Weather-related mortality: how heat, cold, and heat waves affect mortality in the United States.
Weather-related mortality: how heat, cold, and heat waves affect mortality in the United States.
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DOI：
10.1097/ede.0b013e318190ee08
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Bell ML
中科院分区：
文献类型：
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作者：
Anderson BG;Bell ML
许多研究已经将天气与死亡率联系起来;然而，诸如区域变化、易感人群和驯化等关键因素的作用仍然没有得到解决。我们将时间序列模型应用于107个美国社区，通过使用14年的数据集，允许温度和死亡率之间的非线性关系。第二阶段的分析被用来与冷，热，热浪效应估计社区特定的变量。我们考虑了暴露时间、易感性、年龄、死亡原因和污染物的混杂因素。热浪模拟了不同的强度和持续时间。与热相关的死亡率与较短的滞后（同一天和前一天的平均值）最相关，与社区第99和第90百分位数温度相比，死亡风险总体增加3.0%（95%后验间隔：2.4%-3.6%）。与寒冷相关的死亡率与较长的滞后期（从当天到前25天的平均值）最相关，与社区第一和第10百分位温度相比，风险增加了4.2%（3.2%-5.3%）。死亡风险随着热浪的强度或持续时间的增加而增加。影响的空间异质性表明，从一个社区的天气死亡率的关系可能不适用于另一个。绝对温度估计值（比较特定温度下的风险）的空间异质性大于相对温度估计值（比较社区特定温度下的风险），这为适应环境提供了证据。我们根据年龄、社会经济条件、城市化程度和中央空调确定了易感性。适应性、个体易感性和群落特征都会影响热对死亡率的影响。
Many studies have linked weather to mortality; however, role of such critical factors as regional variation, susceptible populations, and acclimatization remain unresolved. We applied time-series models to 107 US communities allowing a nonlinear relationship between temperature and mortality by using a 14-year dataset. Second-stage analysis was used to relate cold, heat, and heat wave effect estimates to community-specific variables. We considered exposure timeframe, susceptibility, age, cause of death, and confounding from pollutants. Heat waves were modeled with varying intensity and duration. Heat-related mortality was most associated with a shorter lag (average of same day and previous day), with an overall increase of 3.0% (95% posterior interval: 2.4%–3.6%) in mortality risk comparing the 99th and 90th percentile temperatures for the community. Cold-related mortality was most associated with a longer lag (average of current day up to 25 days previous), with a 4.2% (3.2%–5.3%) increase in risk comparing the first and 10th percentile temperatures for the community. Mortality risk increased with the intensity or duration of heat waves. Spatial heterogeneity in effects indicates that weather–mortality relationships from 1 community may not be applicable in another. Larger spatial heterogeneity for absolute temperature estimates (comparing risk at specific temperatures) than for relative temperature estimates (comparing risk at community-specific temperature percentiles) provides evidence for acclimatization. We identified susceptibility based on age, socioeconomic conditions, urbanicity, and central air conditioning. Acclimatization, individual susceptibility, and community characteristics all affect heat-related effects on mortality.