Analitis A, Katsouyanni K, Biggeri A, Baccini M, Forsberg B, Bisanti L, Kirchmayer U, Ballester F, Cadum E, Goodman P G, Hojs A, Sunyer J, Tiittanen P, Michelozzi P
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece.
Am J Epidemiol. 2008 Dec 15;168(12):1397-408. doi: 10.1093/aje/kwn266. Epub 2008 Oct 24.
Weather-related health effects have attracted renewed interest because of the observed and predicted climate change. The authors studied the short-term effects of cold weather on mortality in 15 European cities. The effects of minimum apparent temperature on cause- and age-specific daily mortality were assessed for the cold season (October-March) by using data from 1990-2000. For city-specific analysis, the authors used Poisson regression and distributed lag models, controlling for potential confounders. Meta-regression models summarized the results and explored heterogeneity. A 1 degrees C decrease in temperature was associated with a 1.35% (95% confidence interval (CI): 1.16, 1.53) increase in the daily number of total natural deaths and a 1.72% (95% CI: 1.44, 2.01), 3.30% (95% CI: 2.61, 3.99), and 1.25% (95% CI: 0.77, 1.73) increase in cardiovascular, respiratory, and cerebrovascular deaths, respectively. The increase was greater for the older age groups. The cold effect was found to be greater in warmer (southern) cities and persisted up to 23 days, with no evidence of mortality displacement. Cold-related mortality is an important public health problem across Europe. It should not be underestimated by public health authorities because of the recent focus on heat-wave episodes.
由于已观察到的和预测的气候变化，与天气相关的健康影响重新引起了人们的关注。作者研究了寒冷天气对15个欧洲城市死亡率的短期影响。利用1990年至2000年的数据，评估了寒冷季节（10月至次年3月）最低体感温度对特定病因和特定年龄每日死亡率的影响。对于特定城市的分析，作者使用了泊松回归和分布滞后模型，并对潜在的混杂因素进行了控制。元回归模型总结了结果并探讨了异质性。温度每降低1摄氏度，自然死亡总数的每日数量增加1.35%（95%置信区间（CI）：1.16，1.53），心血管疾病、呼吸系统疾病和脑血管疾病死亡人数分别增加1.72%（95%CI：1.44，2.01）、3.30%（95%CI：2.61，3.99）和1.25%（95%CI：0.77，1.73）。年龄较大的群体增加幅度更大。在较温暖（南部）的城市中，寒冷效应更为明显，且持续长达23天，没有死亡替代的迹象。与寒冷相关的死亡率是整个欧洲的一个重要公共卫生问题。公共卫生当局不应因其近期对热浪事件的关注而低估这一问题。
