Oudin Åström Daniel, Schifano Patrizia, Asta Federica, Lallo Adele, Michelozzi Paola, Rocklöv Joacim, Forsberg Bertil
Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
Environ Health. 2015 Mar 29;14:30. doi: 10.1186/s12940-015-0012-0.
Climate change is projected to increase the number and intensity of extreme weather events, for example heat waves. Heat waves have adverse health effects, especially for the elderly, since chronic diseases are more frequent in that group than in the population overall. The aim of the study was to investigate mortality during heat waves in an adult population aged 50 years or over, as well as in susceptible subgroups of that population in Rome and Stockholm during the summer periods from 2000 to 2008.
We collected daily number of deaths occurring between 15th May and 15th September each year for the population above 50 as well as the susceptible subgroups. Heat wave days were defined as two or more days exceeding the city specific 95th percentile of maximum apparent temperature (MAT). The relationship between heat waves and all-cause non-accidental mortality was investigated through time series modelling, adjusting for time trends.
The percent increase in daily mortality during heat waves as compared to normal summer days was, in the 50+ population, 22% (95% Confidence Interval (CI): 18-26%) in Rome and 8% (95% CI: 3-12%) in Stockholm. Subgroup specific increase in mortality in Rome ranged from 7% (95% CI:-17-39%) among survivors of myocardial infarction to 25% in the COPD (95% CI:9-43%) and diabetes (95% CI:14-37%) subgroups. In Stockholm the range was from 10% (95% CI: 2-19%) for congestive heart failure to 33% (95% CI: 10-61%) for the psychiatric subgroup.
Mortality during heat waves increased in both Rome and Stockholm for the 50+ population as well as in the considered subgroups. It should be evaluated if protective measures should be directed towards susceptible groups, rather than the population as a whole.
预计气候变化将增加极端天气事件的数量和强度，例如热浪。热浪对健康有不利影响，尤其是对老年人，因为该群体中慢性病的发病率高于总体人群。本研究的目的是调查2000年至2008年夏季期间，罗马和斯德哥尔摩50岁及以上成年人群以及该人群中的易感亚组在热浪期间的死亡率。
我们收集了每年5月15日至9月15日期间50岁及以上人群以及易感亚组的每日死亡人数。热浪日定义为连续两天或以上超过城市特定最高体感温度（MAT）的第95百分位数。通过时间序列模型研究热浪与全因非意外死亡率之间的关系，并对时间趋势进行调整。
与正常夏季相比，热浪期间50岁及以上人群的每日死亡率增加百分比在罗马为22%（95%置信区间（CI）：18 - 26%），在斯德哥尔摩为8%（95%CI：3 - 12%）。罗马亚组特定的死亡率增加范围从心肌梗死幸存者中的7%（95%CI： - 17 - 39%）到慢性阻塞性肺疾病（COPD）亚组中的25%（95%CI：9 - 43%）和糖尿病亚组中的25%（95%CI：14 - 37%）。在斯德哥尔摩，范围从充血性心力衰竭患者中的10%（95%CI：2 - 19%）到精神疾病亚组中的33%（95%CI：10 - 61%）。
罗马和斯德哥尔摩50岁及以上人群以及所考虑的亚组在热浪期间的死亡率均有所增加。应评估保护措施是否应针对易感人群，而非整个人口。
