Susceptibility to mortality related to temperature and heat and cold wave duration in the population of Stockholm County, Sweden.
Susceptibility to mortality related to temperature and heat and cold wave duration in the population of Stockholm County, Sweden.
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DOI：
10.3402/gha.v7.22737
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发表时间：
2014
影响因子：
2.6
通讯作者：
Bellander T
中科院分区：
文献类型：
--
作者：
Rocklöv J;Forsberg B;Ebi K;Bellander T
环境温度会导致死亡率上升。需要更好地了解健康状况和其他因素如何改变与高温和低温相关的风险，以改善预防措施的基础。对温度和热浪与寒潮持续时间的敏感性差异相对未被探索。我们研究了死亡率与温度、热浪和寒潮持续时间之间的关系，并按年龄、个人和医疗因素分层。1990年至2002年期间，斯德哥尔摩县所有居民的死亡与入院时的出院诊断数据相关，并采用时间分层病例交叉设计对相关性进行了研究。分析按性别、年龄、既存疾病、原籍国和市一级财富进行分层，并对潜在的混杂因素进行调整。热浪持续时间对死亡率的影响在较低年龄、较低财富地区、65岁以下住院患者中更高。在65岁以下的女性中，在先前因精神疾病住院的群体中，以及在先前患有心血管疾病的人群中，几率升高。夏季气温的逐渐升高与80岁以上人群的死亡率相关，与既往心肌梗死组和65岁以下人群中慢性阻塞性肺疾病（COPD）组的死亡率相关。在冬季，死亡率与气温下降有关，特别是在男性中，与80岁以上人口的寒冷持续时间有关。在65岁以上的人群中，心肌梗死住院史增加了与低温相关的几率。先前的精神疾病或药物滥用增加了65岁以下人口的死亡几率。为了提高有效性，我们建议预防工作不应该假设易感人群在温暖和寒冷的日子以及热浪和寒潮中是相同的。
Ambient temperatures can cause an increase in mortality. A better understanding is needed of how health status and other factors modify the risk associated with high and low temperatures, to improve the basis of preventive measures. Differences in susceptibility to temperature and to heat and cold wave duration are relatively unexplored. We studied the associations between mortality and temperature and heat and cold wave duration, stratified by age and individual and medical factors. Deaths among all residents of Stockholm County between 1990 and 2002 were linked to discharge diagnosis data from hospital admissions, and associations were examined using the time stratified case-crossover design. Analyses were stratified by gender, age, pre-existing disease, country of origin, and municipality level wealth, and adjusted for potential confounding factors. The effect on mortality by heat wave duration was higher for lower ages, in areas with lower wealth, for hospitalized patients younger than age 65. Odds were elevated among females younger than age 65, in groups with a previous hospital admission for mental disorders, and in persons with previous cardiovascular disease. Gradual increases in summer temperatures were associated with mortality in people older than 80 years, and with mortality in groups with a previous myocardial infarction and with chronic obstructive pulmonary disease (COPD) in the population younger than 65 years. During winter, mortality was associated with a decrease in temperature particularly in men and with the duration of cold spells for the population older than 80. A history of hospitalization for myocardial infarction increased the odds associated with cold temperatures among the population older than 65. Previous mental disease or substance abuse increased the odds of death among the population younger than 65. To increase effectiveness, we suggest preventive efforts should not assume susceptible groups are the same for warm and cold days and heat and cold waves, respectively.