高雄市空氣汙染物粗懸浮微粒與心血管疾病住院關係之研究

Short-term effects of coarse particulate air pollution on hospital admissions for cardiovascular diseases in Kaohsiung

10.6832/KMU.2015.00053

陳映辰

細懸浮微粒 ； 粗懸浮微粒 ； 自我病例對照法 ； 心血管疾病 ； 醫院住院 ； fine particulate ； coarse particulate ； case crossover ； cardiovascular diseases ； hospital admissions

高雄醫學大學職能治療學系碩士在職專班學位論文

2015年

碩士

楊俊毓

繁體中文

中文摘要 本研究之主要目的在探討台灣高雄市粗懸浮微粒(PM2.5-10)濃度與心血管疾病住院率的相關。心血管疾病包括缺血性心臟病、中風、充血性心衰竭及心律不整。研究期間為2006年至2010年，住院資料取自健保資料庫住院檔，空氣汙染物資料取自環保署網站。本研究以自我病例對照研究設計，此研究設計控制星期的每日效應、季節性及長期趨勢效應。在單汙染物模式(沒有對其他汙染物進行校正)中發現，在冷天(小於攝氏25度)，粗懸浮微粒的濃度越高，則心血管疾病住院率有顯著的增加，當PM2.5-10的濃度每增加10μg/m3時則缺血性心臟病的住院率增加3%(95%CI=2%-4%)，當PM2.5-10的濃度每增加10μg/m3時則中風的住院率增加5%(95%CI=4%-6%)，PM2.5-10的濃度每增加10μg/m3時則充血性心衰竭住院率增加3%(95%CI=1%-6%)，PM2.5-10的濃度每增加10μg/m3時則心律不整的住院率增加3%(95%CI=0%-6%)。在暖天(大於攝氏25度)，粗懸浮微粒和心血管疾病醫院住院率之間沒有觀察到顯著地相關。在冷天雙汙染物模式中，控制SO2、NO2、CO或O3，PM2.5-10與心血管疾病住院率仍保持正相關。與PM2.5濃度每增加10μg/m3所造成的影響相比，粗懸浮微粒濃度每增加10μg/m3對心血管相關疾病住院所造成的影響估計值是較弱的。本篇研究提供當PM2.5-10濃度越高則心血管疾病住院率的風險也會增加的證據。

Abstract This study was undertaken to determine whether there was an association between coarse particles (PM2.5-10) levels and frequency of hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions for CVD including ischemic heart disease (IHD), stroke, congestive heart failure (CHF), and arrhythmias, and ambient air pollution data levels for Kaohsiung were obtained for the period from 2006-2010. The relative risk of hospital admissions for CVD was estimated using a case crossover approach, controlling for weather variables, day of the week, seasonality, and long term time trends. For the single pollutant model (without adjustment for other pollutants), increased rate of admissions for CVD were significantly associated with higher coarse PM levels only on cool days (< 250 C), with a 10 ug/m3 elevation in PM2.5-10 concentrations associated with a 3% (95% CI=2%-4%) rise in IHD admissions, 5% (95% CI=4%-6%) increase in stroke admissions, 3% (95% CI=1%-6%) elevation in CHF admissions, and 3% (95% CI=0%-6%) rise in arrhythmias admissions. No significant associations were found between coarse particle levels and number of hospital admissions for CVD on warm days. In the two-pollutant models, PM2.5-10 levels remained significantly correlated with higher rate of CVD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. Compared to effect estimate associated with a 10 ug/m3 increase in PM2.5 levels, effect estimates of frequency of CVD-related admissions associated with a 10 ug/m3 rise in coarse PM levels were weaker. This study provides evidence that higher levels of PM2.5-10 enhance the risk of hospital admissions for CVD.