Spatial and temporal variation in emergency transport during periods of extreme heat in Japan: A nationwide study
Spatial and temporal variation in emergency transport during periods of extreme heat in Japan: A nationwide study
复制标题
DOI：
10.1016/j.scitotenv.2015.11.098
复制
发表时间：
2016-02-15
影响因子：
9.8
通讯作者：
Hagihara, Akihito
中科院分区：
文献类型：
--
作者：
Onozuka, Daisuke;Hagihara, Akihito
背景：一些研究报告了气候变化对极端高温相关死亡率或发病率的影响。然而，很少有研究在全国范围内调查极端高温期间应急运输的时空变化。方法：收集2007 - 2010年日本全部47个县的每日急诊救护车调度数据。利用泊松回归与分布滞后非线性模型相结合的方法估计了各县热量与发病率关系的时间变异性，并根据时间趋势进行了调整。使用多变量荟萃分析估计各县之间热发病率关系的空间变异性。结果：在研究期间的夏季（6月至9月）共报告了5,289,660次紧急运输。第99个百分位数与最低发病率百分位数的总累积相对危险度（RR）在所有原因中为1.292 (95% CI: 1.251-1.333)，心血管疾病为1.039 (95% CI: 0.989-1.091)，呼吸道疾病为1.287 （95% CI: 1.210-1.368）。估计效应的时间变化显示出非线性关系，并且热、全因和病因特异性发病率之间的时间变化存在差异。各县之间所有原因均存在空间差异（Cochran Q检验，p < 0.001; I-2= 45.8%）；然而，心血管疾病（Cochran Q检验，p= 0.054; I-2 = 15.1%）和呼吸系统疾病（Cochran Q检验，p= 0.681; I-2 = 1.0%）的空间异质性不显著。结论：我们的全国性研究表明，2007年至2010年日本极端高温期间，全因和特定原因紧急运输相对风险的时空变化存在差异。我们的研究结果表明，旨在控制热相关发病率的公共卫生策略应根据区域特定的天气条件量身定制。(C) 2015 Elsevier B.V.版权所有
Background: Several studies have reported the burden of climate change on extreme heat-related mortality or morbidity. However, few studies have investigated the spatial and temporal variation in emergency transport during periods of extreme heat on a national scale.Methods: Daily emergency ambulance dispatch data from 2007 to 2010 were acquired from all 47 prefectures of Japan. The temporal variability in the relationship between heat and morbidity in each prefecture was estimated using Poisson regression combined with a distributed lag non-linearmodel and adjusted for time trends. The spatial variability in the heat-morbidity relationships between prefectures was estimated using a multivariate meta-analysis.Results: A total of 5,289,660 emergency transports were reported during the summer months (June through September) within the study period. The overall cumulative relative risk (RR) at the 99th percentile vs. the minimum morbidity percentile was 1.292 (95% CI: 1.251-1.333) for all causes, 1.039 (95% CI: 0.989-1.091) for cardiovascular diseases, and 1.287 (95% CI: 1.210-1.368) for respiratory diseases. Temporal variation in the estimated effects indicated a non-linear relationship, and there were differences in the temporal variations between heat and all-cause and cause-specific morbidity. Spatial variation between prefectures was observed for all causes (Cochran Q test, p < 0.001; I-2= 45.8%); however, therewas no significant spatial heterogeneity for cardiovascular (Cochran Q test, p= 0.054; I-2 = 15.1%) and respiratory (Cochran Q test, p= 0.681; I-2 = 1.0%) diseases.Conclusions: Our nationwide study demonstrated differences in the spatial and temporal variations in the relative risk for all-cause and cause-specific emergency transport during periods of extreme heat in Japan between 2007 and 2010. Our results suggest that public health strategies aimed at controlling heat-related morbidity should be tailored according to region-specific weather conditions. (C) 2015 Elsevier B.V. All rights reserved.