Lee Michael Joseph, McLean Kathleen E, Kuo Michael, Richardson Gregory R A, Henderson Sarah B
Environmental Health Services British Columbia Centre for Disease Control Vancouver BC Canada.
Extreme Heat Program Climate Change and Innovation Bureau Health Canada Ottawa ON Canada.
Geohealth. 2023 Mar 15;7(3):e2022GH000729. doi: 10.1029/2022GH000729. eCollection 2023 Mar.
Western North America experienced an unprecedented extreme heat event (EHE) in 2021, characterized by high temperatures and reduced air quality. There were approximately 740 excess deaths during the EHE in the province of British Columbia, making it one of the deadliest weather events in Canadian history. It is important to understand who is at risk of death during EHEs so that appropriate public health interventions can be developed. This study compares 1,614 deaths from 25 June to 02 July 2021 with 6,524 deaths on the same dates from 2012 to 2020 to examine differences in the prevalence of 26 chronic diseases between the two groups. Conditional logistic regression was used to estimate the odds ratio (OR) for each chronic disease, adjusted for age, sex, and all other diseases, and conditioned on geographic area. The OR [95% confidence interval] for schizophrenia among all EHE deaths was 3.07 [2.39, 3.94], and was larger than the ORs for other conditions. Chronic kidney disease and ischemic heart disease were also significantly increased among all EHE deaths, with ORs of 1.36 [1.18, 1.56] and 1.18 [1.00, 1.38], respectively. Chronic diseases associated with EHE mortality were somewhat different for deaths attributed to extreme heat, deaths with an unknown/pending cause, and non-heat-related deaths. Schizophrenia was the only condition associated with significantly increased odds of EHE mortality in all three subgroups. These results confirm the role of mental illness in EHE risk and provide further impetus for interventions that target specific groups of high-risk individuals based on underlying chronic conditions.
2021年，北美西部地区经历了一场史无前例的极端高温事件（EHE），其特点是气温极高且空气质量下降。在不列颠哥伦比亚省的极端高温事件期间，大约有740人因高温死亡，这使其成为加拿大历史上最致命的天气事件之一。了解在极端高温事件期间哪些人面临死亡风险非常重要，以便能够制定适当的公共卫生干预措施。本研究将2021年6月25日至7月2日的1614例死亡病例与2012年至2020年同一日期的6524例死亡病例进行比较，以检查两组之间26种慢性病患病率的差异。使用条件逻辑回归来估计每种慢性病的比值比（OR），并对年龄、性别和所有其他疾病进行调整，并以地理区域为条件。在所有极端高温事件死亡病例中，精神分裂症的OR[95%置信区间]为3.07[2.39, 3.94]，高于其他疾病的OR。在所有极端高温事件死亡病例中，慢性肾病和缺血性心脏病也显著增加，OR分别为1.36[1.18, 1.56]和1.18[1.00, 1.38]。与极端高温事件死亡率相关的慢性病在因极端高温导致的死亡、原因不明/待定的死亡以及与高温无关的死亡中略有不同。精神分裂症是所有三个亚组中与极端高温事件死亡率显著增加的几率唯一相关的疾病。这些结果证实了精神疾病在极端高温事件风险中的作用，并为基于潜在慢性病针对特定高危个体群体的干预措施提供了进一步的推动力。
