Michelozzi Paola, Accetta Gabriele, De Sario Manuela, D'Ippoliti Daniela, Marino Claudia, Baccini Michela, Biggeri Annibale, Anderson H Ross, Katsouyanni Klea, Ballester Ferran, Bisanti Luigi, Cadum Ennio, Forsberg Bertil, Forastiere Francesco, Goodman Patrick G, Hojs Ana, Kirchmayer Ursula, Medina Sylvia, Paldy Anna, Schindler Christian, Sunyer Jordi, Perucci Carlo A
Department of Epidemiology Local Health Authority Rome E, Rome, Italy.
Am J Respir Crit Care Med. 2009 Mar 1;179(5):383-9. doi: 10.1164/rccm.200802-217OC. Epub 2008 Dec 5.
Episode analyses of heat waves have documented a comparatively higher impact on mortality than on morbidity (hospital admissions) in European cities. The evidence from daily time series studies is scarce and inconsistent.
To evaluate the impact of high environmental temperatures on hospital admissions during April to September in 12 European cities participating in the Assessment and Prevention of Acute Health Effects of Weather Conditions in Europe (PHEWE) project.
For each city, time series analysis was used to model the relationship between maximum apparent temperature (lag 0-3 days) and daily hospital admissions for cardiovascular, cerebrovascular, and respiratory causes by age (all ages, 65-74 age group, and 75+ age group), and the city-specific estimates were pooled for two geographical groupings of cities.
For respiratory admissions, there was a positive association that was heterogeneous between cities. For a 1 degrees C increase in maximum apparent temperature above a threshold, respiratory admissions increased by +4.5% (95% confidence interval, 1.9-7.3) and +3.1% (95% confidence interval, 0.8-5.5) in the 75+ age group in Mediterranean and North-Continental cities, respectively. In contrast, the association between temperature and cardiovascular and cerebrovascular admissions tended to be negative and did not reach statistical significance.
High temperatures have a specific impact on respiratory admissions, particularly in the elderly population, but the underlying mechanisms are poorly understood. Why high temperature increases cardiovascular mortality but not cardiovascular admissions is also unclear. The impact of extreme heat events on respiratory admissions is expected to increase in European cities as a result of global warming and progressive population aging.
热浪事件分析表明，在欧洲城市，热浪对死亡率的影响相对高于对发病率（住院率）的影响。来自每日时间序列研究的证据稀少且不一致。
评估参与欧洲天气状况对急性健康影响评估与预防（PHEWE）项目的12个欧洲城市4月至9月期间高环境温度对住院率的影响。
对于每个城市，采用时间序列分析来建立最高体感温度（滞后0 - 3天）与按年龄（所有年龄、65 - 74岁年龄组和75岁及以上年龄组）划分的心血管、脑血管和呼吸道病因的每日住院率之间的关系，并将特定城市的估计值汇总为两个城市地理分组。
对于呼吸道疾病住院率，存在正相关关系，且各城市之间存在异质性。在地中海城市和北大陆城市75岁及以上年龄组中，最高体感温度高于阈值每升高1℃，呼吸道疾病住院率分别增加 +4.5%（95%置信区间，1.9 - 7.3）和 +3.1%（95%置信区间，0.8 - 5.5）。相比之下，温度与心血管和脑血管疾病住院率之间的关联往往为负，且未达到统计学显著性。
高温对呼吸道疾病住院率有特定影响，尤其是在老年人群中，但潜在机制尚不清楚。高温为何会增加心血管疾病死亡率但不增加心血管疾病住院率也不清楚。由于全球变暖和人口老龄化加剧，预计极端高温事件对欧洲城市呼吸道疾病住院率的影响将会增加。
