Vulnerability to heat-related mortality in Latin America: A case-crossover study in Sao Paulo, Brazil, Santiago, Chile and Mexico City, Mexico
Vulnerability to heat-related mortality in Latin America: A case-crossover study in Sao Paulo, Brazil, Santiago, Chile and Mexico City, Mexico
复制标题
DOI：
10.1093/ije/dyn094
复制
发表时间：
2008-08-01
影响因子：
7.7
通讯作者：
Gouveia, Nelson C.
中科院分区：
文献类型：
--
作者：
Bell, Michelle L.;O'Neill, Marie S.;Gouveia, Nelson C.
影响热相关死亡率的脆弱性的因素还不清楚。确定易感人群是特别重要的，因为预期的温度上升，从climate change.Methods我们调查了三个拉丁美洲城市（墨西哥城，墨西哥;圣保罗，巴西;圣地亚哥，智利）热相关的死亡率使用的情况下，交叉的方法，从1998年至2002年的754 291例死亡。我们认为滞后的暴露，混杂的空气污染，死亡原因和受教育程度，年龄和sex.Results同一天和前一天的表观温度与死亡风险最强相关的易感性。影响估计仍然是积极的，但在臭氧或PM调整后有所降低（10）。在所有城市，易感性随着年龄的增长而增加。对于那些>= 65的人，比较同一天表观温度的第95次和第75次三分之一，死亡风险增加为圣地亚哥2.69%（95% CI：-2.06至7.88%），圣保罗6.51%（95% CI：3.57-9.52%），墨西哥城3.22%（95% CI：0.93-5.57%）。各社区按教育和性别分列的脆弱性模式各不相同。在墨西哥城，对女性的影响估计高于男性，在其他地方，对男性的影响估计也高于男性，尽管在任何城市，按性别分列的结果都没有明显的不同。在圣保罗，那些受教育程度较低的人更容易受到影响，而没有明显的模式，教育观察到在其他city.Conclusions气温升高与死亡风险在这些拉丁美洲城市，最强的协会在圣保罗，最热的城市。老年人是需要采取有针对性的预防措施的重要人群，但不同城市的脆弱性因性别和教育程度而异。
Background Factors affecting vulnerability to heat-related mortality are not well understood. Identifying susceptible populations is of particular importance given anticipated rising temperatures from climatic change.Methods We investigated heat-related mortality for three Latin American cities (Mexico City, Mexico; Sao Paulo, Brazil; Santiago, Chile) using a case-crossover approach for 754 291 deaths from 1998 to 2002. We considered lagged exposures, confounding by air pollution, cause of death and susceptibilities by educational attainment, age and sex.Results Same and previous day apparent temperature were most strongly associated with mortality risk. Effect estimates remained positive though lowered after adjustment for ozone or PM(10). Susceptibility increased with age in all cities. The increase in mortality risk for those >= 65 comparing the 95th and 75th percentiles of same-day apparent temperature was 2.69% (95% CI: -2.06 to 7.88%) for Santiago, 6.51% (95% CI: 3.57-9.52%) for Sao Paulo and 3.22% (95% CI: 0.93-5.57%) for Mexico City. Patterns of vulnerability by education and sex differed across communities. Effect estimates were higher for women than men in Mexico City, and higher for men elsewhere, although results by sex were not appreciably different for any city. In Sao Paulo, those with less education were more susceptible, whereas no distinct patterns by education were observed in the other cities.Conclusions Elevated temperatures are associated with mortality risk in these Latin American cities, with the strongest associations in So Paulo, the hottest city. The elderly are an important population for targeted prevention measures, but vulnerability by sex and education differed by city.