Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan.
Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan.
Sci Total Environ. 2022 May 15;821:153310. doi: 10.1016/j.scitotenv.2022.153310. Epub 2022 Jan 24.
In summer 2020 under the COVID-19 pandemic, the Ministry of Health, Labour and Welfare has made public warnings that specific preventive measures such as maskwearing and stay-at-home orders, may increase heatstroke risk. In our previous work, we found a lower risk of heatstroke-related ambulance dispatches (HSAD) during the COVID-19 period, however, it is uncertain whether similar risk reductions can be observed in different vulnerable subgroups. This study aimed to determine the HSAD risk during the COVID-19 pandemic by age, severity, and incident place subgroups.
A summer-specific (June-September), time-series analysis was performed, using daily HSAD and meteorological data from 47 Japanese prefectures from 2017 to 2020. A two-stage analysis was applied to determine the association between HSAD and COVID-19 pandemic, adjusting for maximum temperature, humidity, seasonality, and relevant temporal adjustments. A generalized linear model was utilized in the first stage to estimate the prefecture-specific effect estimates. Thereafter, a fixed effect meta-analysis in the second stage was implemented to pool the first stage estimates. Subsequently, subgroup analysis via an interaction by age, severity, and incident place was used to analyze the HSAD risk among subgroups.
A total of 274,031 HSAD cases was recorded across 47 Japanese prefectures. The average total number of HSAD in the pre-COVID-19 period was 69,721, meanwhile, the COVID-19 period was 64,869. Highest reductions in the risks was particularly observed in the young category (ratio of relative risk (RRR) = 0.54, 95% Confidential Interval (CI): 0.51, 0.57) compared to the elderly category. Whereas highest increment in the risks were observed in severe/death (RRR = 1.25, 95% CI: 1.13, 1.37) compared to the mild category.
COVID-19 situation exhibited a non-uniform change in the HSAD risk for all subgroups, with the magnitude of the risks varying by age, severity, and incident place.
在 2020 年夏季 COVID-19 大流行期间，厚生劳动省发布公开警告称，佩戴口罩和居家令等特定预防措施可能会增加中暑风险。在我们之前的工作中，我们发现 COVID-19 期间与中暑相关的救护车派遣（HSAD）风险较低，然而，在不同的弱势群体中是否可以观察到类似的风险降低尚不确定。本研究旨在通过年龄、严重程度和事件地点亚组确定 COVID-19 大流行期间的 HSAD 风险。
采用 2017 年至 2020 年来自日本 47 个县的每日 HSAD 和气象数据，进行了特定于夏季（6 月至 9 月）的时间序列分析。应用两阶段分析来确定 HSAD 与 COVID-19 大流行之间的关联，调整了最高温度、湿度、季节性和相关的时间调整。第一阶段使用广义线性模型来估计县特定的效应估计值。然后，在第二阶段进行固定效应荟萃分析，以汇总第一阶段的估计值。此后，通过年龄、严重程度和事件地点的交互作用进行亚组分析，以分析亚组中的 HSAD 风险。
在日本 47 个县共记录了 274031 例 HSAD 病例。在 COVID-19 之前的时期，HSAD 的平均总数为 69721 例，而 COVID-19 期间为 64869 例。与老年组相比，年轻组的风险降低幅度最大（相对风险比（RRR）=0.54，95%置信区间（CI）：0.51，0.57）。与轻度组相比，严重/死亡组的风险增加幅度最大（RRR=1.25，95%CI：1.13，1.37）。
COVID-19 情况导致所有亚组的 HSAD 风险呈非均匀变化，风险幅度因年龄、严重程度和事件地点而异。
