The relationship between extreme temperature and emergency incidences: a time series analysis in Shenzhen, China
The relationship between extreme temperature and emergency incidences: a time series analysis in Shenzhen, China
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极端气温与突发事件的关系：中国深圳的时间序列分析
DOI：
10.1007/s11356-018-3426-8
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发表时间：
2018-12-01
影响因子：
5.8
通讯作者：
Yu, Shuyuan
中科院分区：
文献类型：
--
作者：
Guo, Yinsheng;Ma, Yue;Yu, Shuyuan
据报道，极端温度与几个城市急性疾病发病率的增加有关。然而，类似的研究很少在深圳，这是一个亚热带城市位于中国南方。本研究探讨了深圳市突发事件与极端温度的关系，并探讨了空气污染物在深圳市极端温度对人体健康影响中的作用。利用分布滞后非线性模型研究了2013-2017年深圳市极端气温对突发事件发生的影响。在此，仅考虑了总急诊发病率、呼吸系统疾病和心血管疾病的急诊发病率。空气污染，亚组和季节进行了调整，以调查极端温度对紧急事件的影响。用R软件计算相对危险度（RR）和95%置信区间。从滞后0到21天，体温与急诊总就诊次数、体温与心血管疾病、体温与呼吸系统疾病的RR分别为1.09在极低温度（温度的第一个百分比，10 °C）下分别为1.22（95%CI：0.96-1.56）和1.06（95%CI：0.70-1.60）。在相同的滞后天数内，极高温度与急诊总就诊次数、心血管疾病和呼吸系统疾病之间的RR分别为1.02（95%CI：0.92-1.14）、0.64（95%CI：0.49-0.86）和0.92（95%CI：0.56-1.53）。在温暖季节（5天移动平均温度< 22 °C），各类突发事件的累积效应随着时间的推移逐渐增大。在高温季节（≥ 22 °C的5天移动平均值），总发病率和心血管病发病率的累积效应在前5天内呈上升趋势，然后下降，直至滞后21天。水库突发事件的累积效应从滞后0到滞后21呈下降趋势。老年人（≥ 65，P1：RR = 1.49，95% CI（1.30，1.71）; P99：RR = 0.86，95% CI（0.71，1.04））和男性（P1：RR = 1.27，95%CI（1.14，1.42））似乎比年轻人更容易受到极端温度的影响（≤ 64，P1：RR = 1.19，95%CI（1.08，1.32）; P99：RR = 1.00，95%CI（0.89，1.12））和女性（P1：RR = 1.17，95%CI（1.06，1.30））。全年极端低温对各类突发事件的影响均强于极端高温。此外，寒冷天气的影响持续了几天左右，而炎热天气的影响是急性和迅速的。温度上升的变化预示着紧急事件发生的频率会增加。这些结果对紧急事件的管理具有临床和公共卫生意义。
Extreme temperature has been reported to be associated with an increase in acute disease incidence in several cities. However, few similar studies were carried out in Shenzhen, which is a subtropical city located in the southern China. This study explored the relationship between the emergency incidences and extreme temperatures, and investigated the role of air pollutants played in the temperature-related effects on human health in Shenzhen. We conducted a distributed lag nonlinear model study on the effect of extreme temperatures on emergency incidences in Shenzhen city during 2013–2017. Here, only the total emergency incidences, emergency incidences for respiratory diseases, and cardiovascular diseases were taken into consideration. Air pollution, subgroups, and seasons were adjusted to investigate the impacts of extreme temperatures on emergency incidences. Relative risk (RR) and 95% confidence intervals were calculated with the R software. From lag 0 to 21 days, the RR of temperature-total emergency department visits, temperature-cardiovascular, and temperature-respiratory diseases was 1.09 (95% CI: 0.98–1.20), 1.22 (95% CI: 0.96–1.56), and 1.06 (95% CI: 0.70–1.60) at extremely low temperature (first percent of temperature, 10 °C), respectively. During the same lag days, the RR was 1.02 (95 % CI: 0.92–1.14), 0.64 (95% CI: 0.49–0.86), and 0.92 (95% CI: 0.56–1.53) between extremely high temperature and total emergency department visits, cardiovascular, and respiratory diseases, respectively. The cumulative effects gradually went up with time for all types of emergency incidences in warm seasons (5 days moving average of temperature < 22 °C). However, the cumulative effects of total emergency incidences and Cvd emergency incidences were increased within the first lag 5 days, and then decreased until lag 21 in hot seasons (5 days moving average of temperature ≥ 22 °C). The cumulative effects of Res emergency incidences showed a declined trend from lag 0 to lag 21. The elderly (≥ 65, P1: RR = 1.49, 95% CI (1.30, 1.71); P99: RR = 0.86, 95% CI (0.71, 1.04)) and men (P1: RR = 1.27, 95% CI (1.14, 1.42)) seemed to be more vulnerable to extreme temperature than the younger (≤ 64, P1: RR = 1.19, 95% CI (1.08, 1.32); P99: RR = 1.00, 95% CI (0.89, 1.12)) and women (P1: RR = 1.17, 95%CI (1.06, 1.30)). The effects of extremely low temperature on all types of emergency incidences were stronger than those of extremely high temperature in the whole year. In addition, impacts of cold weather lasted about several days while those of hot weather were acute and rapid. An increased frequency of emergency incidences is predicted by rising temperatures variations. These results have clinical and public health implications for the management of emergency incidences.