Regional Agency for Environmental Protection of Emilia-Romagna, Regional Center for Environment and Health, Modena, Italy.
Environ Res. 2011 Nov;111(8):1192-200. doi: 10.1016/j.envres.2011.07.005. Epub 2011 Aug 3.
Increases in mortality associated with oppressive weather have been widely investigated in several epidemiological studies. However, to properly understand the full public health significance of heat-related health effects, as well as to develop an effective surveillance system, it is also important to investigate the impact of stressful meteorological conditions on non-fatal events. The objective of our study was to evaluate the exposure-response relationship of ambulance dispatch data in association with biometeorological conditions using time series techniques similar to those used in previous studies on mortality.
Daily data of emergency ambulance dispatches for people aged 35 or older in the summer periods from 2002 to 2006 were collected for the major towns in the Emilia-Romagna region. In the first stage of the analysis, the city-specific relationship between daily ambulance dispatches and increasing apparent temperature was explored using Generalized Additive Models while controlling for air pollution, seasonality, long-term trend, holidays and weekends. The relationship between ambulance dispatches and apparent temperature was approximated by linear splines. The effects of high temperatures on health were evaluated for respiratory and cardiovascular diseases as well as for all non-traumatic conditions. In the second stage of the analysis, city-specific effects were combined in fixed or random effect meta-analyses.
The percent change in the ambulance dispatches associated with every 1 °C increase in the mean apparent temperature between 25 and 30 °C was 1.45% (95% confidence interval: 0.95, 1.95) for non-traumatic diseases and 2.74% (95% CI: 1.34, 4.14) for respiratory diseases. The percent increase in risk was greater on days in which the mean apparent temperature exceeded 30 °C (8.85%, 95% CI: 7.12, 10.58 for non-traumatic diseases). In this interval of biometeorological conditions, cardiovascular diseases became positively associated with the apparent temperature. The risks increased with age. The increase in risk for the non-traumatic diseases reached 13.34% for people aged 75 or older compared to 4.75% for those aged 35-64.
Time series analysis techniques were adopted for the first time to investigate emergency ambulance dispatches to evaluate the risks associated with biometeorological discomfort. Our findings show a strong relationship between biometeorological conditions and ambulance dispatches.
在几项流行病学研究中，人们广泛研究了与闷热天气相关的死亡率增加。然而，为了正确理解与热相关的健康影响的全部公共卫生意义，并建立一个有效的监测系统，研究有压力的气象条件对非致命事件的影响也很重要。我们的研究目的是使用与以前关于死亡率的研究中使用的类似时间序列技术，评估与生物气象条件相关的救护车派遣数据的暴露反应关系。
我们收集了 2002 年至 2006 年夏季期间，艾米利亚-罗马涅地区主要城镇 35 岁及以上人群的每日紧急救护车派遣数据。在分析的第一阶段，使用广义加性模型探索了每日救护车派遣与逐渐升高的表观温度之间的城市特异性关系，同时控制了空气污染、季节性、长期趋势、节假日和周末。救护车派遣与表观温度的关系通过线性样条近似。还评估了高温对呼吸系统疾病和心血管疾病以及所有非创伤性疾病的影响。在分析的第二阶段，将城市特异性效应合并在固定或随机效应荟萃分析中。
与 25 至 30°C 之间平均表观温度每升高 1°C 相关的救护车派遣百分比变化为非创伤性疾病 1.45%（95%置信区间：0.95，1.95），呼吸系统疾病 2.74%（95%置信区间：1.34，4.14）。在表观温度超过 30°C 的日子里，风险增加的百分比更高（非创伤性疾病为 8.85%，95%置信区间：7.12，10.58）。在这个生物气象条件区间内，心血管疾病与表观温度呈正相关。风险随年龄增长而增加。与 35-64 岁人群相比，75 岁及以上人群的非创伤性疾病风险增加了 13.34%，达到 13.34%。
首次采用时间序列分析技术调查救护车派遣，以评估与生物气象不适相关的风险。我们的研究结果表明生物气象条件与救护车派遣之间存在很强的关系。
