首页资讯江苏省六城市空气质量健康指数效果验证

江苏省六城市空气质量健康指数效果验证

来源：泰然健康网时间：2024年12月05日 22:58

目的

采用中国疾病预防控制中心环境与健康相关产品安全所(环境所)开发的空气质量健康指数(AQHI)指数构建方法, 构建常州、淮安、南京、泰州、无锡、扬州市AQHI, 并验证其与空气质量指数(AQI)一致性及健康风险预测能力。

方法

利用文献报道的中国空气PM2.5、O3、NO2、SO2与总死亡的暴露-反应系数、各城市日均死亡数及2015—2017年各城市四种污染物的日均值浓度, 对各城市分别构建相应的AQHI。分析6个城市AQHI风险等级分布特征, 并比较AQHI和AQI对不同健康结局的指示能力。

结果

6个城市AQHI低风险和中风险等级累计占比均大于90%。随着6个城市AQI等级升高, AQHI等级也随之升高, 无互斥的结果, 总体趋势一致。每增加一个风险级别, 6个城市5种死因结局(非意外总死亡、心血管疾病死亡、中风疾病死亡、呼吸系统疾病死亡和慢阻肺死亡)AQHI所致风险增加的百分比较AQI均更高, 敏感性分析显示模型基本稳健。

Objective

To construct an Air Quality Health Index (AQHI) using the method developed by National Institute of Environmental Health, Chinese Center for Disease Control and Prevention for Changzhou, Huai'an, Nanjing, Taizhou, Wuxi, and Yangzhou of Jiangsu Province, China, and to verify its consistency with Air Quality Index(AQI) and health risk prediction ability.

Methods

A region-specific AQHI was constructed for each city using the exposure-response coefficients of PM2.5, O3, NO2, and SO2 with total deaths in China reported in the literature, the daily average number of deaths in each city, and the daily average mass concentrations of the four pollutants in each city in 2015—2017. The distribution characteristics of AQHI risk levels in the six cities were analyzed, and the ability of AQHI and AQI to indicate different health outcomes was compared.

Results

The cumulative proportions of low and medium AQHI risk levels in the six cities all exceeded 90%. The AQHI levels increased with increase in the AQI levels of the six cities, and the result were not mutually exclusive, with a consistent overall trend. Each increase in the risk level was associated with a higher percentage increase in AQHI risks compareid with AQI risks for each of the five causes of death outcomes (total non-accidental mortality, cardiovascular mortality, stroke mortality, respiratory mortality, and chronic obstructive pulmonary mortality) in the all six cities. Sensitivity analysis showed that the model is basically robust.

Conclusion

AQHI has a higher ability to indicate health risks than AQI.

图 1 江苏省6个城市AQHI频数分布

注：横坐标：AQHI等级；纵坐标：某等级的天数；

图 2 江苏省6个城市AQHI和AQI频率对应关系分布

注：横坐标：AQI等级；纵坐标：AQHI某等级的天数；

图 3 江苏省6个城市非意外总死因AQHI和AQI指示能力

图 4 江苏省6个城市心血管疾病死因AQHI和AQI指示能力

图 5 江苏省6个城市中风疾病死因AQHI和AQI指示能力

图 6 江苏省6个城市呼吸系统疾病死因AQHI和AQI指示能力

图 7 江苏省6个城市慢性阻塞性肺疾病死因AQHI和AQI指示能力

表 1 江苏省6个城市AQHI和AQI频率对应关系分布表 %

分级 AQHI 0-1区间 AQHI 1-2区间 AQHI 2-3区间 AQHI 3-4区间常州市 AQI 1级 97.33 2.67 0 0 AQI 2级 33.33 65.91 0.76 0 AQI 3级 1.28 87.18 11.54 0 AQI 4级 0 59.52 40.48 0 AQI 5级 0 33.33 66.67 0 AQI 6级 0 0 100 0 淮安市 AQI 1级 100 0 0 0 AQI 2级 66.77 33.23 0 0 AQI 3级 10.47 86.05 3.49 0 AQI 4级 1.52 90.91 7.58 0 AQI 5级 0 59.26 40.74 0 AQI 6级 0 0 0 0 南京市 AQI 1级 98.39 1.61 0 0 AQI 2级 21.32 78.03 0.65 0 AQI 3级 0.36 83.39 16.25 0 AQI 4级 0 56.67 43.33 0 AQI 5级 0 53.33 46.67 0 AQI 6级 0 0 0 0 泰州市 AQI 1级 100 0 0 0 AQI 2级 54.04 45.80 0.16 0 AQI 3级 6.10 84.96 8.94 0 AQI 4级 0 61.90 38.10 0 AQI 5级 0 48.15 51.85 0 AQI 6级 0 0 0 0 无锡市 AQI 1级 97.14 2.86 0 0 AQI 2级 24.41 75.43 0.16 0 AQI 3级 0.35 86.51 13.15 0 AQI 4级 0 59.26 40.74 0 AQI 5级 0 7.69 92.31 0 AQI 6级 0 0 0 0 扬州市 AQI 1级 99.12 0.88 0 0 AQI 2级 49.07 50.78 0.16 0 AQI 3级 3.88 84.88 11.24 0 AQI 4级 0 64.79 35.21 0 AQI 5级 0 54.55 45.45 0 AQI 6级 0 0 0 0

