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温度变化对救护车调度的影响及季节效应修正

Impacts of temperature change on ambulance dispatches and seasonal effect modification.

作者信息

Cheng Jian, Xu Zhiwei, Zhao Desheng, Xie Mingyu, Yang Huihui, Wen Liying, Li Kesheng, Su Hong

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.

School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, 4509, Australia.

出版信息

Int J Biometeorol. 2016 Dec;60(12):1863-1871. doi: 10.1007/s00484-016-1173-4. Epub 2016 May 4.

Abstract

Ambulance dispatch is a proxy of acute health outcomes, and growing epidemiological evidence documented its relation to extreme temperature events. Research, however, on short-term temperature change and ambulance dispatches is scarce. We aimed to investigate the effect of short-term temperature change on ambulance dispatches and potential modification by season. Daily data on ambulance dispatch and weather factors were collected in Huainan, a Chinese inland city from December 2011 through December 2013. A Poison generalized linear regression model combined with distributed lag nonlinear model was constructed to examine the association of temperature change between neighboring days (TCN) with ambulance dispatches. The effect modification by season was also examined. There were 48,700 ambulance attendances during the study period. A statistically significant association of TCN with ambulance dispatches was observed. Temperature rise between neighboring days (TCN > 0) was associated with elevated adverse risk of ambulance dispatches, and the effects appeared to be acute (lag0, on the current day) and could last for at least a week, while temperature drop between neighboring days (TCN < 0) had a protective effect. For a 1 °C increase of TCN at lag0 and lag06 (on the 7-day moving average), the risk of ambulance dispatches increased by 2 % (95 % CI 1-3 %) and 7 (95 % CI 1-13 %), respectively. Extreme TCN increase (95th percentile, 3.3 °C vs. 0 °C) at lag0 and lag05 was accompanied by 6 (95 % CI 3-8 %) and 27 % (95 % CI 12-44 %) increase in ambulance dispatches. Ambulance dispatches were more vulnerable to extremely great temperature rise in summer and autumn. TCN was adopted for the first time to quantify the impact of short-term temperature change on ambulance dispatches. Temperature drop between neighboring days (TCN < 0) had a protective effect on ambulance dispatches, while temperature rise between neighboring days (TCN > 0) could acutely trigger the increase in ambulance dispatches, and TCN effect differs by season.

摘要

救护车调度是急性健康结果的一个替代指标,越来越多的流行病学证据证明了其与极端温度事件的关系。然而,关于短期温度变化与救护车调度的研究却很匮乏。我们旨在调查短期温度变化对救护车调度的影响以及季节的潜在修正作用。2011年12月至2013年12月期间,在中国内陆城市淮南收集了救护车调度和天气因素的每日数据。构建了一个泊松广义线性回归模型并结合分布滞后非线性模型,以检验相邻日期之间的温度变化(TCN)与救护车调度之间的关联。还检验了季节的效应修正作用。研究期间共有48700次救护车出勤。观察到TCN与救护车调度之间存在统计学上的显著关联。相邻日期之间的温度升高(TCN>0)与救护车调度的不良风险升高相关,且这种影响似乎是急性的(滞后0,即当天),并且可持续至少一周,而相邻日期之间的温度下降(TCN<0)具有保护作用。对于滞后0和滞后06(7天移动平均值)时TCN每升高1°C,救护车调度的风险分别增加2%(95%CI 1 - 3%)和7%(95%CI 1 - 13%)。滞后0和滞后05时极端的TCN升高(第95百分位数,3.3°C对0°C)分别伴随着救护车调度增加6%(95%CI 3 - 8%)和27%(95%CI 12 - 44%)。救护车调度在夏季和秋季更容易受到极端温度升高的影响。首次采用TCN来量化短期温度变化对救护车调度的影响。相邻日期之间的温度下降(TCN<0)对救护车调度有保护作用,而相邻日期之间的温度升高(TCN>0)可急性触发救护车调度增加,且TCN效应因季节而异。

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