Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; Center for Environment and Population Health, Griffith University, Brisbane 4111, Australia.
The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050,China.
Environ Res. 2015 Feb;137:72-7. doi: 10.1016/j.envres.2014.11.016. Epub 2014 Dec 6.
Previous studies examining temperature-mortality associations in China focused on a single city or a small number of cities. A multi-city study covering different climatic zones is necessary to better understand regional differences in temperature risk on mortality in China.
Sixty-six communities from 7 regions across China were included in this study. We first used a Distributed Lag Non-linear Model (DLNM) to estimate community-specific effects of temperature on non-accidental mortality during 2006-2011. A multivariate meta-analysis was then applied to pool the estimates of community-specific effects.
A U-shaped curve was observed between temperature and mortality at the national level in China, indicating both low and high temperatures were associated with increased mortality risk. The overall threshold was at about the 75th percentile of the pooled temperature distribution. The relative risk was 1.61 (95% CI: 1.48-1.74) for extremely cold temperature (1st percentile of temperature), and 1.21 (95% CI: 1.10-1.34) for extreme hot temperature (99th percentile of temperature) at lag0-21 days. The temperature-mortality relationship is different for different regions. Compared with north China, south China had a higher minimum mortality temperature (MMT), and there was a larger cold effect in the more southern parts of China and a more pronounced hot effect in more northern parts.
Both cold and hot temperatures increase mortality risk in China, and the relationship varies geographically. Our findings suggest that public health policies for climate change adaptation should be tailored to the local climate conditions.
之前研究中国气温与死亡率关系的研究主要集中在单个城市或少数几个城市。为了更好地了解中国不同气候区温度对死亡率风险的区域差异，需要进行多城市研究。
本研究纳入了中国 7 个地区的 66 个社区。我们首先使用分布滞后非线性模型（DLNM）估计 2006-2011 年期间温度对非意外死亡率的社区特异性影响。然后应用多变量荟萃分析来汇总社区特异性效应的估计值。
在中国，全国范围内的温度与死亡率之间呈 U 型曲线，表明低温和高温都与死亡率风险增加有关。总体阈值约为温度分布的第 75 个百分位数。极低温（温度的第 1 百分位数）的相对风险为 1.61（95%CI：1.48-1.74），极高温（温度的第 99 百分位数）的相对风险为 1.21（95%CI：1.10-1.34），滞后 0-21 天。不同地区的温度-死亡率关系不同。与华北相比，华南的最低死亡率温度（MMT）更高，中国南部地区的冷效应更大，北部地区的热效应更为明显。
在中国，寒冷和炎热的天气都会增加死亡率风险，这种关系在地理上存在差异。我们的研究结果表明，气候变化适应的公共卫生政策应根据当地气候条件进行调整。
