Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
Sci Total Environ. 2020 May 15;717:137202. doi: 10.1016/j.scitotenv.2020.137202. Epub 2020 Feb 8.
Diurnal temperature range (DTR) is a key indicator reflecting climate stability. Many previous studies have examined the effects of ambient temperature, both hot and cold, on human morbidity and mortality, but few studies have evaluated health effects of DTR, especially those in developing countries. This study aimed to investigate the association between short-term exposure to DTR and hospital admissions for cardiovascular and respiratory diseases in Bangkok, Thailand. We obtained daily meteorological variables from the Thai Meteorological Department from January 2006 through December 2014 and daily hospital admissions from the National Health Security Office during the same period. Quasi-Poisson generalized linear regression model combined with distributed lag non-linear model was used to examine the association between DTR and cardiovascular and respiratory hospital admissions controlling for daily average temperature, relative humidity, day of the week, public holiday, and seasonal and long-term trend. A J-shape relationship between DTR and hospital admissions was observed. With 7.8 °C DTR as a reference value, the relative risks for cardiovascular and respiratory hospital admission associated with extremely high DTR (11.6 °C) at cumulative lag 0-21 (21-day cumulative effects) were 1.206 (95% CI: 1.002-1.452) and 1.021 (95% CI: 0.856-1.218), respectively. The effects of extremely high DTR relative to a reference value did not significantly differ between males and females, as well as between young people (<65 years) and the elderly (≥65 years) for both cardiovascular and respiratory admission. When stratifying the effects by season, the effect of extremely high DTR in winter was greater than that in summer and rainy season. This study showed that short-term exposure to extremely high DTR was significantly associated with increased risk of hospital admissions for cardiovascular disease in Bangkok, especially during winter. Results from this study could provide important scientific evidence for policy decision making to protect populations from adverse health effects of DTR.
日较差（DTR）是反映气候稳定性的关键指标。许多先前的研究都检查了环境温度（包括高温和低温）对人类发病率和死亡率的影响，但很少有研究评估 DTR 的健康影响，特别是在发展中国家。本研究旨在探讨泰国曼谷短期暴露于 DTR 与心血管和呼吸道疾病住院之间的关联。我们从 2006 年 1 月至 2014 年 12 月从泰国气象局获得了每日气象变量，并从同期的国家健康保障办公室获得了每日住院人数。准泊松广义线性回归模型结合分布式滞后非线性模型，用于检验 DTR 与心血管和呼吸道住院之间的关联，同时控制每日平均温度、相对湿度、星期几、公共假期以及季节性和长期趋势。DTR 与住院人数之间存在 J 形关系。以 7.8°C DTR 为参考值，在累积滞后 0-21 天（21 天累积效应）中，心血管和呼吸道住院与极高 DTR（11.6°C）相关的相对风险分别为 1.206（95%CI：1.002-1.452）和 1.021（95%CI：0.856-1.218）。极高 DTR 与参考值相比的影响在男性和女性、年轻人（<65 岁）和老年人（≥65 岁）之间的心血管和呼吸道入院之间没有显著差异。按季节分层影响时，冬季极高 DTR 的影响大于夏季和雨季。本研究表明，短期暴露于极高 DTR 与曼谷心血管疾病住院风险增加显著相关，尤其是在冬季。本研究结果可为保护人群免受 DTR 不良健康影响的政策决策提供重要的科学依据。
