Emergency ambulance dispatches and apparent temperature: A time series analysis in Emilia-Romagna, Italy
Emergency ambulance dispatches and apparent temperature: A time series analysis in Emilia-Romagna, Italy
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DOI：
10.1016/j.envres.2011.07.005
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发表时间：
2011-11-01
影响因子：
8.3
通讯作者：
Lauriola, Paolo
中科院分区：
文献类型：
--
作者：
Alessandrini, Ester;Sajani, Stefano Zauli;Lauriola, Paolo
前言：在几项流行病学研究中，已经广泛调查了与压迫性天气相关的死亡率增加。然而，为了正确理解与热有关的健康影响的全部公共卫生意义，以及建立有效的监测系统，调查压力气象条件对非致命事件的影响也很重要。我们的研究的目的是评估与biomeeps的生物条件下使用的时间序列技术mortality.Methods：在2002年至2006年的夏季期间，每天的数据收集的埃米利亚-罗马涅地区的主要城镇的紧急救护车调度35岁或以上的人的救护车调度的确认响应关系。在分析的第一阶段，使用广义加性模型探索了每日救护车调度和表观温度升高之间的城市特定关系，同时控制了空气污染，季节性，长期趋势，假期和周末。采用线性样条函数拟合救护车出动次数与表观温度的关系。评估了高温对呼吸道和心血管疾病以及所有非创伤性疾病的健康影响。在第二阶段的分析中，城市特定的影响被结合在固定或随机效应的荟萃分析中。结果：在25至30摄氏度之间，平均表观温度每升高1摄氏度，救护车调度的百分比变化为1.45%（95%置信区间：0.95，1.95）非创伤性疾病和2.74%（95% CI：1.34，4.14）呼吸系统疾病。在平均表观温度超过30摄氏度的日子里，风险增加的百分比更大（8.85%，95%CI：7.12，非创伤性疾病10.58）。在这段生物气象条件下，心血管疾病与表观温度呈正相关。风险随着年龄的增长而增加。75岁及以上人群非创伤性疾病风险增加13.34%，而35- 64岁人群非创伤性疾病风险增加4.75%。结论：首次将时间序列分析技术应用于急诊救护车调度的研究，以评估与生物统计学不适相关的风险。我们的研究结果表明，生物统计学条件和救护车调度之间有很强的关系。(C)2011 Elsevier Inc. All rights reserved.
Introduction: Increases in mortality associated with oppressive weather have been widely investigated in several epidemiological studies. However, to properly understand the full public health significance of heat-related health effects, as well as to develop an effective surveillance system, it is also important to investigate the impact of stressful meteorological conditions on non-fatal events. The objective of our study was to evaluate the exposure-response relationship of ambulance dispatch data in association with biometeorological conditions using time series techniques similar to those used in previous studies on mortality.Methods: Daily data of emergency ambulance dispatches for people aged 35 or older in the summer periods from 2002 to 2006 were collected for the major towns in the Emilia-Romagna region. In the first stage of the analysis, the city-specific relationship between daily ambulance dispatches and increasing apparent temperature was explored using Generalized Additive Models while controlling for air pollution, seasonality, long-term trend, holidays and weekends. The relationship between ambulance dispatches and apparent temperature was approximated by linear splines. The effects of high temperatures on health were evaluated for respiratory and cardiovascular diseases as well as for all non-traumatic conditions. In the second stage of the analysis, city-specific effects were combined in fixed or random effect meta-analyses.Results: The percent change in the ambulance dispatches associated with every 1 degrees C increase in the mean apparent temperature between 25 and 30 degrees C was 1.45% (95% confidence interval: 0.95, 1.95) for non-traumatic diseases and 2.74% (95% Cl: 1.34, 4.14) for respiratory diseases. The percent increase in risk was greater on days in which the mean apparent temperature exceeded 30 degrees C (8.85%, 95% Cl: 7.12, 10.58 for non-traumatic diseases). In this interval of biometeorological conditions, cardiovascular diseases became positively associated with the apparent temperature. The risks increased with age. The increase in risk for the non-traumatic diseases reached 13.34% for people aged 75 or older compared to 4.75% for those aged 35-64.Conclusion: Time series analysis techniques were adopted for the first time to investigate emergency ambulance dispatches to evaluate the risks associated with biometeorological discomfort. Our findings show a strong relationship between biometeorological conditions and ambulance dispatches. (C) 2011 Elsevier Inc. All rights reserved.