Kotani Kazuya, Ueda Kayo, Seposo Xerxes, Yasukochi Shusuke, Matsumoto Hiroko, Ono Masaji, Honda Akiko, Takano Hirohisa
a Department of Environmental Engineering , Kyoto University , Kyoto , Japan.
b Environmental Science Section , Fukuoka City Institute of Health and Environment , Fukuoka , Japan.
Glob Health Action. 2018;11(1):1437882. doi: 10.1080/16549716.2018.1437882.
The elderly population has been the primary target of intervention to prevent heat-related illnesses. According to the literature, the highest risks have been observed among the elderly in the temperature-mortality relationship. However, findings regarding the temperature-morbidity relationship are inconsistent.
This study aimed to examine the association of temperature with ambulance dispatches due to acute illnesses, stratified by age group. Specifically, we explored the optimum temperature, at which the relative health risks were found to be the lowest, and quantified the health risk associated with higher temperatures among different age groups.
We used the data for ambulance dispatches in Fukuoka, Japan, during May and September from 2005 to 2012. The data were grouped according to age in 20-year increments. We explored the pattern of the association of ambulance dispatches with temperature using a smoothing spline curve to identify the optimum temperature for each age group. Then, we applied a distributed lag nonlinear model to estimate the risks of the 85th-95th percentile temperature relative to the overall optimum temperature, for each age group.
The relative risk of ambulance dispatches at the 85th and 95th percentile temperature for all ages was 1.08 [95% confidence interval (CI): 1.05, 1.12] and 1.12 (95% CI: 1.08, 1.16), respectively. In comparison, among age groups, the optimum temperature was observed as 25.0°C, 23.2°C, and 25.3°C for those aged 0-19, 60-79, and ≥80, respectively. The optimum temperature could not be determined for those aged 20-39 and 40-59. The relative risks of high temperature tended to be higher for those aged 20-39 and 40-59 than those for other age groups.
We did not find any definite difference in the effect of high temperature on ambulance dispatches for different age groups. However, more measures should be taken for younger and middle-aged people to avoid heat-related illnesses.
老年人群一直是预防与热相关疾病干预措施的主要目标人群。根据文献，在温度与死亡率的关系中，老年人面临的风险最高。然而，关于温度与发病率关系的研究结果并不一致。
本研究旨在按年龄组分层，探讨温度与急性病救护车派遣之间的关联。具体而言，我们探究了相对健康风险最低时的最佳温度，并量化了不同年龄组中高温相关的健康风险。
我们使用了2005年至2012年5月至9月期间日本福冈市救护车派遣的数据。数据按年龄以20年为增量进行分组。我们使用平滑样条曲线探究救护车派遣与温度的关联模式，以确定每个年龄组的最佳温度。然后，我们应用分布滞后非线性模型来估计每个年龄组相对于总体最佳温度的第85至95百分位温度的风险。
所有年龄组在第85和95百分位温度下救护车派遣的相对风险分别为1.08 [95%置信区间（CI）：1.05，1.12]和1.12（95% CI：1.08，1.16）。相比之下，在各年龄组中，0至19岁、60至79岁和≥80岁人群的最佳温度分别为25.0°C、23.2°C和25.3°C。20至39岁和40至59岁人群的最佳温度无法确定。20至39岁和40至59岁人群高温的相对风险往往高于其他年龄组。
我们未发现高温对不同年龄组救护车派遣的影响有任何明确差异。然而，应针对年轻人和中年人采取更多措施以避免与热相关的疾病。
