热浪对居民循环系统疾病死亡影响的病例交叉研究
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摘要
目的探讨浙江省嘉兴市热浪对居民循环系统疾病日死亡人数的影响。方法本研究中热浪定义为日最高温度不低于35℃,且持续不少于3 d。采用时间分层的病例交叉设计方法,调整每日平均气温、降水量、平均风速、平均气压和空气污染指数建立条件Poisson回归模型,分析嘉兴市2008~2011年热浪与居民循环系统疾病死亡的关系,并分析滞后效应。结果 2008~2011年共出现6次热浪。滞后2 d时热浪对循环系统疾病死亡数影响的效应值最大,RR值为1.342(95%CI:1.081~1.667)。热浪对≥65岁老年人在滞后2 d时RR值最大,为1.296(95%CI:1.027~1.636),对女性在滞后2 d时RR值最大,为1.407(95%CI:1.021~1.937)。结论热浪会增加循环系统疾病死亡风险,且存在滞后效应;≥65岁老年人和女性为脆弱人群。
Objective To estimate the impact of heatwave on daily death from cardiovascular diseases( CVD) in Jiaxing City,Zhejiang Province,China. Methods The definition of heatwave was a period at least 3 consecutive days with maximum temperature exceeding 35 ℃ in this study. Multivariate conditional Poisson regression models were applied to examine the heatwave-death association using the relative risk( RR) while adjusting for meteorological and air pollution factors including daily average temperature,average rainfall,average wind speed,average pressure and air pollution index. The impacts were analyzed by using time-stratified case-crossover design based on relevant data from2008 to 2011 in Jiaxing City. The RR of different risk period was calculated to definite lag effects. Results Six heatwaves happened during the study period. The largest effect of the heatwave-CVD association was 1. 342( 95% CI: 1.081-1. 667) at the 2 lag day. The risk of deaths from CVD among people ≥65 years old( RR = 1. 296,95% CI: 1.027-1. 636) and female( RR = 1. 407,95%CI: 1. 021-1. 937) increased at the 2 lag day. Conclusion Heatwave has impacts on the daily deaths caused by CVD and there are lagged effects. People at risk are female and people ≥65.
Objective To estimate the impact of heatwave on daily death from cardiovascular diseases( CVD) in Jiaxing City,Zhejiang Province,China. Methods The definition of heatwave was a period at least 3 consecutive days with maximum temperature exceeding 35 ℃ in this study. Multivariate conditional Poisson regression models were applied to examine the heatwave-death association using the relative risk( RR) while adjusting for meteorological and air pollution factors including daily average temperature,average rainfall,average wind speed,average pressure and air pollution index. The impacts were analyzed by using time-stratified case-crossover design based on relevant data from2008 to 2011 in Jiaxing City. The RR of different risk period was calculated to definite lag effects. Results Six heatwaves happened during the study period. The largest effect of the heatwave-CVD association was 1. 342( 95% CI: 1.081-1. 667) at the 2 lag day. The risk of deaths from CVD among people ≥65 years old( RR = 1. 296,95% CI: 1.027-1. 636) and female( RR = 1. 407,95%CI: 1. 021-1. 937) increased at the 2 lag day. Conclusion Heatwave has impacts on the daily deaths caused by CVD and there are lagged effects. People at risk are female and people ≥65.
引文
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[19]张霞,周脉耕,黄季夏,等.济南市热浪对居民非意外死亡的影响研究[J].华南预防医学,2014,40(4):327-332.ZHANG Xia,ZHOU M aigeng,HUANG Jixia,et al.Impact of heat w ave on non-accidental mortality of local residents in Jinan[J].South China J Prev M ed,2014,40(4):327-332.
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[24]Son JY,Lee JT,Anderson GB,et al.The impact of heat w aves on mortality in seven major cities in Korea[J].Environ Health Perspect,2012,120(4):566-571.
[25]Watts N,Amann M,Ayeb-Karlsson S,et al.The Lancet Countdow n on health and climate change:from 25years of inaction to a global transformation for public health[J].Lancet,2018,391(10120):581-630.
[26]周磊磊,丁国永,周玉兰,等.巢湖市温度与居民心血管疾病死亡人数的时间序列分析[J].环境与健康杂志,2014,31(5):398-401.ZHOU Leilei,DING Guoyong,ZHOU Yulan,et al.Time-series analysis on daily mortality of cardiovascular disease affected by temperature in Chaohu[J].J Environ Health,2014,31(5):398-401.
[27]吴俊,周连,徐斌,等.大气PM10污染与心脑血管疾病死亡的病例交叉研究[J].环境与健康杂志,2014,31(7):569-571.WU Jun,ZHOU Lian,XU Bin,et al.Air particulate matter pollution and cardio-cerebrovascular diseases death:a case-crossover study[J].J Environ Health,2014,31(7):569-571.
[2]董思言,高学杰.长期气候变化—IPCC第五次评估报告解读[J].气候变化研究进展,2014,10(1):56-59.DONG Siyan,GAO Xuejie.Long-term climate change:interpretation of IPPC fifth assessment report[J].Advances in Clamate Change Research,2014,10(1):56-59.
[3]秦大河,Thomas Stocker.IPCC第五次评估报告第一工作组报告的亮点结论[J].气候变化研究进展,2014,10(1):1-6.QIN Dahe,Thomas Stocker.Highlights of the IPCC w orking group I fifth assessment report[J].Advances in Clamate Change Research,2014,10(1):1-6.
[4]沈永平,王国亚.IPCC第一工作组第五次评估报告对全球气候变化认知的最新科学要点[J].冰川冻土,2013,35(5):1068-1076.SHEN Yongping,WANG Guoya.Key fingdings and assessment results of IPCC WGI fifth assessment report[J].Journal of Glaciology and Geocryology,2013,35(5):1068-1076.
