Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Environ Res. 2017 Oct;158:703-709. doi: 10.1016/j.envres.2017.07.021. Epub 2017 Jul 20.
Designing effective public health strategies to prevent adverse health effect of hot weather is crucial in the context of global warming. In Switzerland, the 2003 heat have caused an estimated 7% increase in all-cause mortality. As a consequence, the Swiss Federal Office of Public Health developed an information campaign to raise public awareness on heat threats. For a better understanding on how hot weather affects daily mortality in Switzerland, we assessed the effect of heat on daily mortality in eight Swiss cities and population subgroups from 1995 to 2013 using different temperature metrics (daily mean (Tmean), maximum (Tmax), minimum (Tmin) and maximum apparent temperature (Tappmax)), and aimed to evaluate variations of the heat effect after 2003 (1995-2002 versus 2004-2013). We applied conditional quasi-Poisson regression models with non-linear distributed lag functions to estimate temperature-mortality associations over all cities (1995-2013) and separately for two time periods (1995-2002, 2004-2013). Relative risks (RR) of daily mortality were estimated for increases in temperature from the median to the 98th percentile of the warm season temperature distribution. Over the whole time period, significant temperature-mortality relationships were found for all temperature indicators (RR (95% confidence interval): Tappmax: 1.12 (1.05; 1.18); Tmax: 1.15 (1.08-1.22); Tmean: 1.16 (1.09-1.23); Tmin 1.23 (1.15-1.32)). Mortality risks were higher at the beginning of the summer, especially for Tmin. In the more recent time period, we observed a non-significant reduction in the effect of high temperatures on mortality, with the age group > 74 years remaining the population at highest risk. High temperatures continue to be a considerable risk factor for human health in Switzerland after 2003. More effective public health measures targeting the elderly should be promoted with increased attention to the first heat events in summer and considering both high day-time and night-time temperatures.
设计有效的公共卫生策略来预防全球变暖背景下恶劣天气对健康的不利影响至关重要。瑞士，2003 年的热浪导致全因死亡率上升了约 7%。因此，瑞士联邦公共卫生办公室开展了一项信息宣传活动，以提高公众对热威胁的认识。为了更好地了解炎热天气如何影响瑞士的日常死亡率，我们评估了 1995 年至 2013 年期间不同温度指标（日平均温度（Tmean）、最高温度（Tmax）、最低温度（Tmin）和最大表观温度（Tappmax））对瑞士 8 个城市和人口亚组的日死亡率的影响，并旨在评估 2003 年后（1995-2002 年与 2004-2013 年）热效应的变化。我们应用条件准泊松回归模型和非线性分布滞后函数来估计所有城市（1995-2013 年）和两个时间段（1995-2002 年和 2004-2013 年）的温度-死亡率关联。对于从暖季温度分布的中位数到第 98 百分位数的温度升高，估计了每日死亡率的相对风险（RR）。在整个时期，所有温度指标均显示出显著的温度-死亡率关系（RR（95%置信区间）：Tappmax：1.12（1.05；1.18）；Tmax：1.15（1.08-1.22）；Tmean：1.16（1.09-1.23）；Tmin 1.23（1.15-1.32））。夏季开始时，死亡率风险更高，尤其是 Tmin。在最近的时间段内，我们观察到高温对死亡率的影响呈非显著下降，年龄组>74 岁的人群仍然是面临最高风险的人群。2003 年后，高温仍是瑞士人类健康的一个相当大的风险因素。应该推广更有效的针对老年人的公共卫生措施，并更加关注夏季的首次高温事件，同时考虑白天和夜间的高温。
