本文選題：空氣污染物 + 兒童　； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究2014-2015年合肥市空氣污染物,如可吸入顆粒物(Particulate matter,PM10)、細(xì)顆粒物(Fine particulate matter,PM2.5)、二氧化硫(Sulfur dioxide,SO2)、二氧化氮(Nitrogen dioxide,NO2)、一氧化碳(Carbon monoxide,CO)、臭氧(Ozone,O3)與0-14歲兒童上呼吸道感染(Upper respiratory tract infection,URTI)(以下簡(jiǎn)稱(chēng)上感)日門(mén)診量之間的關(guān)系,并發(fā)現(xiàn)敏感人群。方法1.收集2014-2015年合肥市某兒童醫(yī)院兒童上感的逐日門(mén)診資料,年齡為0-14歲,包括兒童的性別、出生日期、年齡以及世界衛(wèi)生組織國(guó)際疾病分類(lèi)(International classification of diseases 10th Revision,ICD-10)編碼。根據(jù)兒童的性別和年齡分為不同的亞組:(1)男童和女童;(2)0-4歲、5-9歲和10-14歲。2014-2015年的空氣污染物逐日監(jiān)測(cè)資料從合肥市環(huán)境監(jiān)測(cè)中心站獲得,包括24-小時(shí)PM10、PM2.5、SO2、NO2、CO濃度資料和1-小時(shí)O3濃度資料。同時(shí)從合肥市氣象局收集2014-2015年的逐日氣象監(jiān)測(cè)數(shù)據(jù),包括每日的平均氣溫(°C)、平均氣壓(hpa)、平均相對(duì)濕度(%)、風(fēng)速(m/s)和降水(mm)。2.使用時(shí)間序列分析方法中的廣義相加模型(Generalized additive model,GAM),控制長(zhǎng)期趨勢(shì)、季節(jié)性、星期幾效應(yīng)(Day of the week,DOW)、法定節(jié)假日和氣象因素的混雜效應(yīng),定量分析2014-2015年合肥市空氣污染物PM10、PM2.5、SO2、NO2、O3、CO濃度與0-14歲兒童上感日門(mén)診量的關(guān)系及滯后效應(yīng),并發(fā)現(xiàn)敏感人群。結(jié)果1.單污染物模型中,PM10、PM2.5、SO2、NO2、CO對(duì)兒童上感總?cè)臻T(mén)診量的影響均有統(tǒng)計(jì)學(xué)意義(P0.05),滯后效應(yīng)分別在lag3、lag06、lag06、lag06、lag06最明顯,濃度每升高10μg/m3,兒童上感總?cè)臻T(mén)診量分別增加0.15%(0.07%~0.23%)、0.38%(0.17%~0.60%)、2.92%(1.88%~3.97%)、4.47%(3.69%~5.25%)、0.05%(0.02%~0.08%)。全污染物模型1和模型2中,在調(diào)整了其他空氣污染物的影響后,僅NO2對(duì)兒童上感總?cè)臻T(mén)診量的影響有統(tǒng)計(jì)學(xué)意義(P0.05),NO2濃度每上升10μg/m3,兒童上感總?cè)臻T(mén)診量分別增加4.72%(3.76%~5.69%)和4.70%(3.76%~5.65%)。2.本研究中PM10、PM2.5、SO2、NO2、O3和CO對(duì)女童比對(duì)男童的滯后效應(yīng)要強(qiáng)。PM10、PM2.5、SO2、NO2、O3和CO每上升10μg/m3,男童上感日門(mén)診量分別增加0.14%(0.03%~0.24%)、0.29%(0.02%~0.57%)、2.46%(1.13%~3.82%)、4.32%(3.32%~5.33%)、0.02%(-0.22%~0.26%)、0.05%(0.02%~0.08%)。女童上感日門(mén)診量分別增加0.17%(0.05%~0.30%)、0.53%(0.19%~0.87%)、3.69%(2.04%~5.37%)、4.67%(3.45%~5.90%)、0.22%(-0.07%~0.52%)、0.06%(0.01%~0.10%)。3.本研究中PM10、PM2.5、SO2、NO2、O3和CO對(duì)5歲以上兒童的滯后效應(yīng)較強(qiáng),對(duì)5歲以下兒童的滯后效應(yīng)較弱。結(jié)論1.短期暴露于空氣污染物可能與兒童上感日門(mén)診量的增加有關(guān),本研究中NO2是影響0-14歲兒童上感日門(mén)診量的主要空氣污染物。2.PM10、PM2.5、SO2、NO2、O3和CO對(duì)女童比對(duì)男童的滯后效應(yīng)要強(qiáng)。3.PM10、PM2.5、SO2、NO2、O3和CO對(duì)5歲以上兒童的滯后效應(yīng)較5歲以下兒童強(qiáng)。目的探討2015-2016年合肥市空氣污染物對(duì)兒童肺功能指標(biāo)及其發(fā)育的影響,為控制空氣污染以及保護(hù)兒童肺功能發(fā)育提供理論依據(jù),并制定相應(yīng)的防治措施。方法根據(jù)《國(guó)家空氣污染對(duì)人群健康影響監(jiān)測(cè)項(xiàng)目工作手冊(cè)》,合肥市將包河區(qū)和瑤海區(qū)列為國(guó)家監(jiān)測(cè)點(diǎn)。對(duì)2015-2016年合肥市瑤海區(qū)和包河區(qū)環(huán)境監(jiān)測(cè)站點(diǎn)的空氣污染水平進(jìn)行分析,瑤海區(qū)PM10、PM2.5、SO2、NO2、O3、CO的濃度均高于包河區(qū),且差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。選擇包河區(qū)為清潔區(qū),瑤海區(qū)為污染區(qū),在兩區(qū)各隨機(jī)選擇1所小學(xué),采用隨機(jī)整群抽樣的方法,抽取兩個(gè)小學(xué)三年級(jí)的兒童作為調(diào)查對(duì)象,對(duì)其進(jìn)行問(wèn)卷調(diào)查和肺功能測(cè)試,2015年和2016年各進(jìn)行一次肺功能測(cè)試。結(jié)果1.