Association Between Meteorological Factors,Air Pollution And Acute Exacerbation Of Chronic Obstructive Pulmonary Disease In Rural Areas Of Qingyang

Objective:To investigate the association between meteorological factors,air pollution indicators and acute exacerbation of chronic obstruction pulmonary disease?AECOPD?in rural areas,and to analyze the delayed effect of various factors on AECOPD,and provides scientific reference for the prevention and treatment of AECOPD in rural areas of Qingyang.Methods:The study collected daily AECOPD hospitalization data,meteorological data from January 2011 to June 2016 in rural areas of Qingyang,and air pollution data from January 2015 to June 2016.Describe the distribution of AECOPD,the basic conditions of meteorology and air pollution.Using the inpatient data of AECOPD from January 2011 to June 2016 in rural areas of Qingyang combined with contemporaneous meteorological data to construct a distributed lag non-linear model based on a time-stratified case-crossover design,to investigate the relationship between temperature,air pressure,relative humidity and AECOPD and its hysteresis effect.At the same time,after adjusting the influence of meteorological factors,using the AECOPD hospitalization data and air pollution data of Qingyang rural areas from January 2015 to June 2016,a distributed lag non-linear model was constructed based on the time-stratified case-crossover design to investigate the effects of PM₁₀,PM_2.5,NO₂ and other atmospheric pollution indicators on AECOPD.Results:1.The total number of absolute hospitalizations of AECOPD in rural areas of Qingyang has been increasing year by year.From January 2011 to June 2016,the total number of AECOPD in rural areas of Qingyang was 23277,of which the number of hospitalizations for women aged 65 years and over was 7017,and that for men aged 65 years and over was the second,with 6767.Except for 2013,the absolute number of AECOPD of females was higher than males in other years.The absolute number of AECOPD among people aged 65 years and over during study period was higher than those aged 15-64 years.2.The relationship between the daily mean temperature and the exposure-response of AECOPD was inverse"J".For single lag effect,the effect of low temperature??-6.2??on the AECOPD in men and women aged 65 years and older has a significant lag effect,and the effect is greatest on the day of exposure.The effect of low temperature on the AECOPD in men aged 15-64 years has a lag effect,and the effect is greatest at lag3d,with an RR of 1.026?95%CI:1.001¹.050?.For cumulative lag effect,the effects of low temperature on AECOPD in all subgroups have medium and long-term effects.The effect of high temperature on AECOPD in all subgroups was statistically significant?P<0.05?,and it was a protective factor.3.The relationship between the daily mean air pressure and the exposure-response of AECOPD was inverted"S".For single lag effect,the effect of low air pressure??858.7hPa?on the AECOPD in men aged 65 years and over had the largest effect on the day of exposure,and the short-term lag effect was obvious.The effects of low pressure on the AECOPD in other subgroups were statistically significant?P<0.05?,as a protective factor.The effect of high air pressure on AECOPD of various subgroups has different degrees of lag effect?P<0.05?.For cumulative lag effect,except for women aged 15-64 years,the cumulative lag effect of low air pressure on AECOPD in other subgroups was statistically significant?P<0.05?.High air pressure has varying degrees of AECOPD in all subgroups.4.The daily mean relative humidity and the exposure-response relationship of AECOPD were inverted"U".For single lag effect,the effect of low humidity??27%?on AECOPD in all subgroups was statistically significant?P<0.05?.For cumulative lag effect,the cumulative lag effect of low humidity on AECOPD in all subgroups was statistically significant?P<0.05?.The effect of high humidity on the AECOPD in all subgroups was also statistically significant?P<0.05?,showing protective factors.5.In the single pollutant model,except for the cumulative lag effects of lag0-2d in the 15-64-year-old male population,the single and cumulative lag effects of high concentrations of PM_2.5??42?g/m³?and PM₁₀??91?g/m³?on the AECOPD in other subgroups were statistically significant?P<0.05?.In the two-pollutant model,after adjusting for SO₂,the single and cumulative lag effects of high concentration PM_2.5.5 on the AECOPD in each subgroup were not statistically significant?P>0.05?.After adjusting for NO₂,CO and O₃,respectively,the single and cumulative lag effects of high concentration PM_2.5.5 on the AECOPD in each subgroup were still statistically significant?P<0.05?.After adjusting for SO₂,the single and cumulative lag effects of high concentration PM₁₀0 on the AECOPD in each subgroup were not statistically significant?P>0.05?.6.In the single-pollutant model,the effect of high concentration SO₂??58mg/m³?on the day of exposure had the greatest effect on AECOPD in men aged?65 years,with an RR of 1.060?95%CI:1.020¹.102?,and there was a significant lag effect,and it lasted for 14 days.The effect of high concentration CO??1.55mg/m³?on AECOPD in all subgroups was statistically significant?P<0.05?,the optimal single-lag and cumulative lag effects appeared in lag27d and lag0-27d,respectively.High concentration of NO₂??23?g/m³?had a significant single-lag effect on the effect of AECOPD in women aged?65 years?P<0.05?,the optimal cumulative lag effect of high concentration NO₂ on AECOPD for men aged?65 years and women aged?65years appeared in lag0-15d and lag0-27d,respectively.The lag effect of low concentration O₃??64ug/m³?on AECOPD in various subgroups was statistically significant in some lag times?P<0.05?.The effects of high concentration O₃??111ug/m³?on the single-lag and cumulative-lag effects of AECOPD in each subgroup were also statistically significant?P<0.05?.In the two-pollutant model,after adjusting for NO₂,the single lag effect of SO₂ on the AECOPD in men aged 65 years and over was not statistically significant?P>0.05?.After adjusting for CO,the cumulative lag effect of NO₂ on the AECOPD in men aged 65 and over increased to3.243?95%CI:2.645³.976?.After adjusting for SO₂,the single and cumulative lag effects of CO on the AECOPD in each subgroup were not statistically significant?P>0.05?.After adjusting SO₂ and CO,the single and cumulative lag effects of O₃ on the AECOPD in each subgroup were not statistically significant?P>0.05?.Conclusion:1.In addition to the single-lag effect of 15-64-year-old women,low temperature has different degrees of influence on AECOPD in other subgroups,while high temperature has a protective effect on the AECOPD of each subgroup.2.The effects of high air pressure on AECOPD in various subgroups of rural areas in Qingyang have varying degrees of lag effects.The effect of low air pressure on AECOPD in men aged?65 years has a greater effect on the day of exposure.3.Low relative humidity has different degrees of hysteresis effect on all subgroups,and the effect value is the largest on the day of exposure,while the effect of high relative humidity on AECOPD is a protective factor.4.High concentrations of PM_2.5.5 have an effect on AECOPD in all subgroups.High concentrations of PM₁₀0 also had a significant effect on AECOPD in each subgroup,and the effect of each subgroup on the day of exposure reached the maximum.5.The high concentration of SO₂ has a significant effect on AECOPD in men aged?65 years,and has the greatest effect on the day of exposure.The high concentration of NO₂ has a significant single-lag effect on the AECOPD of women aged?65 years,and the effect is greatest at 27 days.The effect of high-concentration CO on AECOPD in each subgroup has a significant lag effect,and its effect gradually increases with the increase of lag days.6.Low-concentration O₃ has varying degrees of influence on AECOPD in each subgroup,while high-concentration O₃ affects AECOPD in each subgroup as a protective factor.