From the Institute at Brown for Environment and Society, Brown University, Providence, RI.
Department of Epidemiology, Brown University School of Public Health, Providence, RI.
Epidemiology. 2018 Jul;29(4):473-481. doi: 10.1097/EDE.0000000000000825.
Climate change is expected to result in more heat-related, but potentially fewer cold-related, emergency department visits and deaths. The net effect of projected changes in temperature on morbidity and mortality remains incompletely understood. We estimated the change in temperature-related morbidity and mortality at two sites in southern New England, United States, through the end of the 21st century.
We used distributed lag Poisson regression models to estimate the present-day associations between daily mean temperature and all-cause emergency department visits and deaths in Rhode Island and in Boston, Massachusetts. We estimated the change in temperature-related visits and deaths in 2045-2054 and 2085-2094 (relative to 2001-2010) under two greenhouse gas emissions scenarios (RCP4.5 and RCP8.5) using downscaled projections from an ensemble of over 40 climate models, assuming all other factors remain constant.
We observed U-shaped relationships between temperature and morbidity and mortality in Rhode Island, with minima at 10.9°C and 22.5°C, respectively. We estimated that, if this population were exposed to the future temperatures projected under RCP8.5 for 2085-2094, there would be 5,976 (95% eCI = 1,630, 11,379) more emergency department visits but 218 (95% eCI = -551, 43) fewer deaths annually. Results were similar in Boston and similar but less pronounced in the 2050s and under RCP4.5.
We estimated that in the absence of further adaptation, if the current southern New England population were exposed to the higher temperatures projected for future decades, temperature-related emergency department visits would increase but temperature-related deaths would not.
预计气候变化将导致更多与热相关的急诊就诊和死亡,但与冷相关的急诊就诊和死亡可能会减少。预计温度变化对发病率和死亡率的净影响仍不完全清楚。我们通过美国南部新英格兰的两个地点估计了与温度相关的发病率和死亡率的变化,预计到 21 世纪末。
我们使用分布式滞后泊松回归模型来估计罗得岛和马萨诸塞州波士顿的每日平均温度与全因急诊就诊和死亡之间的当前关联。我们使用来自 40 多个气候模型的集合的降尺度预测,在两种温室气体排放情景(RCP4.5 和 RCP8.5)下估计 2045-2054 年和 2085-2094 年(与 2001-2010 年相比)与温度相关的就诊和死亡的变化,假设所有其他因素保持不变。
我们在罗得岛观察到温度与发病率和死亡率之间呈 U 形关系,最小值分别为 10.9°C 和 22.5°C。我们估计,如果该人群暴露于 RCP8.5 下预测的未来温度中 2085-2094 年,每年将有 5976 次(95%置信区间为 1630 至 11379 次)更多的急诊就诊,但每年将有 218 次(95%置信区间为-551 至 43 次)更少的死亡。在波士顿的结果相似,并且在 2050 年代和 RCP4.5 下更为相似但不那么明显。
我们估计,如果当前新英格兰南部的人口暴露于未来几十年预测的较高温度下,在没有进一步适应的情况下,与温度相关的急诊就诊次数将会增加,但与温度相关的死亡人数不会增加。