Simón F, Lopez-Abente G, Ballester E, Martínez F
Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Spain.
Euro Surveill. 2005 Jul;10(7):156-61.
The effect of the elevated temperatures on mortality experienced in Europe during the summer of 2003 was observed in several countries. This study, carried out in Spain, describes mortality between 1 June and 31 August and evaluates the effect of the heat wave on mortality. Observed deaths were obtained from official death registers from 50 provincial capitals. Observed deaths were compared with the expected number, estimated by applying a Poisson regression model to historical mortality series and adjusting for the upward trend and seasonality observed. Meteorological information was provided by the Instituto Nacional de Meteorologia (National Institute of Meteorology). Spain experienced three heat waves in 2003. The total associated excess deaths were 8% (43 212 observed deaths compared with 40 046 expected deaths). Excess deaths were only observed in those aged 75 years and over (15% more deaths than expected for the age group 75 to 84 and 29% for those aged 85 or over). This phenomenon (heat-associated excess mortality) is an emerging public health problem because of its increasing attributable risk, the aging of the Spanish population and its forecasted increasing frequency due to global warming. The implementation of alert and response systems based on monitoring of climate-related risks, emergency room activity and mortality, and strengthening the response capacity of the social and health services should be considered.
2003年夏季欧洲经历高温对死亡率的影响在多个国家得到了观测。这项在西班牙开展的研究描述了6月1日至8月31日期间的死亡率，并评估了热浪对死亡率的影响。观测到的死亡数据来自50个省会城市的官方死亡登记册。将观测到的死亡人数与预期人数进行比较，预期人数是通过对历史死亡率序列应用泊松回归模型并针对观测到的上升趋势和季节性进行调整后估算得出的。气象信息由西班牙国家气象局提供。西班牙在2003年经历了三次热浪。总的相关超额死亡人数为8%（观测到43212例死亡，而预期死亡人数为40046例）。超额死亡仅在75岁及以上人群中观测到（75至84岁年龄组的死亡人数比预期多15%，85岁及以上人群则多29%）。由于其归因风险不断增加、西班牙人口老龄化以及预计因全球变暖导致其发生频率上升，这种现象（与高温相关的超额死亡率）正成为一个新出现的公共卫生问题。应考虑基于对气候相关风险、急诊室活动和死亡率的监测来实施警报和应对系统，并加强社会和卫生服务的应对能力。
