Seasonal variation in mortality and the role of temperature: a multi-country multi-city study
Seasonal variation in mortality and the role of temperature: a multi-country multi-city study
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DOI：
10.1093/ije/dyab143
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发表时间：
2021-09-01
影响因子：
7.7
通讯作者：
Hashizume, Masahiro
中科院分区：
文献类型：
--
作者：
Madaniyazi, Lina;Armstrong, Ben;Hashizume, Masahiro
虽然人们已经认识到死亡率的季节性变化已有数千年，但温度的作用仍然不清楚。我们的目的是评估死亡率的季节性变化，并检查温度的贡献。方法我们汇编了热带、干燥、温带和大陆性气候区719个地点的全因、心血管和呼吸系统死亡率、温度和地点特异性指标的每日数据。我们拟合了时间序列回归模型，以估计每日死亡率季节性变化的幅度，定义为一年中最大死亡率估计值与最小死亡率估计值的峰谷比（PTR）。荟萃分析用于总结每个气候带的特定位置估计值。我们估计了有和没有温度调整的PTR，差异代表了归因于温度的季节性影响。我们还使用元回归模型评估了特定于位置的特征对不同位置PTR的影响。结果季节性估计和温度调整的反应在不同的地点。热带地区全因死亡率的未校正PTR为1.05 [95%置信区间（CI）：1.00-1.11]，（95% CI：1.20-1.25）;调整温度后，估计值降至1.02（95% CI：0.95-1.09）和1.10（95% CI：1.07-1.12）。此外，未经调整的PTR与平均气温呈正相关。结论本研究表明，死亡率的季节性是由温度驱动的，最明显的是在温带/大陆性气候区，温暖的地方显示出更强的死亡率的季节性变化，这是与温度的影响更强。
Background Although seasonal variations in mortality have been recognized for millennia, the role of temperature remains unclear. We aimed to assess seasonal variation in mortality and to examine the contribution of temperature. Methods We compiled daily data on all-cause, cardiovascular and respiratory mortality, temperature and indicators on location-specific characteristics from 719 locations in tropical, dry, temperate and continental climate zones. We fitted time-series regression models to estimate the amplitude of seasonal variation in mortality on a daily basis, defined as the peak-to-trough ratio (PTR) of maximum mortality estimates to minimum mortality estimates at day of year. Meta-analysis was used to summarize location-specific estimates for each climate zone. We estimated the PTR with and without temperature adjustment, with the differences representing the seasonal effect attributable to temperature. We also evaluated the effect of location-specific characteristics on the PTR across locations by using meta-regression models. Results Seasonality estimates and responses to temperature adjustment varied across locations. The unadjusted PTR for all-cause mortality was 1.05 [95% confidence interval (CI): 1.00-1.11] in the tropical zone and 1.23 (95% CI: 1.20-1.25) in the temperate zone; adjusting for temperature reduced the estimates to 1.02 (95% CI: 0.95-1.09) and 1.10 (95% CI: 1.07-1.12), respectively. Furthermore, the unadjusted PTR was positively associated with average mean temperature. Conclusions This study suggests that seasonality of mortality is importantly driven by temperature, most evidently in temperate/continental climate zones, and that warmer locations show stronger seasonal variations in mortality, which is related to a stronger effect of temperature.