Faurie Clare, Varghese Blesson M, Liu Jingwen, Bi Peng
School of Public Health, The University of Adelaide, Adelaide SA-5005, Australia.
Sci Total Environ. 2022 Dec 15;852:158332. doi: 10.1016/j.scitotenv.2022.158332. Epub 2022 Aug 27.
A large body of scientific evidence has established the impact of increased temperatures on human health. There is a relationship between extreme heat (either incremental temperature increase or heatwaves), and heat-related illnesses. This study aimed to collate the research findings on the effects of extreme heat on heat-related illness in a systematic review and meta-analysis, and to provide robust evidence for needed public health intervention.
We conducted a search of peer-reviewed articles in three electronic databases (PubMed, EMBASE, and SCOPUS), from database inception until January 2022. A random-effects meta-analysis model was used to calculate the pooled relative risks (RRs) of the association between high temperature and heat-related illness outcomes. A narrative synthesis was also performed for studies analysing heatwave effects. Assessment of evidence was performed in three parts: individual study risk of bias; quality of evidence across studies; and overall strength of evidence.
A total of 62 studies meeting the eligibility criteria were included in the review, of which 30 were qualified to be included in the meta-analysis. The pooled results showed that for every 1 °C increase in temperature, when measured from study-specific baseline temperatures, direct heat illness morbidity and mortality increased by 18 % (RR 1.18, 95%CI: 1.16-1.19) and 35 % (RR 1.35, 95%CI: 1.29-1.41), respectively. For morbidity, the greatest increase was for direct heat illness (RR 1.45, 95%CI: 1.38-1.53), compared to dehydration (RR 1.02, 95%CI: 1.02-1.03). There was higher risk for people aged >65 years (RR 1.25; 95 % CI: 1.20-1.30), and those living in subtropical climates (RR 1.25; 95 % CI: 1.21-1.29).
Increased temperature leads to higher burden of disease from heat-related illness. Preventative efforts should be made to reduce heat-related illness during hot weather, targeting on the most vulnerable populations. This is especially important in the context of climate change.
大量科学证据证实了气温升高对人类健康的影响。极端高温（气温逐渐升高或热浪）与热相关疾病之间存在关联。本研究旨在通过系统评价和荟萃分析整理关于极端高温对热相关疾病影响的研究结果，并为所需的公共卫生干预提供有力证据。
我们检索了三个电子数据库（PubMed、EMBASE和SCOPUS）中从建库至2022年1月的同行评审文章。采用随机效应荟萃分析模型计算高温与热相关疾病结局之间关联的合并相对风险（RRs）。对分析热浪影响的研究也进行了叙述性综合分析。证据评估分三个部分进行：单个研究的偏倚风险；各研究的证据质量；以及证据的总体强度。
本综述共纳入62项符合纳入标准的研究，其中30项有资格纳入荟萃分析。汇总结果显示，从特定研究的基线温度开始测量，温度每升高1°C，直接热疾病的发病率和死亡率分别增加18%（RR 1.18，95%CI：1.16 - 1.19）和35%（RR 1.35，95%CI：1.29 - 1.41）。对于发病率，与脱水（RR 1.02，95%CI：1.02 - 1.03）相比，直接热疾病的增幅最大（RR 1.45，95%CI：1.38 - 1.53）。65岁以上人群（RR 1.25；95%CI：1.20 - 1.30）以及生活在亚热带气候地区的人群（RR 1.25；95%CI：1.21 - 1.29）患病风险更高。
气温升高导致热相关疾病的疾病负担加重。应采取预防措施，在炎热天气期间减少热相关疾病，目标是最脆弱人群。在气候变化背景下，这一点尤为重要。
