极端气温对济南市非意外死亡及主要死因别死亡影响  

Impact of temperature extremes on non-accidental and cause-specific deaths in Ji′nan city

作　　者：韩京[1] 房巧玲[1] 周林[1] 张军[1] 刘守钦[1] 张济[1] 张颖[2] HAN Jing;FANG Qiao-ling;ZHOU Lin(Ji’ nan Municipal Center for Disease Control and Prevention,Ji′nan,Shandong Province 250021,China)

机构地区：[1]济南市疾病预防控制中心,山东250021 [2]悉尼大学公共卫生学院

出　　处：《中国公共卫生》2019年第9期1242-1244,共3页Chinese Journal of Public Health

摘　　要：目的探讨极端气温对山东省济南市居民非意外死亡及主要死因别死亡的影响,筛查敏感人群。方法收集济南市2011—2014年居民非意外死亡及主要死因别逐日死亡资料和同时期的气象资料。采用时间序列泊松回归模型,分析极端气温对济南市非意外死亡及主要死因别死亡人数、死亡风险的影响。结果极端低温暴露(寒潮)显著增加居民非意外死亡及主要死因别日均死亡人数(P<0.01),极端高温暴露(热浪)仅对居民非意外死亡日死亡人数具有影响(P<0.05),对主要死因别死亡无明显影响。回归分析结果显示,寒潮暴露明显增加居民非意外死亡、呼吸系统疾病死亡、卒中和慢性阻塞性肺疾病(COPD)死亡风险(RR=1.27、1.19、1.11、1.08,P<0.01);热浪暴露增加居民非意外死亡和卒中的死亡风险(RR=1.02、1.06,P<0.05)。全部人群不论性别与年龄均是寒潮敏感人群;65岁以上老年人是热浪敏感人群(RR=1.03,P<0.01)。结论极端气温可增加济南市居民非意外死亡及主要死因别日均死亡人数与死亡风险,全部人群均是寒潮敏感人群,65岁以上老年人是热浪敏感人群,在极端气温期间应针对敏感人群采取预防与救治措施。Objective To investigate the relationship between temperature extremes and daily number of non-accidental and cause-specific deaths and to identify populations vulnerable to adverse effect of temperature extremes in Ji ′nan city, Shandong province. Methods We collected data on daily number of non-accidental and cause-specific deaths from death registry of Ji′nan city over the period of 2011 – 2014 and meteorological variables were also collected simultaneously. We applied time-series adjusted Poisson regression to assess the effects of extreme temperature on mortality and death risk of non-accidental and cause-specific deaths by controlling for lagged effect, autocorrelation, age, gender, and other confounders. Results Extreme low-temperature events (cold spells) significantly increased daily number of non-accidental and causespecific deaths (P < 0.01). Extreme high-temperature events (heat waves) increased non-accidental deaths but not causespecific deaths. Cold spells significantly increased the risk of deaths due to non-accidental injury (relative risk [RR]= 1.27), respiratory disease (RR = 1.19), stroke (RR = 1.11), and chronic obstructive pulmonary disease (COPD)(RR = 1.08)(P < 0.01 for all). Heat waves were most pronounced for increased deaths of non-accidental injury (RR = 1.02) and stroke (RR = 1.06)(both P < 0.05). The vulnerability to cold spells was for the whole population regardless of age and gender. The elderly were more vulnerable to adverse effect of heat waves (RR = 1.03, P < 0.01). Conclusion Both extreme high and low temperature could increase daily number and risk of non-accidental and cause-specific deaths among residents in Ji′nan city;the whole population is vulnerable to cold spells and the elderly aged more than 65 years are more vulnerable to heat waves. The findings suggest that interventions should be developed for vulnerable populations during extreme weather events.

关 键 词：极端气温事件 非意外死亡 广义相加模型 

分 类 号：R122.21[医药卫生—环境卫生学]