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中国北京日温差对精神和行为障碍每日急诊就诊的短期影响:一项时间序列研究。

Short-term effect of apparent temperature on daily emergency visits for mental and behavioral disorders in Beijing, China: A time-series study.

机构信息

State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing 100013, China; Research Center for Preventive Medicine of Beijing, Beijing 100013, China.

State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Sci Total Environ. 2020 Sep 1;733:139040. doi: 10.1016/j.scitotenv.2020.139040. Epub 2020 Apr 28.

Abstract

BACKGROUND

The relationship between temperature and mental disorders is still unclear. This study aims to assess the short-term effect of apparent temperature (AT) on daily emergency visits of mental and behavioral disorders (MDs) in Beijing, China.

METHODS

Daily counts of emergency visits related to MDs in Beijing from 2016 to 2018 were obtained. A quasi-Poisson generalized additive model combined with a distributed lag non-linear model (DLNM) was applied to analyze the lag-exposure-response relationship between AT and emergency admissions related to MDs. Sunshine duration, precipitation, PM, SO, O, time trend, day of week and holiday were adjusted in the model.

RESULTS

Total daily emergency visits for MDs during the study period were 16,606. With the reference of -2.4 °C (temperature with the minimum emergency visit risk), the single day effects of low AT (-8.6 °C, 10th percentile) and high AT (9.2 °C, 90th percentile) on MDs emergency visits reached a relative risk peak of 1.043 (95%CI: 1.017-1.069) on lag day 4 and 1.105 (95%CI: 1.006-1.215) on lag day 1, respectively. The greatest cumulative effect of high AT emerged on lag 0-5 days and reached a relative risk of 1.435 (95%CI: 1.048-1.965), while no significant cumulative effect of low AT was observed. There was a significant effect of high AT on emergency visits of MDs due to psychoactive substance use and male patients.

CONCLUSIONS

Both low and high AT are demonstrated to be the significant risk factors of MDs, which highlights the need of strengthening the health interventions, patient medical services and early warning for patients.

摘要

背景

温度与精神障碍之间的关系尚不清楚。本研究旨在评估北京地区表观温度(AT)对精神和行为障碍(MDs)每日急诊就诊的短期影响。

方法

获取 2016 年至 2018 年北京地区与 MDs 相关的每日急诊就诊计数。采用准泊松广义加性模型结合分布滞后非线性模型(DLNM)分析 AT 与 MDs 急诊就诊之间的滞后-暴露-反应关系。模型中调整了日照时间、降水、PM、SO、O、时间趋势、星期几和节假日。

结果

研究期间 MDs 的总日急诊就诊量为 16606 例。以最低急诊就诊风险的-2.4°C(温度)为参照,低温 AT(-8.6°C,第 10 百分位数)和高温 AT(9.2°C,第 90 百分位数)对 MDs 急诊就诊的单日影响在滞后 4 天和滞后 1 天达到相对风险高峰 1.043(95%CI:1.017-1.069)和 1.105(95%CI:1.006-1.215)。高温 AT 的最大累积效应出现在滞后 0-5 天,相对风险为 1.435(95%CI:1.048-1.965),而低温 AT 无明显累积效应。高温 AT 对精神活性物质使用和男性患者的 MDs 急诊就诊有显著影响。

结论

低温和高温 AT 均被证明是 MDs 的重要危险因素,这突显了加强卫生干预、患者医疗服务和对患者进行早期预警的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8523/7298617/f3d0507b9e55/ga1.jpg

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