School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
Department of Occupational Medicine, Shanghai Yangpu District Central Hospital, Shanghai, China.
Sci Total Environ. 2014 Sep 15;493:92-7. doi: 10.1016/j.scitotenv.2014.05.116. Epub 2014 Jun 14.
Diurnal temperature range (DTR) is a meteorological indicator closely associated with global climate change. There have been no multicity studies in China addressing the DTR-related health impact. We hypothesized that an increase of DTR is associated with higher daily mortality with a potential lag of effect, and investigated the acute effects of DTR on total, cardiovascular, and respiratory mortality in 8 large Chinese cities from 2001 to 2010. We first calculated city-specific effect of DTR in the full year, the cool season (November to the next April) and the warm season (May to October) separately using a semi-parametric generalized additive model; then we pooled the city-specific estimates with meta analysis. After adjusting for long-term and seasonal trends, temperature, relative humidity and air pollution levels, we found statistically significant associations between DTR and daily mortality, especially in cool seasons. A 1 °C increment of DTR on lag-day 1 corresponded to a 0.42% (95% CI, 0.14 to 0.70) increase in total non-accidental mortality, 0.45% (95% CI, 0.26 to 0.65) increase in cardiovascular mortality, and a 0.76% (95% CI, 0.24 to 1.29) increase in respiratory mortality in cool seasons. Deaths among females and elderly (≥ 65 years) were more strongly associated with DTR than among males and younger people (<65 years). Our analysis suggests that DTR is a potential trigger for death in China. Our findings may have important implications for the climate policies in the country.
昼夜温差（DTR）是与全球气候变化密切相关的气象指标。中国还没有多城市研究探讨 DTR 相关的健康影响。我们假设 DTR 的增加与更高的每日死亡率有关，且存在潜在的滞后效应，并调查了 2001 年至 2010 年中国 8 个大城市的 DTR 对总死亡率、心血管死亡率和呼吸死亡率的急性影响。我们首先使用半参数广义加性模型分别计算了全年、冷季（11 月至次年 4 月）和暖季（5 月至 10 月）中 DTR 对各城市的具体影响；然后用荟萃分析汇总了各城市的估计值。在调整了长期和季节性趋势、温度、相对湿度和空气污染水平后，我们发现 DTR 与每日死亡率之间存在统计学显著关联，尤其是在冷季。DTR 每增加 1°C，滞后 1 天的总非意外死亡率增加 0.42%（95%CI，0.14 至 0.70），心血管死亡率增加 0.45%（95%CI，0.26 至 0.65），呼吸死亡率增加 0.76%（95%CI，0.24 至 1.29）。在冷季，女性和老年人（≥65 岁）的死亡与 DTR 的相关性强于男性和年轻人（<65 岁）。我们的分析表明，DTR 可能是中国死亡的一个潜在触发因素。我们的研究结果可能对该国的气候政策具有重要意义。
