热带气旋与医院门诊呼吸系统疾病日就诊量的病例交叉研究
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摘要
目的探讨2012~2013年浙江省沿海地区热带气旋对医院门诊呼吸系统疾病日就诊量的影响。方法使用时间分层的病例交叉研究,控制气象因素的混杂作用,以Poisson回归模型分析浙江省苍南县2012~2013年夏季(7~10月)热带气旋与医院门诊呼吸系统疾病日就诊量的关系,并按性别、年龄进行分层分析。结果在热带气旋影响期,全人群、男性和女性的呼吸系统疾病发病风险均上升,分别在滞后第3、4、6天达到最大值。<15岁人群呼吸系统疾病发病风险上升,在滞后第6天达到最大值(RR=1.298,95%CI:1.016~1.658)。热带气旋对15~65岁人群及>65岁人群的呼吸系统疾病发病影响无统计学意义(P>0.05)。结论热带气旋可增加呼吸系统疾病的发病风险且存在滞后效应,<15岁人群为易感人群。
Objective To explore the impacts of tropical cyclones on the daily outpatient numbers of respiratory diseases in the coastal area of Zhejiang Province in 2012 and 2013. Methods Time-stratified case-crossover study was used to explore the relationship between tropical cyclones and the daily outpatient numbers of respiratory diseases from July to October in 2012 and 2013 in Cangnan County,Zhejiang Province. Poisson regression model was used to control meteorological factors and conduct the statistical analysis. Stratified analysis by gender and age was conducted. Results In the tropical cyclone period,the risk of respiratory diseases increased to a maximum on the 3 rd,4 th,and 6 th lag days among all population,males,and females,respectively. The risk of respiratory diseases increased to a maximum on the6 th lag day among population aged < 15 years old( RR = 1. 298,95% CI: 1. 016 ～ 1. 658). There was no statistically significant relationship between tropical cyclones and respiratory diseases among population aged from 15 to 65 years old and population aged > 65 years old( P > 0. 05). Conclusion The tropical cyclone may increase the risk of respiratory diseases and there are lagged effects. The population aged < 15 years old is more vulnerable.
Objective To explore the impacts of tropical cyclones on the daily outpatient numbers of respiratory diseases in the coastal area of Zhejiang Province in 2012 and 2013. Methods Time-stratified case-crossover study was used to explore the relationship between tropical cyclones and the daily outpatient numbers of respiratory diseases from July to October in 2012 and 2013 in Cangnan County,Zhejiang Province. Poisson regression model was used to control meteorological factors and conduct the statistical analysis. Stratified analysis by gender and age was conducted. Results In the tropical cyclone period,the risk of respiratory diseases increased to a maximum on the 3 rd,4 th,and 6 th lag days among all population,males,and females,respectively. The risk of respiratory diseases increased to a maximum on the6 th lag day among population aged < 15 years old( RR = 1. 298,95% CI: 1. 016 ～ 1. 658). There was no statistically significant relationship between tropical cyclones and respiratory diseases among population aged from 15 to 65 years old and population aged > 65 years old( P > 0. 05). Conclusion The tropical cyclone may increase the risk of respiratory diseases and there are lagged effects. The population aged < 15 years old is more vulnerable.
引文
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[2]Wang X,Chen B,Sun D,et al.Study on typhoon characteristic based on bridge health monitoring system[J].Scientific World Journal,2014,2014:204675.doi:10.1155/2014/204675.
[3]姜丽萍,王玉玲,伍晓莹.台风灾害引发疾病特征及救护需求分析[J].中国公共卫生,2011,27(10):1322-1323.JIANG Liping,WANG Yuling,WU Xiaoying.Epidemics of disease and needs for emergency rescue after typhoon disaster[J].Chinese Journal of Public Health,2011,27(10):1322-1323.
[4]Yang Q,Yang Z,Ding H,et al.The relationship betw een meteorological factors and mumps incidence in Guangzhou,China,2005-2012[J].Hum Vaccin,2014,10(8):2421-2432.
[5]Ko WC,Cheung BM,Tang HJ,et al.Melioidosis outbreak after typhoon,southern Taiw an[J].Emerg Infect Dis,2007,13(6):896-898.
[6]Su HP,Chan TC,Chang CC.Typhoon-related leptospirosis andmelioidosis,Taiw an,2009[J].Emerg Infect Dis,2011,17(7):1322-1324.
[7]Bissell RA.Delayed-impact infectious disease after a natural disaster.[J].J Emerg M ed,1983,1(1):59-66.
[8]Gautam S,Menachem J,Srivastav SK,et al.Effect of Hurricane Katrina on the incidence of acute coronary syndrome at a primary angioplasty center in New Orleans.[J].Disaster Med Public Health Prep,2009,3(3):144.
