Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Troy, USA.
Am J Epidemiol. 2012 May 1;175(9):907-16. doi: 10.1093/aje/kwr417. Epub 2012 Mar 28.
This study assessed the association between high temperatures and increased odds of hospitalization for renal diseases that, to date, has been examined in only a small number of studies. A case-crossover design was used to study 147,885 hospital admissions with renal diagnoses during July and August, 1991-2004, in New York State. Regional temperature, humidity, and barometric pressure data from automated monitors were used as exposure indicators. By use of time-stratified referent selection and conditional logistic regression analysis, an overall 9% increase in odds of hospitalization for acute renal failure per 5°F (2.78°C) was found for mean temperature at a 1-day lag (odds ratio = 1.09, 95% confidence interval: 1.07, 1.12). The results suggest increased susceptibility to hospitalization for acute renal failure for blacks, Hispanics, people aged 25-44 years, and those in the lowest income quartile. The odds varied geographically with the largest associations found in the more urban regions. Increased odds of hospitalization were also found for urinary tract infections, renal calculi, lower urinary calculi, and other lower urinary tract disorders. The findings can help to identify vulnerable subpopulations and to inform decisions and policies regarding adaptation strategies and heat-warning systems.
本研究评估了高温与肾脏疾病住院几率增加之间的关联,迄今为止,这一关联仅在少数研究中进行了检验。本研究采用病例交叉设计,研究了 1991 年至 2004 年 7 月和 8 月期间纽约州 147885 例肾脏疾病住院患者。采用自动监测器的区域温度、湿度和气压数据作为暴露指标。通过时间分层参考选择和条件逻辑回归分析,发现平均温度滞后 1 天每升高 5°F(2.78°C),急性肾衰竭住院的几率总体增加 9%(比值比=1.09,95%置信区间:1.07,1.12)。结果表明,黑人、西班牙裔、25-44 岁人群以及收入最低四分位数人群的急性肾衰竭住院易感性增加。结果在地域上存在差异,在更城市化的地区关联最大。尿路感染、肾结石、下尿路结石和其他下尿路疾病的住院几率也有所增加。这些发现有助于确定易受影响的亚人群,并为适应策略和高温预警系统的决策和政策提供信息。