中国七省份热浪与跌倒死亡风险的关联研究  

Study on the association between heatwaves and fall-related mortality risk in seven provinces of China

作　　者：江芷莹 孟瑞琳[2] 张若仪 古学龙 胡建雄 俞敏[3] 陈杨[4] 周纯良[5] 黄飚[6] 梁子怡 陈素娟 黎建浩 何冠豪 刘涛[1] 郭华[7] 马文军 Jiang Zhiying;Meng Ruilin;Zhang Ruoyi;Gu Xuelong;Hu Jianxiong;Yu Min;Chen Yang;Zhou Chunliang;Huang Biao;Liang Ziyi;Chen Sujuan;Li Jianhao;He Guanhao;Liu Tao;Guo Hua;Ma Wenjun(Department of Preventive Medicine,School of Medicine,Jinan University,Guangzhou 510632,China;Institute of Control and Prevention for Chronic Non-infective Disease,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310009,China;Department of Chronic and Non-communicable Disease and Prevention,Yunnan Provincial Center for Disease Control and Prevention,Kunming 650034,China;Department of Environment and Health,Hunan Provincial Center for Disease Control and Prevention,Changsha 410005,China;Jilin Provincial Center for Disease Control and Prevention,Changchun 130062,China;Institute of Public Health Surveillance and Evaluation,Guizhou Provincial Center for Disease Control and Prevention,Guiyang 550004,China)

机构地区：[1]暨南大学基础医学与公共卫生学院预防医学系,广州510632 [2]广东省疾病预防控制中心慢性非传染病疾病预防控制所,广州511430 [3]浙江省疾病预防控制中心,杭州310009 [4]云南省疾病预防控制中心慢性非传染病疾病防制所,昆明650034 [5]湖南省疾病预防控制中心环境健康科,长沙410005 [6]吉林省疾病预防控制中心,长春130062 [7]贵州省疾病预防控制中心公共卫生监测评价研究所,贵阳550004

出　　处：《中华流行病学杂志》2025年第4期566-572,共7页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(42075173,42275187);中国科协青年科学家资助计划(2022QNRC001)。

摘　　要：目的评估热浪与跌倒死亡风险的关联。方法收集2013-2022年中国七省份共61421例跌倒死亡病例,每日气象数据来源于欧洲中期天气预报中心第五代陆面再分析数据集。基于时间分层病例交叉设计,采用条件logistic回归嵌合分布滞后非线性模型分析热浪与跌倒死亡的关联,并按照性别、年龄进行分层分析。结果热浪增加跌倒死亡风险,热浪期人群跌倒死亡风险高于非热浪期(OR=1.11,95%CI:1.05~1.18),对应的死亡归因分值为10.25%(95%CI:4.49%~15.36%)。热浪期气温每高于热浪阈值温度1℃,跌倒死亡风险增加34%(OR=1.34,95%CI:1.02~1.76),热浪持续时间对跌倒死亡的效应无统计学意义。分层分析显示,女性在热浪期间的跌倒死亡风险(OR=1.13,95%CI:1.04~1.22)高于男性(OR=1.10,95%CI:1.04~1.17)。结论热浪可以增加跌倒死亡风险,热浪的强度越强,死亡风险越高,女性是脆弱人群。Objective To evaluate the association between heatwaves and fall-related mortality.Methods A total of 61421 fall-related mortality from 2013 to 2022 in 7 provinces of China were included in a time-stratified case-crossover design,with daily meteorological data derived from the fifth generation European Reanalysis dataset produced by the European Centre for Medium-Range Weather Forecasts.Conditional logistic regression chimeric distributed lag nonlinear model was used to analyze the association between heatwaves and fall-related mortality and stratified analysis was conducted according to gender and age.Results Heatwaves were associated with an increased risk of fall-related morality.The risk of fall-related mortality during heatwaves was higher than during non-heatwave periods(OR=1.11,95%CI:1.05-1.18).The attributable fraction of fall-related motality due to heatwaves was 10.25%(95%CI:4.49%-15.36%).For each 1℃increase above the heatwave threshold,the risk of fall-related mortality increased by 34%(OR=1.34,95%CI:1.02-1.76).The effect of heatwave duration on fall-related mortality was not statistically significant.Stratified analyses indicated that women experienced a higher risk of fall-related mortality during heatwaves(OR=1.13,95%CI:1.04-1.22)compared to man(OR=1.10,95%CI:1.04-1.17).Conclusions Heatwave increases the risk of fall-related mortality,and the intensity of heatwaves modify this risk.Women are vulnerable populations.

关 键 词：热浪 跌倒 死亡 分布滞后非线性模型 

分 类 号：R195[医药卫生—卫生统计学]