Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics / Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China.
Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China.
Environ Int. 2024 Mar;185:108484. doi: 10.1016/j.envint.2024.108484. Epub 2024 Feb 9.
Flooding has become more frequent and intensive due to climate change, particularly in Asian countries. However, evidence on the long-term health effects of floods from large-scale studies on the vulnerable aged population in China is insufficient. This study analyzed the long-term effects of exposure to flood on electrocardiographic (ECG) abnormalities, a commonly used indicator of cardiovascular disease (CVD) screening, in middle-aged and elderly people.
We evaluated the Chinese National Stroke Screening Survey data of 80,711 follow-up records from 38,375 participants aged > 40 years with two or more visits between 2013 and 2018 in this longitudinal study. Flood exposure was assessed as the presence of a satellite-detected flooded area within 500 m of the residence within 5 years before the survey date. The association between ECG abnormalities and flood exposure was analyzed using a random effects model with multiple adjustments. As age is an important CVD risk factor, a varying-coefficient function was derived to estimate the nonlinear modifying effect of age on the association between ECG abnormalities and flood exposure. The strata-specific associations between ECG abnormalities and flood exposure were applied to characterize vulnerability to flood.
The fully adjusted model suggested that flood exposure was associated with an increased risk for ECG abnormalities among the middle-aged and elderly population (odds ratio [OR] 1.74, 95 % confidence interval [CI] 1.49, 2.03). The ORs of flood exposure for ECG suggesting atrial fibrillation, ST depression, and left ventricular hypertrophy were 1.85 (95 % CI 1.16, 2.94), 6.92 (95 % CI 5.23, 9.16), and 1.55 (95 % CI 0.66, 3.65), respectively. These associations were generally robust in various subpopulations, while a sublinear curve for the negative modifying effect of age was observed on the population vulnerability to flood.
Flood exposure was associated with an increased long-term risk for an ECG abnormality. The need for effective measures to mitigate vulnerability to flood is not negligible in China.
气候变化导致洪水愈发频繁和剧烈，亚洲国家尤甚。然而，中国脆弱老年人群体的大规模研究对于洪水的长期健康影响的证据仍不足。本研究分析了暴露于洪水对 80711 名随访记录中 38375 名年龄大于 40 岁的参与者的心电图（ECG）异常（心血管疾病（CVD）筛查的常用指标）的长期影响。
本纵向研究中，我们评估了中国国家卒中筛查调查数据，该数据包含 2013 年至 2018 年期间两次或两次以上就诊的 38375 名年龄大于 40 岁的参与者的 80711 条随访记录。洪水暴露的评估方法是在调查日期前 5 年内，以居住地址为中心，利用卫星检测到的 500 米范围内存在洪泛区。使用随机效应模型和多项调整，分析心电图异常与洪水暴露之间的关系。鉴于年龄是一个重要的心血管疾病危险因素，我们得出了一个时变系数函数，以估计年龄对心电图异常与洪水暴露之间关联的非线性修饰作用。对不同年龄组的心电图异常与洪水暴露之间的关联进行分层分析，以确定洪水暴露的脆弱性。
在充分调整模型中，洪水暴露与中老年人群心电图异常的发生风险增加相关（比值比 [OR] 1.74，95%置信区间 [CI] 1.49，2.03）。洪水暴露与心电图提示心房颤动、ST 段压低和左心室肥厚的 OR 分别为 1.85（95%CI 1.16，2.94）、6.92（95%CI 5.23，9.16）和 1.55（95%CI 0.66，3.65）。这些关联在各种亚人群中基本稳健，而年龄的负向修饰作用呈亚线性曲线，表明人群对洪水的脆弱性存在差异。
洪水暴露与心电图异常的长期风险增加有关。中国需要采取有效措施来减轻对洪水的脆弱性。
