McMichael Anthony J, Wilkinson Paul, Kovats R Sari, Pattenden Sam, Hajat Shakoor, Armstrong Ben, Vajanapoom Nitaya, Niciu Emilia M, Mahomed Hassan, Kingkeow Chamnong, Kosnik Mitja, O'Neill Marie S, Romieu Isabelle, Ramirez-Aguilar Matiana, Barreto Mauricio L, Gouveia Nelson, Nikiforov Bojidar
National Centre for Epidemiology and Population Health, The Australian National University College of Medicine and Health Sciences, Canberra, Australia.
Int J Epidemiol. 2008 Oct;37(5):1121-31. doi: 10.1093/ije/dyn086. Epub 2008 Jun 3.
This study describes heat- and cold-related mortality in 12 urban populations in low- and middle-income countries, thereby extending knowledge of how diverse populations, in non-OECD countries, respond to temperature extremes.
The cities were: Delhi, Monterrey, Mexico City, Chiang Mai, Bangkok, Salvador, São Paulo, Santiago, Cape Town, Ljubljana, Bucharest and Sofia. For each city, daily mortality was examined in relation to ambient temperature using autoregressive Poisson models (2- to 5-year series) adjusted for season, relative humidity, air pollution, day of week and public holidays.
Most cities showed a U-shaped temperature-mortality relationship, with clear evidence of increasing death rates at colder temperatures in all cities except Ljubljana, Salvador and Delhi and with increasing heat in all cities except Chiang Mai and Cape Town. Estimates of the temperature threshold below which cold-related mortality began to increase ranged from 15 degrees C to 29 degrees C; the threshold for heat-related deaths ranged from 16 degrees C to 31 degrees C. Heat thresholds were generally higher in cities with warmer climates, while cold thresholds were unrelated to climate.
Urban populations, in diverse geographic settings, experience increases in mortality due to both high and low temperatures. The effects of heat and cold vary depending on climate and non-climate factors such as the population disease profile and age structure. Although such populations will undergo some adaptation to increasing temperatures, many are likely to have substantial vulnerability to climate change. Additional research is needed to elucidate vulnerability within populations.
本研究描述了低收入和中等收入国家12个城市人口中与高温和低温相关的死亡率，从而拓展了关于非经合组织国家不同人群如何应对极端温度的认识。
这些城市分别是：德里、蒙特雷、墨西哥城、清迈、曼谷、萨尔瓦多、圣保罗、圣地亚哥、开普敦、卢布尔雅那、布加勒斯特和索非亚。对于每个城市，使用自回归泊松模型（2至5年序列），针对季节、相对湿度、空气污染、星期几和公共假日进行调整，研究每日死亡率与环境温度的关系。
大多数城市呈现出U型温度-死亡率关系，除卢布尔雅那、萨尔瓦多和德里外，所有城市在低温时死亡率明显上升的证据确凿；除清迈和开普敦外，所有城市在高温时死亡率也上升。与低温相关死亡率开始上升的温度阈值估计范围为15摄氏度至29摄氏度；与高温相关死亡的阈值范围为16摄氏度至31摄氏度。气候较温暖城市的高温阈值通常更高，而低温阈值与气候无关。
不同地理环境下的城市人口，因高温和低温都会经历死亡率上升。高温和低温的影响因气候以及人口疾病状况和年龄结构等非气候因素而异。尽管这些人群会对气温上升进行一定程度的适应，但许多人可能对气候变化仍有很大的脆弱性。需要进一步研究以阐明人群中的脆弱性。
