Time-series analysis of association between air pollutants and the incidence of acute diseases of otorhinolaryngology
Objective To analyze the relationship between air pollutants and the incidence of acute diseases of otorhinolaryngology.Methods The outpatient and emergency volume of acute diseases of otolaryngology,including acute tonsillitis,acute epiglottitis,acute laryngitis,acute rhinitis and nasal sinusitis,and acute otitis media in four large tertiary general hospitals in the main urban area of Hangzhou(Hangzhou First People's Hospital,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou Hospital of Traditional Chinese Medicine,and Hangzhou Third People's Hospital)was collected during 2013-2018,and data on atmospheric pollution and meteorological parameters in the area during the same period were obtained.R statistical software was used to establish a generalized additive model to study the effects of different air pollutant concentrations on the outpatient and emergency volume of acute otolaryngological diseases,and the relationship between different air pollutant concentrations and daily outpatient and emergency volume in different subgroups stratified by season and age was analyzed.Results The total number of outpatient and emergency visits for acute otolaryngology diseases in the main urban area of Hangzhou during 2013-2018 was 333,254,and the average daily number of outpatient and emergency visits was 152.For every 10 μg/m3 increase in the average daily concentration of particulate pollutants(PM25,PM10),the effect on the number of outpatient and emergency visits for acute otorhinolaryngological diseases was the greatest on the 4th day of lag(Lag 4),while for every 10 μg/m3 increase in the average daily concentration of gaseous pollutants(SO2,NO2),the effect on the number of outpatient and emergency visits was the greatest on the 4th and 6th days of lag(Lag 4 and Lag 6,respectively).In the single-pollutant model:Age-stratified analysis showed that the correlation between the concentration of each air pollutant and the volume of emergency and outpatient visits was most significantly seen in 5-14-year-old subgroup,and the effects of each 10 μg/m3 increase in the concentration of PM2.5,PM10,SO2,and NO2 were NO22＞SO2＞PM10＞PM2.5,and the RR values were 1.07(95％CI:1.05-1.09),1.05(95％CI:1.03-1.07),1.04(95％CI:1.02-1.05),1.03(95％CI:1.02-1.05),respectively;Seasonal stratification analysis showed that the effect of atmospheric pollutants on the increase of outpatient and emergency department visits was larger in the cooler seasons(November to April)than the warmer seasons(May to October)(P＜0.05).In the two-pollutants model,there was significant correlation between each two-air pollutants and the volume of outpatient and emergency visits(all P＜0.05),but the effect of their influence was not significantly different.Conclusion Elevated concentrations of air pollutants in the main urban area of Hangzhou were associated with increased outpatient and emergency department visits for acute otorhinolaryngological diseases from 2013 to 2018,with a lagged effect.Stratified studies showed that the effect in cold season was larger than the warm season,and it was most significant in children aged 5-14 years.This is an important scientific reference for the development of prevention and treatment strategies for acute otolaryngologic diseases.
Air pollutionAcute otorhinolaryngology diseaseTime series analysisGeneralized additive model
万方数据
维普
