Research Center for Environmental Changes, Academia Sinica, No. 128, Sec. 2, Academia Rd. Nangang, Taipei, 115, Taiwan; Department of Atmospheric Sciences, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 106, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University, No. 17, Xuzhou Rd., Taipei, 100, Taiwan.
Research Center for Environmental Changes, Academia Sinica, No. 128, Sec. 2, Academia Rd. Nangang, Taipei, 115, Taiwan.
Environ Res. 2024 Dec 15;263(Pt 1):120083. doi: 10.1016/j.envres.2024.120083. Epub 2024 Sep 29.
The health impacts of the diurnal temperature range (DTR), which may be affected by climate change, have received little attention. The objectives of this study were (1) to evaluate the association of DTR and cardiopulmonary outcomes, (2) to select the proper thresholds for a DTR warning system, and (3) to identify vulnerable groups. The weather and health records in Taiwan from 2000 to 2019, with a maximum DTR of 12.8 °C, were analyzed using generalized additive models. The health outcomes included cardiovascular (CVD) and respiratory disease (RD) categories and several sub-categories, such as ischemic heart disease, stroke, pneumonia, asthma, and chronic obstructive pulmonary disease. The results showed that the associations of DTR and cardiopulmonary outcomes were as significant as, and sometimes even stronger than, those of the daily maximum temperature and daily minimum apparent temperature in the warm and cold seasons, respectively. The significant association began at DTR of 6 °C, lower than previously reported. The identified DTR warning thresholds were 8.5 and 11 °C for the warm and cold seasons, respectively. DTR is statistically significantly associated with a 5-36% and a 9-20% increase in cardiopulmonary emergency and hospitalized cases in the warm season with a 1 °C increase above 8.5 °C, respectively. In the cold season, DTR is significantly associated with 7-41%, 4-30%, and 36-100% increases in cardiopulmonary emergency, hospitalized, and mortality with a 1 °C increase above 11 °C, respectively. People with hypertension, hyperglycemia, and hyperlipidemia had even higher risks. Vulnerable age and sex groups were identified if they had a lower DTR-health threshold than the general population, which can be integrated into a warning system. In conclusion, DTR may be increased on a local or city scale under climate change; a DTR warning system and vulnerable group identification may be warranted in most countries for health risk reduction.
昼夜温差（DTR）对健康的影响可能受到气候变化的影响，但目前关注较少。本研究的目的是：(1) 评估 DTR 与心肺疾病结局的关联；(2) 选择 DTR 预警系统的适当阈值；(3) 确定易受影响的人群。本研究使用广义加性模型分析了 2000 年至 2019 年台湾的天气和健康记录，其中 DTR 的最大值为 12.8°C。健康结局包括心血管疾病（CVD）和呼吸道疾病（RD）类别，以及缺血性心脏病、中风、肺炎、哮喘和慢性阻塞性肺疾病等几个亚类。结果表明，DTR 与心肺疾病结局的关联与日最高温度和日最小表观温度在暖季和冷季的关联一样显著，有时甚至更强。显著关联始于 DTR 为 6°C，低于之前的报告。确定的 DTR 预警阈值分别为暖季和冷季的 8.5°C 和 11°C。与 8.5°C 相比，DTR 每升高 1°C，暖季心肺急症和住院病例分别增加 5-36%和 9-20%。在冷季，DTR 每升高 1°C，心肺急症、住院和死亡率分别增加 7-41%、4-30%和 36-100%。高血压、高血糖和高血脂的人群风险更高。如果易受影响的年龄和性别组的 DTR-健康阈值低于一般人群，则可以将其纳入预警系统。总之，在气候变化下，局部或城市规模的 DTR 可能会增加；大多数国家可能需要建立 DTR 预警系统并识别易受影响的人群，以降低健康风险。