[9]Jiao Z,Kakoulides SV,Moscona J,et al.Effect of Hurricane Katrina on incidence of acute myocardial infarction in New Orleans three years after the storm[J]Am J Cardiol,2012,109(4):502-505.
[10]Miller AC,Arquilla B.Chronic diseases and natural hazards:impact of disasters on diabetic,renal,and cardiac patients[J].Prehosp Disaster M ed,2008,23(2):185-194.
[11]Cefalu WT,Smith SR,Blonde L,et al.The Hurricane Katrina aftermath and its impact on diabetes care:observations from“ground zero”:lessons in disaster preparedness of people w ith diabetes[J].Diabetes Care,2006,29(1):158-160.
[12]Lacasse Y,Martin S,Lasserson TJ,et al.Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease.A Cochrane systematic review[J].Eura M edicophys,2007,43(4):475-485.
[13]中华人民共和国卫生部.2010中国卫生统计年鉴[M].北京:中国协和医科大学出版社,2010.
[14]Pawankar R,Baena-Cagnani CE,Bousquet J,et al.State of w orld allergy report 2008:allergy and chronic respiratory diseases[J].World Allergy Organ J,2008,1(Suppl 1):S1.doi:10.1097/1939-4551-1-S1-S1.
[15]杨道余,王映辉,朱善冰,等.浙江省苍南县沿海居民台风灾害意识及认知水平调查[J].上海预防医学,2011,23(12):640-642.
[16]中国气象局.热带气旋年鉴2012[M].北京:气象出版社,2014.
[17]中国气象局.热带气旋年鉴2013[M].北京:气象出版社,2015.
[18]张彩霞,刘志东,张斐斐,等.时间分层病例交叉研究的R软件实现[J].中国卫生统计,2016,33(3):507-509.
[19]许浩恩,陈海燕,赵璐.浙江影响热带气旋的几个统计特征[J].浙江气象,2009,30(2):4-8.
[20]Home C.Morbidity surveillance after hurricane KatrinaArkansas,Louisiana,M ississippi,and Texas,September 2005[J].M orb M ortal Wkly Rep,2006,55(26):727-731.
[21]Keim ME.Building human resilience:the role of public health preparedness and response as an adaptation to climate change[J].Am J Prev M ed,2008,35(5):508-516.
[22]Tu HM,Chen HM.Slopeland hazard and respiratory health:the example of typhoon M orakot in Taiw an[J].Landscape&Urban Planning,2017,157:375-382.doi:10.1016/j.landurbplan.2016.08.008.
[23]Jaf VL,Gil CJ,Abello JE,et al.The impact of typhoon Haiyan on admissions in tw o hospitals in Eastern Visayas,Philippines[J].PLo S One,2018,13(1):e0191516.doi:10.1371/journal.pone.0191516.
[24]Savage E,Christian MD,Smith S,et al.The canadian armed forces medical response to Typhoon Haiyan[J].Can J Surg,2015,58(3):S146-152.
[25]车薇,沈丹,刘元明,等.海燕台风后菲律宾某灾区疾病谱分析[J].中华灾害救援医学,2015,3(4):189-191.CHE Wei,SHEN Dan,LIU Yuanming,et al.Analysis on the spectrum of diseases during medical relief after typhoon Haiyan in Philippines[J].Chinese Journal of Disaster M edicine,2015,3(4):189-191.
[26]王洪新.兰州市气象因素对居民健康影响的研究[D].兰州:兰州大学,2013.
[27]王莹,周林,韩京,等.2011~2015年济南市居民呼吸系统疾病死亡流行病学特征分析[J].现代预防医学,2017,44(3):389-392.WANG Ying,ZHOU Lin,HAN Jing,et al.Epidemiological characteristics of respiratory disease mortality in residents of Jinan,2011-2015[J].M odern Preventive M edicine,2017,44(3):389-392.
[28]Wang SL,Guo XB.Study on the effects of ambient air pollution on respiratory disease and symptoms among school-age children in Beijing[J].Journal of Environment&Health,2004,21(1):41-44.
[29]Jalaludin B,Morgan G,Lincoln D,et al.Associations betw een ambient on air pollution and daily emergency department presentations for respiratory disease and cardiovascular disease in the elderly(65+Years),Sydney,Australia:Isee-546[J].Epidemiology,2003,14(5):S107.
[30]邓霞君,蔡振群,项晓美,等.浙江省空气质量及主要气象因子的影响分析[J].环境科学与技术,2014,37(120):372-377.DENG Xiajun,CAI Zhenqun,XIANG Xiaomei,et al.Air quality in Zhejiang province and the impact of main meteorological elements[J].Environmental Science&Technology,2014,37(120):372-377.