Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China.
Dezhou Center for Disease Control and Prevention, Dezhou, China.
J Hazard Mater. 2024 Dec 5;480:136114. doi: 10.1016/j.jhazmat.2024.136114. Epub 2024 Oct 9.
This study aims to examine the association between temperature variabilit (TV) exposure and influenza incidence in China, and the modification effect of PM levels. Data on daily influenza cases, weather conditions, and PM concentrations were collected from 339 cities across mainland China from 2014 to 2019. TV was computed as the standard deviation of daily maximum and minimum temperatures for the current day and the previous several days (i.e., TV0-1 to TV0-7). A space-time-stratified case-crossover design with conditional Poisson regression was employed. Overall, each 1 °C increase in TV0-6 was linked to 3.3 % (95 % CI: 3.1 %, 3.5 %) rise in influenza incidence, potentially attributing 14.73 % (95 % CI: 14.08 %, 15.37 %) of cases to this exposure. PM concentration showed substantial modification effect on the association, such that the relative risk (RR) of influenza incidence grew from 1.027 (95 % CI: 1.025, 1.029) to 1.040 (95 % CI: 1.038, 1.042) as PM levels increased from 15 to 75 μg/m³ . Females and individuals over 65 years old were more susceptible to TV exposure and the PM modification. Stronger effects were observed during cold season and in North region. The findings highlight the integrating considerations of TV and PM exposures into public health measures for influenza prevention and control.
本研究旨在探讨中国气温变异性（TV）暴露与流感发病率之间的关联，以及 PM 水平的修饰作用。从 2014 年到 2019 年，我们从中国大陆 339 个城市收集了每日流感病例、天气条件和 PM 浓度数据。TV 被计算为当前日和前几天（即 TV0-1 到 TV0-7）的每日最高和最低温度的标准差。采用时空分层病例交叉设计和条件泊松回归。总体而言，TV0-6 每增加 1°C，流感发病率上升 3.3%（95%CI：3.1%，3.5%），可能归因于该暴露的 14.73%（95%CI：14.08%，15.37%）病例。PM 浓度对这种关联有显著的修饰作用，例如，随着 PM 水平从 15 增加到 75μg/m³，流感发病率的相对风险（RR）从 1.027（95%CI：1.025，1.029）增长到 1.040（95%CI：1.038，1.042）。女性和 65 岁以上的人更容易受到 TV 暴露和 PM 修饰的影响。在寒冷季节和北方地区观察到更强的影响。这些发现强调了将 TV 和 PM 暴露综合考虑到流感预防和控制的公共卫生措施中。
