Borchers-Arriagada Nicolas, Gasparrini Antonio, Rodriguez-Villamizar Laura A
Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
Environment & Health Modelling Lab, Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Air Qual Atmos Health. 2025 Aug;18(8):2373-2384. doi: 10.1007/s11869-025-01782-9. Epub 2025 Jun 27.
Adverse effects of non-optimal temperatures on mortality have been reported in different climates. However, only a low number of studies have been conducted in tropical locations where these effects might differ. Here, we estimate the association between ambient air temperature and all-cause mortality and assess the impact of non-optimal temperatures on attributable mortality at national and subnational levels in Colombia during 2010-2019. We obtained daily temperature and mortality data for 32 departments and conducted a two-stage analysis. In stage-1 we fitted a time-series Poisson model for each department and estimated the mortality-temperature association using distributed-lag-nonlinear models with 7-28 days of lag. In stage-2, we pooled these estimates using a multivariate meta-analytic model including mean temperature, relative humidity, and a multidimensional poverty index. We calculated attributable deaths and fractions due to non-optimal temperatures and due to overall heat and cold. We analyzed 2,561,561 deaths and found marked differences in exposure-response curves of mortality-temperature, where most departments showed acute heat effects but no cold effects for the 7-days lag. This lag-response curve for heat showed that the risk of death is higher during the same day (lag 0) of extreme temperatures and decreases after the third day. The country attributable fraction due to non-optimal temperature was higher for heat (1.77, 95% CI 1.16 - 2.31) during the 0-7 days lag, but higher for cold temperatures (4.68, 95% CI 2.34 - 6.72) during the 0-28 days lag. There was high heterogeneity in the estimated risks between departments. These results should inform planning adaptation strategies for climate change differentiated at subnational level.
在不同气候条件下，已报道了非最佳温度对死亡率的不利影响。然而，在热带地区进行的研究数量较少，而这些影响在热带地区可能有所不同。在此，我们估计了2010 - 2019年期间哥伦比亚全国和次国家层面环境气温与全因死亡率之间的关联，并评估了非最佳温度对可归因死亡率的影响。我们获取了32个部门的每日温度和死亡率数据，并进行了两阶段分析。在第一阶段，我们为每个部门拟合了一个时间序列泊松模型，并使用具有7 - 28天滞后的分布滞后非线性模型估计死亡率与温度的关联。在第二阶段，我们使用包括平均温度、相对湿度和多维贫困指数的多元荟萃分析模型汇总这些估计值。我们计算了由于非最佳温度以及总体炎热和寒冷导致的可归因死亡数和比例。我们分析了2561561例死亡病例，发现死亡率 - 温度的暴露 - 反应曲线存在显著差异，其中大多数部门在滞后7天时显示出急性热效应，但没有冷效应。这种热的滞后反应曲线表明，在极端温度的同一天（滞后0天）死亡风险较高，第三天后风险降低。在滞后0 - 7天期间，因非最佳温度导致的全国可归因比例在炎热时较高（1.77，95%置信区间1.16 - 2.31），但在滞后0 - 28天期间，寒冷温度时较高（4.68，95%置信区间2.34 - 6.72）。各部门之间估计风险存在高度异质性。这些结果应为次国家层面差异化的气候变化规划适应策略提供参考。
