Association between ambient temperature and mortality risk and burden: time series study in 272 main Chinese cities.
Association between ambient temperature and mortality risk and burden: time series study in 272 main Chinese cities.
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DOI：
10.1136/bmj.k4306
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发表时间：
2018-10-31
期刊：
影响因子：
--
通讯作者：
Zhou M
中科院分区：
文献类型：
--
作者：
Chen R;Yin P;Wang L;Liu C;Niu Y;Wang W;Jiang Y;Liu Y;Liu J;Qi J;You J;Kan H;Zhou M
研究温度与死因特异性死亡率之间的关系，并量化非最佳环境温度导致的相应疾病负担。时间序列分析。中国272个主要城市。2013年1月至2015年12月中国疾病监测点系统覆盖的272个城市的非意外死亡情况。每日因所有非意外原因和主要心肺疾病死亡的人数。潜在的影响因素包括人口、气候、地理和社会经济特征。采用分布滞后非线性模型估算城市间的关联，采用多元元回归分析估算国家和区域层面的影响。在研究期间，共记录了1 826 186例非意外死亡。温度与死亡率呈负J型关系。在全国平均水平上，相对于最低死亡温度（22.8°C， 79.1百分位），极冷（- 1.4°C， 2.5百分位）的死亡风险持续14天以上，而极热（29.0°C， 97.5百分位）的死亡风险立即出现，持续2 ~ 3天。14.33%的非意外总死亡率归因于非最佳温度，其中中低温（- 1.4 ~ 22.8°C）、中高温（22.8 ~ 29.0°C）、极低温（- 6.4 ~ - 1.4°C）和极高温（29.0 ~ 31.6°C）分别占10.49%、2.08%、1.14%和0.63%。总体心血管疾病的归因分数为17.48%，冠心病的归因分数为18.76%，总体卒中的归因分数为16.11%，缺血性卒中的归因分数为14.09%，出血性卒中的归因分数为18.10%，总体呼吸道疾病的归因分数为10.57%，慢性阻塞性肺病的归因分数为12.57%。在温带季风和亚热带季风气候带、特定亚群（女性、年龄≥75岁、受教育年限≤9年）以及城市化率较高、集中供暖时间较短的城市中，死亡风险和负担更为突出。这项全国性的研究提供了环境温度与所有自然原因和主要心肺疾病死亡率之间的非线性关联的全面图景，以及主要归因于中国中等低温的相应疾病负担。脆弱性特征的研究结果有助于改善临床和公共卫生实践，以减少与当前和未来异常天气相关的疾病负担。
To examine the association between temperature and cause specific mortality, and to quantify the corresponding disease burden attributable to non-optimum ambient temperatures. Time series analysis. 272 main cities in China. Non-accidental deaths in 272 cities covered by the Disease Surveillance Point System of China, from January 2013 to December 2015. Daily numbers of deaths from all non-accidental causes and main cardiorespiratory diseases. Potential effect modifiers included demographic, climatic, geographical, and socioeconomic characteristics. The analysis used distributed lag non-linear models to estimate city specific associations, and multivariate meta-regression analysis to obtain the effect estimates at national and regional levels. 1 826 186 non-accidental deaths from total causes were recorded in the study period. Temperature and mortality consistently showed inversely J shaped associations. At the national average level, relative to the minimum mortality temperature (22.8°C, 79.1st centile), the mortality risk of extreme cold temperature (at −1.4°C, the 2.5th centile) lasted for more than 14 days, whereas the risk of extreme hot temperature (at 29.0°C, the 97.5th centile) appeared immediately and lasted for two to three days. 14.33% of non-accidental total mortality was attributable to non-optimum temperatures, of which moderate cold (ranging from −1.4 to 22.8°C), moderate heat (22.8 to 29.0°C), extreme cold (−6.4 to −1.4°C), and extreme heat (29.0 to 31.6°C) temperatures corresponded to attributable fractions of 10.49%, 2.08%, 1.14%, and 0.63%, respectively. The attributable fractions were 17.48% for overall cardiovascular disease, 18.76% for coronary heart disease, 16.11% for overall stroke, 14.09% for ischaemic stroke, 18.10% for haemorrhagic stroke, 10.57% for overall respiratory disease, and 12.57% for chronic obstructive pulmonary diseases. The mortality risk and burden were more prominent in the temperate monsoon and subtropical monsoon climatic zones, in specific subgroups (female sex, age ≥75 years, and ≤9 years spent in education), and in cities characterised by higher urbanisations rates and shorter durations of central heating. This nationwide study provides a comprehensive picture of the non-linear associations between ambient temperature and mortality from all natural causes and main cardiorespiratory diseases, as well as the corresponding disease burden that is mainly attributable to moderate cold temperatures in China. The findings on vulnerability characteristics can help improve clinical and public health practices to reduce disease burden associated with current and future abnormal weather.
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DOI：
10.3390/ijerph13050454
发表时间：
2016-04-28
影响因子：
--
作者：
Imai C;Barnett AG;Hashizume M;Honda Y
通讯作者：
Honda Y
影响因子：
2
作者：
Gasparrini, A.;Armstrong, B.;Kenward, M. G.
通讯作者：
Kenward, M. G.
影响因子：
8.3
作者：
Guo, Yuming;Barnett, Adrian G.;Tong, Shilu
通讯作者：
Tong, Shilu
影响因子：
2.7
作者：
Moghadamnia MT;Ardalan A;Mesdaghinia A;Keshtkar A;Naddafi K;Yekaninejad MS
通讯作者：
Yekaninejad MS
DOI：
10.1016/s0140-6736(14)62114-0
发表时间：
2015-07-25
期刊：
Lancet (London, England)
影响因子：
--
作者：
Gasparrini A;Guo Y;Hashizume M;Lavigne E;Zanobetti A;Schwartz J;Tobias A;Tong S;Rocklöv J;Forsberg B;Leone M;De Sario M;Bell ML;Guo YL;Wu CF;Kan H;Yi SM;de Sousa Zanotti Stagliorio Coelho M;Saldiva PH;Honda Y;Kim H;Armstrong B
通讯作者：
Armstrong B