Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
Jinan Municipal Center for Disease Control and Prevention; Jinan Municipal Center for Disease Control and Prevention Affiliated to Shandong University, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China.
Environ Res. 2022 Nov;214(Pt 3):114073. doi: 10.1016/j.envres.2022.114073. Epub 2022 Aug 12.
We aimed to investigate the acute effect of extreme cold weather on circulatory disease mortality of older adults in Jinan, with individual and regional-scale characteristics as subgroup analyses to further identify vulnerable populations.
This study contained the death data of Jinan from 2011 to 2020 (Nov-Mar). A time-stratified case-crossover method was used to estimate the effects of extreme cold weather and lags 0-8 days, controlling for holiday and relative humidity. To evaluate the impact of different durations and thresholds of extreme cold weather, we considered 4 cold day and 12 cold wave definitions RESULTS: Our results showed an increase in circulatory disease deaths under several definitions. The number of older adults died of circulatory diseases totaled 92,119 during the study period. In the definitions of cold day, the maximum significant effect ranging from 1.08 (95% CI: 1.03,1.14) to 1.13 (95% CI: 1.04,1.24) and appeared on Lag5 or Lag6. In the definitions of cold wave, the maximum significant effect ranging from 1.07 (95% CI: 1.02, 1.12) to 1.14 (95% CI: 1.03, 1.25). The cold effect is mainly attributable to cold day rather than an added effect related to the duration. Our research confirmed that extreme cold weather had a stronger impact on women [maximum effects with an OR of 1.21 (95% CI: 1.08, 1.36) in P1, 1.19 (95% CI: 1.05, 1.36) in M12)], and the effect gradient increased with age.
Our findings support the evidence on the impact of extreme cold weather on circulatory disease mortality and provide a basis for policymakers to select target groups to develop policies and reduce the public health burden.
本研究旨在探讨济南极端寒冷天气对老年人循环系统疾病死亡率的急性影响，并进行个体和区域特征的亚组分析，以进一步确定脆弱人群。
本研究包含了 2011 年至 2020 年（11 月至 3 月）济南的死亡数据。采用时间分层病例交叉法估计极端寒冷天气的影响及其滞后 0-8 天，控制节假日和相对湿度的影响。为了评估不同持续时间和极端寒冷天气阈值的影响，我们考虑了 4 个寒冷日和 12 个寒潮定义。
在几种定义下，循环系统疾病死亡人数增加。研究期间，共有 92119 名老年人死于循环系统疾病。在寒冷日的定义中，最大显著效应范围为 1.08（95%CI：1.03，1.14）至 1.13（95%CI：1.04，1.24），并出现在滞后 5 天或滞后 6 天。在寒潮的定义中，最大显著效应范围为 1.07（95%CI：1.02，1.12）至 1.14（95%CI：1.03，1.25）。寒冷效应主要归因于寒冷日，而不是与持续时间相关的附加效应。我们的研究证实，极端寒冷天气对女性的影响更大[在 P1 中，最大效应的 OR 为 1.21（95%CI：1.08，1.36），在 M12 中为 1.19（95%CI：1.05，1.36）]，且随着年龄的增长，效应梯度增加。
本研究结果支持了极端寒冷天气对循环系统疾病死亡率影响的证据，并为政策制定者选择目标人群制定政策和减轻公共卫生负担提供了依据。
