de' Donato Francesca K, Leone Michela, Scortichini Matteo, De Sario Manuela, Katsouyanni Klea, Lanki Timo, Basagaña Xavier, Ballester Ferran, Åström Christofer, Paldy Anna, Pascal Mathilde, Gasparrini Antonio, Menne Bettina, Michelozzi Paola
Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza 53, Rome 00198, Italy.
Department of Hygiene and Epidemiology, Medical School, University of Athens, Athens 11527, Greece.
Int J Environ Res Public Health. 2015 Dec 8;12(12):15567-83. doi: 10.3390/ijerph121215006.
The European project PHASE aims to evaluate patterns of change in the temperature-mortality relationship and in the number of deaths attributable to heat in nine European cities in two periods, before and after summer 2003 (1996-2002 and 2004-2010). We performed age-specific Poisson regression models separately in the two periods, controlling for seasonality, air pollution and time trends. Distributed lag non-linear models were used to estimate the Relative Risks of daily mortality for increases in mean temperature from the 75th to 99th percentile of the summer distribution for each city. In the recent period, a reduction in the mortality risk associated to heat was observed only in Athens, Rome and Paris, especially among the elderly. Furthermore, in terms of heat-attributable mortality, 985, 787 and 623 fewer deaths were estimated, respectively, in the three cities. In Helsinki and Stockholm, there is a suggestion of increased heat effect. Noteworthy is that an effect of heat was still present in the recent years in all cities, ranging from +11% to +35%. In Europe, considering the warming observed in recent decades and population ageing, effective intervention measures should be promoted across countries, especially targeting vulnerable subgroups of the population with lower adaptive resources.
欧洲项目“PHASE”旨在评估2003年夏季前后两个时期（1996 - 2002年和2004 - 2010年）九个欧洲城市温度与死亡率关系以及高温所致死亡人数的变化模式。我们在这两个时期分别进行了特定年龄的泊松回归模型分析，控制了季节性、空气污染和时间趋势。采用分布滞后非线性模型来估计每个城市夏季平均温度从第75百分位数升至第99百分位数时每日死亡率的相对风险。在近期，仅在雅典、罗马和巴黎观察到与高温相关的死亡风险降低，尤其是在老年人中。此外，就高温所致死亡而言，这三个城市估计分别减少了985例、787例和623例死亡。在赫尔辛基和斯德哥尔摩，有迹象表明高温效应增加。值得注意的是，近年来所有城市仍存在高温效应，范围从 +11% 到 +35%。在欧洲，考虑到近几十年来观测到的气候变暖以及人口老龄化，各国应推广有效的干预措施，尤其针对适应资源较少的弱势群体。
