Heat effects on mortality in 15 European cities
Heat effects on mortality in 15 European cities
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DOI：
10.1097/ede.0b013e318176bfcd
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发表时间：
2008-09-01
期刊：
影响因子：
5.4
通讯作者：
Michelozzi, Paola
中科院分区：
文献类型：
--
作者：
Baccini, Michela;Biggeri, Annibale;Michelozzi, Paola
背景：流行病学研究表明，高温与死亡率有关，但对暴露响应功能和热量的滞后效应知之甚少。我们报告了15个欧洲城市的温暖季节每天最高明显温度与每日死亡之间的关联。方法：特定于城市的分析基于广义估计方程和（贝叶斯随机效应荟萃分析合并了。我们指定了分布滞后模型在温暖的季节中。重新分析：城市特定的暴露 - 响应功能的变化点在城市之间有所不同。大陆城市的所有自然死亡率的总体变化1度在地中海地区，3.12％（95％的可信度间隔= 0.60％至5.72％），1.84％）（0.06％，至3.64％）。在呼吸道疾病的热量和死亡率之间发现了更牢固的关联，并且在老年人中死亡。这种效果显而易见，六月至八月。它是有限的，温度过高，具有死亡率位移的证据。有一些建议，即早期暴露的影响更高。适应性和个人易感性需要进一步研究，作为对城市之间观察到的异质性的可能解释。
Background: Epidemiologic Studies show that high temperatures are related to mortality, but little is known about the exposure-response function and the lagged effect of heat. We report the associations between daily maximum apparent temperature and daily deaths during the warm season in 15 European cities.Methods: The city-specific analyses were based on generalized estimating equations and (lie city-specific results were combined in Bayesian random effects meta-analysis. We specified distribute lag models in studying the delayed efTect ot'exposure. Tinic-varying coefficient models were used to check the assumption of a constant heat effect over the warm season.Results: The city-specific exposure-response functions have a V with a change-point that varied among cities. The meta-analytic estimate of the threshold was 29.4 degrees C for Mediterranean cities and 23.3 degrees C for north-continental cities. The estimated overall change in all natural mortality associated with it 1 degrees C increase ill maximum apparent temperature above the city-specific threshold was 3.12%, (95% credibility interval = 0.60% to 5.72%) in the mediterranean region and 1.84%) (0.06%, to 3.64%) in the north-continental region. Stronger associations were found between heat and mortality from respiratory diseases, and with mortality in the elderly.Conclusions: There is an important mortality effect of heat across Europe. The effect is evident front June through August. it is limited, temperature excess, with evidence of mortality displacement. There is some Suggestion of a higher effect of early season exposures. Acclimatization and individual susceptibility need further investigation as possible explanations for the observed heterogeneity among cities.