表 2 江苏省6个城市不同健康结局AQHI和AQI指示能力的对应关系a %

健康结局 AQHI 95% CI AQI 95% CI 非意外总死因的暴露风险变化常州 1.58 (0.02，3.16) 0.26 (-0.84，1.38) 淮安 3.42 (2.05，4.80) 1.65 (0.73，2.58) 南京 1.58 (0.20，2.98) 0.54 (-0.35，1.43) 泰州 1.98 (0.66，3.32) 0.98 (0.10，1.88) 无锡 0.84 (-0.52，2.21) 0.04 (-0.90，0.99) 扬州 2.50 (1.15，3.87) 2.32 (1.34，3.30) 心血管疾病死因的暴露风险变化常州 1.41 (-1.27，4.15) -0.18 (-2.05，1.74) 淮安 3.95 (1.66，6.30) 1.75 (0.22，3.31) 南京 2.07 (-0.08，4.27) 0.80 (-0.58，2.20) 泰州 1.59 (-0.57，3.80) 1.03 (-0.42，2.50) 无锡 1.56 (-0.90，4.09) 0.35 (-1.35，2.09) 扬州 3.56 (1.41，5.76) 2.98 (1.44，4.55) 中风疾病死因的暴露风险变化常州 0.24 (-3.20，3.80) -2.81 (-5.19，-0.36) 淮安 3.36 (0.52，6.29) 1.64 (-0.27，3.59) 南京 2.61 (-0.15，5.45) 0.16 (-1.59，1.95) 泰州 0.47 (-2.49，3.53) 0.23 (-1.77，2.28) 无锡 2.25 (-0.92，5.51) 1.67 (-0.53，3.93) 扬州 5.32 (2.42，8.29) 3.87 (1.81，5.98) 呼吸系统疾病死因的暴露风险变化常州 4.72 (-0.04，9.69) 1.54 (-1.71，4.90) 淮安 5.61 (2.19，9.15) 2.51 (0.25，4.81) 南京 1.11 (-3.13，5.53) 0.13 (-2.60，2.92) 泰州 3.10 (-0.63，6.98) 1.40 (-1.05，3.92) 无锡 0.81 (-3.39，5.19) -0.64 (-3.53，2.32) 扬州 3.55 (-0.50，7.75) 0.03 (-2.80，2.94) 慢性阻塞性肺疾病死因的暴露风险变化常州 3.17 (-2.70，9.39) 1.76 (-2.30，5.98) 淮安 5.44 (1.90，9.09) 2.97 (0.63，5.36) 南京 0.03 (-5.66，6.07) -2.78 (-6.38，0.95) 泰州 2.88 (-1.14，7.06) 2.20 (-0.46，4.94) 无锡 0.28 (-4.51，5.31) -1.60 (-4.88，1.80) 扬州 2.99 (-1.44，7.61) 0.71 (-2.43，3.96)注：a AQI和AQHI分别每增加1个风险等级，不同健康结局死因风险增加的百分比

表 3 6个城市人群非意外死亡AQHI和AQI指示能力的敏感性分析 %

组别 AQHI 95% CI AQI 95% CI 原自由度非意外总死因 time=7
Tem=3
Rh=3 常州 1.58 (0.02，3.16) 0.26 (-0.84，1.38) 淮安 3.42 (2.05，4.80) 1.65 (0.73，2.58) 南京 1.58 (0.20，2.98) 0.54 (-0.35，1.43) 泰州 1.98 (0.66，3.32) 0.98 (0.10，1.88) 无锡 0.84 (-0.52，2.21) 0.04 (-0.90，0.99) 扬州 2.50 (1.15，3.87) 2.32 (1.34，3.30) 调整自由度非意外总死因 time=8
Tem=3
Rh=3 常州 1.94 (3.54，0.36) 0.63 (1.76，-0.49) 淮安 3.60 (5.00，2.22) 1.85 (2.79，0.92) 南京 1.70 (3.11，0.31) 0.60 (5.51，-0.30) 泰州 2.28 (3.63，0.95) 1.18 (2.08，0.28) 无锡 1.12 (2.52，-0.25) 0.20 (1.17，-0.77) 扬州 2.72 (4.09，1.36) 2.54 (3.54，1.56) 调整自由度非意外总死因 time=7
Tem=4
Rh=3 常州 1.65 (3.23，0.08) 0.33 (1.44，-0.78) 淮安 3.42 (4.80，2.05) 1.67 (2.60，0.75) 南京 1.47 (2.87，0.09) 0.52 (1.41，-0.37) 泰州 2.05 (3.38，0.73) 0.91 (1.81，0.03) 无锡 0.78 (2.15，-0.57) 0.05 (1.00，-0.89) 扬州 2.38 (3.75，1.03) 2.13 (3.12，1.16) 调整自由度非意外总死因 time=7
Tem=3
Rh=4 常州 1.48 (3.06，-0.08) 0.25 (1.36，-0.86) 淮安 3.42 (4.80，2.05) 1.65 (2.58，0.73) 南京 1.59 (2.99，0.21) 0.55 (1.44，-0.34) 泰州 2.03 (3.36，0.71) 1.06 (1.96，0.17) 无锡 0.85 (2.22，-0.51) 0.09 (1.04，-0.86) 扬州 2.50 (3.87，1.15) 2.33 (3.31，1.35) [1]

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