Romani Santiago Gestal, Royé Dominic, Sánchez Santos Luis, Figueiras Adolfo
Hospital of Montecelo Pontevedra, 36071 Pontevedra, Spain.
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
Int J Environ Res Public Health. 2020 Dec 3;17(23):9001. doi: 10.3390/ijerph17239001.
. The increase in mortality and hospital admissions associated with high and low temperatures is well established. However, less is known about the influence of extreme ambient temperature conditions on cardiovascular ambulance dispatches. This study seeks to evaluate the effects of minimum and maximum daily temperatures on cardiovascular morbidity in the cities of Vigo and A Coruña in North-West Spain, using emergency medical calls during the period 2005-2017. For the purposes of analysis, we employed a quasi-Poisson time series regression model, within a distributed non-linear lag model by exposure variable and city. The relative risks of cold- and heat-related calls were estimated for each city and temperature model. A total of 70,537 calls were evaluated, most of which were associated with low maximum and minimum temperatures on cold days in both cities. At maximum temperatures, significant cold-related effects were observed at lags of 3-6 days in Vigo and 5-11 days in A Coruña. At minimum temperatures, cold-related effects registered a similar pattern in both cities, with significant relative risks at lags of 4 to 12 days in A Coruña. Heat-related effects did not display a clearly significant pattern. An increase in cardiovascular morbidity is observed with moderately low temperatures without extremes being required to establish an effect. Public health prevention plans and warning systems should consider including moderate temperature range in the prevention of cardiovascular morbidity.
高温和低温与死亡率及住院人数增加之间的关联已得到充分证实。然而，关于极端环境温度条件对心血管急救调度的影响，人们了解得较少。本研究旨在利用2005年至2017年期间的紧急医疗呼叫数据，评估西班牙西北部维戈市和拉科鲁尼亚市每日最低和最高气温对心血管疾病发病率的影响。为了进行分析，我们采用了拟泊松时间序列回归模型，该模型置于按暴露变量和城市划分的分布式非线性滞后模型之中。我们估计了每个城市和温度模型中与寒冷和炎热相关呼叫的相对风险。总共评估了70537次呼叫，其中大部分与两个城市寒冷日子里较低的最高和最低气温有关。在最高气温时，维戈市在滞后3至6天、拉科鲁尼亚市在滞后5至11天观察到显著的寒冷相关影响。在最低气温时，两个城市的寒冷相关影响呈现相似模式，拉科鲁尼亚市在滞后4至12天出现显著的相对风险。炎热相关影响未呈现明显的显著模式。在不需要极端温度的适度低温情况下，心血管疾病发病率就会增加。公共卫生预防计划和预警系统应考虑将适度温度范围纳入心血管疾病发病率的预防工作中。
