Heat-Related Hospitalizations in Older Adults: An Amplified Effect of the First Seasonal Heatwave.
Heat-Related Hospitalizations in Older Adults: An Amplified Effect of the First Seasonal Heatwave.
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DOI：
10.1038/srep39581
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发表时间：
2017-01-11
影响因子：
4.6
通讯作者：
Naumova EN
中科院分区：
文献类型：
--
作者：
Liss A;Wu R;Chui KK;Naumova EN
老年人非常容易受到极端天气的伤害。与热有关的发病率的快速非线性增加难以量化，这阻碍了将暴露的直接影响归因于严重的健康后果。我们研究了环境温度对老年人中存在强烈季节性的热相关住院（HH）的影响，并评估了第一次和随后的季节性热浪造成的影响。我们根据16年的日常观测经验得出了波士顿MSA热浪事件的阈值。我们比较了热浪的健康风险，使用拟议的定义和四个替代定义。使用谐波回归模型检查了波士顿地区老年居民中的701例HH病例，该模型旨在捕获连续3个晚上夜间温度高于65.5 °F时环境温度和热浪事件的非线性影响。与热浪发作相关的HH的总体相对风险为6.9 [95%CI：4.8-9.8]。与第一次热浪相关的HH相对风险增加至13.3 [95%CI：7.4-24.0]。对于随后的热浪，风险降至3.7 [95%CI：2.4-5.8]。其他四个常用的热浪定义证实了这些发现。公共卫生行动必须针对第一次热浪，以最大限度地发挥预防措施的影响。
Older adults are highly vulnerable to the detriment of extreme weather. The rapid non-linear increase in heat-related morbidity is difficult to quantify, hindering the attribution of direct effects of exposure on severe health outcomes. We examine the effects of ambient temperatures on heat-related hospitalizations (HH) among the elderly in presence of strong seasonality and by assessing the effects caused by the first and subsequent seasonal heatwaves. We empirically derived the thresholds for a heatwave episode in Boston MSA based on 16 years of daily observations. We compared the health risks of heatwaves using the proposed and four alternative definitions. 701 cases of HH in older residents of Boston area were examined using harmonic regression models, designed to capture the non-linear effects of ambient temperatures and heatwave episodes when the night-time temperature is above 65.5 °F for 3 consecutive nights. The overall relative risk of HH associated with a heatwave episode was 6.9 [95%CI:4.8–9.8]. The relative risk of HH associated with the first heatwave increases up to 13.3 [95%CI:7.4–24.0]. The risk declined to 3.7 [95%CI:2.4–5.8] for the subsequent heatwave. Four other commonly used heatwave definitions confirmed these findings. Public health actions have to target the first heatwave to maximize the impact of preventive measures.