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2020年中国大气臭氧对慢性阻塞性肺病死亡影响的疾病负担分析和健康经济学评价

夏永杰 周璐 牛越 陈仁杰 阚海东

夏永杰, 周璐, 牛越, 陈仁杰, 阚海东. 2020年中国大气臭氧对慢性阻塞性肺病死亡影响的疾病负担分析和健康经济学评价[J]. 环境科学研究, 2023, 36(2): 237-245. doi: 10.13198/j.issn.1001-6929.2023.01.05
引用本文: 夏永杰, 周璐, 牛越, 陈仁杰, 阚海东. 2020年中国大气臭氧对慢性阻塞性肺病死亡影响的疾病负担分析和健康经济学评价[J]. 环境科学研究, 2023, 36(2): 237-245. doi: 10.13198/j.issn.1001-6929.2023.01.05
XIA Yongjie, ZHOU Lu, NIU Yue, CHEN Renjie, KAN Haidong. COPD Mortality Burden and Related Health Economic Assessment Associated Related with to Ambient Ozone in 2020 in China[J]. Research of Environmental Sciences, 2023, 36(2): 237-245. doi: 10.13198/j.issn.1001-6929.2023.01.05
Citation: XIA Yongjie, ZHOU Lu, NIU Yue, CHEN Renjie, KAN Haidong. COPD Mortality Burden and Related Health Economic Assessment Associated Related with to Ambient Ozone in 2020 in China[J]. Research of Environmental Sciences, 2023, 36(2): 237-245. doi: 10.13198/j.issn.1001-6929.2023.01.05
【PM2.5与臭氧协同控制专题】编者按:目前,PM2.5和臭氧已成为影响我国环境空气质量的主要污染物. 2021年3月,第十三届全国人民代表大会第四次会议批准了《中华人民共和国国民经济和社会发展第十四个五年规划和2035年远景目标纲要》,该纲要明确提出要加强城市大气质量达标管理,推进PM2.5与臭氧协同控制. 2021年11月,中共中央、国务院印发《关于深入打好污染防治攻坚战的意见》,明确要求到2025年,臭氧浓度增长趋势得到有效遏制,实现PM2.5与臭氧协同控制. 2022年11月生态环境部等15部门联合印发《深入打好重污染天气消除、臭氧污染防治和柴油货车污染治理攻坚战行动方案》,提出到2025年,全国重度及以上污染天气基本消除,PM2.5与臭氧协同控制取得积极成效,臭氧浓度增长趋势得到有效遏制等目标. 因此,PM2.5与臭氧的协同控制成为我国“十四五”时期大气污染防治的一项重要任务. PM2.5与臭氧之间具有复杂的关联性,使得二者的协同控制具有复杂性与艰巨性,亟需加强有效的科学指导. 近期,众多学者在PM2.5与臭氧协同控制的理论探索与区域实践方面开展了大量工作,并取得了一定的成果. 鉴于此,本刊特开设“PM2.5与臭氧协同控制”专题,计划在“十四五”期间持续刊发该领域研究成果,助力PM2.5与臭氧协同控制科学研究成果的推广应用. 本刊已于2022年第3期刊发了本专题第1期11篇文章,受到广泛关注. 本期专题经严格的同行评议后,共刊发9篇文章,内容涵盖臭氧的人体健康影响、PM2.5与臭氧复合污染特征及影响因素、PM2.5与臭氧共同前体物挥发性有机物特征分析及管控对策、PM2.5与臭氧协同控制路径等方面,以期能引起学界的深入思考与探讨.

2020年中国大气臭氧对慢性阻塞性肺病死亡影响的疾病负担分析和健康经济学评价

doi: 10.13198/j.issn.1001-6929.2023.01.05
基金项目: 国家自然科学基金项目(No.82030103)
详细信息
    作者简介:

    夏永杰(1983-),女,黑龙江望奎县人,实验师,博士,主要从事空气污染对人体健康影响研究,xiayongjie@fudan.edu.cn

    通讯作者:

    阚海东(1974-),男,江苏盐城人,教授,博士,博导,主要从事环境流行病学研究,kanh@fudan.edu.cn

  • 中图分类号: X511;R122.2

COPD Mortality Burden and Related Health Economic Assessment Associated Related with to Ambient Ozone in 2020 in China

