中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2014年
6期
684-688
,共5页
李萌萌%周脉耕%张霞%黄季夏%白莉%桑少伟%张济%刘起勇
李萌萌%週脈耕%張霞%黃季夏%白莉%桑少偉%張濟%劉起勇
리맹맹%주맥경%장하%황계하%백리%상소위%장제%류기용
气温%非意外死亡%死因别死亡%分布滞后非线性模型
氣溫%非意外死亡%死因彆死亡%分佈滯後非線性模型
기온%비의외사망%사인별사망%분포체후비선성모형
Temperature%Non-accidental death%Cause-specific mortality%Distributed lag non-linear model
目的:研究气温与济南市4个区居民日均非意外死亡的关系,探讨气温在不同滞后天数下对各死因别死亡的影响。方法收集济南市4个区(市中、槐荫、天桥、历下)2008年1月至2012年12月死亡资料,以及同期气温数据和空气污染指数(API)数据,采用分布滞后非线性模型,控制长期趋势和季节效应以及其他混杂因素后,研究气温与非意外死亡的关系以及在不同滞后天数时气温对心血管疾病、呼吸系统疾病、消化系统疾病、泌尿系统疾病及部分亚类(高血压病、缺血性心脏病、急性心肌梗死、脑血管病、慢性下呼吸道疾病)的影响。结果济南市4个区气温与非意外死亡的暴露-反应曲线为“W”形;低温的滞后天数较长,累计效应可达1个月,高温的滞后天数较短,不超过5 d,且呈现出收获效应;心血管疾病、呼吸系统疾病、缺血性心脏病、脑血管病、急性心肌梗死存在热效应,高温当天的RR值分别为1.12(95%CI:1.07~1.17)、1.06(95%CI:1.02~1.31)、1.08(95%CI:1.003~1.16)、1.10(95%CI:1.02~1.20)、1.13(95%CI:1.003~1.26),滞后期较短,泌尿系统疾病和高血压病在极高温时有较高的RR值,分别为2.30(95%CI:1.18~4.51)、1.65(95%CI:1.02~2.69);其中心血管疾病、呼吸系统疾病、慢性下呼吸道疾病、高血压、缺血性心脏病、脑血管病、急性心肌梗死均呈现出一定的冷效应,30 d滞后的累计效应分别为1.51(95%CI:1.42~1.60)、1.90(95%CI:1.64~2.20)、2.12(95%CI:1.67~2.69)、1.48(95%CI:1.08~2.03)、1.60(95%CI:1.46~1.75)、1.40(95%CI:1.26~1.55)、1.68(95%CI:1.45~1.95)。结论气温与济南市4个区居民的非意外死亡及各死因别死亡存在关系,温度过高或过低均是其危险因素,在高温或低温期间需针对敏感疾病采取相应的预防措施。
目的:研究氣溫與濟南市4箇區居民日均非意外死亡的關繫,探討氣溫在不同滯後天數下對各死因彆死亡的影響。方法收集濟南市4箇區(市中、槐蔭、天橋、歷下)2008年1月至2012年12月死亡資料,以及同期氣溫數據和空氣汙染指數(API)數據,採用分佈滯後非線性模型,控製長期趨勢和季節效應以及其他混雜因素後,研究氣溫與非意外死亡的關繫以及在不同滯後天數時氣溫對心血管疾病、呼吸繫統疾病、消化繫統疾病、泌尿繫統疾病及部分亞類(高血壓病、缺血性心髒病、急性心肌梗死、腦血管病、慢性下呼吸道疾病)的影響。結果濟南市4箇區氣溫與非意外死亡的暴露-反應麯線為“W”形;低溫的滯後天數較長,纍計效應可達1箇月,高溫的滯後天數較短,不超過5 d,且呈現齣收穫效應;心血管疾病、呼吸繫統疾病、缺血性心髒病、腦血管病、急性心肌梗死存在熱效應,高溫噹天的RR值分彆為1.12(95%CI:1.07~1.17)、1.06(95%CI:1.02~1.31)、1.08(95%CI:1.003~1.16)、1.10(95%CI:1.02~1.20)、1.13(95%CI:1.003~1.26),滯後期較短,泌尿繫統疾病和高血壓病在極高溫時有較高的RR值,分彆為2.30(95%CI:1.18~4.51)、1.65(95%CI:1.02~2.69);其中心血管疾病、呼吸繫統疾病、慢性下呼吸道疾病、高血壓、缺血性心髒病、腦血管病、急性心肌梗死均呈現齣一定的冷效應,30 d滯後的纍計效應分彆為1.51(95%CI:1.42~1.60)、1.90(95%CI:1.64~2.20)、2.12(95%CI:1.67~2.69)、1.48(95%CI:1.08~2.03)、1.60(95%CI:1.46~1.75)、1.40(95%CI:1.26~1.55)、1.68(95%CI:1.45~1.95)。結論氣溫與濟南市4箇區居民的非意外死亡及各死因彆死亡存在關繫,溫度過高或過低均是其危險因素,在高溫或低溫期間需針對敏感疾病採取相應的預防措施。
목적:연구기온여제남시4개구거민일균비의외사망적관계,탐토기온재불동체후천수하대각사인별사망적영향。방법수집제남시4개구(시중、괴음、천교、력하)2008년1월지2012년12월사망자료,이급동기기온수거화공기오염지수(API)수거,채용분포체후비선성모형,공제장기추세화계절효응이급기타혼잡인소후,연구기온여비의외사망적관계이급재불동체후천수시기온대심혈관질병、호흡계통질병、소화계통질병、비뇨계통질병급부분아류(고혈압병、결혈성심장병、급성심기경사、뇌혈관병、만성하호흡도질병)적영향。