文章摘要
李静,罗书全,丁贤彬,杨军,李京,刘小波,高景宏,许磊,唐文革,刘起勇.重庆市逐日温度对人群死亡及寿命损失年影响的研究[J].中华流行病学杂志,2016,37(3):375-380
重庆市逐日温度对人群死亡及寿命损失年影响的研究
Influence of daily ambient temperature on mortality and years of life lost in Chongqing
收稿日期:2015-08-07  出版日期:2016-03-15
DOI:10.3760/cma.j.issn.0254-6450.2016.03.017
中文关键词: 温度;死亡率;寿命损失年;分布滞后非线性模型
英文关键词: Temperature;Mortality;Years of life lost;Distributed lag non-linear model
基金项目:国家重点基础研究发展计划(973计划)(2012CB955504);传染病预防控制国家重点实验室项目(2014SKLID106)
作者单位E-mail
李静 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室  
罗书全 400042 重庆市疾病预防控制中心  
丁贤彬 400042 重庆市疾病预防控制中心  
杨军 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室  
李京 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室
250012 济南, 山东大学公共卫生学院 
 
刘小波 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室  
高景宏 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室  
许磊 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室  
唐文革 400042 重庆市疾病预防控制中心 twg@cqcdc.org 
刘起勇 102206 北京, 中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室 liuqiyong@icdc.cn 
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中文摘要:
      目的 量化逐日温度对重庆市人群死亡率及寿命损失年(YLL)的影响。方法 利用2010-2013年重庆市主城区全人群死亡个案资料,结合同期气象及空气污染资料,采用分布滞后非线性模型(DLNM)拟合逐日平均气温与逐日死亡数及逐日YLL的关系,分析高温和低温对不同疾病别、不同人群死亡率及YLL的累积滞后效应。结果 日均气温与非意外、心血管系统及呼吸系统疾病死亡的日死亡数和日YLL呈"U"或"W"形。高温当日可增加人群死亡风险,累积滞后效应在第7天时达到最大,持续2周;低温滞后1周后才表现出危害效应,持续时间长达30 d。高温时,日均气温每升高1 ℃,人群非意外、呼吸系统和心血管系统疾病死亡的7 d累积相对危险度(CRR)分别为1.05(95%CI:1.03~1.07)、1.08(95%CI:1.05~1.11)、1.05(95%CI:1.01~1.09),YLL分别为23.81(95%CI:12.31~35.31)年、14.34(95%CI:8.98~19.70)年、4.43(95%CI:1.64~7.21)年;低温时,日均气温每降低1 ℃,人群非意外死亡、呼吸系统和心血管系统疾病死亡的14 d CRR分别为1.06(95%CI:1.04~1.08)、1.09(95%CI:1.06~1.12)、1.06(95%CI:1.02~1.11);YLL分别为23.34(95%CI: 10.04~36.64)年、16.39(95%CI:10.19~22.59)年、2.61(95%CI:-0.61~5.82)年。高温和低温对≥65岁年龄组的影响明显大于<65岁年龄组。高温时,女性死亡率大于男性,男性的YLL大于女性;低温时,女性的死亡率和YLL均大于男性。结论 重庆市高温和低温均可增加人群的死亡风险和YLL,≥65岁年龄组的人群更敏感, 高温对年轻男性影响较大,低温对女性和老年男性影响较大,应有针对性保护极端温度敏感人群。
英文摘要:
      Objective To evaluate the influence of extreme ambient temperature on mortality and years of life lost (YLL) in Chongqing. Methods The daily mortality, meteorology and air pollution index data in Chongqing from the 1st January 2010 to the 31st December 2013 were collected. Distributed lag non-linear model (DLNM) was used to assess the influence of daily ambient temperature on daily number of deaths and daily YLL respectively. The delayed and cumulative effects of extreme temperature on sex, age, and cause-specific mortality were also assessed. Results The relationships between ambient temperature and non-accidental, cardiovascular disease and respiratory disease mortalities and YLL were U-shaped or W-shaped. The effect of heat was obvious on that day, peaked on day 7, and lasted for two weeks, whereas the effect of cold was obvious a week later and lasted for a month. As 1 ℃ increase of ambient temperature, the cumulative relative risks (CRR) of high temperature across lag 0-7 days on non-accidental, respiratory disease and cardiovascular disease mortalities were 1.05 (95%CI: 1.03-1.07), 1.08(95%CI: 1.05-1.11) and 1.05 (95%CI: 1.01-1.09) respectively. The effects of heat on YLL for each cause were 23.81(95%CI: 12.31-35.31), 14.34(95%CI: 8.98-19.70) and 4.43(95%CI: 1.64-7.21), respectively. On cold days, 1 ℃ decrease of ambient temperature was correlated with an increase in CRR of 1.06 (95%CI: 1.04-1.08), 1.09(95%CI:1.06-1.12) and 1.06(95%CI: 1.02-1.11) from lag 0 to 14 for non-accidental, respiratory disease and cardiovascular disease mortalities, respectively. The estimated YLL were 23.34(95%CI: 10.04-36.64), 16.39(95%CI: 10.19-22.59) and 2.61(95%CI: -0.61-5.82). People aged ≥65 years tend to have higher CRR and YLL than those aged <65 years. On high temperature days, the CRR in women was higher than that in men, while the YLL in women was lower than that in men. On low temperature days, both the CRR and YLL in women were higher than those in men. Conclusions Both high and low ambient temperature have adverse health effects. People aged ≥65 years are more sensitive to both high and low ambient temperature. Younger men are more sensitive to high ambient temperature and women and elder men are sensitive to low ambient temperature. It is necessary to take targeted measures to protect the population in Chongqing from the adverse influence of extreme ambient temperature.
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