Environmental Epidemiology Unit, Department of Epidemiology, Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, 00147 Rome, Italy.
Environmental Epidemiology Unit, Department of Epidemiology, Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, 00147 Rome, Italy.
Public Health. 2018 Aug;161:154-162. doi: 10.1016/j.puhe.2018.03.030. Epub 2018 May 8.
The aim of the article is to evaluate the temporal change in the effect of heat on mortality in Italy in the last 12 years after the introduction of the national heat plan.
Time series analysis.
Distributed lag non-linear models were used to estimate the association between maximum apparent temperature and mortality in 23 Italian cities included in the national heat plan in four study periods (before the introduction of the heat plan and three periods after the plan was in place between 2005 and 2016). The effect (relative risks) and impact (attributable fraction [AF] and number of heat-related deaths) were estimated for mild summer temperatures (20th and 75th percentile maximum apparent temperature [Tappmax]) and extreme summer temperatures (75th and 99th percentile Tappmax) in each study period. A survey of the heat preventive measures adopted over time in the cities included in the Italian heat plan was carried out to better describe adaptation measures and response.
Although heat still has an impact on mortality in Italian cities, a reduction in heat-related mortality is observed progressively over time. In terms of the impact, the heat AF related to extreme temperatures declined from 6.3% in the period 1999-2002 to 4.1% in 2013-2016. Considering the entire temperature range (20th vs 99th percentile), the total number of heat-related deaths spared over the entire study period was 1900.
Considering future climate change and the health burden associated to heat waves, it is important to promote adaptation measures by showing the potential effectiveness of heat prevention plans.
本文旨在评估在意大利国家热计划实施后的 12 年内，高温对死亡率影响的时间变化。
时间序列分析。
采用分布式滞后非线性模型，在四个研究期间（国家热计划实施之前以及 2005 年至 2016 年期间实施该计划的三个期间），评估 23 个纳入国家热计划的意大利城市的最大表观温度与死亡率之间的关联。在每个研究期间，估计了轻度夏季温度（20 分位和 75 分位最大表观温度[Tappmax]）和极端夏季温度（75 分位和 99 分位 Tappmax）的效应（相对风险）和影响（归因分数[AF]和与热相关的死亡人数）。对意大利热计划中纳入的城市随时间采用的热预防措施进行了调查，以更好地描述适应措施和应对措施。
尽管高温仍然对意大利城市的死亡率有影响，但随着时间的推移，与热相关的死亡率呈逐渐下降趋势。就影响而言，与极端温度相关的热 AF 从 1999-2002 年期间的 6.3%下降到 2013-2016 年期间的 4.1%。考虑到整个温度范围（20 分位与 99 分位），整个研究期间避免的与热相关的死亡总人数为 1900 人。
考虑到未来的气候变化和与热浪相关的健康负担，通过展示热预防计划的潜在效果，促进适应措施非常重要。
