Hu Jianxiong, Huang Shaoli, Zhuo Yulin, Zhang Jianhua, Gong Weiwei, He Guanhao, Zhou Maigeng, Zeng Fangfang, Meng Ruilin, Liu Tao, Zhou Chunliang, Xiao Yize, Yu Min, Huang Biao, Bai Guoxia, Guo Hua, Ma Wenjun
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control (Jinan University), Ministry of Education, Guangzhou 510632, China.
Chemical and Biological Engineering Department, School of Engineering, Hong Kong University of Science and Technology, Hong Kong 999077, China.
Environ Int. 2025 Jan;195:109241. doi: 10.1016/j.envint.2024.109241. Epub 2024 Dec 26.
Numerous studies have investigated the impact of heatwaves on non-accidental mortality, yet the association and burden of heatwaves on mechanism-specific injury mortality remain underexplored. This study collected 257,267 injury-related fatalities and corresponding daily maximum temperatures (DMT) across seven Chinese provinces from 2013 to 2023. A heatwave was characterized by two or more successive days where the DMT surpassed its 92.5th percentile. Employing a case-crossover design, the study revealed a 12 % increase in injury mortality [95 % confidence interval (CI): 10 %, 14 %] during heatwave days compared to non-heatwave days, with a notably higher risk for drowning (ER = 22 %, 95 % CI: 16 %, 30 %). From 2013 to 2023, heatwaves were responsible for 1.64 % (95 % CI: 1.37 %, 1.90 %) of total injury-related fatalities. Additionally, future mortality burdens from 2030 to 2099 were projected, revealing that under the SSP5-8.5 scenario, the attributable fractions (AFs) of injury mortality due to heatwaves is expected to escalate from 2.66 % in the 2030s (95 % CI: 2.02 %, 3.44 %) to 7.72 % (95 % CI: 5.87 %, 9.97 %) in the 2090s, particularly in southwest China. Regarding specific mechanisms of injury, AFs for drowning is projected to rise significantly from 4.60 % (95 % CI: 3.36 %, 5.87 %) in the 2030s to 13.35 % (95 % CI: 9.75 %, 17.02 %) by the 2090s under the SSP5-8.5 scenario. This investigation underscores that heatwaves pose a significant risk for injury-related mortality, offering valuable insights for the development of adaptation strategies to effectively address climate change.
众多研究调查了热浪对非意外死亡率的影响，然而热浪与特定机制损伤死亡率之间的关联及负担仍未得到充分探索。本研究收集了2013年至2023年中国七个省份257,267例与损伤相关的死亡病例及相应的每日最高气温（DMT）。热浪的特征是连续两天或两天以上DMT超过其第92.5百分位数。采用病例交叉设计，该研究显示，与非热浪日相比，热浪期间损伤死亡率增加了12%[95%置信区间（CI）：10%，14%]，溺水风险显著更高（超额风险率（ER）=22%，95%CI：16%，30%）。2013年至2023年，热浪导致的损伤相关死亡病例占总病例的1.64%（95%CI：1.37%，1.90%）。此外，还预测了2030年至2099年未来的死亡负担，结果显示，在共享社会经济路径（SSP）5-8.5情景下，热浪导致的损伤死亡率归因分数（AFs）预计将从2030年代的2.66%（95%CI：2.02%，3.44%）升至2090年代的7.72%（95%CI：5.87%，9.97%），在中国西南部地区尤为明显。就特定损伤机制而言，在SSP5-8.5情景下，溺水的AFs预计将从2030年代的4.60%（95%CI：3.36%，5.87%）显著升至2090年代的13.35%（95%CI：9.75%，17.02%）。本调查强调，热浪对损伤相关死亡率构成重大风险，为制定有效应对气候变化的适应策略提供了宝贵见解。