包河區(qū)和瑤海區(qū)共納入研究對(duì)象245和234人,完成兩年肺功能測(cè)試及問(wèn)卷調(diào)查分別為240人和230人,再排除患過(guò)敏性鼻炎、肺炎、哮喘、氣管炎或支氣管炎以及居住年限不足2年的兒童,清潔區(qū)和污染區(qū)的有效應(yīng)答人數(shù)分別為236人和227人,總有效應(yīng)答率分別為96.33%和97.01%。2.2015年,瑤海區(qū)男童最大呼氣中期流速(MMEF,The maximum mid-expiratory flow rate或FEF25~75,Mid-forced expiratory flow)和75%用力肺活量時(shí)的呼氣流速(FEF75)的實(shí)測(cè)值均顯著低于包河區(qū)(t=2.473,P=0.014;t=2.407,P=0.017)。2016年,瑤海區(qū)男童25%用力肺活量時(shí)的呼氣流速(FEF25)顯著低于包河區(qū)(t=2.231,P=0.027);瑤海區(qū)女童用力肺活量(FVC,forced vital capacity)顯著高于包河區(qū)(t=-2.424,P=0.016),呼氣峰值流量(PEF,Peak expiratory flow)和FEF25顯著低于包河區(qū)(t=3.937,P=0.000;t=4.298,P=0.000)。3.調(diào)整了年齡、身高、體重后,2015年,瑤海區(qū)男童MMEF的預(yù)測(cè)值低于包河區(qū)。2016年,瑤海區(qū)男童FVC、第1秒用力呼氣容積(FEV1,Forced expiratory volume in 1 second)、MMEF、FEF75均低于包河區(qū)。4.瑤海區(qū)兒童肺功能指標(biāo)的增長(zhǎng)量均低于包河區(qū)。另外,除瑤海區(qū)和包河區(qū)男童FVC、包河區(qū)FEV1增長(zhǎng)量高于女童外,其余指標(biāo)均是女童高于男童。5.在控制了各種影響因素后,空氣污染暴露對(duì)兒童FVC、PEF、MMEF、FEF25均有顯著影響(P0.05),其中瑤海區(qū)兒童的PEF和FEF25的異常率明顯高于包河區(qū)(OR=2.809,P0.05;OR=3.052,P0.05)。結(jié)論1.合肥市瑤海區(qū)兒童PEF、MMEF、FEF25、FEF75均低于包河區(qū),提示兒童肺功能下降可能與空氣污染物有關(guān)。2.瑤海區(qū)兒童肺功能指標(biāo)的增長(zhǎng)量均低于包河區(qū),表明兒童肺功能的增長(zhǎng)發(fā)育可能受到空氣污染物的影響。3.空氣污染物可能是兒童肺功能指標(biāo)異常的危險(xiǎn)因素。
[Abstract]:Objective to study air pollutants in Hefei city for 2014-2015 years, such as Particulate matter (PM10), fine particles (Fine particulate matter, PM2.5), sulfur dioxide (Sulfur dioxide, SO2), nitrogen dioxide (Nitrogen dioxide), carbon monoxide, ozone, and 0-14 year old children's upper respiratory tract infection. Espiratory tract infection, URTI) (hereinafter referred to as the sense) the relationship between the day out-patient volume, and found the sensitive population. Method 1. collected 2014-2015 years of children's Hospital in Hefei city children's day by day outpatient data, age 0-14 years old, including children's sex, birth date, age and WHO International Classification of diseases (Internationa L classification of Diseases 10th Revision, ICD-10) coding. According to the sex and age of children, it is divided into different subgroups: (1) boys and girls; (2) the daily monitoring data of air pollutants for 0-4, 5-9 and 10-14 years old are obtained from the Hefei environmental monitoring center station, including 24- hours PM10, PM2.5, SO2, concentration data and Hourly O3 concentration data. At the same time, the daily meteorological monitoring data of 2014-2015 years were collected from the Hefei Meteorological Bureau, including daily average temperature (C), average pressure (HPA), average relative humidity (%), wind speed (m/s) and precipitation (mm).2. use time series analysis method (Generalized additive model, GAM), to control the long-term trend. The seasonal, Day of the week (DOW), the mixed effect of the statutory holidays and meteorological factors, the quantitative analysis of the relationship and lag