中国南方三省份日夜复合热与跌倒死亡风险的关联研究  

Study on the association between compound hot extremes and fall death risk in three provinces of southern China

作　　者：谢琳琳 曾加梅 万杰[1] 唐子杭 孟瑞琳[2] 周纯良[3] 俞敏[4] 林意 曾卫权 马文军 何冠豪 Xie Linlin;Zeng Jiamei;Wan Jie;Tang Zihang;Meng Ruilin;Zhou Chunliang;Yu Min;Lin Yi;Zeng Weiquan;Ma Wenjun;He Guanhao(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;Department of Environment and Health,Hunan Provincial Center for Disease Control and Prevention,Changsha 410005,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;China Greater Bay Area Research Center of Environmental Health,Jinan University,Guangzhou 510632,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病非传染性疾病预防控制所,广州511430 [3]湖南省疾病预防控制中心环境与健康科,长沙410005 [4]浙江省疾病预防控制中心,杭州310051 [5]暨南大学粤港澳大湾区环境健康研究中心,广州510632

出　　处：《中华流行病学杂志》2025年第4期581-586,共6页Chinese Journal of Epidemiology

基　　金：国家重点研发计划(2023YFC3605001);国家自然科学基金(42075173,42275187);中国科协青年人才托举工程(2022QNRC001);广州市荔湾区科技计划(20240601)。

摘　　要：目的探索日夜复合热相关的跌倒死亡风险。方法收集2013-2018年广东、湖南与浙江三省份的跌倒死亡数据,并匹配其暴露的气象数据,基于时间分层病例交叉设计,应用嵌入分布滞后非线性模型交叉基函数的条件logistic回归模型来估计日夜复合热相关的跌倒死亡风险。结果与正常日相比,日夜复合热显著增加跌倒死亡的发生风险(OR=1.19,95%CI:1.09~1.30),且女性(OR=1.27,95%CI:1.11~1.45)和≥65岁老年人(OR=1.24,95%CI:1.12~1.39)对日夜复合热更为敏感。日夜复合热持续时间最长为7 d,最高强度为6.2℃,持续时间和强度与跌倒死亡风险均呈正比。线性化后日夜复合热持续时间每增加1 d,跌倒死亡风险增加12%(OR=1.12,95%CI:1.06~1.18)。线性化后日夜复合热强度每增加1℃,跌倒死亡风险增加16%(OR=1.16,95%CI:1.10~1.22)。结论日夜复合热增加了人群跌倒死亡风险。Objective To explore the risk fall death associated with compound hot extremes.Methods This study collected data on fall deaths in Guangdong,Hunan,and Zhejiang Provinces from 2013 to 2018 and matched their exposure to meteorological data.Based on a time-stratified case-crossover design,a conditional logistic regression model embedded with a cross-basis function of the distributed lag nonlinear model was applied to estimate the risk of fall to death due to compound hot extremes.Results Compared with regular days,compound hot extremes significantly increased the risk of death from falls(OR=1.19,95%CI:1.09-1.30),and women(OR=1.27,95%CI:1.11-1.45)and the elderly age 65 and above(OR=1.24,95%CI:1.12-1.39)were more sensitive to compound hot extremes.The maximum duration of compound hot extremes was 7 days,and the maximum intensity was 6.2℃,and the duration and intensity were proportional to the risk of death from falls.The risk of death from falls increased by 12%(OR=1.12,95%CI:1.06-1.18)each day,increasing in duration after linearization.The risk of death from falls increased by 16%(OR=1.16,95%CI:1.10-1.22)for each 1℃increase in linearized intensity.Conclusion Compound hot extremes increase the risk of death cases from falls.

关 键 词：日夜复合热 跌倒 气候变化 病例交叉研究 

分 类 号：R195[医药卫生—卫生统计学]