Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China.
Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
J Expo Sci Environ Epidemiol. 2023 Jan;33(1):118-124. doi: 10.1038/s41370-022-00424-x. Epub 2022 Mar 24.
Several studies have investigated the associations between temperature variability (TV) and death counts. However, evidence of TV-attributable years of life lost (YLL) is scarce.
To investigate the associations between TV and YLL rates (/100,000 population), and quantify average life loss per death (LLD) caused by TV in China.
We calculated daily YLL rates (/100,000 population) of non-accidental causes and cardiorespiratory diseases by using death data from 364 counties of China during 2006-2017, and collected meteorological data during the same period. A distributed lag non-linear model (DLNM) and multivariate meta-analysis were used to estimate the effects of TV at national or regional levels. Then, we calculated the LLD to quantify the mortality burden of TV.
U-shaped curves were observed in the associations of YLL rates with TV in China. The minimum YLL TV (MYTV) was 2.5 °C nationwide. An average of 0.89 LLD was attributable to TV in total, most of which was from high TV (0.86, 95% CI: 0.56, 1.16). However, TV caused more LLD in the young (<65 years old) (1.87, 95% CI: 1.03, 2.71) than 65-74 years old (0.85, 95% CI: 0.40-1.31) and ≥75 years old (0.40, 95% CI: 0.21-0.59), cerebrovascular disease (0.74, 95% CI: 0.36, 1.11) than respiratory disease (0.54, 95% CI: 0.21, 0.87), South (1.23, 95% CI: 0.77, 1.68) than North (0.41, 95% CI: -0.7, 1.52) and Central China (0.40, 95% CI: -0.02, 0.81). TV-attributed LLD was modified by annual mean temperature, annual mean relative humidity, altitude, latitude, longitude, and education attainment.
Our findings indicate that high and low TVs are both associated with increases in premature death, however the majority of LLD was attributable to high TV. TV-related LLD was modified by county level characteristics. TV should be considered in planning adaptation to climate change or variability.
(1) We estimated the associations of TV with YLL rates, and quantified the life loss per death (LLD) caused by TV. (2) An average of 0.89 years of LLD were attributable to TV, most of which were from high TVs. (3) TV caused more LLD in the young, cerebrovascular disease, and southern China. (4) The mortality burdens were modified by county level characteristics.
已有多项研究调查了温度变化（TV）与死亡人数之间的关联。然而，关于 TV 导致的生命损失年数（YLL）的证据仍然很少。
研究 TV 与 YLL 率（/10 万人）之间的关联，并量化中国因 TV 导致的平均死亡损失（LLD）。
我们利用中国 2006-2017 年 364 个县的死亡数据和同期气象数据，计算了非意外原因和心肺疾病的每日 YLL 率（/10 万人）。采用分布式滞后非线性模型（DLNM）和多变量荟萃分析来估计国家或地区层面 TV 的影响。然后，我们计算了 LLD，以量化 TV 导致的死亡率负担。
在中国，YLL 率与 TV 之间存在 U 型关系。全国的最小 YLL TV（MYTV）为 2.5°C。总体而言，有 0.89 年的 LLD 归因于 TV，其中大部分归因于高 TV（0.86，95%CI：0.56，1.16）。然而，TV 对年轻人（<65 岁）造成的 LLD 更多（1.87，95%CI：1.03，2.71），而对 65-74 岁（0.85，95%CI：0.40，1.31）和≥75 岁（0.40，95%CI：0.21，0.59），脑血管病（0.74，95%CI：0.36，1.11）造成的 LLD 比呼吸道疾病（0.54，95%CI：0.21，0.87）更多。南方（1.23，95%CI：0.77，1.68）比北方（0.41，95%CI：-0.7，1.52）和中国中部（0.40，95%CI：-0.02，0.81）的 LLD 更多。TV 归因的 LLD 受到年平均温度、年平均相对湿度、海拔、纬度、经度和教育程度的影响。
我们的研究结果表明，高低 TV 都会导致过早死亡增加，然而大部分的 LLD 归因于高 TV。TV 相关的 LLD 受到县级特征的影响。在应对气候变化或变化时，应考虑 TV。
（1）我们评估了 TV 与 YLL 率的关联，并量化了 TV 导致的死亡损失（LLD）。（2）平均有 0.89 年的 LLD 归因于 TV，其中大部分归因于高 TV。（3）TV 在年轻人、脑血管疾病和中国南方造成了更多的 LLD。（4）死亡率负担受到县级特征的影响。
