Abstract
李萌萌,周脉耕,张霞,黄季夏,白莉,桑少伟,张济,刘起勇.济南市4 个区气温对非意外死亡及死因别死亡的影响[J].Chinese journal of Epidemiology,2014,35(6):684-688
济南市4 个区气温对非意外死亡及死因别死亡的影响
Impact of temperature on non-accidental deaths and cause-specific mortality in four districts of Jinan
Received:January 02, 2014  
DOI：
KeyWord: 气温  非意外死亡  死因别死亡  分布滞后非线性模型
English Key Word: Temperature  Non-accidental death  Cause-specific mortality  Distributed lag non-linear model
FundProject:国家重大科学研究计划（973 计划）（2012CB955504）
Author NameAffiliationE-mail
Li Mengmeng ###############################################################################################################################################################################################################################################################  
Zhou Maigeng National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention  
Zhang Xia National Institute for Communicable Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention  
Huang Jixia State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences  
Bai Li National Institute for Communicable Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention  
Sang Shaowei National Institute for Communicable Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention  
Zhang Ji Jinan Center for Disease Control and Prevention  
Liu Qiyong National Institute for Communicable Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention liuqiyong@icdc.cn 
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Abstract:
      目的 研究气温与济南市4 个区居民日均非意外死亡的关系，探讨气温在不同滞后天数下对各死因别死亡的影响。方法 收集济南市4 个区（市中、槐荫、天桥、历下）2008 年1 月至2012 年12 月死亡资料，以及同期气温数据和空气污染指数（API）数据，采用分布滞后非线性模型，控制长期趋势和季节效应以及其他混杂因素后，研究气温与非意外死亡的关系以及在不同滞后天数时气温对心血管疾病、呼吸系统疾病、消化系统疾病、泌尿系统疾病及部分亚类（高血压病、缺血性心脏病、急性心肌梗死、脑血管病、慢性下呼吸道疾病）的影响。结果 济南市4 个区气温与非意外死亡的暴露-反应曲线为“W”形;低温的滞后天数较长，累计效应可达1 个月，高温的滞后天数较短，不超过5 d，且呈现出收获效应;心血管疾病、呼吸系统疾病、缺血性心脏病、脑血管病、急性心肌梗死存在热效应，高温当天的RR 值分别为1.12（95%CI：1.07～1.17）、1.06（95%CI：1.02～1.31）、1.08（95%CI：1.003～1.16）、1.10（95%CI：1.02～1.20）、1.13（95%CI：1.003～1.26），滞后期较短，泌尿系统疾病和高血压病在极高温时有较高的RR 值，分别为2.30（95%CI：1.18～4.51）、1.65（95%CI：1.02～2.69）;其中心血管疾病、呼吸系统疾病、慢性下呼吸道疾病、高血压、缺血性心脏病、脑血管病、急性心肌梗死均呈现出一定的冷效应，30 d 滞后的累计效应分别为1.51（95%CI：1.42～1.60）、1.90（95%CI：1.64～2.20）、2.12（95%CI：1.67～2.69）、1.48（95%CI：1.08～2.03）、1.60（95%CI：1.46～1.75）、1.40（95%CI：1.26～1.55）、1.68（95%CI：1.45～1.95）。结论 气温与济南市4个区居民的非意外死亡及各死因别死亡存在关系，温度过高或过低均是其危险因素，在高温或低温期间需针对敏感疾病采取相应的预防措施。
English Abstract:
      Objective To study the relationship between daily temperature and non-accidental deaths in four districts of Jinan，and to investigate the impact of temperature on cause-specific mortality. Methods Data on daily mortality of the four districts（Shizhong，Huaiyin，Tianqiao，Lixia） as well as data related to meteorology and air pollution index were collected from January 1，2008 to December 31，2012. Distributed lag non-linear model（DLNM）was then used to assess the effects of temperature on all non-accidental deaths and deaths caused by cardiovascular diseases （CVD）， respiratory diseases（RD），digestive diseases，urinary diseases，and also subcategories to hypertension， ischemic heart diseases（IHD），acute myocardial infarction（AMI），cerebro-vascular diseases（CBD） and chronic lower respiratory diseases. Results A W-shaped relationship was noticed between daily average temperature and non-accidental deaths. The effect of low temperature last for more than 30 days，much longer than that of high temperature，in which presented a harvesting effect less than 5 days. As to the cause-specific mortality，short-term heat effects were seen in CVD and RD as well as related subgroups as IHD，CBD and AMI，with RRs at lag 0 as 1.12（95%CI：1.07-1.17），1.06 （95% CI：1.02-1.31），1.08（95% CI：1.003-1.16），1.10（95% CI：1.02-1.20） and 1.13 （95% CI： 1.003-1.26）. Relatively higher RRs were seen in urinary diseases and hypertension under extremely high temperature，reaching as high as 2.30（95%CI：1.18-4.51）and 1.65（95%CI：1.02-2.69）. Cold weather presented a delayed effect for 30 days，with cumulative RRs as 1.51（95%CI：1.42-1.60），1.90 （95%CI：1.64-2.20），2.12（95%CI：1.67-2.69），1.48（95%CI：1.08-2.03），1.60（95%CI：1.46-1.75）， 1.40（95%CI：1.26-1.55），1.68（95%CI：1.45-1.95）for CVD，RD，chronic lower respiratory diseases， hypertension，IHD，CBD and AMI，on sequence. Conclusion A relationship was seen between daily temperature and non-accidental deaths as well as cause-specific mortality. Either high or low temperature seemed to be detrimental. Related measures on disease prevention should be taken during the cold and hot seasons.
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