effect Of Air Pollutants On Respiratory Disease Outpatients In Shenyang During The Heating Period

Objective:In recent years,Many epidemiologic studies have confirmed the harm of air pollutants on human health.The respiratory system is the first target organ of air pollutants.Air pollutants enter the body and deposit on the respiratory system.They can induce respiratory spasm,increase mucus secretion and airway ventilation resistance,thereby slowing the flow of air in the lung,leading to a decrease in lung ventilation function.Air pollution is the cause and factor of many respiratory diseases such as lung inflammation,respiratory infections,asthma and lung cancer.It may even further develop system inflammation and oxidative stress,eventually raising the mortality rate of the population.The effects of air pollutants on the respiratory diseases outpatients during heating in winter in Shenyang were studied by the method of a case-crossover design,screening out risk factors that may affect respiratory diseases.To provide scientific basis for prevention of diseases and control of air pollution.Method:1.This study was conducted at the outpatients department of respiratory medicine of three-grade class-A hospitals in Shenyang.To collect statistics of outpatients respiratory diseases during heating period from November 1st,2013 to March 31st,2014 and environmental monitoring data(PM_2.5,PM₁₀,SO₂,NO₂,CO,and O₃)and meteorological monitoring data?average air temperature,average air pressure,average wind speed and average relative humidity?during the same period.SPSS 22.0 was used to analyze the frequency distribution of respiratory diseases,air pollutants concentration and meteorological factors.2.The Spearman correlation analysis was used to evaluate the correlation between air pollutants and meteorological factors of the same period.The correlations between air pollutants and meteorological factors and the total number of outpatients of respiratory diseases?upper respiratory tract infections,and pneumonia.3.This study used a case-crossover design to study the association between exposure of air pollutants and the occurrence of the disease by comparing the exposure of the same patient on the day of treatment?case period?and the exposure after three weeks?control period?.The concentration of air pollutants from 0 to 5 days?lag0⁵?was included in the single pollutant model.Using conditional logistic regression model to discuss the influence of air pollutants on the outpatients of respiratory diseases.Results:1.From November 1st,2013 to March 31st,2014 in Shenyang,the total number of outpatients for respiratory medicine was 18,090,of whom 8,444 were males and 9,646were females.The number of outpatients with upper respiratory tract infection and pneumonia was 1,091 cases and 3,553 cases respectively.During the heating period,the daily average number of outpatient visits for respiratory medicine was 128.30,and the daily outpatient visits for upper respiratory tract infection and pneumonia were 8.02 and25.20 respectively.2.The daily average air temperature,average air pressure,average wind speed and average relative humidity of the air pollutants(PM_2.5,PM₁₀,SO₂,NO₂,CO and O₃)were 88.65?g/m³,136.46?g/m³,138.80?g/m³,55.91?g/m³,2.57?g/m³,28.95?g/m³respectively,The concentration of PM2.5 is higher than that of the national secondary air quality standards,and all others are in accordance with the national air quality standards.Average air temperature,average air pressure,average wind speed and average relative humidity were-3.37?,1017.50hPa,2.21m/s,57.51%respectively.3.Spearman correlation analysis showed that air pollutants,meteorological factors within and each other showed varying degrees of correlation.There was a positive correlation between total respiratory system outpatients>65 years old and O₃.There was a positive correlation between outpatients with upper respiratory tract infection and SO₂ and CO,and a negative correlation with O₃.There was a positive correlation between male patients and PM_2.5,PM₁₀,SO₂,NO₂,CO,and O₃.There was a negative correlation between O₃ and female.There was a positive correlation between PM_2.5,SO₂,NO₂ and CO in 15-64 age group and negative correlation with O₃.There was a positive correlation between O₃ and pneumonia in men and there was a positive correlation between PM_2.5and SO_2.4.After controlling the influence of meteorological factors,the concentrations of PM_2.5,PM₁₀,SO₂,and NO₂ lag-4 day had the most significant effect on upper respiratory tract infection,both of which were statistically significant.The concentrations of CO lag-2day had the most significant effect on upper respiratory tract infection?P<0.05?.PM_2.5and PM₁₀ day had the strongest impact on pneumonia on the day?P<0.05?.SO₂ and NO₂had the strongest impact on pneumonia on the day?P<0.001?.Conclusion:there is correlation between Shenyang heating period of air pollutants and upper respiratory tract infection and pneumonia in outpatients.Short-term increases in air pollutant concentrations may lead to an increase in outpatient visits to hospital respiratory diseases.