Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
Department of Public Health, Environments and Society, Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
Int J Environ Res Public Health. 2020 Mar 17;17(6):1957. doi: 10.3390/ijerph17061957.
The epidemiological research relating mortality and hospital admissions to ambient temperature is well established. However, less is known about the effect temperature has on Accident and Emergency (A&E) department attendances. Time-series regression analyses were conducted to investigate the effect of temperature for a range of cause- and age-specific attendances in Greater London (LD) between 2007 to 2012. A seasonally adjusted Poisson regression model was used to estimate the percent change in daily attendances per 1 °C increase in temperature. The risk of overall attendance increased by 1.0% (95% CI 0.8, 1.4) for all ages and 1.4% (1.2, 1.5) among 0- to 15-year-olds. A smaller but significant increase in risk was found for cardiac, respiratory, cerebrovascular and psychiatric presentations. Importantly, for fracture-related attendances, the risk rose by 1.1% (0.7, 1.5) per 1 °C increase in temperature above the identified temperature threshold of 16 °C, with the highest increase of 2.1% (1.5, 3.0) seen among 0- to 15-year-olds. There is a positive association between increasing temperatures and A&E department attendance, with the risk appearing highest in children and the most deprived areas. A&E departments are vulnerable to increased demand during hot weather and therefore need to be adequately prepared to address associated health risks posed by climate change.
有关死亡率和住院率与环境温度关系的流行病学研究已经很成熟。然而,对于温度对急症科(A&E)就诊人数的影响,我们了解得较少。本研究采用时间序列回归分析,调查了 2007 年至 2012 年期间,伦敦大伦敦区(LD)各种病因和年龄特定就诊人数与温度的关系。采用季节调整泊松回归模型,估计温度每升高 1°C,每日就诊人数的百分比变化。对于所有年龄段,整体就诊风险增加 1.0%(95%CI 0.8, 1.4),0 至 15 岁儿童增加 1.4%(1.2, 1.5)。在心脏、呼吸、脑血管和精神科就诊方面,风险也略有增加,但具有统计学意义。重要的是,对于与骨折相关的就诊,在确定的 16°C 温度阈值以上,温度每升高 1°C,风险增加 1.1%(0.7, 1.5),0 至 15 岁儿童的风险增加最高,为 2.1%(1.5, 3.0)。随着温度升高,急症科就诊人数呈正相关,风险在儿童和最贫困地区最高。在炎热天气下,急症科容易出现就诊人数增加的情况,因此需要充分准备,应对气候变化带来的相关健康风险。