China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China.
Environ Res. 2024 Oct 15;259:119509. doi: 10.1016/j.envres.2024.119509. Epub 2024 Jun 28.
Public health is greatly affected by heatwaves, especially as a result of climate change. It is unclear whether heatwaves affect injury hospitalization, especially as developing countries facing the impact of climate change.
To assess the impact of heatwaves on injury-related hospitalization and the economic burden.
The daily hospitalizations and meteorological data from 2014 to 2019 were collected from 23 study sites in 11 meteorological geographic zones in China. We conducted a two-stage time series analysis based on a time-stratified case-crossover design, combined with DLNM to assess the association between heatwaves and daily injury hospitalization, and to further assess the regional and national economic losses resulting from hospitalization by calculating excess hospitalization costs (direct economic losses) and labor losses (indirect economic losses). To determine the vulnerable groups and areas, we also carried out stratified analyses by age, sex, and region.
We found that 6.542% (95%CI: 3.939%, 9.008 %) of injury hospitalization were attributable to heatwaves during warm season (May to September) from 2014 to 2019. Approximately 361,447 injury hospitalizations were attributed to heatwaves each year in China, leading to an excess economic loss of 5.173 (95%CI: 3.104, 7.196) billion CNY, of which 3.114 (95%CI: 1.454, 4.720) billion CNY for males and 4.785 (95%CI: 3.203, 6.321) billion CNY for people aged 15-64 years. The attributable fraction (AF) of injury hospitalizations due to heatwaves was the highest in the plateau mountain climate zone, followed by the subtropical monsoon climate zone and the temperate monsoon climate zone.
Heatwaves significantly increase the disease and economic burden of injury hospitalizations, and vary across populations and regions. Our findings implicate the necessity for targeted measures, including raising public awareness, improving healthcare infrastructure, and developing climate resilience policies, to reduce the threat of heatwaves to vulnerable populations and the associated disease and economic burden.
热浪对公共卫生的影响很大，尤其是气候变化的影响。目前尚不清楚热浪是否会影响伤害住院治疗，尤其是在发展中国家面临气候变化影响的情况下。
评估热浪对与伤害相关的住院治疗和经济负担的影响。
从中国 11 个气象地理区的 23 个研究点收集了 2014 年至 2019 年的每日住院和气象数据。我们基于时间分层病例交叉设计，结合 DLNM 进行了两阶段时间序列分析，以评估热浪与每日伤害住院治疗之间的关联，并通过计算超额住院费用（直接经济损失）和劳动力损失（间接经济损失），进一步评估因住院治疗而导致的区域和国家经济损失。为了确定脆弱群体和地区，我们还按年龄、性别和地区进行了分层分析。
我们发现，2014 年至 2019 年暖季（5 月至 9 月），有 6.542%（95%CI：3.939%，9.008%）的伤害住院治疗归因于热浪。每年中国约有 361447 例伤害住院治疗归因于热浪，导致经济损失超过 51.733 亿元人民币（95%CI：31.040 亿至 71.966 亿元人民币），其中男性为 31.143 亿元人民币（95%CI：14.540 亿至 47.200 亿元人民币），15-64 岁人群为 47.855 亿元人民币（95%CI：32.030 亿至 63.211 亿元人民币）。热浪导致伤害住院治疗的归因分数（AF）在高原山地气候区最高，其次是亚热带季风气候区和温带季风气候区。
热浪显著增加了伤害住院治疗的疾病和经济负担，且因人群和地区而异。我们的研究结果表明，有必要采取有针对性的措施，包括提高公众意识、改善医疗基础设施和制定适应气候变化的政策，以减少热浪对脆弱人群的威胁以及相关疾病和经济负担。
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