From the Department of Environmental & Radiological Health Sciences, Colorado State University.
Beijing Innovation Center for Engineering Science and Advanced Technology and State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China.
Epidemiology. 2020 May;31(3):319-326. doi: 10.1097/EDE.0000000000001182.
On 21-22 July 2012, Beijing, China, suffered its heaviest rainfall in 60 years. Two studies have estimated the fatality toll of this disaster using a traditional surveillance approach. However, traditional surveillance can miss disaster-related deaths, including a substantial number of deaths from natural causes triggered by disaster exposure. Here, we investigated community-wide mortality risk during this flood compared with rates in unexposed reference periods.
We compared community-wide mortality rates on the peak flood day and the four following days to seasonally matched nonflood days in previous years (2008-2011), controlling for potential confounders, to estimate the relative risks (RRs) of daily mortality among Beijing residents associated with this flood.
On 21 July 2012, the flood-associated RRs were 1.34 (95% confidence interval = 1.11, 1.61) for all-cause, 1.37 (1.01, 1.85) for circulatory, and 4.40 (2.98, 6.51) for accidental mortality, compared with unexposed periods. We observed no evidence of increased risk of respiratory mortality. For the flood period of 21-22 July 2012, we estimated a total of 79 excess deaths among Beijing residents; by contrast, only 34 deaths were reported among Beijing residents in a study using a traditional surveillance approach.
To our knowledge, this is the first study analyzing community-wide changes in mortality rates during the 2012 flood in Beijing and one of the first to do so for any major flood worldwide. This study offers critical evidence on flood-related health impacts, as urban flooding is expected to become more frequent and severe in China.
2012 年 7 月 21 日至 22 日,中国北京遭遇 60 年来最强降雨。两项研究采用传统监测方法估计了此次灾害的死亡人数。然而,传统监测可能会遗漏与灾害相关的死亡人数,包括因灾害暴露而引发的大量自然原因死亡人数。在这里,我们调查了此次洪水中社区范围内的死亡风险与未暴露时期的参考率相比的情况。
我们比较了 2012 年 7 月 21 日洪峰日及随后的四天与前几年同期(2008-2011 年)非洪峰日的社区内全因死亡率,控制了潜在的混杂因素,以估计与此次洪水相关的北京居民的每日死亡风险的相对风险(RR)。
2012 年 7 月 21 日,与未暴露期相比,所有原因、循环系统和意外死亡的洪水相关 RR 分别为 1.34(95%置信区间=1.11,1.61)、1.37(1.01,1.85)和 4.40(2.98,6.51)。我们没有发现呼吸死亡风险增加的证据。对于 2012 年 7 月 21 日至 22 日的洪水期,我们估计北京居民共有 79 例超额死亡;相比之下,另一项使用传统监测方法的研究仅报告了 34 例北京居民死亡。
据我们所知,这是首次分析 2012 年北京洪水中社区内死亡率变化的研究,也是首次对全球任何重大洪水进行此类分析的研究之一。这项研究提供了关于洪水相关健康影响的重要证据,因为预计中国的城市洪水将更加频繁和严重。