文献类型：期刊文献

中文题名：甘肃省NO_(2)短期暴露与肺结核确诊人数的关联

英文题名：Association between short-term NO_(2)exposure and the number of confirmed tuberculosis cases in Gansu Province

作者：李永悦[1];冯渤曦[1];黄怡炜[1];林昇[1];吴建军[1];杨海霞[2]

第一作者：李永悦

机构：[1]甘肃中医药大学公共卫生学院,兰州730000;[2]海口市疾病预防控制中心,海口570100

第一机构：甘肃中医药大学公共卫生学院

年份：2025

卷号：29

期号：7

起止页码：854

中文期刊名：中华疾病控制杂志

外文期刊名：Chinese Journal of Disease Control & Prevention

收录：;北大核心:【北大核心2023】；

基金：甘肃省联合科研基金重大项目(24JRRA876)。

语种：中文

中文关键词：肺结核;二氧化氮;分布滞后非线性模型;确诊人数

外文关键词：Tuberculosis;Nitrogen dioxide;Distributed lag nonlinear model;Number of confirmed diagnoses

摘要：目的探讨2016-2020年甘肃省二氧化氮(nitrogen dioxide,NO_(2))短期暴露对肺结核确诊人数的影响,为甘肃省制定有针对性的空气质量改善和疾病预警措施提供科学依据。方法收集2016-2020年甘肃省肺结核确诊病例、空气污染物和气象数据,采用广义加性模型结合分布滞后非线性模型,分析NO_(2)短期暴露与肺结核确诊人数之间的关系,并进一步按性别、年龄和季节分层分析。结果2016-2020年肺结核平均每日确诊人数为13.00(5.00,19.00)例,NO_(2)的平均浓度为21.20(26.28,18.18)μg/m^(3)。单污染模型分析表明,NO_(2)短期暴露对肺结核确诊人数的影响在lag 1 d~lag 7 d和lag 0~7 d时均有统计学意义(均P<0.05),且在lag 0~7 d时效应值达到最大,NO_(2)浓度每增加10μg/m^(3),肺结核确诊相对风险增加12.2%(RR=1.122,95%CI:1.059~1.189)。分层分析结果显示,男性和女性均在lag 0~7 d时相关性最强,NO_(2)浓度每增加10μg/m^(3),肺结核确诊相对风险分别增加13.9%(RR=1.139,95%CI:1.063~1.220)、9.8%(RR=1.098,95%CI:1.021~1.181);<65岁人群和≥65岁人群均在lag 0~7 d时效应值最大,NO_(2)浓度每增加10μg/m^(3),肺结核确诊相对风险分别增加7.3%(RR=1.073,95%CI:1.004~1.146)、21.9%(RR=1.219,95%CI:1.128~1.317);通过冷、暖季节分层后,在冷季时NO_(2)短期暴露与肺结核确诊人数在lag 0~5 d时相关性最强,NO_(2)浓度每增加10μg/m^(3),肺结核确诊相对风险增加20.8%(RR=1.208,95%CI:1.073~1.361),而在暖季中只有lag 7 d时差异无统计学意义,其余均有统计学意义,且呈负相关。结论2016-2020年甘肃省NO_(2)短期暴露会增加肺结核确诊风险,男性和老年人是重点人群,冷季是NO_(2)短期暴露的危险因素。应加强对男性和老年人群的健康防护,特别是在冷季高污染时期。
Objective To explore the effect of short-term to nitrogen dioxide(NO_(2))exposure on the number of confirmed tuberculosis(TB)cases in Gansu Province from 2016 to 2020,and to provide a scientific basis for the development of targeted air quality improvement and disease early warning measures in Gansu Province.Methods Confirmed cases of tuberculosis,air pollutants and meteorological data were collected from 2016 to 2020 in Gansu Province,and a generalized additive model combined with a distributional lag nonlinear model was used to analyse the relationship between NO_(2)exposure and confirmed diagnosis of tuberculosis,which was further stratified by gender,age and season.Results During the study period,the average number of confirmed TB cases per day was 13.00(5.00,19.00),and the average concentration range of NO_(2)was 21.20(26.28,18.18)μg/m^(3).Single-contamination model analysis showed that NO_(2)had a statistically significant effect on the number of confirmed TB cases from lag 1 to lag 7 and lag 07,effect value reached its maximum at lag 07,with a 12.2%increase in the relative risk of confirmed TB cases for every 10μg/m^(3)increase in NO_(2)(RR=1.122,95%CI:1.059-1.189).Stratified analyses showed that the correlation was most significant at a cumulative lag of 7 days for both males and females,with each 10μg/m^(3)increase in NO_(2)concentration increasing the relative risk of a confirmed TB diagnosis by 13.9%(RR=1.139,95%CI:1.063-1.220)and 9.8%(RR=1.098,95%CI:1.021-1.181),respectively;the relative risk of a confirmed TB diagnosis increased by 12.2%(RR=1.122,95%CI:1.059-1.189)for those aged<65 years and≥65 years.Both<65 years old and≥65 years old had the largest effect value at a cumulative lag of 7 days,and each 10μg/m^(3)increase in NO_(2)concentration increased the relative risk of confirmed TB diagnosis by 7.3%(RR=1.073,95%CI:1.004-1.146)and 21.9%(RR=1.219,95%CI:1.128-1.317),respectively;after stratification by cold and warm seasons,the cold season was associated with a higher risk of confirmed TB diagnosis,and the cold season was associated with an increase in NO_(2)exposure.The correlation between NO_(2)exposure and the number of TB diagnoses was most significant at a cumulative lag of 5 days,with a 20.8%increase in the relative risk of TB diagnosis for every 10μg/m^(3)increase in NO_(2)concentration(RR=1.208,95%CI:1.073-1.361).In contrast,only lag7 was not statistically significant during the warm season,and all the rest were statistically significant,and the correlation was negative.Conclusions Short-term exposure to NO_(2)in Gansu Province from 2016 to 2020 increases the risk of tuberculosis,and men and the elderly are the key populations,and the cold season is a risk factor for short-term exposure to NO_(2).Health protection for men and the elderly should be strengthened,especially during the cold season and high pollution periods.