Ostro Bart D, Roth Lindsey A, Green Rochelle S, Basu Rupa
Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th Floor, Oakland, CA 94612, USA.
Environ Res. 2009 Jul;109(5):614-9. doi: 10.1016/j.envres.2009.03.010. Epub 2009 Apr 25.
As a result of the California heat wave in July 2006, county coroners reported that the high temperatures during that period caused approximately 147 deaths. However, heat wave-related deaths are likely to be underreported due to a lack of a clear case definition and the multi-factorial nature of heat-related mortality. Public health policy suggests a need for a careful assessment of mortality following a heat wave. In addition, it is useful to provide a comparison of the mortality impact per degree change during heat waves versus high temperatures observed during non-heat wave periods.
Daily data were collected for mortality, weather and ozone in seven California counties impacted by the July 2006 heat wave. The association between apparent temperature and daily mortality was assessed using a Poisson regression model and combined across counties in a meta-analysis. These results were then used to estimate the increases in the number of deaths during the heat wave.
Our analysis indicated that during the July heat wave, there was a 9% (95% CI = 1.6, 16.3) increase in daily mortality per 10 degrees Fahrenheit (F) change in apparent temperature for all counties combined. This estimate is almost 3 times larger than the effect estimated for the full warm season of May-September, during the non-heat wave years. Our estimates also determined that actual mortality during the July 2006 heat wave was 2-3 times greater than the coroner estimates.
This multi-county analysis provides additional evidence that the attributable risk of mortality following a heat wave may be underestimated by examining only direct heat-related deaths. In addition, we have found that the mortality effect per degrees F is several times higher than that reported during non-heat wave periods.
由于2006年7月加利福尼亚州的热浪,县验尸官报告称,该时期的高温导致了约147人死亡。然而,由于缺乏明确的病例定义以及与热相关死亡率的多因素性质,与热浪相关的死亡人数可能被低估。公共卫生政策表明需要对热浪后的死亡率进行仔细评估。此外,比较热浪期间每度变化的死亡率影响与非热浪期间观测到的高温下的死亡率影响是有用的。
收集了受2006年7月热浪影响的加利福尼亚州7个县的死亡率、天气和臭氧的每日数据。使用泊松回归模型评估体感温度与每日死亡率之间的关联,并在荟萃分析中跨县合并这些结果。然后使用这些结果来估计热浪期间死亡人数的增加。
我们的分析表明,在7月的热浪期间,所有县合并后,体感温度每升高10华氏度(°F),每日死亡率增加9%(95%置信区间 = 1.6,16.3)。这个估计值几乎是非热浪年份5月至9月整个温暖季节估计效应的3倍。我们的估计还确定,2006年7月热浪期间的实际死亡率比验尸官的估计值高2至3倍。
这项多县分析提供了额外的证据,表明仅检查与热直接相关的死亡可能会低估热浪后死亡率的归因风险。此外,我们发现每华氏度的死亡率影响比非热浪期间报告的高出几倍。