[5]陈敏,耿福海,马雷鸣,等.近138年上海地区高温热浪事件分析[J].高原气象,2013,32(2):597-607.CHEN M in,GENG Fuhai,M A Leiming,et al.Analyses on the heat w ave events in Shanghai in recent 138 years[J].Plateau Meteorology,2013,32(2):597-607.
[6]Ye DX,Yin JF,Chen ZH,et al.Spatial and temporal variations of heat w aves in China from 1961 to 2010[J].Advances in Climate Change Research,2014,5(2):66-73.
[7]扈海波,熊亚军.城市极端高温灾害研究综述[J].气象科技进展,2015,5(1):18-22.HU Haibo,XIONG Yajun.A research summary of extreme heat w ave[J].Advances in M et S&T,2015,5(1):18-22.
[8]Lubczyńska MJ,Christophi CA,Lelieveld J.Heat-related cardiovascular mortality risk in Cyprus:a case-crossover study using a distributed lag non-linear model[J].Environ Health,2015,14:39.doi:10.1186/s12940-015-0025-8.
[9]Basaga1a X,Sartini C,Barrera-Gómez J,et al.Heat w aves and cause-specific mortality at all ages[J].Epidemiology,2011,22(6):765.
[10]Wang XY,Barnett AG,YU W,et al.The impact of heatw aves on mortality and emergency hospital admissions from non-external causes in Brisbane,Australia[J].Occup Environ Med,2012,69(3):163-169.
[11]Phung D,Chu C,Rutherford S,et al.Heatwave and risk of hospitalization:a multi-province study in Vietnam[J].Environ Pollut,2017,220(Pt A):597-607.
[12]Gronlund CJ,Zanobetti A,Schwartz JD,et al.Heat,heat w aves,and hospital admissions among the elderly in the United States,1992-2006[J].Environ Health Perspect,2014,122(11):1187-1192.
[13]刘玲,张金良.热浪与非意外死亡和呼吸系统疾病死亡的病例交叉研究[J].环境与健康杂志,2010,27(2):95-99.LIU Ling,ZHANG Jinliang.Relationship betw een heat w aves and daily death from non-accidental death and respiratory disease:a case-crossover study[J].J Environ Health,2010,27(2):95-99.
[14]Yang Jun,Liu Huazhang,Ou Chunquan,et al.Impact of heat w ave in 2005 on mortality in Guangzhou,China[J].Biomed Environ Sci,2013,26(8):647-654.
[15]Huang Wei,Kan Haidong,Kovats Sari.The impact of the 2003 heat w ave on mortality in Shanghai,China[J].Science of the Total Environment,2010,408(11):2418-2420.
[16]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.HAN Jing,ZHANG Jun,ZHOU Lin,et al.Impact of extreme temperatures on cardiovascular deaths in Jinan[J].Journal of Shandong University(Health Science),2017,55(11):71-74.
[17]Maclure M.The case-crossover design:a method for studying transient effects on the risk of acute events[J].Am J Epidemiol,1991,133(2):144-153.
[18]Armstrong BG,Gasparrini A,Tobias A.Conditional Poisson models:a flexible alternative to conditional logistic case cross-over analysis[J].BMC Med Res Methodol,2014,14:122.doi:10.1186/1471-2288-14-122.
[19]张霞,周脉耕,黄季夏,等.济南市热浪对居民非意外死亡的影响研究[J].华南预防医学,2014,40(4):327-332.ZHANG Xia,ZHOU M aigeng,HUANG Jixia,et al.Impact of heat w ave on non-accidental mortality of local residents in Jinan[J].South China J Prev M ed,2014,40(4):327-332.
[20]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.WU Fan,JING Yuanshu,LI Xueyuan,et al.Effect of heat w ave in the death-toll of cardiovascular diseases in Nanjing area[J].Journal of Environmental Hygiene,2013,3(4):288-292.
[21]曾韦霖.广东四地区热浪对死亡的影响及热浪特点的效应修饰作用[D].广州:暨南大学,2013.
[22]Ma WJ,Zeng WL,Zhou MG,et al.The short-term effect of heat waves on mortality and its modifiers in China:an analysis from 66 communities[J].Environ Int,2015,75:103-109.doi:10.1016/j.envint.2014.11.004.
[23]Huang ZJ,Lin HL,Liu YN,et al.Individual-level and community-level effect modifiers of the temperature-mortality relationship in 66 Chinese communities[J].BM J Open,2015,5(9):e009172.doi:10.1136/bmjopen-2015-009172.
[24]Son JY,Lee JT,Anderson GB,et al.The impact of heat w aves on mortality in seven major cities in Korea[J].Environ Health Perspect,2012,120(4):566-571.
[25]Watts N,Amann M,Ayeb-Karlsson S,et al.The Lancet Countdow n on health and climate change:from 25years of inaction to a global transformation for public health[J].Lancet,2018,391(10120):581-630.
[26]周磊磊,丁国永,周玉兰,等.巢湖市温度与居民心血管疾病死亡人数的时间序列分析[J].环境与健康杂志,2014,31(5):398-401.ZHOU Leilei,DING Guoyong,ZHOU Yulan,et al.Time-series analysis on daily mortality of cardiovascular disease affected by temperature in Chaohu[J].J Environ Health,2014,31(5):398-401.
[27]吴俊,周连,徐斌,等.大气PM10污染与心脑血管疾病死亡的病例交叉研究[J].环境与健康杂志,2014,31(7):569-571.WU Jun,ZHOU Lian,XU Bin,et al.Air particulate matter pollution and cardio-cerebrovascular diseases death:a case-crossover study[J].J Environ Health,2014,31(7):569-571.