effect of the air pollutants in Hefei City, PM10, PM2.5, SO2, NO2, O3, CO concentration and 0-14 year old children, and the sensitive population in the 1. single pollutant model. The effects of O2 and CO on the total daily outpatient service of children were statistically significant (P0.05). The lag effect was the most obvious in Lag3, lag06, lag06, lag06, lag06, and the concentration increased by 10 u g/m3, and the total daily outpatient quantity of children increased by 0.15% (0.07%~0.23%), 0.38% (0.17%~ 0.60%), 2.92% (1.88%~3.97%), 4.47% (1.88%~3.97%), 0.05%. In model 1 and model 2, after adjusting the effects of other air pollutants, only NO2 had a statistically significant effect on the total daily outpatient service of children (P0.05), the concentration of NO2 increased by 10 g/m3, and the total daily outpatient outpatient volume increased by 4.72% (3.76%~5.69%) and 4.70% (3.76%~5.65%).2. in the study of PM10, PM2.5, SO2, NO2, O3, and the girls' ratio. The lag effect on boys was strong.PM10, PM2.5, SO2, NO2, O3 and CO were up 10 mu each, and the boys' daily outpatient volume increased by 0.14% (0.03%~0.24%), 0.29% (0.02%~0.57%), 2.46% (1.13%~3.82%), 4.32% (3.32%~5.33%), 0.02% (-0.22%~0.26%), 0.05% (0.53%), 0.53% (0.53%), 0.53%, respectively. 3.69% (2.04%~5.37%), 4.67% (3.45%~5.90%), 0.22% (-0.07%~0.52%), 0.06% (0.01%~0.10%).3. in this study, PM10, PM2.5, SO2, NO2, O3 and CO are stronger for children over 5 years of age, and the lag effect is weaker for children under 5 years of age. Conclusion 1. short-term exposure to air pollutants may be related to the increase of the outpatient outpatient dose of children. NO2 is the main air pollutant.2.PM10, PM2.5, SO2, NO2, O3 and CO which affect the day outpatient quantity of 0-14 year old children, which are stronger.3.PM10, PM2.5, SO2, NO2, the lag effect on children over 5 years old is stronger than that of children under the age of 5. The influence of its development provides a theoretical basis for controlling air pollution and protecting children's lung function development, and formulates corresponding prevention and control measures. According to the working manual of the national air pollution monitoring project for the population health, Hefei has listed the Baohe district and Yaohai district as the national monitoring point for the Yaohai District of Hefei and the Baohe River in 2015-2016 years. The air pollution level of the district environmental monitoring station is analyzed. The concentration of PM10, PM2.5, SO2, NO2, O3 and CO in Yaohai district is higher than that of Baohe District, and the difference is statistically significant (P0.05). In the Baohe District, the clean area is a clean area, and the Yaohai District is a polluted area. In the two district, 1 primary schools are selected randomly, and