Excess cardiovascular mortality associated with cold spells in the Czech Republic
Excess cardiovascular mortality associated with cold spells in the Czech Republic
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DOI：
10.1186/1471-2458-9-19
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发表时间：
2009-01-15
影响因子：
4.5
通讯作者：
Kriz, Bohumir
中科院分区：
文献类型：
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作者：
Kysely, Jan;Pokorna, Lucie;Kriz, Bohumir
背景：对1986-2006年间捷克共和国人群中心血管死亡率与冬季寒冷期之间的关系进行了评估。尽管中欧地区的冷空气入侵比西欧和南欧更为频繁和严重，但尚未对与寒冷有关的死亡率进行全面研究。方法：寒潮被定义为气温不超过-3.5摄氏度的天数。流感流行/急性呼吸道感染影响死亡率的天数被确定并从分析中省略。在排除了死亡率的长期变化和季节性周期后，确定了心血管死亡率过高。在各个年龄组和性别中检查了感冒期间和之后的超额死亡率。结果：在所有年龄组（25-59岁、60-69岁、70-79岁和80岁以上），男性和女性中，感冒期与心血管疾病平均超额死亡率呈正相关。相对死亡率的影响在中年男性（25-59岁）中最明显和最直接，这与其他地区大多数关于感冒相关死亡率的研究形成对比。1987年1月酷寒期间估计的超额死亡率（274例心血管死亡）与1994年该区域最严重的热浪造成的死亡率相当。结论：研究结果表明，冷应激对中欧的死亡率有相当大的影响，这是一种与热浪类似的公共卫生威胁。25-59岁男性死亡风险升高可能与冬季大量在户外工作的男性职业暴露有关。基于天气预报并针对易受影响人群的早期预警和预防措施可能有助于减轻寒潮的影响并挽救生命。
Background: The association between cardiovascular mortality and winter cold spells was evaluated in the population of the Czech Republic over 21-yr period 1986-2006. No comprehensive study on cold-related mortality in central Europe has been carried out despite the fact that cold air invasions are more frequent and severe in this region than in western and southern Europe.Methods: Cold spells were defined as periods of days on which air temperature does not exceed -3.5 degrees C. Days on which mortality was affected by epidemics of influenza/acute respiratory infections were identified and omitted from the analysis. Excess cardiovascular mortality was determined after the long-term changes and the seasonal cycle in mortality had been removed. Excess mortality during and after cold spells was examined in individual age groups and genders.Results: Cold spells were associated with positive mean excess cardiovascular mortality in all age groups (25-59, 60-69, 70-79 and 80+ years) and in both men and women. The relative mortality effects were most pronounced and most direct in middle-aged men (25-59 years), which contrasts with majority of studies on cold-related mortality in other regions. The estimated excess mortality during the severe cold spells in January 1987 (+274 cardiovascular deaths) is comparable to that attributed to the most severe heat wave in this region in 1994.Conclusion: The results show that cold stress has a considerable impact on mortality in central Europe, representing a public health threat of an importance similar to heat waves. The elevated mortality risks in men aged 25-59 years may be related to occupational exposure of large numbers of men working outdoors in winter. Early warnings and preventive measures based on weather forecast and targeted on the susceptible parts of the population may help mitigate the effects of cold spells and save lives.