Li Jing, Luo Shuquan, Ding Xianbin, Yang Jun, Li Jing, Liu Xiaobo, Gao Jinghong, Xu Lei, Tang Wenge, Liu Qiyong
National Institute for Communicable Disease Control and Prevention, State Key Laboratory for Communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Chongqing Center for Disease Control and Prevention, Chongqing 400042, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Mar;37(3):375-80. doi: 10.3760/cma.j.issn.0254-6450.2016.03.017.
To evaluate the influence of extreme ambient temperature on mortality and years of life lost (YLL) in Chongqing.
The daily mortality, meteorology and air pollution index data in Chongqing from the 1(st) January 2010 to the 31(st) December 2013 were collected. Distributed lag non-linear model (DLNM) was used to assess the influence of daily ambient temperature on daily number of deaths and daily YLL respectively. The delayed and cumulative effects of extreme temperature on sex, age, and cause-specific mortality were also assessed.
The relationships between ambient temperature and non-accidental, cardiovascular disease and respiratory disease mortalities and YLL were U-shaped or W-shaped. The effect of heat was obvious on that day, peaked on day 7, and lasted for two weeks, whereas the effect of cold was obvious a week later and lasted for a month. As 1 ℃ increase of ambient temperature, the cumulative relative risks (CRR) of high temperature across lag 0-7 days on non-accidental, respiratory disease and cardiovascular disease mortalities were 1.05 (95%CI: 1.03-1.07), 1.08 (95%CI: 1.05-1.11) and 1.05 (95%CI: 1.01-1.09) respectively. The effects of heat on YLL for each cause were 23.81 (95%CI: 12.31-35.31), 14.34 (95%CI: 8.98-19.70) and 4.43 (95%CI: 1.64-7.21), respectively. On cold days, 1 ℃ decrease of ambient temperature was correlated with an increase in CRR of 1.06 (95%CI: 1.04-1.08), 1.09 (95%CI:1.06-1.12) and 1.06 (95%CI: 1.02-1.11) from lag 0 to 14 for non-accidental, respiratory disease and cardiovascular disease mortalities, respectively. The estimated YLL were 23.34 (95%CI: 10.04-36.64), 16.39 (95%CI: 10.19-22.59) and 2.61 (95%CI: -0.61-5.82). People aged ≥65 years tend to have higher CRR and YLL than those aged <65 years. On high temperature days, the CRR in women was higher than that in men, while the YLL in women was lower than that in men. On low temperature days, both the CRR and YLL in women were higher than those in men.
Both high and low ambient temperature have adverse health effects. People aged ≥65 years are more sensitive to both high and low ambient temperature. Younger men are more sensitive to high ambient temperature and women and elder men are sensitive to low ambient temperature. It is necessary to take targeted measures to protect the population in Chongqing from the adverse influence of extreme ambient temperature.
评估极端环境温度对重庆地区死亡率和寿命损失年数(YLL)的影响。
收集重庆2010年1月1日至2013年12月31日的每日死亡率、气象数据及空气污染指数数据。采用分布滞后非线性模型(DLNM)分别评估每日环境温度对每日死亡人数和每日YLL的影响。同时评估极端温度对性别、年龄及特定病因死亡率的延迟和累积效应。
环境温度与非意外、心血管疾病和呼吸系统疾病死亡率及YLL之间的关系呈U形或W形。高温影响在当天明显,第7天达到峰值,并持续两周,而低温影响在一周后明显,持续一个月。环境温度每升高1℃,滞后0 - 7天高温对非意外、呼吸系统疾病和心血管疾病死亡率的累积相对风险(CRR)分别为1.05(95%CI:1.03 - 1.07)、1.08(95%CI:1.05 - 1.11)和1.05(95%CI:1.01 - 1.09)。高温对各病因YLL的影响分别为23.81(95%CI:12.31 - 35.31)、14.34(95%CI:8.98 - 19.70)和4.43(95%CI:1.64 - 7.21)。在寒冷天气,环境温度每降低1℃,滞后0至14天非意外、呼吸系统疾病和心血管疾病死亡率的CRR分别增加1.06(95%CI:1.04 - 1.08)、1.09(95%CI:1.06 - 1.12)和1.06(95%CI:1.02 - 1.11)。估计的YLL分别为23.34(95%CI:10.04 - 36.64)、16.39(95%CI:10.19 - 22.59)和2.61(95%CI: - 0.61 - 5.82)。≥65岁人群的CRR和YLL往往高于<65岁人群。在高温天,女性的CRR高于男性,而女性的YLL低于男性。在低温天,女性的CRR和YLL均高于男性。
环境温度过高和过低均对健康有不利影响。≥65岁人群对环境温度过高和过低均更敏感。年轻男性对高温环境更敏感,而女性和老年男性对低温环境敏感。有必要采取针对性措施保护重庆地区人群免受极端环境温度的不利影响。