Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Albany, NY, USA.
Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
Environ Health. 2019 Apr 18;18(1):35. doi: 10.1186/s12940-019-0467-5.
Regional National Weather Service (NWS) heat advisory criteria in New York State (NYS) were based on frequency of heat events estimated by sparse monitoring data. These may not accurately reflect temperatures at which specific health risks occur in large geographic regions. The objectives of the study were to use spatially resolved temperature data to characterize health risks related to summertime heat exposure and estimate the temperatures at which excessive risk of heat-related adverse health occurs in NYS. We also evaluated the need to adjust current heat advisory threshold and messaging based on threshold temperatures of multiple health outcomes.
We assessed the effect of multi-day lag exposure for maximum near-surface air temperature (T and maximum Heat Index derived from the gridded National Land Data Assimilation System (NLDAS) reanalysis dataset on emergency department (ED) visits/ hospitalizations for heat stress, dehydration, acute kidney failure (AKF) and cardiovascular diseases (CVD) using a case-crossover analysis during summers of 2008-2012. We assessed effect modification using interaction terms and stratified analysis. Thresholds were estimated using piecewise spline regression.
We observed an increased risk of heat stress (Risk ratio (RR) = 1.366, 95% confidence interval (CI): 1.347, 1.386) and dehydration (RR = 1.024, 95% CI: 1.021, 1.028) for every 1 °C increase in T on the day of exposure. The highest risk for AKF (RR = 1.017, 95% CI: 1.014, 1.021) and CVD (RR = 1.001, 95% CI: 1.000, 1.002) were at lag 1 and 4 respectively. The increased risk of heat-health effects persists up to 6 days. Rural areas of NYS are at as high a risk of heat-health effects as urban areas. Heat-health risks start increasing at temperatures much lower than the current NWS criteria.
Reanalysis data provide refined exposure-response functions for health research, in areas with sparse monitor observations. Based on this research, rural areas in NYS had similar risk for health effects of heat. Heat advisories in New York City (NYC) had been reviewed and lowered previously. As such, the current NWS heat advisory threshold was lowered for the upstate region of New York and surrounding areas. Enhanced outreach materials were also developed and disseminated to local health departments and the public.
纽约州（NYS）的区域国家气象局（NWS）高温预警标准是基于由稀疏监测数据估计的高温事件频率制定的。这些标准可能无法准确反映在较大地理区域发生特定健康风险时的温度。本研究的目的是使用空间分辨率温度数据来描述与夏季高温暴露有关的健康风险，并估计 NYS 发生与热相关的不良健康的过度风险的温度。我们还评估了根据多种健康结果的阈值温度调整当前高温预警阈值和信息传递的必要性。
我们使用逐日滞后的近地表空气温度（T）和最大热指数评估多日滞后暴露的影响，这些数据来源于网格化国家陆地数据同化系统（NLDAS）再分析数据集，用于评估 2008 年至 2012 年夏季因热应激、脱水、急性肾衰竭（AKF）和心血管疾病（CVD）导致的急诊科（ED）就诊/住院情况。我们使用病例交叉分析，通过交互项和分层分析评估了效应修饰。使用分段样条回归估计了阈值。
我们观察到，暴露日 T 每升高 1°C，热应激（风险比（RR）=1.366，95%置信区间（CI）：1.347，1.386）和脱水（RR=1.024，95%CI：1.021，1.028）的风险增加。AKF（RR=1.017，95%CI：1.014，1.021）和 CVD（RR=1.001，95%CI：1.000，1.002）的最高风险分别出现在滞后 1 天和 4 天。高温健康影响的风险持续到第 6 天。NYS 的农村地区与城市地区一样面临高温健康影响的高风险。高温健康风险开始增加的温度远低于当前 NWS 标准。
再分析数据为在监测观察稀疏的地区的健康研究提供了更精细的暴露-反应函数。基于这项研究，纽约州的农村地区也面临着类似的高温健康影响风险。纽约市（NYC）的高温预警已经过审查并降低。因此，纽约州北部和周边地区的国家气象局提高了高温预警标准。此外，还制定并向当地卫生部门和公众发布了增强的外展材料。
