Phung Dung, Huang Cunrui, Rutherford Shannon, Chu Cordia, Wang Xiaoming, Nguyen Minh
Centre for Environment and Population Health (CEPH), Griffith University, Queensland, Australia.
Centre for Environment and Population Health (CEPH), Griffith University, Queensland, Australia.
Environ Res. 2014 Nov;135:212-20. doi: 10.1016/j.envres.2014.08.035. Epub 2014 Oct 2.
The Mekong Delta is the most vulnerable region to extreme climate and hydrological conditions however the association between these conditions and children's health has been little studied. We examine the association between annual river flood pulse and paediatric hospital admissions in a Vietnam Mekong Delta city. Daily paediatric hospital admissions (PHA) were collected from the City Paediatric Hospital, and daily river water level (RWL) and meteorological data were retrieved from the Southern Regional Hydro-Meteorological Centre from 2008 to 2011. We evaluated the association between annual river flood pulse (>=90th percentile of RWL) and PHA using the Poisson distributed lag model, controlling for temperature, relative humidity, day of week, seasonal and long-term trends. The seasonal pattern of PHA was examined using harmonic and polynomial regression models. The cumulative risk ratios estimated for a 15-day period following an extreme RWL was 1.26 (95%CI, 1.2-1.38) for all age groups, 1.27 (95%CI, 1.23-1.30) for under five-years and 1.15 (95%CI, 1.07-1.20) for school-aged children, 1.24 (95%CI, 1.21-1.27) for all-causes, 1.18 (95%CI, 1.12-1.21) for communicable infection, 1.66 (95%CI, 1.57-1.74) for respiratory infection and 1.06 (95%CI, 1.01-1.1) for other diseases. The peak PHA risk is in the September-October period corresponding to the highest RWL, and the PHA-RWL association was modified by temperature. An increase in PHA is significantly associated with annual river flood, and the pattern of PHA is seasonally correspondent to the RWL. These findings combined with projected changes in climate conditions suggest important implications of climate change for human health in the Mekong Delta region.
湄公河三角洲是最易受极端气候和水文条件影响的地区，然而，这些条件与儿童健康之间的关联鲜有研究。我们考察了越南湄公河三角洲某城市的年度河流洪水脉冲与儿科住院情况之间的关联。从市儿童医院收集每日儿科住院数据（PHA），并从南方区域水文气象中心获取2008年至2011年的每日河流水位（RWL）和气象数据。我们使用泊松分布滞后模型评估年度河流洪水脉冲（RWL的第90百分位数及以上）与PHA之间的关联，并控制温度、相对湿度、星期几、季节和长期趋势。使用谐波和多项式回归模型研究PHA的季节模式。极端RWL之后15天期间估计的累积风险比，所有年龄组为1.26（95%置信区间，1.2 - 1.38），五岁以下儿童为1.27（95%置信区间，1.23 - 1.30），学龄儿童为1.15（95%置信区间，1.07 - 1.20），所有病因的为1.24（95%置信区间，1.21 - 1.27），传染病的为1.18（95%置信区间，1.12 - 1.21），呼吸道感染的为1.66（95%置信区间，1.57 - 1.74），其他疾病的为1.06（95%置信区间，1.01 - 1.1）。PHA风险峰值出现在9月至10月期间，对应最高的RWL，且PHA - RWL关联受温度影响。PHA增加与年度河流洪水显著相关，且PHA模式与RWL呈季节性对应。这些发现结合气候条件的预测变化表明，气候变化对湄公河三角洲地区人类健康具有重要影响。
