【摘要】 目的：探究超细颗粒物及不同粒径范围颗粒物短期暴露对儿童肺炎发病风险的影响。方法：从首都医科大学附属北京儿童医院、中日友好医院收集2015—2020年0～14岁儿童肺炎急诊数据。通过固定监测站点监测同期空气动力学直径5～560 nm的大气颗粒物数浓度(PNC)以及常规大气污染物浓度。采用时间分层的病例交叉对照研究设计和条件logistic回归模型分析颗粒物短期暴露与儿童肺炎发病风险的关联，并根据年龄、性别、就诊季节进行分层分析。结果：5～560 nm粒径范围颗粒物短期暴露会导致0～14岁儿童肺炎发病风险上升。粒径5～25、25～100、100～560 nm的颗粒物及超细颗粒物累积滞后0～7 d暴露浓度每升高四分位数间距(IQR)，儿童肺炎发病风险分别上升11.3%[OR=1.113,95%CI(1.063,1.164)]、21.8%[OR=1.218,95%CI(1.159,1.280)]、7.0%[OR=1.070,95%CI(1.037,1.104)]、20.0%[OR=1.200,95%CI(1.143,1.260)]。分层分析结果显示，在冷季超细颗粒物对儿童的肺炎发病风险影响更明显，其累积滞后0～7 d暴露浓度每升高四分位间距，肺炎发病风险上升24.2%[OR=1.242,95%CI(1.178,1.309)]。结论：5～560 nm粒径大气颗粒物，特别是超细粒径尺度颗粒物短期暴露会增加城市地区儿童肺炎的发病风险。更多还原

【Abstract】 OBJECTIVE: To investigate association between short-term exposure to size-specific ultrafine particles and risk of pediatric pneumonia. METHODS:Data between 2015—2020 were collected on emergency visits for pneumonia in children aged 0～14 years from Beijing Children’s Hospital and China-Japan Friendship Hospital. Concurrent monitoring of particle number concentrations(PNC) in size fractions of 5-560 nm,conventional air pollutants, and meteorological data from fixed monitoring stations were collected. A time-stratified case-crossover study design and conditional logistic regression models were used to analyze associations between the exposure and pediatric emergency visits, with stratified analyses by age,gender,and season of visit. RESULTS:The short-term exposures were associated with increased risk of emergency visits for pneumonia in the children. An interquartile range(IQR) increment in PNC5-25, PNC25-100, PNC100-560, and UFP exposure in the cumulative lag 0～7 days was associated with increased risks of emergency visits for pneumonia of 11.3% [OR=1.113,95% CI(1.063,1.164)],21.8%[OR=1.218,95% CI(1.159,1.280)],7.0% [OR=1.070,95% CI(1.037,1.104)],and 20.0% [OR=1.200,95%CI(1.143,1.260)],respectively. Stratified analysis showed that the effect of ambient particles on risk of the emergency visits was more pronounced during the cold season. For every interquartile range increase in the cumulative lag 0～7 days exposure concentration,the risk of pneumonia emergency visits rises by 24.2% [OR=1.242, 95% CI(1.178, 1.309)]. CONCLUSION: Short-term exposure to ambient particles in size fractions of 5-560 nm, particularly ultrafine particles, was associated with increased risk of pediatric pneumonia in urban area.更多还原