From the bHyundai Marine and Fire Insurance Research Center. Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea; and cDepartment of Health Policy and Management, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
Epidemiology. 2017 Oct;28 Suppl 1:S98-S105. doi: 10.1097/EDE.0000000000000731.
The objective of the present study was to estimate the current and projected burden of disease from high ambient temperature using population-based data sources of nationwide mortality and morbidity in Korea.
Disability-adjusted life years (DALY) were estimated using noninjury-related deaths, and cerebrovascular and cardiovascular diseases from recently released nationwide health and mortality databases. Years of life lost and years lost due to disability were measured based on the point prevalence and number of deaths during the study period. Future DALY attributable to heat waves were estimated from projected populations, and temperature predictions for the years 2030 and 2050 were under Representative Concentration Pathways (RCP) 4.5 and 8.5 with summertime temperatures above threshold.
Relative risks (RR) of total mortality and of cardiovascular disease were 1.02 (95% CI, 1.01, 1.02) and 1.08 (95% CI, 1.06, 1.09) for each 1°C increase in temperature above threshold, respectively. The morbidity of heat-related disease was RR 1.67 (95% CI, 1.64, 1.68) for each 1°C increase in temperature above threshold. DALY for all-cause death were 0.49 DALY/1000 in 2011, 0.71 (0.71) DALY/1000 in 2030 and 0.77 (1.72) DALY/1000 in 2050 based on RCP 4.5 (RCP 8.5). DALY for cardio- and cerebrovascular diseases were 1.24 DALY/1000 in 2011, 1.63 (1.82) DALY/1000 in 2030, and 1.76 (3.66) DALY/1000 in 2050 based on RCP 4.5 (RCP 8.5).
Future excess mortality due to high ambient temperature is expected to be profound in Korea. Efforts to mitigate climate change can provide substantial health benefits via reducing heat-related mortality.
本研究旨在利用韩国全国死亡率和发病率的基于人群数据来源，估算高温环境下的疾病负担现状和预测疾病负担。
使用最近发布的全国卫生和死亡率数据库中的非伤害性死亡以及脑血管和心血管疾病来估算伤残调整生命年（DALY）。基于研究期间的点患病率和死亡人数，测量生命年损失和因残疾导致的生命年损失。通过预测人口估算与热浪相关的未来 DALY，使用代表性浓度路径（RCP）4.5 和 8.5 预测 2030 年和 2050 年夏季温度高于阈值时的未来温度预测值。
与阈值以上每升高 1°C 相关的总死亡率和心血管疾病的相对风险（RR）分别为 1.02（95%CI，1.01，1.02）和 1.08（95%CI，1.06，1.09）。与高温相关疾病的发病率 RR 为 1.67（95%CI，1.64，1.68），每升高 1°C。基于 RCP 4.5（RCP 8.5），2011 年全因死亡的 DALY 为 0.49 DALY/1000，2030 年为 0.71（0.71）DALY/1000，2050 年为 0.77（1.72）DALY/1000。2011 年心血管疾病的 DALY 为 1.24 DALY/1000，2030 年为 1.63（1.82）DALY/1000，2050 年为 1.76（3.66）DALY/1000，均基于 RCP 4.5（RCP 8.5）。
预计韩国未来因高温导致的额外死亡人数将会显著增加。通过减少与高温相关的死亡人数，减轻气候变化的努力将带来巨大的健康益处。
