地震和海啸后肺炎死亡的特征：一项对日本131个市町村570万参与者的生态学研究
Characteristics of pneumonia deaths after an earthquake and tsunami: an ecological study of 5.7 million participants in 131 municipalities, Japan.
作者信息
Shibata Yosuke, Ojima Toshiyuki, Tomata Yasutake, Okada Eisaku, Nakamura Mieko, Kawado Miyuki, Hashimoto Shuji
机构信息
Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
出版信息
BMJ Open. 2016 Feb 23;6(2):e009190. doi: 10.1136/bmjopen-2015-009190.
OBJECTIVE
On 11 March 2011, the Great East Japan Earthquake struck off Japan. Although some studies showed that the earthquake increased the risk of pneumonia death, no study reported whether and how much a tsunami increased the risk. We examined the risk for pneumonia death after the earthquake/tsunami.
DESIGN
This is an ecological study.
SETTING
Data on population and pneumonia deaths obtained from the Vital Statistics 2010 and 2012, National Census 2010 and Basic Resident Register 2010 and 2012 in Japan.
PARTICIPANTS
About 5.7 million participants residing in Miyagi, Iwate and Fukushima Prefectures during 1 year after the disaster were targeted. All municipalities (n=131) were categorised into inland (n=93), that is, the earthquake-impacted area, and coastal types (n=38), that is, the earthquake-impacted and tsunami-impacted area.
OUTCOME MEASURES
The number of pneumonia deaths per week was totalled from 12 March 2010 to 9 March 2012. The number of observed pneumonia deaths (O) and the sum of the sex and age classes in the observed population multiplied by the sex and age classes of expected pneumonia mortality (E) were calculated. Expected pneumonia mortality was the pneumonia mortality during the year before. Standardised mortality ratios (SMRs) were calculated for pneumonia deaths (O/E), adjusting for sex and age using the indirect method. SMRs were then calculated by coastal and inland municipalities.
RESULTS
6603 participants died of pneumonia during 1 year after the earthquake. SMRs increased significantly during the 1st-12th weeks. In the 2nd week, SMRs in coastal and inland municipalities were 2.49 (95% CI 2.02 to 7.64) and 1.48 (95% CI 1.24 to 2.61), respectively. SMRs of coastal municipalities were higher than those of inland municipalities.
CONCLUSIONS
An earthquake increased the risk of pneumonia death and tsunamis additionally increased the risk.
目的
2011年3月11日，东日本大地震在日本近海发生。尽管一些研究表明地震增加了肺炎死亡风险，但尚无研究报告海啸是否以及在多大程度上增加了这种风险。我们调查了地震/海啸后肺炎死亡的风险。
设计
这是一项生态学研究。
背景
人口和肺炎死亡数据来自日本2010年和2012年的生命统计、2010年全国人口普查以及2010年和2012年的基本居民登记册。
参与者
以灾难发生后1年内居住在宫城、岩手和福岛县的约570万参与者为研究对象。所有市町村（n = 131）被分为内陆地区（n = 93），即受地震影响的地区，以及沿海地区（n = 38），即受地震和海啸影响的地区。
观察指标
统计2010年3月12日至2012年3月9日期间每周的肺炎死亡人数。计算观察到的肺炎死亡人数（O）以及观察人群中性别和年龄组的总和乘以预期肺炎死亡率的性别和年龄组（E）。预期肺炎死亡率为前一年的肺炎死亡率。采用间接法，针对肺炎死亡人数（O/E）计算标准化死亡率（SMR），并根据性别和年龄进行调整。然后按沿海和内陆市町村计算SMR。
结果
地震后1年内有6603名参与者死于肺炎。在第1至12周期间，SMR显著升高。在第2周，沿海和内陆市町村的SMR分别为2.49（95%可信区间2.02至7.64）和1.48（95%可信区间1.24至2.61）。沿海市町村的SMR高于内陆市町村。
结论
地震增加了肺炎死亡风险，海啸进一步增加了该风险。
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