Funds: National Natural Science Foundation of China (No.82030103)
  • 摘要: 大气臭氧暴露对人群慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)的影响不断加剧. 为评价大气臭氧暴露对COPD的不良影响,量化与大气臭氧暴露相关的COPD死亡负担以及相应的健康经济损失,本研究收集了2020年我国31个省(自治区、直辖市)臭氧浓度高峰季(4—9月)数据、社会经济及人口数据,基于已有研究中确立的大气臭氧暴露与COPD死亡的暴露-反应关系,以世界卫生组织2021年提出的臭氧浓度高峰季平均值(60 µg/m3)为参考,分别估算我国大气臭氧暴露的COPD归因死亡人数和经济损失. 结果表明:① 2020年我国大气臭氧暴露的COPD总死亡风险比为1.12〔95%CI (95%置信区间)为1.00~1.21〕. ② 2020年我国大气臭氧暴露的COPD归因死亡人数为10.12×104人(95%CI为0.00~17.49×104人). ③ 2020年我国大气臭氧暴露造成的COPD的健康经济损失为2 131×108元,占GDP的0.21%. 研究显示,2020年我国大气臭氧暴露造成了较大的COPD疾病负担和经济损失,在气候变化和控制碳排放政策实施背景下,为达到世界卫生组织2021年提出的臭氧浓度高峰季平均值(60 µg/m3)的目标,我国仍需因地制宜地制定相关政策降低臭氧浓度,积极应对大气臭氧暴露对人群健康的危害.

     

  • 表  1  2020年我国31个省(自治区、直辖市)人口、经济及大气臭氧浓度高峰季数据的基本信息

    Table  1.   Basic information on population,economy and data of ambient ozone concentration during peak-season in 31 provinces,autonomous regions and municipalities of China in 2020

    省份人口数/(104人)死亡率/‰人均年收入/(104元)生产总值/(1011元)大气臭氧浓度
    高峰季平均值/(µg/m3)
    统计生命
    价值/(104元)
    北京市2 1895.196.9436.10132.45445.96
    天津市1 3875.924.3914.08134.20281.67
    河北省7 4647.222.7136.21132.64174.29
    山西省3 4907.022.5217.65130.26161.95
    内蒙古自治区2 4037.303.1517.36106.82202.30
    辽宁省4 2558.593.2725.11108.65210.27
    吉林省2 3997.812.5812.3193.99165.40
    黑龙江省3 1718.232.4913.7078.50159.94
    上海市2 4885.587.2238.70113.23463.94
    江苏省8 4776.494.34102.72120.31278.69
    浙江省6 4686.565.2464.61108.42336.54
    安徽省6 1057.962.8138.68114.97180.50
    福建省4 1616.243.7243.9091.28238.95
    江西省4 5196.612.8025.6998.09179.95
    山东省10 1657.253.2973.13132.73211.22
    河南省9 9417.152.4855.00129.58159.35
    湖北省5 7457.672.7943.44105.21179.07
    湖南省6 6457.922.9441.7887.70188.70
    广东省12 6244.704.10110.7686.42263.52
    广西壮族自治区5 0196.462.4622.1677.82157.76
    海南省1 0125.852.795.5356.89179.23
    重庆市3 2097.703.0825.0092.21197.98
    四川省8 3718.482.6548.6091.84170.35
    贵州省3 8587.172.1817.8373.30139.99
    云南省4 7227.922.3324.5272.46149.62
    西藏自治区3665.372.171.9084.01139.66
    陕西省3 9557.112.6226.18107.85168.45
    甘肃省2 5017.912.039.02108.19130.61
    青海省5936.652.403.01105.49154.39
    宁夏回族自治区7215.882.573.92113.38165.29
    新疆维吾尔自治区2 5905.462.3813.8096.09153.15
    合计141 2127.073.221 015.99102.74206.75
    下载: 导出CSV

    表  2  2020年我国31个省(自治区、直辖市)大气臭氧暴露的COPD死亡风险比

    Table  2.   Hazard ratios associated with ambient ozone in 31 provinces,autonomous regions and municipalities of Chinain 2020

