Zeng Wei-Lin, Li Guang-Chun, Xiao Yi-Ze, Xu Yan-Jun, Xu Xiao-Jun, Liu Tao, Luo Yuan, Xiao Jian-Peng, Ma Wen-Jun
Guangdong Institute of Public Health, Guangzhou 510300, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2012 Oct;33(10):1021-5.
To estimate the effects of temperature on cardiovascular disease (CVD) deaths in 4 cities-Kunming, Changsha, Guangzhou and Zhuhai, from southern part of China.
Daily CVD deaths, meteorological and air pollution data were used to explore the association between temperature and mortality. Distributed lag non-linear model was fitted for each city to access the delayed and cumulative effects of low, median and high temperature on CVD deaths. Cold and hot effects of temperature on CVD deaths were then accessed, based on the linear threshold model.
The city-specific exposure-response functions appeared to be non-linear. Temperatures that associated with the lowest mortality for Changsha, Kunming, Guangzhou and Zhuhai were 22.0°C, 20.0°C, 26.0°C, and 25.5°C. The greatest cumulative RRs (95%CI) for CVD deaths of low temperature during the delayed period of the study in the 4 cities were 1.858 (1.089 - 3.170), 1.537 (1.306 - 1.809), 2.121 (1.771 - 2.540) and 1.934 (1.469 - 2.548), while 1.100 (0.816 - 1.483), 1.061 (0.956 - 1.177), 1.134 (1.047 - 1.230) and 1.259 (1.104 - 1.436) for high temperatures in Changsha, Kunming, Guangzhou and Zhuhai respectively. The hot effect was greater than the cold effect on the current days. The hot effect was restricted to the first week, whereas the cold effect increased over the lag days, and then last for 3 - 4 weeks.
The city-specific exposure-response functions appeared to be non-linear. Both high and cold temperatures were associated with increased CVD deaths, but the impact of low temperature was more notable. Cold effect was delayed by several days but last for a longer period than the hot effect did.
评估温度对中国南方4个城市——昆明、长沙、广州和珠海心血管疾病（CVD）死亡的影响。
利用每日CVD死亡数据、气象数据和空气污染数据来探究温度与死亡率之间的关联。对每个城市拟合分布滞后非线性模型，以评估低温、中等温度和高温对CVD死亡的延迟和累积影响。然后基于线性阈值模型评估温度对CVD死亡的冷热效应。
各城市特定的暴露-反应函数似乎呈非线性。长沙、昆明、广州和珠海与最低死亡率相关的温度分别为22.0°C、20.0°C、26.0°C和25.5°C。在研究的延迟期内，4个城市低温导致CVD死亡的最大累积相对危险度（95%可信区间）分别为1.858（1.089 - 3.170）、1.537（1.306 - 1.809）、2.121（1.771 - 2.540）和1.934（1.469 - 2.548），而长沙、昆明、广州和珠海高温导致的分别为1.100（0.816 - 1.483）、1.061（0.956 - 1.177）、1.134（1.047 - 1.230）和1.259（1.104 - 1.436）。当前天数上热效应大于冷效应。热效应局限于第一周，而冷效应在滞后天数中增加，然后持续3 - 4周。
各城市特定的暴露-反应函数似乎呈非线性。高温和低温均与CVD死亡增加相关，但低温的影响更显著。冷效应延迟数天，但持续时间比热效应更长。
