| Objective:To describe the distribution of major atmospheric pollutants and meteorological factors and the situation of outpatient visits of pediatric acute respiratory diseases in the three hospitals from 2014 to 2016 in Shijiazhuang City.To analyze the independent impact of atmospheric particulate matter(PM2.5 and PM10)on outpatient visits of pediatric acute respiratory disease during the study period in Shijiazhuang.To investigate the short-term modification effect of temperature in the relationship between atmospheric particulate matter and outpatient visits of pediatric acute respiratory system,and to quantitatively analyze the harmful effects of atmospheric particulate matter on the outpatient visits of pediatric acute respiratory disease under different levels of gaseous pollutants?NO2 and SO2?.Methods:The meteorological data and daily average concentration data of atmospheric pollutants were obtained from January 1,2014 to December 31,2016 in Shijiazhuang City,as well as the daily outpatient visit data of acute respiratory diseases in Hebei Medical University First Hospital,Shijiazhuang First Hospital and pediatric clinic of Children's Hospital of Hebei Province was collected during the same period.Spearman correlation analysis was used to analyze the correlations between atmospheric pollutants,meteorological factors,and outpatient visits of pediatric acute respiratory disease in Shijiazhuang City.The methods of"binary response surface model"was used to explore the modification effect of temperature on the impact of PM2.5 and PM100 on outpatient visits of pediatric acute respiratory diseases.The semi-parametric quasi-Poisson regression model combining the Generalized Additive Model?GAM?with the Distributed Lag Nonlinear Model?DLNMS?was employed to analyze the impact of atmospheric particulate matter at different lag times on outpatient visits of pediatric acute respiratory diseases to determine the strongest lag period.During the strongest lag period,the impact of atmospheric particulate matter on outpatient visits of pediatric acute respiratory diseases were analyzed by the model at different temperature levels and different levels of gaseous pollutants?NO2 and SO2?,respectively.Results:1)In the descriptive results,the daily average temperature is 16.60?from 2014 to2016 in Shijiazhuang City,the daily average relative humidity is 57.00%,and the daily average air pressure is 1004.43 hpa,the changing rule of temperature and humidity is high in July and low in January,while the pressure changes in the opposite direction.During the study period,the daily average concentrations of gaseous pollutants NO2 and SO2 were 47.00?g/m3 and 36.62?g/m3,and the daily average concentrations of atmospheric particulate matter PM2.5 and PM10 were 80.22?g/m3 and 142.43?g/m3,which were higher than gaseous pollutants;the overall change law of the four atmospheric pollutants was increased in winter and spring,and decreased in summer and autumn.In the outpatient department of pediatrics of three hospitals in Shijiazhuang City from 2014 to 2016,the outpatient visits of acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections and the total outpatient visits of three acute respiratory diseases were the highest at low temperature?438 person-times/day?,and the lowest at high temperature?137 person-times/day?.The overall rule is lower temperature layer>daily average temperature layer>high temperature layer,and the trend was higher in winter and spring and lower in summer and autumn during the study period.2)In the correlation analysis results,significant associations were found among atmospheric pollutants,meteorological factors,and outpatient visits of pediatric acute respiratory diseases in Shijiazhuang City?P<0.05?,except between SO2 and sunlight,SO2 and acute upper respiratory infections,wind speed and precipitation,wind speed and influenza and pneumonia,sunlight and influenza and pneumonia,sunshine and total acute respiratory diseases?P>0.05?.3)Hysteresis analysis of atmospheric particulate matter shows that the impact of atmospheric particulate matter PM2.5 in Shijiazhuang City on pediatric acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,and total acute respiratory disease outpatient visits were largest in 4,2,3 and 3 lags,respectively,and the biggest effects of PM10 on the corresponding acute respiratory diseases were lags of 4,2,3,and 2 days,respectively.4)During the strongest lag period,the modification effect of temperature suggest that the impact of PM2.5 and PM10 on outpatient visits of pediatric acute respiratory disease was statistically significant in low temperature,but which was not statistically significant in high temperature,for every 10?g/m3 increase in PM2.5,the outpatient visits of pediatric acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,and the total acute respiratory diseases increased by 0.34%?0.05%0.62%?,0.30%?0.11%0.48%?,0.23%?0.00%0.46%?,and 0.20%?0.08%0.32%?,respectively;for every 10?g/m3 increase in PM10,corresponding outpatient visits of pediatric acute respiratory system diseases increased by 0.10%?0.00%0.21%?,0.21%?0.08%0.34%?,0.18%?0.02%0.34%?,and 0.17%?0.08%0.25%?,respectively.5)During the strongest lag period,the modification effect of gaseous pollutants shows that when the concentrations of NO2 and SO2 were at a high level,the impact of PM2.5.5 and PM10 on outpatient visits of pediatric acute respiratory disease were higher than at a lower concentration level,and both had statistical significance.when NO2 was at high concentration level?>47.00?g/m3?,for every 10?g/m3 increase in PM2.5,the outpatient visits of pediatric acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,and total acute respiratory diseases increased by0.26%.?0.14%0.39%?,0.19%?0.03%0.34%?,0.24%?0.04%0.43%?,and 0.22%?0.12%0.32%?,respectively;for every 10?g/m3 increase in PM10,corresponding outpatient visits of acute respiratory diseases increased by 0.20%?0.12%0.29%?,0.14%?0.03%0.24%?,0.18%?0.05%0.31%?,and 0.16%?0.10%0.23%?,respectively.When SO2 was at high concentration level?>36.60?g/m3?,for every 10?g/m3 increase in PM2.5,the outpatient visits of acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,and total acute respiratory diseases increased by 0.27%?0.14%0.41%?,0.17%?0.01%0.34%?,0.29%?0.08%0.50%?,and 0.23%?0.12%0.34%?,respectively;every 10?g/m3 increase in PM10,corresponding outpatient visits of pediatric acute respiratory diseases increased by 0.22%?0.12%0.31%?,0.14%?0.02%0.25%?,0.21%?0.07%0.36%?and 0.18%?0.11%0.25%?,respectively.Conclusion:1)The atmospheric particulate matter pollution in Shijiazhuang City is serious,as the daily average concentrations of PM2.5 and PM10 increase,the outpatient visits of pediatric acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,and total acute respiratory diseases has gradually increased.;2)The harmful effects of atmospheric particulate matter PM2.5 and PM10 on pediatric acute respiratory system are greatly affected by low temperature;3)When the concentrations of NO2 and SO2 are at high levels,the harmful effects of atmospheric particulate matter are stronger. |
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