Bobb Jennifer F, Ho Kalon K L, Yeh Robert W, Harrington Lori, Zai Adrian, Liao Katherine P, Dominici Francesca
Am J Epidemiol. 2017 Feb 15;185(4):283-294. doi: 10.1093/aje/kww219.
With global climate change, more frequent severe snowstorms are expected; however, evidence regarding their health effects is very limited. We gathered detailed medical records on hospital admissions (n = 433,037 admissions) from the 4 largest hospitals in Boston, Massachusetts, during the winters of 2010-2015. We estimated the percentage increase in hospitalizations for cardiovascular and cold-related diseases, falls, and injuries on the day of and for 6 days after a day with low (0.05-5.0 inches), moderate (5.1-10.0 inches), or high (>10.0 inches) snowfall using distributed lag regression models. We found that cardiovascular disease admissions decreased by 32% on high snowfall days (relative risk (RR) = 0.68, 95% confidence interval (CI): 0.54, 0.85) but increased by 23% 2 days after (RR = 1.23, 95% CI: 1.01, 1.49); cold-related admissions increased by 3.7% on high snowfall days (RR = 3.7, 95% CI: 1.6, 8.6) and remained high for 5 days after; and admissions for falls increased by 18% on average in the 6 days after a moderate snowfall day (RR = 1.18, 95% CI: 1.09, 1.27). We did not find a higher risk of hospitalizations for injuries. To our knowledge, this is the first study in which the time course of hospitalizations during and immediately after snowfall days has been examined. These findings can be translated into interventions that prevent hospitalizations and protect public health during harsh winter conditions.
随着全球气候变化,预计会出现更频繁的严重暴风雪;然而,关于其对健康影响的证据非常有限。我们收集了2010年至2015年冬季马萨诸塞州波士顿4家最大医院的详细住院病历(n = 433,037例住院)。我们使用分布滞后回归模型估计了降雪量低(0.05 - 5.0英寸)、中等(5.1 - 10.0英寸)或高(>10.0英寸)的当天及之后6天中心血管疾病、与寒冷相关疾病、跌倒和受伤的住院人数增加百分比。我们发现,降雪量大的日子中心血管疾病住院人数减少了32%(相对风险(RR)= 0.68,95%置信区间(CI):0.54,0.85),但在两天后增加了23%(RR = 1.23,95% CI:1.01,1.49);与寒冷相关的住院人数在降雪量大的日子增加了3.7%(RR = 3.7,95% CI:1.6,8.6),并在之后5天保持高位;中度降雪日后6天内跌倒住院人数平均增加了18%(RR = 1.18,95% CI:1.09,1.27)。我们没有发现受伤住院的风险更高。据我们所知,这是第一项研究降雪日期间及之后住院时间进程的研究。这些发现可以转化为在恶劣冬季条件下预防住院和保护公众健康的干预措施。