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1990 年至 2019 年期间的环境高温暴露与全球疾病负担:2019 年全球疾病负担研究分析。

Ambient high temperature exposure and global disease burden during 1990-2019: An analysis of the Global Burden of Disease Study 2019.

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.

出版信息

Sci Total Environ. 2021 Sep 15;787:147540. doi: 10.1016/j.scitotenv.2021.147540. Epub 2021 May 7.

Abstract

BACKGROUND

A warming climate throughout the 21st century makes ambient high temperature exposure a major threat to population health worldwide. Mitigating the health impact of high temperature requires a timely, comprehensive and reliable assessment of disease burden globally, regionally and temporally.

AIM

Based on Global Burden of Disease (GBD) Study 2019, this study aimed to evaluate the disease burden attributable to high temperature from various epidemiology perspectives.

METHODS

A three-stage analysis was undertaken to investigate the number and age-standardized rates of death and disability-adjusted life years (DALY) attributable to high temperature from GBD Study 2019. First, we reported the high temperature-related disease burden for the whole world and for different groups by gender, age, region, country and disease. Second, we examined the temporal trend of the disease burden attributable to high temperature from 1990 to 2019. Finally, we explored if and how the high temperature-related disease burden was modified by a number of country-level indicators.

RESULTS

Globally, high temperature accounted for 0.54% of death and 0.46% of DALY in 2019, equating to the age-standardized rates of death and DALY (per 100,000 population) of 3.99 (95% uncertainty interval (UI): 2.88, 5.93) and 156.81 (95% UI: 107.98, 261.98), respectively. In 2019, the high temperature-related DALY and death rates were the highest for lower respiratory infections, although they showed a downward trend. In contrast, during 1990-2019, high temperature-related non-communicable diseases burden exhibited an upward trend. Meanwhile, the disease burden attributable to high temperature varied spatially, with the heaviest burden in regions with low sociodemographic index (SDI) and the lightest burden in regions with high SDI. In addition, high temperature-related disease burden appeared to be higher in a country with a higher population density and PM concentration background but lower in a country with a higher density of greenness.

CONCLUSION

This study for the first time provided a comprehensive understanding of the global disease burden attributable to high temperature, underscoring the policy priority to protect human health worldwide in the context of global warming with particular attention to vulnerable countries or regions as well as susceptible population and diseases.

摘要

背景

在 21 世纪,气候不断变暖,使人们暴露在高温环境中成为全球人口健康的主要威胁。减轻高温对健康的影响需要及时、全面和可靠地评估全球、区域和时间层面的疾病负担。

目的

本研究基于 2019 年全球疾病负担(GBD)研究,旨在从不同流行病学角度评估高温导致的疾病负担。

方法

采用三阶段分析方法,从 GBD 研究 2019 年中调查高温相关疾病负担的死亡人数和年龄标准化率以及伤残调整生命年(DALY)。首先,我们报告了全球范围内高温相关疾病负担,以及按性别、年龄、地区、国家和疾病划分的疾病负担。其次,我们分析了 1990 年至 2019 年高温相关疾病负担的时间趋势。最后,我们探讨了高温相关疾病负担是否以及如何受到一些国家层面指标的影响。

结果

全球范围内,高温在 2019 年导致 0.54%的死亡和 0.46%的 DALY,相当于年龄标准化死亡率(每 10 万人)为 3.99(95%置信区间(CI):2.88,5.93)和 DALY 为 156.81(95%CI:107.98,261.98)。2019 年,下呼吸道感染导致的高温相关 DALY 和死亡率最高,但呈下降趋势。相比之下,1990 年至 2019 年期间,高温相关非传染性疾病负担呈上升趋势。同时,高温相关疾病负担在社会人口指数(SDI)较低的地区空间差异最大,在 SDI 较高的地区负担最轻。此外,人口密度和 PM 浓度背景较高的国家高温相关疾病负担较高,而绿化密度较高的国家则较低。

结论

本研究首次全面了解了高温导致的全球疾病负担,强调了在全球变暖背景下,优先保护全球人类健康的政策重点,特别是关注脆弱国家或地区以及易受影响的人群和疾病。

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