Public health vulnerability to wintertime weather: time-series regression and episode analyses of national mortality and morbidity databases to inform the Cold Weather Plan for England
Public health vulnerability to wintertime weather: time-series regression and episode analyses of national mortality and morbidity databases to inform the Cold Weather Plan for England
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DOI：
10.1016/j.puhe.2015.12.015
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发表时间：
2016-08-01
期刊：
影响因子：
5.2
通讯作者：
Mays, N.
中科院分区：
文献类型：
--
作者：
Hajat, S.;Chalabi, Z.;Mays, N.
目的：通过表征冬季天气与死亡率与发病率结果之间的既有关系，以及对最风险的群体的确定：时间序列回归分析和情节分析，来为英格兰公共卫生的寒冷天气计划（CWP）提供信息。每日死亡率，紧急医院入院以及英格兰每个地区的事故和紧急就诊。每1度c的事件在温度下降或在极端天气的个别发作中下降。种族：在所有地区都观察到不良冷作用，东北，西北和伦敦的死亡风险最大。在全国范围内，全因死亡人数增加了3.44％（95％CI：3.01，3.87），每1度C的全因紧急入院率每1度下降到低于低于确定的阈值。非常老年人和COPD的人受到低温的最大风险。在大雪期间，a＆e的骨折访问升高，成年人（16-64岁）是最敏感的年龄组。由于即使是中度寒冷的日子也会与不利的健康影响有关，因此迄今为止，寒冷天气最大的健康负担不在CWP.Conclusions中当前使用的警报时期：我们的发现表明水平为0（“全年计划”）和1个（“冬季准备和行动”）与警报相比是CWP的关键组成部分。冬季最脆弱的人可能会因经历的天气状况类型而有所不同。为CWP提出了建议。 （c）2016年皇家公共卫生学会。由Elsevier Ltd.出版。保留所有权利。
Objectives: To inform development of Public Health England's Cold Weather Plan (CWP) by characterizing pre-existing relationships between wintertime weather and mortality and morbidity outcomes, and identification of groups most at risk.Study design: Time-series regression analysis and episode analysis of daily mortality, emergency hospital admissions, and accident and emergency visits for each region of England.Methods: Seasonally-adjusted Poisson regression models estimating the percent change in daily health events per 1 degrees C fall in temperature or during individual episodes of extreme weather.Results: Adverse cold effects were observed in all regions, with the North East, North West and London having the greatest risk of cold-related mortality. Nationally, there was a 3.44% (95% CI: 3.01, 3.87) increase in all-cause deaths and 0.78% (95% CI: 0.53, 1.04) increase in all-cause emergency admissions for every 1 degrees C drop in temperature below identified thresholds. The very elderly and people with COPD were most at risk from low temperatures. A&E visits for fractures were elevated during heavy snowfall periods, with adults (16-64 years) being the most sensitive age-group. Since even moderately cold days are associated with adverse health effects, by far the greatest health burdens of cold weather fell outside of the alert periods currently used in the CWP.Conclusions: Our findings indicate that levels 0 ('year round planning') and 1 ('winter preparedness and action ') are crucial components of the CWP in comparison to the alerts. Those most vulnerable during winter may vary depending on the type of weather conditions being experienced. Recommendations are made for the CWP. (C) 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.