School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
Sci Total Environ. 2015 Dec 15;538:524-30. doi: 10.1016/j.scitotenv.2015.08.097. Epub 2015 Aug 28.
The objective of this study was to explore the long-term variation in the association between ambient temperature and daily cardiovascular (CVD) mortality in Shanghai, China.
We collected daily data on ambient temperature and CVD mortality from a central urban district in Shanghai, China, during the period from 1981 to 2012. We used overdispersed generalized additive Poisson regression together with a distributed lag nonlinear model to estimate potentially lagged and nonlinear effects of temperature on CVD mortality after controlling for the seasonality, relative humidity, day of the week, holidays and population size. To allow for the evaluation of long-term variations in the effects, we divided the entire study period into six sub-periods (1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2012) and analyzed the effect estimates in each sub-period separately.
The association between temperature and daily CVD mortality was J-shaped with both low and high temperatures increasing the risk of CVD deaths. The effects of extremely low temperatures were delayed and persisted for two weeks, while extreme hot effects were limited to the first five days followed by a significant mortality displacement (9days). The relative risks (RRs) of extremely low, moderately low, moderately high, and extremely high temperatures comparing the 1st, 10th, 90th, and 99th percentile with the reference temperature (26°C) over the cumulative lags of 0-14days were 1.95 [95% confidence interval (CI): 1.84,2.07], 1.61 (95% CI: 1.57,1.66), 1.03 (95% CI: 1.01,1.05), and 1.14 (95% CI: 1.07,1.21). The RRs for extremely low and moderately low temperature attenuated substantially from 9.78 and 5.52 in 1981-1985 to 1.42 and 1.18 in 2006-2012, respectively, but the RRs remained almost stable for extremely high and moderately high temperatures.
This time-series study suggested that there might have been some human adaptation to low ambient temperature in Shanghai, China, over the last 3 decades.
本研究旨在探讨中国上海环境温度与每日心血管疾病（CVD）死亡率之间长期变化的关系。
我们收集了中国上海一个中心城区 1981 年至 2012 年期间每日环境温度和 CVD 死亡率的数据。我们使用过度分散广义加性泊松回归和分布式滞后非线性模型，在控制季节性、相对湿度、星期几、节假日和人口规模的情况下，估计温度对 CVD 死亡率的潜在滞后和非线性影响。为了评估影响的长期变化，我们将整个研究期间分为六个子期间（1981-1985 年、1986-1990 年、1991-1995 年、1996-2000 年、2001-2005 年和 2006-2012 年），并分别分析每个子期间的效应估计值。
温度与每日 CVD 死亡率之间的关系呈 J 形，低温和高温都会增加 CVD 死亡的风险。极低温度的影响具有延迟性，并持续两周，而极热影响仅限于前五天，随后出现明显的死亡率转移（9 天）。与参考温度（26°C）相比，在 0-14 天的累积滞后期内，极低、中度低、中度高和极高温度的相对风险（RR）分别为 1.95（95%置信区间[CI]：1.84，2.07）、1.61（95% CI：1.57，1.66）、1.03（95% CI：1.01，1.05）和 1.14（95% CI：1.07，1.21）。极低和中度低温的 RR 从 1981-1985 年的 9.78 和 5.52 大幅减弱至 2006-2012 年的 1.42 和 1.18，但极高和中度高温的 RR 几乎保持稳定。
这项时间序列研究表明，在过去的 30 年中，中国上海可能对环境低温有一定的适应。
