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环境温度对中国西郊农民心血管疾病住院的影响。

Impact of ambient temperature on cardiovascular disease hospital admissions in farmers in China's Western suburbs.

机构信息

School of Management, Lanzhou University, Lanzhou 730000, PR China; Research Center for Emergency Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China.

School of Management, Lanzhou University, Lanzhou 730000, PR China; Research Center for Emergency Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China.

出版信息

Sci Total Environ. 2021 Mar 20;761:143254. doi: 10.1016/j.scitotenv.2020.143254. Epub 2020 Nov 3.

Abstract

Cardiovascular disease (CVD) has been a major threat to global public health. The association between temperature and CVD has been widely studied and reported in cities in developed countries. However, information from developing countries, especially from suburbs and countryside, is quite limited. In this study, the daily time series data on CVD hospital admissions in farmers in the suburbs of Tianshui, China, and the meteorological data from 2012 to 2015, were collected; besides, a quasi-Poisson regression with a distributed-lag non-linear model (DLNM) was used to explore the impact of local daily mean temperature on CVD hospital admissions in suburban farmers. This study found that, first, from 2011 to 2015, a total of 30,611 person-times of CVD hospital admissions in farmers were recorded; second, there was a "J-shaped" relation between temperature and CVD hospital admissions, and both low and high temperature increased the risk of hospital admission, but the impact of high temperature was greater; third, compared with the minimum hospitalization temperature (MHT) at 0.3 °C, during 0 to 21 lag days, the cumulative relative risk (RR) for extreme cold and heat (1st and 99th percentile of temperature, respectively) was 1.117 (95% CI 0.941-1.325) and 1.740 (95% CI 1.302-2.327), respectively, and that of moderate cold and heat (5st and 95th percentile of temperature, respectively) was 1.029 (95% CI 0.958-1.106) and 1.572 (95% CI 1.210-2.042), respectively; fourth, compared with male and ≥ 65 years groups, the risk for low temperature was greater for female and < 65 years groups, the risk for high temperature was just the opposite; last, about 21.04% of CVD hospital admissions burden were attributed to the ambient temperature, and most of (about 19.26%) were caused by moderate heat. In Tianshui, alongside with extreme temperature, the moderate temperature might be an important risk factor for CVD hospital admissions in suburban farmers.

摘要

心血管疾病(CVD)一直是全球公共卫生的主要威胁。在发达国家的城市中,已经广泛研究并报道了温度与 CVD 之间的关联。然而,来自发展中国家的信息,特别是来自郊区和农村地区的信息,相当有限。在这项研究中,收集了中国天水郊区农民的 CVD 住院日时间序列数据和 2012 年至 2015 年的气象数据;此外,还使用了具有分布式滞后非线性模型(DLNM)的准泊松回归模型来探索当地日平均温度对郊区农民 CVD 住院的影响。本研究发现,第一,2011 年至 2015 年,共记录了 30611 人次的农民 CVD 住院治疗;第二,温度与 CVD 住院之间存在“J 形”关系,低温和高温都会增加住院风险,但高温的影响更大;第三,与最低住院温度(MHT)0.3°C 相比,在 0 至 21 滞后天内,极寒和极热(温度的第 1 和 99 百分位数)的累积相对风险(RR)分别为 1.117(95%CI 0.941-1.325)和 1.740(95%CI 1.302-2.327),中温和极热(温度的第 5 和 95 百分位数)的 RR 分别为 1.029(95%CI 0.958-1.106)和 1.572(95%CI 1.210-2.042);第四,与男性和≥65 岁组相比,女性和<65 岁组的低温风险更高,高温风险则相反;最后,大约 21.04%的 CVD 住院负担归因于环境温度,其中大部分(约 19.26%)是由中度热引起的。在天水,除了极端温度之外,中度温度可能是郊区农民 CVD 住院的一个重要危险因素。

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