National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
Sci Total Environ. 2023 Oct 20;896:165267. doi: 10.1016/j.scitotenv.2023.165267. Epub 2023 Jul 3.
Few large-scale, nationwide studies have assessed cause-specific mortality risks and burdens associated with temperature variability (TV).
To estimate associations between TV and cause-specific mortality and quantify the mortality burden in China.
Data on daily total and cause-specific mortality in 272 Chinese cities between 2013 and 2015 were recorded. TVs were computed as the standard deviations of daily minimum and maximum temperatures over a duration of 2 to 7 days. The time-series quasi-Poisson regression model with adjustment of the cumulative effects of daily mean temperature over the same duration was applied to evaluate the city-specific associations of TV and mortality. Then, we pooled the effect estimates using a random-effects meta-analysis and calculated the mortality burdens.
Overall, TV showed significant and positive associations with total and cause-specific mortality. The TV-mortality associations were generally stronger when using longer durations. A 1 °C increase in TV at 0-7 days (TV) was associated with a 0.79 % [95 % confidence interval (CI): 0.55 %, 0.96 %] increase in total mortality. Mortality fractions attributable to TV were 4.37 % for total causes, 4.75 % for overall cardiovascular disease, 4.37 % for coronary heart disease, 5.05 % for stroke, 8.28 % for ischaemic stroke, 1.08 % for haemorrhagic stroke, 6.93 % for respiratory disease, and 6.81 % for COPD, respectively. The mortality risk and burden were generally higher in the temperate monsoon zone, females, and elders.
This nationwide study indicated that TV was an independent risk factor of mortality, and could result in significant burden for main cardiorespiratory diseases.
鲜有大规模的全国性研究评估过温度变化（TV）与特定病因死亡率和负担之间的关系。
评估 TV 与特定病因死亡率之间的关联，并量化中国的死亡负担。
记录了 2013 年至 2015 年期间 272 个中国城市的每日总死亡率和死因特异性死亡率数据。将 TV 定义为 2 至 7 天内每日最低和最高温度的标准差。应用具有同一时期内每日平均温度累积效应调整的时间序列拟泊松回归模型，评估 TV 与死亡率的城市特异性关联。然后，我们使用随机效应荟萃分析汇总效应估计值，并计算死亡率负担。
总体而言，TV 与总死亡率和死因特异性死亡率呈显著正相关。使用较长时间间隔时，TV 与死亡率的关联通常更强。0-7 天内 TV 每增加 1°C，总死亡率增加 0.79%（95%置信区间：0.55%，0.96%）。归因于 TV 的死亡率分别占总死亡率的 4.37%、总体心血管疾病的 4.75%、冠心病的 4.37%、中风的 5.05%、缺血性中风的 8.28%、出血性中风的 1.08%、呼吸疾病的 6.93%和 COPD 的 6.81%。温带季风区、女性和老年人的死亡率风险和负担通常更高。
这项全国性研究表明，TV 是死亡率的一个独立危险因素，可能导致主要心肺疾病的死亡负担显著增加。
