National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
Environ Int. 2018 Jul;116:10-17. doi: 10.1016/j.envint.2018.04.001. Epub 2018 Apr 7.
Many of the studies that analyze the future impact of climate change on mortality assume that the temperature that constitutes a heat wave will not change over time. This is unlikely, however, given the process of adapting to heat changes, prevention plans, and improvements in social and health infrastructure. The objective of this study is to analyze whether, during the 1983-2013 period, there has been a temporal change in the maximum daily temperatures that constitute a heat wave (T) in Spain, and to investigate whether there has been variation in the attributable risk (AR) associated with mortality due to high temperatures in this period. This study uses daily mortality data for natural causes except accidents CIEX: A00-R99 in municipalities of over 10,000 inhabitants in 10 Spanish provinces and maximum temperature data from observatories located in province capitals. The time series is divided into three periods: 1983-1992, 1993-2003 and 2004-2013. For each period and each province, the value of T was calculated using scatter-plot diagram of the daily mortality pre-whitened series. For each period and each province capitals, it has been calculated the number of heat waves and quantifying the impact on mortality through generalized linear model (GLM) methodology with the Poisson regression link. These models permits obtained the relative risks (RR) and attributable risks (AR). Via a meta-analysis, using the Global RR and AR were calculated the heat impact for the total of the 10 provinces. The results show that in the first two periods RR remained constant RR: 1.14 (CI95%: 1.09 1.19) and RR: 1.14 (CI95%: 1.10 1.18), while the third period shows a sharp decrease with respect to the prior two periods RR: 1.01 (CI95%: 1.00 1.01); the difference is statistically significant. In Spain there has been a sharp decrease in mortality attributable to heat over the past 10 years. The observed variation in RR puts into question the results of numerous studies that analyze the future impact of heat on mortality in different temporal scenarios and show it to be constant over time.
许多分析气候变化对死亡率未来影响的研究假设，构成热浪的温度不会随时间变化。然而，鉴于适应气温变化、预防计划以及社会和卫生基础设施的改善，这种情况不太可能发生。本研究旨在分析 1983-2013 年期间，西班牙构成热浪的日最高温度（T）是否存在时间变化，并研究在此期间，由于高温导致的归因风险（AR）是否存在变化。本研究使用了 10 个西班牙省份 10000 人以上的城市自然原因（除事故外）的每日死亡率数据和位于省会的观测站的最高温度数据。时间序列分为三个时期：1983-1992 年、1993-2003 年和 2004-2013 年。对于每个时期和每个省份，使用每日死亡率预白化系列的散点图计算 T 值。对于每个时期和每个省会城市，计算了热浪的数量，并通过广义线性模型（GLM）方法和泊松回归链接量化了对死亡率的影响。这些模型得出了相对风险（RR）和归因风险（AR）。通过荟萃分析，使用全球 RR 和 AR 计算了 10 个省份的总热量影响。结果表明，在前两个时期，RR 保持不变（RR：1.14[95%CI：1.09-1.19]和 RR：1.14[95%CI：1.10-1.18]），而第三个时期与前两个时期相比，RR 急剧下降（RR：1.01[95%CI：1.00-1.01]）；差异具有统计学意义。在过去的 10 年里，西班牙归因于热浪的死亡率急剧下降。RR 的观察到的变化质疑了许多分析不同时间情景下热对死亡率未来影响的研究结果，并表明其随时间保持不变。
