High Temperature and Hospitalizations for Cardiovascular and Respiratory Causes in 12 European Cities
High Temperature and Hospitalizations for Cardiovascular and Respiratory Causes in 12 European Cities
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DOI：
10.1164/rccm.200802-217oc
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发表时间：
2009-03-01
影响因子：
24.7
通讯作者：
Perucci, Carlo A.
中科院分区：
文献类型：
--
作者：
Michelozzi, Paola;Accetta, Gabriele;Perucci, Carlo A.
基本原理 热浪事件分析表明，在欧洲城市，热浪对死亡率的影响要高于对发病率（入院率）的影响。每日时间序列研究的证据稀缺且不一致。 目的：评估参与欧洲天气条件急性健康影响评估和预防（PHEWE）项目的 12 个欧洲城市 4 月至 9 月期间高温环境对入院人数的影响。方法：对于每个城市，使用时间序列分析来模拟最高表观温度（滞后 0-3 天）与按年龄（所有年龄段、 65-74 岁年龄组和 75 岁以上年龄组），并且针对两个地理分组的城市汇总了特定城市的估计值。测量和主要结果：对于呼吸系统入院，存在正相关性，但城市之间存在异质性。最高表观温度每升高 1 摄氏度（高于阈值），地中海和北大陆城市 75 岁以上年龄组的呼吸道入院率分别增加 +4.5%（95% 置信区间，1.9-7.3）和 +3.1%（95% 置信区间，0.8-5.5）。相比之下，温度与心脑血管入院之间的相关性往往呈负相关，未达到统计显着性。结论：高温对呼吸道入院有特定影响，特别是在老年人群中，但其潜在机制知之甚少。为什么高温会增加心血管死亡率但不会增加心血管入院率也尚不清楚。由于全球变暖和人口老龄化，预计极端高温事件对欧洲城市呼吸道入院的影响将会增加。
Rationale Episode analyses of heat waves have documented a comparatively higher impact on mortality than on morbidity (hospital admissions) in European cities. The evidence from daily time series studies is scarce and inconsistent.Objectives: To evaluate the impact of high environmental temperatures on hospital admissions during April to September in 12 European cities participating in the Assessment and Prevention of Acute Health Effects of Weather Conditions in Europe (PHEWE) project.Methods: For each city, time series analysis was used to model the relationship between maximum apparent temperature (lag 0-3 days) and daily hospital admissions for cardiovascular, cerebrovascular, and respiratory causes by age (all ages, 65-74 age group, and 75+ age group), and the city-specific estimates were pooled for two geographical groupings of cities.Measurements and Main Results: For respiratory admissions, there was a positive association that was heterogeneous between cities. For a 1 degrees C increase in maximum apparent temperature above a threshold, respiratory admissions increased by +4.5% (95% confidence interval, 1.9-7.3) and +3.1% (95% confidence interval, 0.8-5.5) in the 75+ age group in Mediterranean and North-Continental cities, respectively. In contrast, the association between temperature and cardiovascular and cerebrovascular admissions tended to be negative and did not reach statistical significance.Conclusions: High temperatures have a specific impact on respiratory admissions, particularly in the elderly population, but the underlying mechanisms are poorly understood. Why high temperature increases cardiovascular mortality but not cardiovascular admissions is also unclear. The impact of extreme heat events on respiratory admissions is expected to increase in European cities as a result of global warming and progressive population aging.