2020―2022年南京市极端气温对居民急救接诊量的影响和归因风险研究  

The impact and attributable risk of extreme temperature on the number of emergency ambulance calls in Nanjing

作　　者：张艺 郑浩[2] 孙凤霞 韦丽[1] 莫小小 葛明[1] 熊丽林[1] ZHANG Yi;ZHENG Hao;SUN Feng-xia;WEI Li;MO Xiao-xiao;GE Ming;XIONG Li-lin(Department of Environmental Health,Nanjing Center for Disease Control and Prevention,Nanjing,Jiangsu 210003,China)

机构地区：[1]南京市疾病预防控制中心环境卫生科,江苏南京210003 [2]江苏省疾病预防控制中心 [3]南京医科大学

出　　处：《现代预防医学》2023年第22期4077-4082,4129,共7页Modern Preventive Medicine

基　　金：南京市卫生科技发展项目(YKK21177,ZKX20046)。

摘　　要：目的探讨南京市极端气温对居民急救接诊量的影响并评估其归因风险。方法收集南京市2020年1月1日至2022年12月31日逐日急救接诊量数据资料、气象资料和空气污染资料,采用分布滞后非线性模型计算相对危险度,评估极端温度暴露对急救接诊量的滞后效应、累积滞后效应和人群归因风险。结果低温和高温均会增加南京市每日急救接诊量。极端低温在滞后14 d对非意外、呼吸系统和心血管疾病急救接诊量的累积效应达到最大,RR(95%CI)值分别为1.32(1.27~1.38)、2.17(1.95~2.41)和1.17(1.12~1.22);极端高温对非意外和呼吸系统疾病急救接诊量在滞后7 d累积效应最大,RR(95%CI)值分别为1.26(1.19~1.34)和1.41(1.23~1.64),而心血管疾病急救接诊对高温不敏感。气温造成的非意外、呼吸系统和心血管疾病急救接诊量分别为21639、5397和3083例,对应的AFs分别为8.26%、19.06%和3.88%,其中归因于冷效应的AFs为5.05%、14.09%和3.67%,归因于热效应的AFs为3.22%、4.97%和0.21%。结论高温和低温均是南京市居民急救接诊量的危险因素,高温存在即时性,低温存在滞后性,且主要影响为低温效应。Objective To investigate the effect of ambient temperature exposure on emergency ambulance calls(EACs)in Nanjing.Methods The daily data on EACs,meteorological factors and air pollutants from 2020 to 2022 were obtained from Nanjing,China.A distributed lag non-linear model(DLNM)was used to assess the association between ambient temperature and EACs after adjusting for potential confounding factors.The fractions of EACs to non-optimum temperature were also estimated.Results Both low and high temperature would increase the number of daily EACs.The greatest impact of low temperature on the number of EACs of non-accidental,respiratory disease and cardiovascular disease at a lag of 14 d,the cumulative RR values(95%CI)about 1.32(1.27-1.38),2.17(1.95-2.41)and 1.17(1.12-1.22),respectively.The greatest impact of high temperature on the number of EACs of non-accidental and respiratory disease at a lag of 7 d,the cumulative RR values about 1.26(1.19-1.34)and 1.41(1.23-1.64),respectively.The number of EACs of cardiovascular disease was not sensitive to high temperature.The attribute numbers of EACs of non-accidental,respiratory and cardiovascular disease that caused by temperature were 21639,5397 and 3083,corresponding to 8.26%,19.06%and 3.88%of attribute fractions.Cold effects were responsible for 5.05%,14.09%and 3.67%,respectively.While heat effects were responsible for 3.22%,4.97%and 0.21%,respectively.Conclusion High and low temperature both increase the risk of EACs,the high temperature exposure could increase the number of EACs within 1 day,while the low temperature increases the number of EACs with delayed effect.Cold effects afford most of temperature-related EACs.

关 键 词：气温 急救 时间序列分析 人群归因风险 

分 类 号：R122[医药卫生—环境卫生学]