2018—2022年5~10月山东省热浪与学龄人群其他感染性腹泻发病的关联研究  

Association between heat waves and other infectious diarrhea among school-aged children in Shandong Province from May to October,2018 to 2022

作　　者：李欣怡 张骁驰 李文 高杉杉 赵琦 张玮 LI Xinyi;ZHANG Xiaochi;LI Wen;GAO Shanshan;ZHAO Qi;ZHANG Wei(Department of Epidemiology,School of Public Health,Cheeloo College of Medicine,Jinan 250012,Shandong,China;Department of Gastroenterology,The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital,Jinan 250014,Shandong,China;Department of Occupational and Environmental Health,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China;Dezhou Center for Disease Control and Prevention,Dezhou 253016,Shandong,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院流行病学系,山东济南250012 [2]山东第一医科大学第一附属医院(山东省千佛山医院)消化科,山东济南250014 [3]山东大学齐鲁医学院公共卫生学院劳动卫生与环境卫生学系,山东济南250012 [4]德州市疾病预防控制中心,山东德州253016

出　　处：《山东大学学报(医学版)》2025年第3期110-116,共7页Journal of Shandong University:Health Sciences

基　　金：国自然青年基金(82203149);山东省优秀青年基金(海外,2022HWYQ-055);山东省青年基金(ZR2021QH349;ZR2021QH318)。

摘　　要：目的研究热浪(heat wave,HW)与6~18岁人群(学龄人群)其他感染性腹泻(other infectious diarrhea,OID)发病之间的关联,并评估城市化水平的修饰作用,为制定学龄人群OID防控措施提供科学依据。方法收集2018—2022年山东学龄人群每日OID发病病例、同期气象和城市化指标(人均GDP、常住人口城镇化率以及人均医疗机构床位数)数据;研究时段设为每年5~10月;以每个城市日平均气温的第90和95百分位数为阈值、以持续至少3 d为必要条件定义2种HW(HW1和HW2)。基于山东省的时间序列数据,使用结合分布滞后非线性模型的准泊松回归探索HW与OID发病的关联,并通过交互项量化3个城市化指标对HW效应的修饰作用。结果研究期间内,山东省学龄人群累计报告OID 35929例。与非HW日相比,HW1和HW2的效应分别在暴露的当天(lag0)和第2天(lag2)达到峰值,相对危险度分别为1.05(95%CI:1.02~1.09)和1.08(95%CI:1.05~1.11)。在整个滞后期(15 d),HW1和HW2的累积相对危险度值分别为1.62(95%CI:1.37~1.92)和1.93(95%CI:1.47~2.53)。常住人口城镇化率和人均GDP低的地区与HW相关的OID发病风险更高。结论HW与学龄人群OID的发病显著关联,城市化水平是强修饰因子。Objective To provide evidence for the development of targeted other infectious diarrhea(OID)prevention and control measures for individuals aged 6-18 years(school-aged individuals)by examining the association between heat waves(HW)and OID in Shandong Province,and explore the potential modifying effect of urbanization.Methods Data from 2018 to 2022 in Shandong Province were collected,including daily OID cases among school-aged individuals,meteorological data,and urbanization indicators(per capita GDP,urbanization rate,and per capita medical institution beds).The study period was set from May to October each year.Two definitions of HW(HW1 and HW2)were established based on the 90th and 95th percentiles of daily average temperature for each city,with a minimum duration of three consecutive days.A time-series analysis was conducted using a quasi-Poisson regression model combined with distributed lag non-linear models to explore the association between HW and OID incidence.Interaction terms were added to quantify the modifying effects of urbanization indicators.Results A total of 35,929 cases of OID were reported among school-aged individuals in Shandong Province during the study period.Compared to non-HW days,the effects of HW1 and HW2 peaked on the current day of exposure(lag 0 day)and the lag 2 days,with relative risks(RRs)being 1.05(95%CI:1.02-1.09)and 1.08(95%CI:1.05-1.11),respectively.Over the entire lag period(lag 0-15 days),the cumulative RR values were 1.62(95%CI:1.37-1.92)for HW1 and 1.93(95%CI:1.47-2.53)for HW2.Areas with lower urbanization rate and per capita GDP showed a higher risk of HW-related OID.Conclusion HW are associated with an increased incidence of OID among school-aged individuals,with urbanization considered as strong effect modifiers.

关 键 词：热浪 其他感染性腹泻 学龄人群 时间序列分析 分布滞后非线性模型 城市化 

分 类 号：R122[医药卫生—环境卫生学]