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夏季气温和湿度暴露对人群非意外死亡的联合效应研究

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目的 研究夏季气温和湿度暴露对人群非意外死亡的影响.方法 从中国疾病预防控制中心及广东省、浙江省、湖南省、云南省和吉林省等多省的疾病预防控制中心收集2006-2017年共124个市(自治州)的夏季人群非意外死亡时间序列资料,分别从国家气象科学数据中心和全国城市空气质量实时发布平台获取各研究市与死亡同期的气象数据和污染物数据.运用分布滞后非线性模型(distributed lag non-linear model,DLNM)分别拟合气温、湿度与人群死亡风险的暴露反应关系.运用分位数g计算回归(quantile g-computation,qgcomp)模型评估气温和湿度复合暴露对人群非意外死亡的联合效应.结果 夏季气温与人群死亡风险的累计死亡效应呈"J"型,而湿度与死亡之间的暴露-反应关系则呈倒"J"型.气温和湿度复合暴露与人群非意外死亡风险的关联呈非线性关系,以复合暴露的第一分位数作为参考,第二、三、四分位数对应的相对危险度(relative risk,RR)分别是 1.01(95%CI:1.00~1.02)、1.04(95%CI:1.02~1.05)和 1.08(95%CI:1.05~1.10),其中男性、≥65岁人群以及脑血管疾病患者是敏感人群,中部地区人群危险性较低.气温和湿度在全人群联合效应中的贡献分别为84.92%和15.08%,男性与≥ 65岁人群的气温效应占比大于同亚组人群,分别为86.98%和86.16%,北方、中部和南方地区气温效应占比均在80%左右.心血管疾病、脑血管疾病和呼吸系统疾病气温效应占比分别为68.01%、72.44%和71.46%.结论 在夏季随着气温和湿度均升高,人群的非意外死亡风险增加,气温在联合效应中的贡献占比较高.性别、年龄、地区和患病情况均对气温和湿度的联合死亡效应有修饰作用.
The joint effect of temperature and humidity exposure on non-accidental mortality in summer
Objective To explore the joint effect of temperature and humidity exposure on non-accidental mortality in summer.Methods The time series data on non-accidental mortality in 124 cities(autonomous prefectures)in summer during 2006-2017 were collected from Chinese Center for Disease Control and Prevention and the centers for disease control and prevention of Guangdong,Zhejiang,Hunan,Yunnan,and Jilin provinces in China.The meteorological data and pollutant data of these cities during the same pe-riod were obtained from the National Meteorological Information Center and the National Urban Air Quality Real-Time Dissemination Platform,respectively.The distributed lag non-linear model was employed to evaluate the associations of temperature and humidity with mortality.The quantile g-computation model was employed to evaluate the joint effect of temperature and humidity exposure on non-ac-cidental mortality.Results The exposure-response correlation between summer temperature and cumulative mortality exhibited a"J"shape,while that between relative humidity and cumulative mortality showed an inversed"J"shape.The correlation of summer temper-ature and humidity exposure with non-accidental mortality was non-linear.Compared to the first quantile of the joint exposure,the rela-tive risks for the second,third,and fourth quantiles were 1.01(95%confidence interval[CI]:1.00-1.02),1.04(95%CI:1.02-1.05),and 1.08(95%CI:1.05-1.10),respectively.Males,the elderly(≥65 years),and patients with cerebrovascular diseases showed relatively high sensitivity,while those in central China showed relatively low risk.The contributions of temperature and humidity to the joint effect in entire population were 84.92%and 15.08%,respectively.The contributions of temperature in males and the elderly(≥65 years)were 86.98%and 86.16%,respectively,which were higher than those of humidity in the same subgroups.The contributions of temperature in northern,central,and southern China were about 80%.The contributions of temperature in cardio-vascular,cerebrovascular,and respiratory diseases were 68.01%,72.44%,and 71.46%,respectively.Conclusion The risk of non-accidental mortality increases as temperature and humidity increase in summer,and the contribution of temperature to the joint effect is relatively higher.The associations of temperature and humidity with non-accidental mortality might be modified by sex,age,region,and diseases.

temperaturehumidityjoint effectnon-accidental mortality

方雯、林自强、孟瑞琳、何冠豪、侯筑林、周脉耕、周纯良、肖义泽、俞敏、黄飙、许晓君、林立丰、肖建鹏、金东辉、秦明芳、殷鹏、许意清、胡建雄、刘涛、黄存瑞、马文军

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暨南大学基础医学与公共卫生学院,广州 510632

广东省疾病预防控制中心

吉林省疾病预防控制中心

中国疾病预防控制中心慢性非传染性疾病预防控制中心

湖南省疾病预防控制中心

云南省疾病预防控制中心

浙江省疾病预防控制中心

广东省公共卫生研究院

清华大学万科公共卫生与健康学院

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气温 湿度 联合效应 非意外死亡

国家自然科学基金项目

42075173

2024

环境卫生学杂志
中国疾病预防控制中心

环境卫生学杂志

CSTPCD
影响因子:0.735
ISSN:2095-1906
年,卷(期):2024.14(9)