Spatial analysis of hospital admissions for respiratory diseases during summer months in Berlin taking bioclimatic and socio-economic aspects into account
Spatial analysis of hospital admissions for respiratory diseases during summer months in Berlin taking bioclimatic and socio-economic aspects into account
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考虑生物气候和社会经济因素，对柏林夏季呼吸系统疾病住院情况进行空间分析
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
W. Endlicher
中科院分区：
文献类型：
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作者：
K. Scherber;M. Langner;W. Endlicher
近年来，国际环境健康研究讨论了热应激对人类健康的影响。特别是，呼吸道疾病的发病率在欧洲城市中显示出显着的热效应。大都市地区，如柏林的特点是城市内部的空间变异的社会经济和生物气候条件，被认为是导致呼吸系统健康风险的空间差异。从本质上讲，老年人、儿童和慢性病患者都会受到热应激的影响。选择了一种空间流行病学方法来绘制2000年至2009年夏季（6月至9月）期间64岁以上呼吸系统疾病（RD）患者住院的高风险图，并将呼吸系统健康风险与柏林的生物气候和社会经济条件联系起来。该研究旨在检测64岁以上RD患者住院相对风险升高的显著集群，并适当考虑社会经济条件作为健康结局的协变量。纯空间分析的结果显示，在> 64岁的RD患者中，住院的相对风险存在显著的城市内差异。根据2000-2009年期间的研究，以及2003年和2006年7月和8月的炎热月份，基本上在西北部和东南部城市中心发现了重要集群内的最高相对风险。相关性分析显示，在柏林的邮政编码水平上，1971 - 2000年期间以及1971 - 2000年和2021-2050年期间的平均值的基础上，64岁以上RD患者住院的相对风险与人口密度、社会经济条件和年平均热负荷天数之间存在显著的正相关关系。为了在城市规划中具体实施保健干预和预防战略，并对慢性阻塞性肺病患者进行远程医疗指导，空间流行病学分析是确定城市热脆弱地区的一个重要方法。
International environmental health studies of the past years have discussed the impacts of heat stress on human health. In particular, respiratory morbidity has shown significant heat effects in European cities. Metropolitan areas such as Berlin are characterised by an intra-urban spatial variability in socio-economic and bioclimatic conditions that is assumed to result in spatial differences in respiratory health risks. In essence, the elderly, children and people with chronic diseases suffer from heat stress. A spatial epidemiological approach was chosen to map elevated risks for hospital admissions among > 64-year-olds with respiratory diseases (RD) during the summer months (June–September) from 2000 to 2009 and to link respiratory health risks to bioclimatic and socio-economic conditions in Berlin. The study aims to detect significant clusters with elevated relative risks for hospital admissions among > 64-year-olds with RD in due consideration of socio-economic conditions as a covariate for health outcomes. The findings from the purely spatial analysis show significant intra-urban disparities in the relative risks for hospital admissions among > 64-year-olds with RD. The highest relative risks within significant clusters were basically detected in the north-western and south-eastern city centre based on the study period 2000–2009 and also during the hot months of July and August in 2003 and 2006. The correlation analysis depicted significantly positive relationships between relative risks for hospital admissions among > 64-year-olds with RD and population density, socio-economic conditions and the annual mean number of days with heat loads on the basis of the period 1971–2000 and the average of the periods 1971–2000 and 2021–2050 at the zip code level in Berlin. To specifically implement health care intervention and prevention strategies into urban planning and to apply a directed practice of telemedicine for patients with chronic obstructive pulmonary diseases, spatial epidemiological analyses are an important approach to identifying heat-vulnerable urban areas.