The Influence Of Air Pollutants In A Certain Area On Acute Attack Of Chronic Bronchitis In 2014-2017

objectiveAir pollutants are one of the main causes of acute attack of chronic bronchitis.Shenyang,an important hub city in Northeast China,was selected as the research city.Through the collection,sorting and mathematical statistics of the data of air pollutants,meteorological factors and admission records of chronic bronchitis in Shenyang from2014 to 2017,the paper explores the pollution degree of air pollution in this area and the chronic bronchitis of the population Health hazards of acute inflammation.The purpose of this study is to provide targeted suggestions and guidance for the health protection of respiratory diseases,and provide the basis for relevant departments to formulate corresponding policies.MethodsData of air pollutants,meteorological factors and admission records of chronic bronchitis in Shenyang were collected from 2014 to 2017.Air pollutant data include PM_2.5The daily average concentrations of PM₁₀,SO₂,NO₂,O₃and co come from Shenyang Environmental Protection Bureau;meteorological factors include average daily temperature,relative humidity,air pressure and wind speed,and from Shenyang Meteorological Bureau;the admission records of chronic bronchitis acute attack of Shenyang residents include demographic basic materials,admission date,discharge date,disease diagnosis,complications,etc.Excel2016 is used to fill,screen,sort out and summarize the data;SPSS22.0 is used to test the normality of data variables for air pollutant data,meteorological factor data and patient data,and the statistical description and correlation analysis are conducted by using the corresponding statistical methods;the distribution lag nonlinear model with the connection function of four Si Poisson distribution is established by R4.0.1 to establish a distribution lag nonlinear model with the connection function of the four Poisson distribution The effects of the control of weeks,holidays,daily average temperature,relative humidity,wind speed and air pressure on the concentration of air pollutants and the admission of chronic bronchitis were analyzed.The effects of air pollutants on the admission of bronchitis were analyzed by using natural spline smoothing function.The stratified analysis of seasons,gender and age was established To study the effect of air pollutants on admission of different population characteristics in different seasons.Results（1）The median（quartile spacing）of SO₂,NO₂,PM₁₀,PM_2.5,O₃and CO in Shenyang are 32（17-79.5）μg/m³,42（32-54）μg/m³,89（61-129）μg/m³,48（32-79）μg/m³,87.5（56-127）μg/m³,0.9（0.7-1.2）mg/m3,and the maximum value of AQI,the minimum and median（quartered spacing）are 496,22.5,86.667（65-120）.（2）Among the common air pollutants in Shenyang,the main pollutants are air PM_2.5and PM₁₀,and 523 days（36.57%）with air PM_2.5as the primary pollutants,327 days with air PM₁₀as the primary pollutants,accounting for 22.87%of the total days;the number of days of exceeding the standard for national level II of PM_2.5is 389 days,the over standard rate is 27.2%,the second level of atmospheric PM₁₀exceeds the standard for 259 days,and the over standard rate is 18.11%.（3）The daily average concentrations of SO₂,NO₂,PM₁₀,PM_2.5and CO in Shenyang have obvious seasonal variation characteristics,and in winter（November April）are significantly higher than that in warm season（may October）（P<0.05）.（4）The proportion of winter（November April）,warm season（may October）and annual pollution days in 2014 respectively accounted for 60.8%,34.8%and 47.7%;the proportion of winter,warm season and annual pollution days in 2015 accounted for 61.3%,25.5%and 43.3%respectively;the proportion of winter,warm season and annual pollution days in 2016 accounted for 40.7%,23.4%and 32.0%respectively;2017 The proportion of pollution days in winter,warm season and whole year respectively accounted for 34.0%,25.5%and 29.3%respectively.In 2014-2017,the total pollution days in the whole year showed a downward trend.（5）From 2014 to 2017,3361 patients with chronic acute bronchopathy were admitted to hospital,including 1675 men（49.84%）,1686 females（50.16%）;243patients under 60 years old（7.23%）,3118 patients aged 60 years and above（92.77%）;1762 patients（52.42%）in winter,1599 in warm season（47.58%）.（6）During the study,the number of admission on the acute attack day of chronic bronchitis was positively correlated with the concentration of SO₂,NO₂,PM₁₀and PM_2.5,and negatively correlated with the daily mean temperature,wind speed,relative humidity and O₃concentration.The number of admission patients with acute attack of chronic bronchitis at 60 years old and above was positively correlated with SO₂and NO₂concentration,and negatively correlated with O₃concentration.（7）The single pollutant model showed that the influence of air PM₁₀and PM_2.5on admission to chronic bronchitis over 60 years old was the largest and had statistical significance（P<0.05）.When the air PM₁₀increased by 10μg/m³,the risk of admission of chronic bronchitis increased by 1.302%（95%CI:0.8%-1.804%,P<0.05）,and PM in the atmosphere 2.5 the risk of admission to hospital of chronic bronchitis over60 years old increased by 1.102%（95%CI:0.8%-1.404%,P<0.05）for every10μg/m³increase.（8）Based on the single pollutant model,the two pollutant models PM_2.5+SO₂,PM_2.5+NO₂,PM_2.5+CO and PM_2.5+O₃were constructed.The results showed that the risk of admission to hospital of chronic bronchitis over 60 years old increased by1.13%（95%CI:0.028%-2.234%,P<0.05）,1.444%（95%CI:0.684%-2.204%,P<0.05）,0.985%（95%CI:0.407%-1.563%,P<0.05）,1.985%（95%CI:0.407%-1.563%,P<0.05）,1.985%（95%CI:0.407%-1.563%,P<0.05）,and 1.985%(95%CI:The risk of admission of chronic bronchitis over 60 years old increased by1.552%（95%CI:0.76%-2.344%,P<0.05）,1.937%（95%CI:1.46%-2.414%,P<0.05）,1.969%（95%CI:1.2%-2.738%,P<0.05）,1.000%（95%CI:0.263%-1.737%,P<0.05）,respectively（9）The three pollutant models:PM_2.5+SO₂+NO₂,PM_2.5+SO₂+O₃,PM_2.5+NO₂+O₃,PM_2.5+CO+O₃,PM_2.5+CO+O₃,PM_2.5+NO₂.5,PM_2.5,10μg/m³,and1.413%（95%CI:0.393%-2.433%,P<0.05）,1.74%（95%CI:0.764%-2.716%,P<0.05）,0.977%（95%CI 0.2%-1.754%,P<0.05）,2.11%（P<0.05）,2.11%（P<0.05）,2.11%（P<0.05）,2.11%（P<0.05）,2.11%（P<0.95%CI:1.25%-2.970%,P<0.05）The risk of admission for acute attack of chronic bronchitis increased by 1.515%（95%CI:0.947%-2.083%,P<0.05）,1.743%（95%CI:0.889%-2.597%,P<0.05）,0.970%（95%CI:0.146%-1.794%,P<0.05）,1.443%（95%CI:0.646%-2.240%,P<0.05）.Conclusions1.The main air pollutants in Shenyang from 2014 to 2017 are PM_2.5and PM₁₀,and their concentration is higher in winter and spring than in summer and autumn.2.the effects of PM₁₀and PM_2.5on admission to hospital with chronic bronchitis over 60 years old were the highest when the air PM₁₀and PM_2.5were delayed for 5days,and had statistical significance（P<0.05）.The maximum lag days of health effects in different characteristics were different.