State Key Laboratory of Resources and Environmental Information System, Chinese Academy of Sciences, Institute of Geographic Sciences and Nature Resources Research, A11, Datun Road, Beijing, China.
The University of Chinese Academy of Sciences, Beijing, China.
Environ Sci Pollut Res Int. 2019 Mar;26(9):8895-8901. doi: 10.1007/s11356-019-04247-6. Epub 2019 Feb 4.
Few detailed, individual-focused studies have researched the added effect of temperature on cardiovascular disease (CVD), particularly in China. Moreover, no prior studies have explored the exposure-response relationship among all populations and different sub-sociodemographic groups. A distributed lag nonlinear model (DLNM) was applied to evaluate the adverse health effects of temperature on CVD mortality for all populations and different sub-sociodemographic groups (by age, sex, educational level, living arrangement, and occupation) in Beijing. Based on the exposure-response relationships, firstly, we proposed a new model (COCKTAIL, Code Of Climate Key To An Ill) for revealing the split-and-merge relationships of the temperature-CVD mortality curve. This method could be used to apply the CVD deaths in a studied area to forecast the exposure-response relationships in the same area in the future. Secondly, this is the most detailed study to analyze the relationship between temperature and CVD mortality for different subgroups among the existing researches for developed and developing countries. We found that the cold temperature (at - 14 °C) was the risk factor for people with low socioeconomic status, especially for single people (including unmarried, divorced, and widowed), for indoor workers, and for people with low education, compared with the minimum mortality temperature, with a cumulative increase of 3.9 (80%CI, 2.9-5.4), 3.8 (80%CI, 2.8-5.1), and 4.5 (80%CI, 3.1-6.3) times respectively. Meanwhile, the hot temperature (at 35 °C) was the risk factor for CVD death, with a cumulative increase of 2.6 (80%CI, 2.0-3.4) for females, and 3.1 (80%CI, 2.4-4.2) for single people. The varying CVD vulnerability in terms of CVD mortality among various groups may assist governments in preparing health resources and taking measures to prevent or reduce temperature-related deaths.
在中国，很少有详细的、以个体为中心的研究探讨温度对心血管疾病（CVD）的附加影响。此外，以前没有研究探讨过所有人群和不同亚社会人口群体之间的暴露-反应关系。本研究采用分布滞后非线性模型（DLNM）评估了温度对 CVD 死亡率的不良健康影响，研究对象为北京的所有人群和不同亚社会人口群体（按年龄、性别、教育水平、居住安排和职业划分）。基于暴露-反应关系，首先，我们提出了一种新模型（COCKTAIL），用于揭示温度-CVD 死亡率曲线的分裂和合并关系。这种方法可用于将研究区域内的 CVD 死亡人数应用于未来对同一区域的暴露-反应关系进行预测。其次，这是现有发达国家和发展中国家研究中针对不同亚组人群分析温度与 CVD 死亡率关系最详细的研究。我们发现，与最低死亡率温度相比，寒冷温度（-14°C）是社会经济地位较低人群（特别是单身人群，包括未婚、离婚和丧偶）、室内工作者和低教育程度人群的危险因素，累积增加 3.9（80%CI，2.9-5.4）、3.8（80%CI，2.8-5.1）和 4.5（80%CI，3.1-6.3）倍。同时，高温（35°C）也是 CVD 死亡的危险因素，女性的累积增加率为 2.6（80%CI，2.0-3.4），单身人群的累积增加率为 3.1（80%CI，2.4-4.2）。不同人群 CVD 死亡率方面存在不同的 CVD 脆弱性，这可能有助于政府准备卫生资源并采取措施预防或减少与温度相关的死亡。
