Hajat Shakoor, Bird William, Haines Andy
London School of Hygiene and Tropical Medicine, London WCIE 7HT, UK.
Eur J Epidemiol. 2004;19(10):959-68. doi: 10.1007/s10654-004-5731-4.
Cold weather is associated with increases in mortality and demands on hospital services in the UK, particularly by the elderly. Less is known about the relationship with patterns of consultation in primary care. We wished to determine the magnitude and consistency of associations between cold temperature and consultations for respiratory conditions in primary care settings at different sites in the UK.
Time series analysis of any short-term effects of temperature on daily general practitioner (GP) consultations made by elderly people (65+ years) for lower and upper respiratory tract infections (LRTI, URTI) over a 10-year period, 1992--2001. Practices were situated in 16 urban locations across the UK where a Met Office monitoring station was in operation.
An association between low temperatures and an increase in LRTI consultations was observed in all 16 locations studied. The biggest increase was estimated for the Norwich practices for which a 19.0% increase in LRTI consultations (95% CI 13.6, 24.7) was associated with every 1 degrees C drop in mean temperature below 5 degrees C observed 0-20 days before the day of consultation. Slightly weaker relationships were observed in the case of URTI consultations. A north/south gradient, with larger temperature effects in the north, was in evidence for both LRTI and URTI consultations.
An effect that was consistent and generally strongest in populations in the north was observed between cold temperature and respiratory consultations. Better understanding of the mechanisms by which cold weather is associated with increases in consultations for respiratory infections could lead to improved strategies for prevention and reduced burdens for health services.
在英国,寒冷天气与死亡率上升以及医院服务需求增加有关,尤其是对老年人而言。人们对寒冷天气与基层医疗咨询模式之间的关系了解较少。我们希望确定在英国不同地点的基层医疗环境中,低温与呼吸道疾病咨询之间关联的程度和一致性。
对1992年至2001年期间,温度对老年人(65岁及以上)因下呼吸道感染(LRTI)和上呼吸道感染(URTI)进行的每日全科医生(GP)咨询的任何短期影响进行时间序列分析。这些医疗机构位于英国16个有气象局监测站运行的城市地区。
在所研究的所有16个地点均观察到低温与LRTI咨询增加之间存在关联。诺维奇的医疗机构预计增幅最大,在咨询日之前0至20天观察到平均温度每低于5摄氏度1摄氏度,LRTI咨询就会增加19.0%(95%置信区间13.6, 24.7)。在URTI咨询方面观察到的关系略弱。对于LRTI和URTI咨询,均存在南北梯度差异,北方的温度影响更大。
在低温与呼吸道疾病咨询之间观察到一种在北方人群中一致且通常最强的效应。更好地理解寒冷天气与呼吸道感染咨询增加之间的关联机制,可能会带来更好的预防策略并减轻卫生服务负担。