Miron Isidro Juan, Linares Cristina, Montero Juan Carlos, Criado-Alvarez Juan Jose, Díaz Julio
Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority, Torrijos, Toledo, Spain,
Int J Biometeorol. 2015 Sep;59(9):1213-22. doi: 10.1007/s00484-014-0933-2. Epub 2014 Nov 16.
The relationship between heat waves and mortality has been widely described, but there are few studies using long daily data on specific-cause mortality. This study is undertaken in central Spain and analysing natural causes, circulatory and respiratory causes of mortality from 1975 to 2008. Time-series analysis was performed using ARIMA models, including data on specific-cause mortality and maximum and mean daily temperature and mean daily air pressure. The length of heat waves and their chronological number were analysed. Data were stratified in three decadal stages: 1975-1985, 1986-1996 and 1997-2008. Heat-related mortality was triggered by a threshold temperature of 37 °C. For each degree that the daily maximum temperature exceeded 37 °C, the percentage increase in mortality due to circulatory causes was 19.3 % (17.3-21.3) in 1975-1985, 30.3 % (28.3-32.3) in 1986-1996 and 7.3 % (6.2-8.4) in 1997-2008. The increase in respiratory cause ranged from 12.4 % (7.8-17.0) in the first period, to 16.3 % (14.1-18.4) in the second and 13.7 % (11.5-15.9) in the last. Each day of heat-wave duration explained 5.3 % (2.6-8.0) increase in respiratory mortality in the first period and 2.3 % (1.6-3.0) in the last. Decadal scale differences exist for specific-causes mortality induced by extreme heat. The impact on heat-related mortality by natural and circulatory causes increases between the first and the second period and falls significantly in the last. For respiratory causes, the increase is no reduced in the last period. These results are of particular importance for the estimation of future impacts of climate change on health.
热浪与死亡率之间的关系已有广泛描述，但利用特定病因死亡率的长期每日数据进行的研究却很少。本研究在西班牙中部开展，分析了1975年至2008年自然病因、循环系统病因和呼吸系统病因导致的死亡率。使用自回归积分滑动平均（ARIMA）模型进行时间序列分析，纳入特定病因死亡率、每日最高和平均气温以及每日平均气压的数据。分析了热浪的持续时间及其按时间顺序排列的次数。数据按三个十年阶段分层：1975 - 1985年、1986 - 1996年和1997 - 2008年。与热相关的死亡率由37°C的阈值温度触发。每日最高温度每超过37°C一度，1975 - 1985年循环系统病因导致的死亡率增加19.3%（17.3 - 21.3），1986 - 1996年为30.3%（28.3 - 32.3），1997 - 2008年为7.3%（6.2 - 8.4）。呼吸系统病因导致的死亡率增加幅度在第一个时期为12.4%（7.8 - 17.0），第二个时期为16.3%（14.1 - 18.4），最后一个时期为13.7%（11.5 - 15.9）。热浪持续的每一天在第一个时期解释了呼吸系统死亡率增加5.3%（2.6 - 8.0），在最后一个时期为2.3%（1.6 - 3.0）。极端高温导致的特定病因死亡率存在十年尺度的差异。自然病因和循环系统病因对与热相关死亡率的影响在第一个时期和第二个时期之间增加，在最后一个时期显著下降。对于呼吸系统病因，在最后一个时期增加幅度并未降低。这些结果对于估计气候变化对健康的未来影响尤为重要。