결과제남시4개구기온여비의외사망적폭로-반응곡선위“W”형;저온적체후천수교장,루계효응가체1개월,고온적체후천수교단,불초과5 d,차정현출수획효응;심혈관질병、호흡계통질병、결혈성심장병、뇌혈관병、급성심기경사존재열효응,고온당천적RR치분별위1.12(95%CI:1.07~1.17)、1.06(95%CI:1.02~1.31)、1.08(95%CI:1.003~1.16)、1.10(95%CI:1.02~1.20)、1.13(95%CI:1.003~1.26),체후기교단,비뇨계통질병화고혈압병재겁고온시유교고적RR치,분별위2.30(95%CI:1.18~4.51)、1.65(95%CI:1.02~2.69);기중심혈관질병、호흡계통질병、만성하호흡도질병、고혈압、결혈성심장병、뇌혈관병、급성심기경사균정현출일정적랭효응,30 d체후적루계효응분별위1.51(95%CI:1.42~1.60)、1.90(95%CI:1.64~2.20)、2.12(95%CI:1.67~2.69)、1.48(95%CI:1.08~2.03)、1.60(95%CI:1.46~1.75)、1.40(95%CI:1.26~1.55)、1.68(95%CI:1.45~1.95)。결론기온여제남시4개구거민적비의외사망급각사인별사망존재관계,온도과고혹과저균시기위험인소,재고온혹저온기간수침대민감질병채취상응적예방조시。
Objective To study the relationship between daily temperature and non-accidental deaths in four districts of Jinan,and to investigate the impact of temperature on cause-specific mortality. Methods Data on daily mortality of the four districts(Shizhong,Huaiyin,Tianqiao,Lixia) as well as data related to meteorology and air pollution index were collected from January 1,2008 to December 31,2012. Distributed lag non-linear model(DLNM)was then used to assess the effects of temperature on all non-accidental deaths and deaths caused by cardiovascular diseases (CVD), respiratory diseases(RD),digestive diseases,urinary diseases,and also subcategories to hypertension, ischemic heart diseases(IHD),acute myocardial infarction(AMI),cerebro-vascular diseases(CBD) and chronic lower respiratory diseases. Results A W-shaped relationship was noticed between daily average temperature and non-accidental deaths. The effect of low temperature last for more than 30 days,much longer than that of high temperature,in which presented a harvesting effect less than 5 days. As to the cause-specific mortality,short-term heat effects were seen in CVD and RD as well as related subgroups as IHD,CBD and AMI,with RRs at lag 0 as 1.12(95%CI:1.07-1.17),1.06 (95%CI:1.02-1.31),1.08(95%CI:1.003-1.16),1.10(95%CI:1.02-1.20) and 1.13 (95%CI:1.003-1.26). Relatively higher RRs were seen in urinary diseases and hypertension under extremely high temperature,reaching as high as 2.30(95%CI:1.18-4.51)and 1.65(95%CI:1.02-2.69). Cold weather presented a delayed effect for 30 days,with cumulative RRs as 1.51(95%CI:1.42-1.60),1.90 (95%CI:1.64-2.20),2.12(95%CI:1.67-2.69),1.48(95%CI:1.08-2.03),1.60(95%CI:1.46-1.75), 1.40(95%CI:1.26-1.55),1.68(95%CI:1.45-1.95)for CVD,RD,chronic lower respiratory diseases, hypertension,IHD,CBD and AMI,on sequence. Conclusion A relationship was seen between daily temperature and non-accidental deaths as well as cause-specific mortality. Either high or low temperature seemed to be detrimental. Related measures on disease prevention should be taken during the cold and hot seasons.