Yang Daewon, Hashizume Masahiro, Tobías Aurelio, Honda Yasushi, Roye Dominic, Oh Jaemin, Dang Tran Ngoc, Kim Yoonhee, Abrutzky Rosana, Guo Yuming, Tong Shilu, Coelho Micheline de Sousa Zanotti Stagliorio, Saldiva Paulo Hilario Nascimento, Lavigne Eric, Correa Patricia Matus, Ortega Nicolás Valdés, Osorio Samuel, Kyselý Jan, Urban Aleš, Orru Hans, Indermitte Ene, Jaakkola Jouni, Ryti Niilo, Pascal Mathilde, Huber Veronika, Schneider Alexandra, Katsouyanni Klea, Analitis Antonis, Entezari Alireza, Mayvaneh Fatemeh, Goodman Patrick, Zeka Ariana, Michelozzi Paola, de'Donato Francesca, Alahmad Barrak, Diaz Magali Hurtado, la Cruz Valencia César De, Overcenco Ala, Houthuijs Danny, Ameling Caroline, Rao Shilpa, Nunes Baltazar, Madureira Joana, Holo-Bâc Iulian Horia, Scovronick Noah, Acquaotta Fiorella, Kim Ho, Lee Whanhee, Íñiguez Carmen, Forsberg Bertil, Vicedo-Cabrera Ana Maria, Ragettli Martina S, Guo Yue-Liang Leon, Pan Shih Chun, Li Shanshan, Sera Francesco, Zanobetti Antonella, Schwartz Joel, Armstrong Ben, Gasparrini Antonio, Chung Yeonseung
Department of Information and Statistics, Chungnam National University, Daejeon, South Korea.
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Environ Epidemiol. 2024 Sep 30;8(5):e334. doi: 10.1097/EE9.0000000000000334. eCollection 2024 Oct.
The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries.
Daily time-series data for mortality and ambient mean temperature for 699 communities in 34 countries spanning 1986-2015 were analyzed using a two-stage meta-analysis. First, a quasi-Poisson regression was employed to estimate MMT and MMTP for each community during the designated subperiods. Second, we pooled the community-specific temporally varying estimates using mixed-effects meta-regressions to examine temporal changes in MMT and MMTP in the entire study population, as well as by climate zone, geographical region, and country.
Temporal increases in MMT and MMTP from 19.5 °C (17.9, 21.1) to 20.3 °C (18.5, 22.0) and from the 74.5 (68.3, 80.6) to 75.0 (71.0, 78.9) percentiles in the entire population were found, respectively. Temporal change was significantly heterogeneous across geographical regions ( < 0.001). Temporal increases in MMT were observed in East Asia (linear slope [LS] = 0.91, = 0.02) and South-East Asia (LS = 0.62, = 0.05), whereas a temporal decrease in MMT was observed in South Europe (LS = -0.46, = 0.05). MMTP decreased temporally in North Europe (LS = -3.45, = 0.02) and South Europe (LS = -2.86, = 0.05).
The temporal change in MMT or MMTP was largely heterogeneous. Population susceptibility in terms of optimum temperature may have changed under a warming climate, albeit with large region-dependent variations.
最低死亡温度(MMT)或最低死亡温度百分位数(MMTP)是衡量人群对非最适宜温度易感性的指标。MMT和MMTP会随时间变化;然而,其变化方向在区域范围内存在异质性。我们研究了多个社区和多个国家中MMT和MMTP时间变化的异质性。
利用两阶段荟萃分析,对1986 - 2015年期间34个国家699个社区的死亡率和环境平均温度的每日时间序列数据进行分析。首先,采用拟泊松回归估计每个社区在指定子时期的MMT和MMTP。其次,我们使用混合效应荟萃回归汇总特定社区随时间变化的估计值,以研究整个研究人群以及按气候区、地理区域和国家划分的MMT和MMTP的时间变化。
在整个人口中,MMT和MMTP分别从19.5℃(17.9, 21.1)上升至20.3℃(18.5, 22.0),以及从第74.5(68.3, 80.6)百分位数上升至第75.0(71.0, 78.9)百分位数。地理区域间的时间变化存在显著异质性(< 0.001)。在东亚(线性斜率[LS] = 0.91, = 0.02)和东南亚(LS = 0.62, = 0.05)观察到MMT随时间增加,而在南欧观察到MMT随时间下降(LS = -0.46, = 0.05)。北欧(LS = -3.45, = 0.02)和南欧(LS = -2.86, = 0.05)的MMTP随时间下降。
MMT或MMTP的时间变化在很大程度上是异质的。在气候变暖的情况下,人群对适宜温度的易感性可能已经发生变化,尽管存在很大的区域依赖性差异。