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张丽, 相晓妹, 张水平, 李力, 黄小正, 赵燕娥, 苏莹, 贾冬华, 颜虹, 党少农. 西安市空气污染对先天性心脏病影响[J]. 中国公共卫生, 2019, 35(10): 1416-1420. DOI: 10.11847/zgggws1122077
引用本文: 张丽, 相晓妹, 张水平, 李力, 黄小正, 赵燕娥, 苏莹, 贾冬华, 颜虹, 党少农. 西安市空气污染对先天性心脏病影响[J]. 中国公共卫生, 2019, 35(10): 1416-1420. DOI: 10.11847/zgggws1122077
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Li ZHANG, Xiao-mei XIANG, Shui-ping ZHANG, . Influence of air pollution on congenital heart disease in Xi′an city: 2009 – 2016[J]. Chinese Journal of Public Health, 2019, 35(10): 1416-1420. DOI: 10.11847/zgggws1122077
Citation: Li ZHANG, Xiao-mei XIANG, Shui-ping ZHANG, . Influence of air pollution on congenital heart disease in Xi′an city: 2009 – 2016[J]. Chinese Journal of Public Health, 2019, 35(10): 1416-1420. DOI: 10.11847/zgggws1122077
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西安市空气污染对先天性心脏病影响

Influence of air pollution on congenital heart disease in Xi′an city: 2009 – 2016

    摘要
  • 摘要:
      目的  了解先天性心脏病与空气污染的关系，为进一步调整和优化先天性心脏病防控体系，提高出生人口质量提供依据。
      方法  对先天性心脏病采用发生率描述，空气污染、气象因素采用年均数、超标天数等统计描述；采用时间序列分析先天性心脏病及空气污染的长期变化趋势；采用Spearman秩相关分析先天性心脏病与不同滞后月（lag 0～lag 12）、空气污染物浓度的相关性；采用广义泊松相加模型分析空气污染物对先天性心脏病发生的影响。
      结果  2009 — 2016年西安市发生先天性心脏病2 098例，占总出生缺陷的18.7 %；先天性心脏病发生率逐年增加，发生率从2010年的73.3/万，增加到2015年的159.5/万。孕早期多污染物模型分析显示，当调整二氧化氮（NO2）、可吸入颗粒物（PM10）、细颗粒物（PM2.5）时，二氧化硫（SO2）浓度每升高10 μg/m3，先天性心脏病风险增加48.5 %（RR = 1.485，95 % CI = 1.441～1.530）。当调整其他污染物时，发现NO2和PM10与先天性心脏病可能有关。未发现PM2.5与先天性心脏病有关。
      结论  西安市先天性心脏病整体呈增长趋势，可能与空气污染有关；孕早期暴露SO2可增加先天性心脏病发生风险。

     

    Abstract:
      Objective  To explore the association of ambient air pollution with congenital heart disease (CHD) and to provide evidences for improving CHD prevention strategies.
      Methods  We collected the data on all reported CHD incidences diagnosed from pregnancy to 7th day after birth among all fetuses and newborns in Xi’an city of Shaanxi province from October 1, 2009 to September 30, 2016. Ambient air pollution monitoring data and meteorological data during the period were also retrieved. Monthly CHD incidence rate and average concentrations of air pollutants (sulfur dioxide SO2, nitrogen dioxide NO2, particulate matter < 10 micron in aerodynamic diameter PM10, and particulate matter < 2.5 micron in aerodynamic diameter PM2.5) were adopted in time series analysis to describe long-term variations in CHD incidence and air pollution. Spearman rank correlation was used to analyze the association of air pollutant concentration with CHD and in different lag months (lag 0 for the month of delivery and lag 12 for 12-month before delivery). Generalized Poisson addition model was used to assess effects of air pollutants on CHD incidence.
      Results  Totally 2 098 CHD incidents were reported, accounting for 18.7% of the total birth defects reported in Xi′an city during the period. The annual CHD incidence rate increased from 73.3 /10 000 in 2010 to 150.5/10 000 in 2015. The multiple pollutants model analysis revealed that an increased SO2 of 10 μg/m3 during early pregnancy was correlated with a 48.5% increased risk of CHD in the newborns after adjusting for NO2, PM10, and PM2.5 (relative risk = 1.485, 95% confidence interval: 1.441 – 1.530); the analysis results also demonstrated that increased NO2 and PM10 were probably related to CHD incidence after adjusting for other air pollutants; but the analysis showed no significant impact of PM2.5 on CHD incidence.
      Conclusion  The incidence rate of congenital heart disease is increasing generally in Xi′an city and the increase may be related to ambient air pollution. Exposure to SO2 during the first trimester of pregnancy may increase the risk of congenital heart disease.

     

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