日温差对湖南省居民寿命损失年影响的时间序列研究  

Effect of diurnal temperature range on years of life lost in Hunan Province: A time-series analysis

作　　者：许意清 蔡敏 陈思齐 吕玲双 周纯良[1] XU Yi-qing;CAI Min;CHEN Si-qi;LÜLing-shuang;ZHOU Chun-liang(Department of Environment and Health,Hunan Provincial Center for Disease Control and Prevention,Changsha,Hunan 410005,China;Guangdong Provincial Institute of Public Health,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou,Guangdong 511430,China)

机构地区：[1]湖南省疾病预防控制中心环境与健康科,湖南长沙410005 [2]广东省疾病预防控制中心广东省公共卫生研究院,广东广州511430

出　　处：《环境与职业医学》2020年第7期650-656,共7页Journal of Environmental and Occupational Medicine

基　　金：湖南省自然科学基金面上项目(2020JJ4388)。

摘　　要：[背景]温度变化是影响人类健康的重要因素之一。昼夜日温差(DTR)是衡量温度变化的重要指标之一,了解其健康效应有助于制定人群适应气候变化的策略。[目的]了解湖南省DTR对居民寿命损失年(YLLs)的影响。[方法]采用分布滞后非线性模型分析湖南省69个区县2013—2017年DTR与每10万人寿命损失年率(YLLsR)的暴露-反应关系,然后利用多变量meta分析合并每个县区的效应,并分冷暖季、亚组人群和DTR区间计算疾病负担。[结果]研究共涉及5000多万人口。各研究点非意外总死亡日均YLLs R为(22.6±13.4)/10万,暖季(5—10月)DTR中位数(8.1℃)高于冷季(11月—次年4月)(6.4℃)。暖季DTR与YLLsR的暴露-反应关系呈"U"形,较高DTR增加非意外总死亡(DTR≥14.3℃)和呼吸系统死亡(DTR≥15.8℃)YLLs的归因分值(AF)分别为0.2%(95%CI:0.0%~0.5%)和0.1%(95%CI:0.0%~0.3%)。女性和≥65岁老年人为暖季敏感人群。冷季DTR与YLLsR的暴露-反应关系呈"J"形,最小归因YLLsR对应的DTR(MYD)在2.1~2.2℃之间。冷季归因YLLs高于暖季,DTR<MYD和DTR>MYD均增加居民非意外总死亡和心脑血管疾病死亡归因YLLs。在冷季,各亚组人群DTR的非意外总死亡AF均大于0且有统计学意义,男性AF(13.8%,95%CI:4.5%~23.0%)高于女性(12.3%,95%CI:1.7%~22.9%);≥65岁人群的归因YLLsR及其95%CI为[13.1/10万(2.7/10万~23.6/10万)]高于0~64岁人群[1.8/10万(0.5/10万~3.1/10万)],但0~64岁人群AF值更大,达14.6%(95%CI:4.1%~25.0%)。[结论]DTR变化能增加湖南省居民YLLs。女性和老年人为暖季脆弱人群,冷季则人群普遍受影响,且危害效应较暖季更大。[Background]Temperature change has become an important factor affecting human health.Exploring the health effect of diurnal temperature difference(DTR),one of the important indicators to measure temperature change,is conducive to develop strategies for population adaptation to climate change.[Objective]This study aims to evaluate the effect of DTR on years of life lost(YLLs)in Hunan Province.[Methods]The exposure-response relationship between DTR and years of life lost rate(YLLsR,per 100000 population)among 69 counties from 2013 to 2017 in Hunan Province was evaluated by distributed lag nonlinear model(DLNM).The pooled effect was estimated by multivariate meta-analysis.Selected category-specific disease burdens due to DTR were estimated including warm or cold season,gender,age groups and DTR intervals.[Results]Over 50 million population was covered in this study,and the mean daily YLLsR of non-accidental deaths was(22.6±13.4)/10~5,and the median DTR in warm season(from May to October)(8.1℃)was higher than that in cold season(from November to next April)(6.4℃).In warm season,the pooled relationship between DTR and attributable YLLs R was nearly U-shaped,and the attributable fractions(AF)of YLLs increased by high level of DTR in total non-accidental deaths(DTR≥14.3 tory system disease deaths(DTR15.8℃)were 0.2%(95%CI:0.0%-0.05%)and 0.1%(95%CI:0.0%-0.3%),respectively.Wom℃en)and respira≥and seniors(≥65 years old)were the vulnerable subgroups in warm season.In cold season,the pooled relationship between DTR and attribu℃table YLLs R was nearly J-shaped,and the minimum attributable YLLs R diurnal temperature differences(MYD)were found between 2.1-2.2.The attributable YLLs of cold season were higher than that of warm season,and both DTR<MYD and DTR>MYD increased residents’YLLs from total non-accidental deaths and respiratory system disease deaths.The AF of total non-accidental deaths in each subgroup was significantly larger than zero in cold season.The AF of men(13.8%,95%CI:4.5%~23.0%)was larger than t

关 键 词：日温差 分布滞后非线性模型 META分析 时间序列 寿命损失年 归因分值 

分 类 号：R122[医药卫生—环境卫生学]