two primary schools are selected for three years by random cluster sampling. A questionnaire survey and lung function test were carried out for the children of the class, and the lung function tests were conducted in 2015 and 2016. Results 1. people and 234 people were included in the 1. Baohe and Yaohai areas. The lung function test and questionnaire survey were performed for 240 and 230 people for two years, and then the allergic rhinitis, pneumonia, asthma, and gas were excluded. The effective responses of children with tracheitis or bronchitis and less than 2 years of residence were 236 and 227 in clean and polluted areas, respectively, and the total effective response rate was 96.33% and 97.01%.2.2015 years respectively. The maximum expiratory flow rate (MMEF, The maximum mid-expiratory flow rate or FEF25~75, Mid-forced expiratory flow) for boys in Yaohai district. The measured values of expiratory flow velocity (FEF75) at the 75% forced vital capacity were significantly lower than that in the Baohe region (t=2.473, P=0.014; t=2.407, P=0.017).2016. The expiratory flow rate (FEF25) of 25% forced lung capacity in Yaohai boys was significantly lower than that in the Baohe area (t=2.231, P=0.027), and the forced vital capacity (FVC, forced vital) of the girls in Yaohai was significantly higher than that of the Baohe district. (t=-2.424, P=0.016), the peak expiratory flow (PEF, Peak expiratory flow) and FEF25 are significantly lower than the Baohe district (t=3.937, P=0.000; t=4.298, P=0.000).3. adjusted the age, height and weight. In 2015, the prediction value of the Yaohai District boys was lower than that of the Baohe District, the boy in Yaohai District, the first second forced expiratory volume. In 1 second), MMEF, FEF75 were lower than that of Baohe District of.4. Yaohai District of Baohe district. Besides, the growth of FEV1 in Yaohai and Baohe district was higher than that of girls, and the rest of the other indicators were that children were higher than boys'.5. in control of various factors, and air pollution was exposed to FVC, PEF, MMEF, FE. There were significant effects of F25 (P0.05). The abnormal rate of PEF and FEF25 in children in Yaohai was significantly higher than that in Baohe district (OR=2.809, P0.05; OR=3.052, P0.05). Conclusion 1. children in Yaohai District of Hefei city are PEF, MMEF, FEF25, and FEF75 are lower than the Baohe District, suggesting that the decline of lung function in children can be related to the increase of air pollutants in Yaohai district. The growth and development of lung function in children may be affected by air pollutants..3. air pollutants may be a risk factor for abnormal pulmonary function in children.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R725.6

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