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智利不同地区在短期和长期内基于RCP2.6和RCP8.5情景估计温度对死亡率和住院率的影响:一项基于人群的建模研究。

Estimating the effects of temperature on mortality and hospitalisations under RCP2.6 and RCP8.5 scenarios in the short- and long-term by region in Chile: a population-based, modelling study.

作者信息

Palmeiro-Silva Yasna, Chandler Richard E, Kelman Ilan

机构信息

Institute for Global Health, University College London, London, UK.

Centro Políticas Públicas UC, Pontificia Universidad Católica de Chile, Chile.

出版信息

Lancet Reg Health Am. 2025 Jun 16;48:101151. doi: 10.1016/j.lana.2025.101151. eCollection 2025 Aug.

Abstract

BACKGROUND

In a warming world, it is generally accepted that increasing temperatures affect human health. In many regions of the world, however, these effects are poorly understood. To address this issue in Chile, we estimated the potential change in all-cause and cardiovascular and temperature-related (CVT) mortality and hospitalisations associated with four different climate scenarios by region.

METHODS

Using Chilean health data and ERA5 reanalysis data, we modelled the relationship between historical health outcomes and monthly temperature indices using Generalised Additive Models. After evaluating the models' predictive performance, we used them to estimate changes in health outcomes associated with bias-adjusted climate projections representing four scenarios: short-term (2031-2060) and long-term (2061-2090) periods under both Representative Concentration Pathways (RCPs) 2.6 and 8.5.

FINDINGS

Scenario-based health outcomes show clear north-south variations. Compared to historical levels, all-cause mortality increases by ∼1.5% in northern regions but decreases by ∼1% in southern regions across scenarios. CVT mortality decreases (0.2-3.6%), especially in the south; however, Arica and Tarapacá in the north show sharp increases (up to 30%) under warmer scenarios. Conversely, all-cause and CVT hospitalisations increase in northern/central regions (higher in summer, lower in winter), while southern/austral regions show slight decreases (∼1%).

INTERPRETATION

These findings highlight the need for region-specific analyses and public health strategies in Chile. Northern regions might require plans that reduce the risk of heat-related mortality and morbidity, while southern regions might adjust healthcare services because of potential shifts in healthcare needs.

FUNDING

National Agency for Research and Development, Chile and University College London, UK.

摘要

背景

在全球变暖的背景下,气温上升影响人类健康这一观点已被广泛接受。然而,世界上许多地区对这些影响的了解却很有限。为了解决智利的这一问题,我们按地区估算了与四种不同气候情景相关的全因死亡率、心血管疾病及与温度相关疾病(CVT)死亡率和住院率的潜在变化。

方法

利用智利的健康数据和ERA5再分析数据,我们使用广义相加模型对历史健康结果与月温度指数之间的关系进行建模。在评估模型的预测性能后,我们用它们来估计与代表四种情景的偏差调整后的气候预测相关的健康结果变化:在代表性浓度路径(RCP)2.6和8.5下的短期(2031 - 2060年)和长期(2061 - 2090年)。

研究结果

基于情景的健康结果呈现出明显的南北差异。与历史水平相比,在所有情景下,北部地区的全因死亡率增加约1.5%,而南部地区则下降约1%。CVT死亡率下降(0.2 - 3.6%),尤其是在南部地区;然而,北部的阿里卡和塔拉帕卡地区在气候变暖情景下显示出急剧上升(高达30%)。相反,北部/中部地区的全因和CVT住院率增加(夏季较高,冬季较低),而南部/南方地区则略有下降(约1%)。

解读

这些发现凸显了智利进行地区特定分析和制定公共卫生策略的必要性。北部地区可能需要制定计划以降低与热相关的死亡率和发病率风险,而南部地区可能需要根据医疗需求的潜在变化调整医疗服务。

资金来源

智利国家研究与发展局和英国伦敦大学学院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3edc/12211848/1e4df31c4001/gr1.jpg

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