中国五省份热浪与道路交通伤害死亡风险的关联研究  

Study on the association between heatwaves and road traffic injury mortality in five provinces of China

作　　者：余斯文 俞敏[3] 郑阿呷 周纯良[4] 孟瑞琳[5] 黄飚[6] 肖义泽[7] 吴为[8] 何冠豪 胡建雄 马文军 刘涛[1,2] Yu Siwen;Yu Min;Zheng Aga;Zhou Chunliang;Meng Ruilin;Huang Biao;Xiao Yize;Wu Wei;He Guanhao;Hu Jianxiong;Ma Wenjun;Liu Tao(Department of Preventive Medicine,School of Medicine,Jinan University,Guangzhou 510632,China;China Greater Bay Area Research Center of Environmental Health,Jinan University,Guangzhou 510632,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Department of Environment and Health,Hunan Provincial Center for Disease Control and Prevention,Changsha 450001,China;Institute of Control and Prevention for Chronic Non-infective Disease,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,China;Jilin Provincial Center for Disease Control and Prevention,Changchun 130062,China;Yunnan Provincial Center for Disease Control and Prevention,Kunming 650022,China;Guangdong Provincial Institute of Public Health,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,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]暨南大学粤港澳大湾区环境健康研究中心,广州510632 [3]浙江省疾病预防控制中心,杭州310051 [4]湖南省疾病预防控制中心环境健康科,长沙450001 [5]广东省疾病预防控制中心慢性非传染性疾病预防控制所,广州511430 [6]吉林省疾病预防控制中心,长春130062 [7]云南省疾病预防控制中心,昆明650022 [8]广东省疾病预防控制中心广东省公共卫生研究院,广州511430

出　　处：《中华流行病学杂志》2025年第4期573-580,共8页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(42075173,42175181,42375180);广东省自然科学基金(2024A1515012088)。

摘　　要：目的评估日间热浪、夜间热浪和日夜复合热浪的短期暴露对道路交通伤害死亡风险的影响及死亡负担。方法收集2013-2018年广东、湖南、浙江、云南和吉林五省份的道路交通伤害死亡个案数据。采用时间分层病例交叉设计,将每例病例的死亡日期作为病例日,并选择与病例日处于同年同月同星期几的其他时间设为对照日。使用条件logistic回归模型分析短期暴露于日间热浪、夜间热浪和日夜复合热浪对道路交通死亡风险的累积效应(滞后0~1 d),并计算死亡归因分值(AF)。结果与非热浪日相比,日间热浪日、夜间热浪日、日夜复合热浪日发生道路交通死亡的超额风险(ER)值分别为5.3%(95%CI:0.5%~10.2%)、4.9%(95%CI:0.5%~9.4%)和7.5%(95%CI:2.3%~12.9%),对应的AF分别为5.0%(95%CI:0.5%~9.3%)、4.7%(95%CI:0.5%~8.6%)和6.9%(95%CI:2.3%~11.4%)。分层分析显示,日间热浪对女性发生道路交通死亡伤害风险的影响(ER=15.7%,95%CI:5.8%~26.5%)高于男性(ER=1.8%,95%CI:-3.6%~7.4%);日夜复合热浪对>64岁老年人发生道路交通死亡伤害风险的影响(ER=10.9%,95%CI:0.3%~22.6%)高于<45岁人群(ER=2.6%,95%CI:-5.4%~11.2%),日夜复合热浪引起的机动车道路交通伤害死亡风险(ER=16.6%,95%CI:2.4%~32.7%)高于非机动车(ER=5.7%,95%CI:0.1%~11.5%)。结论短期暴露于日间热浪、夜间热浪和日夜复合热浪均与道路交通死亡风险升高有关,且日夜复合热浪的效应较大。热浪对女性、>64岁老年人以及机动车道路交通伤害死亡风险的影响更明显。Objective To evaluate the impact of short-term exposure to daytime heatwaves,nighttime heatwaves,and compound heatwaves on the risk of road traffic mortality and calculate the attributable mortality burden.Methods This study collected road traffic mortality data from the Disease Surveillance System in Guangdong,Hunan,Zhejiang,Yunnan,and Jilin Provinces from 2013 to 2018.A time-stratified case-crossover design was used in this study,with the death date for each case serving as the case day.Control days were selected from the same year,month,and day of the week as the case day.A conditional logistic regression model was employed to estimate the cumulative associations of short-term exposure to daytime heatwaves,nighttime heatwaves,and compound heatwaves on the risk of road traffic mortality(lag 0-1 day)and to calculate the attributable fractions(AF).Results Compared to non-heatwave days,the excess risk(ER)of road traffic mortality on daytime heatwave days,nighttime heatwave days,and compound heatwave days was 5.3%(95%CI:0.5%-10.2%),4.9%(95%CI:0.5%-9.4%)and 7.5%(95%CI:2.3%-12.9%),with corresponding AF of 5.0%(95%CI:0.5%-9.3%),4.7%(95%CI:0.5%-8.6%),and 6.9%(95%CI:2.3%-11.4%),respectively.Stratified analysis showed that the risk of traffic mortalities caused by daytime heatwaves was higher in females(ER=15.7%,95%CI:5.8%-26.5%)than in males(ER=1.8%,95%CI:-3.6%-7.4%).Elderly individuals over 64 years old(ER=10.9%,95%CI:0.3%-22.6%)had a higher risk of road traffic mortalities from compound heatwaves than those under 45 years old(ER=2.6%,95%CI:-5.4%-11.2%).The risk of road traffic injury mortality from motor vehicle accidents caused by compound heatwaves(ER=16.6%,95%CI:2.4%-32.7%)was higher than that from non-motor vehicle accidents(ER=5.7%,95%CI:0.1%-11.5%).Conclusions Short-term exposure to daytime heatwaves,nighttime heatwaves,and compound heatwaves was associated with an increased risk of road traffic mortality,with the strongest association observed for compound heatwaves.The mortality burden attributable to compound

关 键 词：热浪 道路交通伤害 死亡 复合事件 

分 类 号：R12[医药卫生—环境卫生学]