Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China.
Xining Centre for Disease Control and Prevention, Xining, China.
Front Public Health. 2024 May 15;12:1414945. doi: 10.3389/fpubh.2024.1414945. eCollection 2024.
With global climate change, the health impacts of cold spells and air pollution caused by PM are increasingly aggravated, especially in high-altitude areas, which are particularly sensitive. Exploring their interactions is crucial for public health.
We collected time-series data on meteorology, air pollution, and various causes of death in Xining. This study employed a time-stratified case-crossover design and conditional logistic regression models to explore the association between cold spells, PM exposure, and various causes of death, and to assess their interaction. We quantitatively analyzed the interaction using the relative excess odds due to interaction (REOI), attributable proportion due to interaction (AP), and synergy index (S). Moreover, we conducted stratified analyses by average altitude, sex, age, and educational level to identify potential vulnerable groups.
We found significant associations between cold spells, PM, and various causes of death, with noticeable effects on respiratory disease mortality and COPD mortality. We identified significant synergistic effects (REOI>0, AP > 0, S > 1) between cold spells and PM on various causes of death, which generally weakened with a stricter definition of cold spells and longer duration. It was estimated that up to 9.56% of non-accidental deaths could be attributed to concurrent exposure to cold spells and high-level PM. High-altitude areas, males, the older adults, and individuals with lower educational levels were more sensitive. The interaction mainly varied among age groups, indicating significant impacts and a synergistic action that increased mortality risk.
Our study found that in high-altitude areas, exposure to cold spells and PM significantly increased the mortality risk from specific diseases among the older adults, males, and those with lower educational levels, and there was an interaction between cold spells and PM. The results underscore the importance of reducing these exposures to protect public health.
随着全球气候变化，寒冷天气和 PM 污染导致的健康影响日益加剧，尤其是在高海拔地区，这些地区尤其敏感。探索它们的相互作用对公共卫生至关重要。
我们收集了西宁气象、空气污染和各种死因的时间序列数据。本研究采用时间分层病例交叉设计和条件逻辑回归模型，探讨寒冷天气、PM 暴露与各种死因之间的关联，并评估它们的相互作用。我们使用交互超额相对优势（REOI）、交互归因比例（AP）和协同指数（S）定量分析交互作用。此外，我们还按平均海拔、性别、年龄和教育水平进行分层分析，以确定潜在的脆弱人群。
我们发现寒冷天气、PM 和各种死因之间存在显著关联，对呼吸道疾病死亡率和 COPD 死亡率有明显影响。我们发现寒冷天气和 PM 对各种死因存在显著协同作用（REOI>0，AP>0，S>1），这种协同作用随着寒冷天气定义的严格和持续时间的延长而减弱。据估计，高达 9.56%的非意外死亡可归因于同时暴露于寒冷天气和高水平的 PM。高海拔地区、男性、老年人和教育水平较低的人更为敏感。这种相互作用主要在年龄组之间变化，表明存在显著影响和协同作用，增加了死亡风险。
本研究发现，在高海拔地区，寒冷天气和 PM 暴露会显著增加老年人、男性和教育水平较低人群特定疾病的死亡率，且寒冷天气和 PM 之间存在相互作用。研究结果强调了减少这些暴露以保护公众健康的重要性。
