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冬季风暴和停电对多种健康结果的即时影响,以及易损性的时间窗。

The immediate effects of winter storms and power outages on multiple health outcomes and the time windows of vulnerability.

机构信息

Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.

Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.

出版信息

Environ Res. 2021 May;196:110924. doi: 10.1016/j.envres.2021.110924. Epub 2021 Mar 6.

Abstract

BACKGROUND

While most prior research has focused on extreme heat, few assessed the immediate health effects of winter storms and associated power outages (PO), although severe storms have become more frequent. This study evaluates the joint and independent health effects of winter storms and PO, snow versus ice-storm, effects by time window (peak timing, winter/transitional months) and the impacts on critical care indicators including numbers of comorbidity, procedure, length of stay and cost.

METHODS

We use distributed lag nonlinear models to assess the impacts of winter storm/PO on hospitalizations due to cardiovascular, lower respiratory diseases (LRD), respiratory infections, food/water-borne diseases (FWBD) and injuries in New York State on 0-6 lag days following storm/PO compared with non-storm/non-PO periods (references), while controlling for time-varying factors and PM. The storm-related hospitalizations are described by time window. We also calculate changes in critical care indicators between the storm/PO and control periods.

RESULTS

We found the joint effects of storm/PO are the strongest (risk ratios (RR) range: 1.01-1.90), followed by that of storm alone (1.02-1.39), but not during PO alone. Ice storms have stronger impacts (RRs: 1.04-3.15) than snowstorms (RRs: 1.03-2.21). The storm/PO-health associations, which occur immediately, and some last a whole week, are stronger in FWBD, October/November, and peak between 3:00-8:00 p.m. Comorbidity and medical costs significantly increase after storm/PO.

CONCLUSION

Winter storms increase multiple diseases, comorbidity and medical costs, especially when accompanied by PO or ice storms. Early warnings and prevention may be critical in the transitional months and afternoon rush hours.

摘要

背景

虽然大多数先前的研究都集中在极端高温上,但很少有研究评估冬季风暴和相关停电(PO)对健康的直接影响,尽管严重的风暴变得更加频繁。本研究评估了冬季风暴和 PO、雪与冰暴、时间窗口(峰值时间、冬季/过渡月份)以及对关键护理指标(包括合并症数量、手术、住院时间和成本)的影响的联合和独立健康影响。

方法

我们使用分布式滞后非线性模型来评估冬季风暴/PO 对纽约州心血管、下呼吸道疾病(LRD)、呼吸道感染、食源性/水源性疾病(FWBD)和伤害住院的影响,与风暴/PO 之前的 0-6 天滞后期相比,与非风暴/非 PO 期(参考)相比,同时控制随时间变化的因素和 PM。根据时间窗口描述与风暴相关的住院情况。我们还计算了风暴/PO 与对照期之间关键护理指标的变化。

结果

我们发现风暴/PO 的联合效应最强(风险比(RR)范围:1.01-1.90),其次是风暴单独的效应(1.02-1.39),但 PO 单独的效应则不是。冰暴的影响比暴风雪更强(RRs:1.04-3.15)比暴风雪(RRs:1.03-2.21)。风暴/PO-健康的关联立即发生,其中一些持续整整一周,在 FWBD、10 月/11 月和下午 3 点至 8 点之间最强。风暴/PO 后合并症和医疗费用显著增加。

结论

冬季风暴会增加多种疾病、合并症和医疗费用,尤其是在伴有 PO 或冰暴的情况下。在过渡月份和下午高峰时段,提前预警和预防可能至关重要。

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