Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Environ Int. 2022 Jun;164:107267. doi: 10.1016/j.envint.2022.107267. Epub 2022 May 2.
Greenhouse gas emissions are changing the Earth's climate, most directly by modifying temperatures and temperature variability (TV). Residents of low- and middle-income countries (LMICs) are likely more adversely affected, due to lack of air conditioning to compensate. To date, there is no local epidemiological evidence documenting the cardio-respiratory health effects of TV in Dhaka, Bangladesh, one of the most climate change vulnerable cities in the world.
We assessed short-term TV associations with daily cardiovascular disease (CVD) and respiratory emergency department (ED) visits, as well as effect modification by age and season.
TV was calculated from the standard deviations of the daily minimum and maximum temperatures over exposure days. Time-series regression modeling was applied to daily ED visits for respiratory and CVD from January 2014 through December 2017. TV effect sizes were estimated after controlling for long-term trends and seasonality, day-of-week, holidays, and daily mean relative humidity and ambient temperature.
A 1 °C increase in TV was associated with a 1.00% (95 %CI: 0.05%, 1.96%) increase in CVD ED visits at lag 0-1 days (TV) and a 2.77% (95 %CI: 0.24%, 5.20%) increase in respiratory ED visits at lag 0-7 days (TV). TV-CVD associations were larger in the monsoon and cold seasons. Respiratory ED visit associations varied by age, with older adults more affected by the TV across all seasons. A 1 °C increase in TV at lag 0-7 days (TV) was associated with a 7.45% (95 %CI: 2.33%, 12.57%) increase in respiratory ED visits among patients above 50 years of age.
This study provided novel and important evidence that cardio-pulmonary health in Dhaka is adversely affected year-round by day-to-day increases in TV, especially among older adults. TV is a key factor that should be considered in evaluating the potential human health impacts of climate change induced temperature changes.
温室气体排放正在改变地球的气候，最直接的方式是改变温度和温度可变性（TV）。由于缺乏空调来补偿，中低收入国家（LMICs）的居民可能受到更不利的影响。迄今为止，孟加拉国首都达卡还没有当地的流行病学证据来证明 TV 对心肺健康的影响，达卡是世界上气候变化最脆弱的城市之一。
我们评估了 TV 与每日心血管疾病（CVD）和呼吸急症部门（ED）就诊之间的短期关联，以及年龄和季节的影响修饰作用。
根据暴露日的每日最低和最高温度的标准差计算 TV。从 2014 年 1 月至 2017 年 12 月，采用时间序列回归模型分析每日 ED 就诊的呼吸和 CVD 数据。在控制长期趋势和季节性、周几、节假日、每日平均相对湿度和环境温度后，估计 TV 效应量。
TV 每增加 1°C，心血管疾病 ED 就诊量在滞后 0-1 天（TV）增加 1.00%（95%CI：0.05%，1.96%），在滞后 0-7 天（TV）增加 2.77%（95%CI：0.24%，5.20%）。在季风和寒冷季节，TV-CVD 关联更大。呼吸 ED 就诊的关联因年龄而异，所有季节老年人受 TV 影响更大。滞后 0-7 天的 TV 每增加 1°C（TV），50 岁以上患者的呼吸 ED 就诊量增加 7.45%（95%CI：2.33%，12.57%）。
本研究提供了新的重要证据，表明达卡的心肺健康全年受到 TV 逐日升高的不利影响，尤其是老年人。TV 是评估气候变化引起的温度变化对人类健康潜在影响时应考虑的关键因素。
