浙江省台州市极端高温和低温对心脑血管疾病死亡的影响分析
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摘要
目的调查浙江省台州市气温与心脑血管疾病死亡率间关系。方法收集2014年1月1日至2016年12月31日台州市心血管疾病(CVD)和脑血管疾病(CBD)数据,使用具有对数关联和泊松误差的分布滞后非线性模型(DLNM)来分析温度对CVD和CBD死亡率及其相关滞后结构的影响。结果 CBD和CVD的温度–死亡率曲线相似,均呈U形。CBD的冷热阈值分别为12℃和25℃,CVD的冷热阈值分别为12℃和26℃。随着滞后天数增加,寒冷累积效应逐渐增加,CBD(RR=1.068,95%CI:1.052~1.084)和CVD(RR=1.111,95%CI:1.078~1.145)的滞后效应峰值出现在滞后27 d(Lag0~27)。CBD(RR=1.017,95%CI:1.004~1.030)和CVD(RR=1.036,95%CI:1.012~1.061)的高温效应均在滞后当天(Lag0)出现峰值。结论极端高温和低温均与台州市心脑血管疾病死亡率增加有关,其中低温影响有很长的滞后期,而高温影响则较短。
Objective To understand the association between air temperature and cardio and cerebrovascular disease mortality in the urban area of Taizhou, Zhejiang province. Methods Poisson regression model in a distributed lag nonlinear model framework was used to analyze the effect of air temperature on mortality rates of cardiovascular disease(CVD) and cerebrovascular disease(CBD) and related lag effects. Results U-shaped curves on relationships between air temperature and the mortality rates of CBD and CVD were observed. The cold and heat thresholds were 12 °C and 25 °C for CBD, 12 °C and26 °C for CVD, respectively. The cold effects increased gradually with the lag days. The peak of cold effects appeared on lag0–27 days for CBD(RR=1.068, 95% CI: 1.052–1.084) and CVD(RR=1.111, 95% CI: 1.078–1.145). As for heat effects, the peak was observed on the current day(lag 0) for CBD(RR=1.017, 95% CI: 1.004–1.030) and CVD(RR=1.036, 95% CI:1.012–1.061). Conclusion Both extreme high air temperature and low air temperature are associated with an increased risk of cardio and cerebrovascular mortality in the urban area of Taizhou. The effect of heat is immediate while the effect of cold has longer time lags.
Objective To understand the association between air temperature and cardio and cerebrovascular disease mortality in the urban area of Taizhou, Zhejiang province. Methods Poisson regression model in a distributed lag nonlinear model framework was used to analyze the effect of air temperature on mortality rates of cardiovascular disease(CVD) and cerebrovascular disease(CBD) and related lag effects. Results U-shaped curves on relationships between air temperature and the mortality rates of CBD and CVD were observed. The cold and heat thresholds were 12 °C and 25 °C for CBD, 12 °C and26 °C for CVD, respectively. The cold effects increased gradually with the lag days. The peak of cold effects appeared on lag0–27 days for CBD(RR=1.068, 95% CI: 1.052–1.084) and CVD(RR=1.111, 95% CI: 1.078–1.145). As for heat effects, the peak was observed on the current day(lag 0) for CBD(RR=1.017, 95% CI: 1.004–1.030) and CVD(RR=1.036, 95% CI:1.012–1.061). Conclusion Both extreme high air temperature and low air temperature are associated with an increased risk of cardio and cerebrovascular mortality in the urban area of Taizhou. The effect of heat is immediate while the effect of cold has longer time lags.
引文
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[18]韩京,张军,周林,等.极端气温对济南市心脑血管疾病死亡的影响[J].山东大学学报:医学版,2017,55(11):71-74.DOI:10.6040/j.issn.1671-7554.0.2016.1009.Han J,Zhang J,Zhou L,et al.Impact of extreme temperatures on cardiovascular deaths in Jinan city[J].J Shandong Univ,2017,55(11):71-74.DOI:10.6040/j.issn.1671-7554.0.2016.1009.
[2]Chung JY,Honda Y,Hong YC,et al.Ambient temperature and mortality:An international study in four capital cities of East Asia[J].Sci Total Environ,2009,408(2):390-396.DOI:10.1016/j.scitotenv.2009.09.009.
[3]Huang JX,Wang JF,Yu WW.The lag effects and vulnerabilities of temperature effects on cardiovascular disease mortality in a subtropical climate zone in China[J].Int J Environ Res Public Health,2014,11(4):3982-3994.DOI:10.3390/ijerph110403982.