    省份COPD死亡风险比
    数值95%置信区间
    北京市1.191.00~1.19
    天津市1.200.99~1.29
    河北省1.200.99~1.29
    山西省1.191.00~1.19
    内蒙古自治区1.131.00~1.13
    辽宁省1.131.00~1.13
    吉林省1.090.99~1.99
    黑龙江省1.051.00~1.05
    上海市1.141.00~1.14
    江苏省1.161.00~1.16
    浙江省1.131.00~1.13
    安徽省1.151.00~1.15
    福建省1.080.99~1.98
    江西省1.100.99~1.19
    山东省1.200.99~1.29
    河南省1.191.00~1.19
    湖北省1.121.00~1.12
    湖南省1.080.99~1.98
    广东省1.070.99~1.97
    广西壮族自治区1.051.00~1.05
    海南省0.991.00~0.99
    重庆市1.090.99~1.99
    四川省1.090.99~1.99
    贵州省1.041.00~1.04
    云南省1.031.00~1.03
    西藏自治区1.061.00~1.06
    陕西省1.131.00~1.13
    甘肃省1.131.00~1.13
    青海省1.121.00~1.12
    宁夏回族自治区1.141.00~1.14
    新疆维吾尔自治区1.100.99~1.19
    全国1.121.00~1.12
    下载: 导出CSV

    表  3  2020年我国31个省(自治区、直辖市)归因于大气臭氧暴露的COPD死亡人数

    Table  3.   Attributable number of COPD deaths due to ambient ozone in 31 provinces,autonomous regions and municipalities of China in 2020

    省份归因于大气臭氧暴露的COPD死亡人数/(104人)
    数值95%置信区间
    北京市0.180~0.30
    天津市0.130~0.22
    河北省0.860~1.42
    山西省0.380~0.63
    内蒙古自治区0.190~0.33
    辽宁省0.420~0.71
    吉林省0.150~0.27
    黑龙江省0.120~0.23
    上海市0.170~0.29
    江苏省0.750~1.26
    浙江省0.470~0.81
    安徽省0.610~1.04
    福建省0.200~0.35
    江西省0.270~047
    山东省1.180~1.95
    河南省1.100~1.82
    湖北省0.470~0.80
    湖南省0.360~0.64
    广东省0.380~0.68
    广西壮族自治区0.150~0.27
    海南省<0.0011)<0.001
    重庆市0.190~0.34
    四川省0.550~0.97
    贵州省0.090~0.17
    云南省0.110~0.21
    西藏自治区0.010~0.02
    陕西省0.310~0.54
    甘肃省0.220~0.38
    青海省0.040~0.07
    宁夏回族自治区0.050~0.09
    新疆维吾尔自治区0.120~0.21
    合计10.120~17.49
    注:1)海南省的总死亡小于0.001×104人,未纳入健康经济损失计算.
    下载: 导出CSV

    表  4  2020 年我国31个省(自治区、直辖市)大气臭氧暴露导致的COPD健康经济损失及其占GDP的比例

    Table  4.   Health economic loss and its proportion of local GDP due to ambient ozone exposure in 31 provinces,autonomous regions and municipalities of China in 2020

    省份大气臭氧暴露导致的COPD健康经济损失
    数值/(108元)占GDP比重/%
    北京市80.32(0.00~132.54)0.22
    天津市37.51(0.00~61.72)0.27
    河北省150.63(0.00~248.19)0.42
    山西省61.43(0.00~101.67)0.35
    内蒙古自治区38.92(0.00~66.83)0.22
    辽宁省87.47(0.00~149.67)0.35
    吉林省25.38(0.00~44.60)0.21
    黑龙江省19.84(0.00~35.92)0.14
    上海市78.53(0.00~133.49)0.20
    江苏省208.20(0.00~349.90)0.20
    浙江省159.57(0.00~273.52)0.25
    安徽省110.47(0.00~187.15)0.29
    福建省46.67(0.00~82.50)0.11
    江西省48.72(0.00~84.99)0.19
    山东省249.63(0.00~411.33)0.34
    河南省175.36(0.00~290.23)0.32
    湖北省83.26(0.00~143.46)0.19
    湖南省67.99(0.00~120.87)0.16
    广东省99.90(0.00~178.29)0.09
    广西壮族自治区23.09(0.00~41.89)0.10
    海南省
    重庆市37.89(0.00~66.85)0.15
    四川省93.67(0.00~165.25)0.19
    贵州省12.79(0.00~23.45)0.07
    云南省17.10(0.00~31.43)0.07
    西藏自治区1.63(0.00~2.92)0.09
    陕西省52.93(0.00~90.73)0.20
    甘肃省28.87(0.00~49.49)0.32
    青海省6.42(0.00~11.07)0.21
    宁夏回族自治区8.54(0.00~14.52)0.22
    新疆维吾尔自治区18.69(0.00~32.72)0.14
    合计2 131.43(0.00~7 243.08)0.21
    注:括号中数值为COPD健康经济损失的95%置信区间. 海南省未纳入健康经济损失计算.
    下载: 导出CSV
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  • 收稿日期:  2022-10-09
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