Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study
Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study
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DOI：
10.1136/bmj.317.7164.978
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发表时间：
1998-10-10
影响因子：
--
通讯作者：
Keatinge, WR
中科院分区：
文献类型：
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作者：
Donaldson, GC;Ermakov, SP;Keatinge, WR
目的评估如何有效地采取措施，在极端寒冷的雅库茨克控制冬季死亡率。设计访谈，以评估户外服装和测量室内温度;回归这些和延迟的原因特异性死亡率的温度。设置雅库茨克，东西伯利亚，俄罗斯主题：年龄在50-59岁和65-74岁的Au人，1989-95年期间居住在雅库茨克400 km范围内，1002名男性和女性同意接受采访。和呼吸道疾病。结果1989-95年10月至3月的平均气温为-26.6 ° C。在10.2摄氏度时，人们在户外穿3.30层（95%置信区间3.08至3.53）衣服，在-20摄氏度时增加到4.39层（4.13至4.66; P < 0.0001）。当气温降到-48.2摄氏度时，厚外套（通常是毛皮）取代了夹克，82%的人在气温10.2摄氏度到-20摄氏度时每天外出，但在-20摄氏度以下，这一比例稳步下降到44%。（35%至53%）在-48.2摄氏度（P < 0.001），和整体颤抖户外没有增加。在室外10.2摄氏度时，客厅温度为17.9（17.2至18.5）摄氏度，在-20摄氏度时为19.6（18.8至20.4）摄氏度，在-48.2摄氏度时为19.1（18.6至19.6）摄氏度。各种原因以及缺血性心脏病和呼吸道疾病的死亡率不受气温下降的影响。呼吸道疾病死亡率（每百万人每日死亡人数）从4.7（4.3至5.1）至5.1（4.4至5.7）（P = 0.03），但这被受伤死亡人数的下降所抵消。结论雅库茨克的人们穿着非常暖和的衣服，在极端寒冷的天气里，呆在温暖的室内，防止世界上较温和地区冬季死亡率的增加。只有呼吸道死亡率上升，可能是因为呼吸冷空气。
Objective To assess how effectively measures adopted in extreme cold in Yakutsk control winter mortality.Design interviews to assess outdoor clothing and measure indoor temperatures; regressions of these and of delayed cause-specific mortalities on temperature.Setting Yakutsk, east Siberia, RussiaSubjects: AU people aged 50-59 and 65-74 years living within 400 km of Yakutsk during 1989-95 and sample of 1002 men and women who agreed to be interviewed.Main outcome measures Daily mortality from all causes and from ischaemic heart, cerebrovascular, and respiratory disease.Results Mean temperature for October-March 1989-95 was - 26.6 degrees C. At 10.2 degrees C people wore 3.30 (95% confidence interval 3.08 to 3.53) layers ofclothing outdoors, increasing to 4.39 (4.13 to 4.66; P < 0.0001) layers at - 20 degrees C. Thick coats, often of fur, replaced anoraks as temperature fell to - 48.2 degrees C, 82% of people went out each day when temperatures were 10.2 degrees C to - 20 degrees C, but below - 20 degrees C the proportion fell steadily to 44% (35% to 53%) at -48.2 degrees C (P < 0.001), and overall shivering outdoors did not increase. Living room temperature was 17.9 (17.2 to 18.5)degrees C at 10.2 degrees C outdoors, 19.6 (18.8 to 20.4)degrees C at - 20 degrees C, and 19.1 (18.6 to 19.6)degrees C at -48.2 degrees C. Mortality from all causes and from ischaemic heart and respiratory disease was unaffected by the fall in temperature. Mortality from respiratory disease (daily deaths per million) rose from 4.7 (4.3 to 5.1) to 5.1 (4.4 to 5.7) (P = 0.03), but this was offset by a fall in deaths from injuryConclusions People in Yakutsk wore very warm clothing, and in extremely cold weather stayed indoors in warm housing preventing the increases in mortality seen in winter in milder regions of the world. Only respiratory mortality rose, perhaps because of breathing cold air.