[4]Mills D,Schwartz J,Lee M,et al.Climate change impacts on extreme temperature mortality in select metropolitan areas in the United States[J].Climatic Change,2015,131(1):83-95.DOI:10.1007/s10584-014-1154-8.
[5]吴凡,景元书,李雪源,等.南京地区高温热浪对心脑血管疾病日死亡人数的影响[J].环境卫生学杂志,2013,3(4):288-292.DOI:10.13421/j.cnki.hjwsxzz.2013.04.005.Wu F,Jing YS,Li XY,et al.Effect of heat wave on the death-toll of cardiovascular diseases in Nanjing Area[J].J Environ Hyg,2013,3(4):288-292.DOI:10.13421/j.cnki.hjwsxzz.2013.04.005.
[6]Wu W,Xiao YZ,Li GC,et al.Temperature-mortality relationshipin four subtropical Chinese cities:a time-series study using a distributed lag non-linear model[J].Sci Total Environ,2013,449 :355-362.DOI:10.1016/j.scitotenv.2013.01.090.
[7]Gasparrini A,Armstrong B,Kenward MG.Distributed lag nonlinear models[J].Stat Med,2017,29(21):2224-2234.DOI:10.1002/sim.3940.
[8]Yu WW,Vaneckova P,Mengersen K,et al.Is the association between temperature and mortality modified by age,gender and socio-economic status?[J].Sci Total Environ,2010,408(17):3513-3518.DOI:10.1016/j.scitotenv.2010.04.058.
[9]de Freitas CR,Grigorieva EA.Role of acclimatization in weatherrelated human mortality during the transition seasons of autumn and spring in a thermally extreme mid-latitude continental climate[J].Int J Environ Res Public Health,2015,12(12):14974-14987.DOI:10.3390/ijerph121214962.
[10]Chollett I,Müller-Karger FE,Heron SF,et al.Seasonal and spatial heterogeneity of recent sea surface temperature trends in the Caribbean Sea and southeast Gulf of Mexico[J].Mar Pollut Bull,2012,64(5):956-965.DOI:10.1016/j.marpolbul.2012.02.016.
[11]Tian ZX,Li SS,Zhang JL,et al.The characteristic of heat wave effects on coronary heart disease mortality in Beijing,China:a time series study[J].PLo S One,2013,8(9):e77321.DOI:10.1371/journal.pone.0077321.
[12]孙兴国.人体的血液循环系统功能是如何调控的?[J].中国循环杂志,2015,30(Suppl 1):146.DOI:10.3969/j.issn.1000-3614.2015.z1.401.Sun XG.How does the function of the blood circulation system be regulated by the human body?[J].Chin Circulation Magazine,2015,30(Suppl 1):146.DOI:10.3969/j.issn.1000-3614.2015.z1.401.
[13]Neuberger M,Moshammer H,Rabczenko D.Acute and subacute effects of urban air pollution on cardiopulmonary emergencies and mortality:time series studies in Austrian cities[J].Int J Environ Res Public Health,2013,10(10):4728-4751.DOI:10.3390/ijerph10104728.
[14]Guo YM,Barnett AG,Pan XC,et al.The impact of temperature on mortality in Tianjin,China:a case-crossover design with a distributed lag nonlinear model[J].Environ Health Perspect,2011,119(12):1719-1725.DOI:10.1289/ehp.1103598.
[15]Lin YK,Ho TJ,Wang YC.Mortality risk associated with temperature and prolonged temperature extremes in elderly populations in Taiwan[J].Environ Res,2011,111(8):1156-1163.DOI:10.1016/j.envres.2011.06.008.
[16]Curriero FC,Heiner KS,Samet JM,et al.Temperature and mortality in 11 cities of the eastern United States[J].Am JEpidemiol,2002,155(1):80-87.DOI:10.1093/aje/155.1.80.
[17]Liu L,Breitner S,Pan X,et al.Associations between air temperature and cardio-respiratory mortality in the urban area of Beijing,China:a time-series analysis[J].Environ Health,2011,10:51.DOI:10.1186/1476-069X-10-51.
[18]韩京,张军,周林,等.极端气温对济南市心脑血管疾病死亡的影响[J].山东大学学报:医学版,2017,55(11):71-74.DOI:10.6040/j.issn.1671-7554.0.2016.1009.Han J,Zhang J,Zhou L,et al.Impact of extreme temperatures on cardiovascular deaths in Jinan city[J].J Shandong Univ,2017,55(11):71-74.DOI:10.6040/j.issn.1671-7554.0.2016.1009.
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