辽宁省两县域城市气温对呼吸系统疾病住院人数的影响

Influence of air temperature on number of respiratory diseases hospitalization in two counties of Liaoning Province

为了探明气温与呼吸系统疾病住院人数的关系,合理实施辽宁省县域城市疾病预防预警,基于2016—2018年辽宁省北票市和西丰县两县域城市的逐日气象观测资料和呼吸系统疾病住院病例资料,分析当地呼吸系统疾病住院就诊人数的季节分布特征及其年龄分布特征。在此基础上,采用广义相加模型(Generalized Additive Model,GAM)和分布滞后非线性模型(the Distributed Lag Non-linear Model,DLNM)探究了气温对呼吸系统疾病住院人数的影响,并按性别、年龄分层建模,使用归因分值(Attributable Fraction,AF)量化了暴露在特定气温(极端低温、中度低温、中度高温、极端高温)范围内的患病风险。结果表明,两地呼吸系统疾病住院人数全年峰值出现在冬春季,患病人群以少儿和老年人群居多。北票市、西丰县人群的最适宜气温分别为26.2、22.2℃;气温对呼吸系统疾病患病的影响以低温滞后效应为主,高温存在即时效应但并不显著。北票市和西丰县分别有27.0%(95%置信区间为20.3%~32.9%)和29.0%(95%置信区间为22.1%~35.0%)的呼吸系统住院人数归因于气温,且患病风险主要以中度低温为主,北票市和西丰县患病归因于中度低温分别占25.9%(95%置信区间为19.5%~31.5%)和28.1%(95%置信区间为21.5%~33.9%)。就年龄分布而言,与成年组相比,少儿组和老年组中归因于中度低温的患病百分比均较高,此外老年组对极端低温也较敏感。就性别而言,女性比男性更容易受低温影响。辽宁省两县域城市的气温对不同人群的影响不同,气温对女性与老年居民造成的发病风险较大。

In order to find out the relationship between temperature and the number of hospitalized patients with respiratory diseases,relevant departments reasonably implement disease prevention and early warning in county-level cities in Liaoning Province. Based on the daily meteorological observation data and respiratory system hospitalization data of Beipiao City and Xifeng County in Liaoning Province from 2016 to 2018, the seasonal distribution characteristics and age distribution characteristics of the number of hospitalizations with respiratory system were analyzed. On this basis, the generalized additive model(GAM) and the distributed lag non-linear model(DLNM) were used to explore the effect of temperature on the number of hospitalizations for respiratory diseases, and the results were stratified by sex and age. Modeling using attributable fractions(AF) to quantify the disease risk of exposure to specific temperature ranges(eg, extreme cold temperature, moderate cold temperature, moderate hot temperature, extreme hot temperature). The results show that the annual peak of the number of hospitalizations for respiratory diseases in the two places occurs in winter and spring, and the majority of the sick people are children and the elderly. The optimal temperatures for people in Beipiao City and Xifeng County are 26.2 ℃ and 22.2 ℃, respectively. The impact of temperature on the incidence of respiratory diseases is dominated by the lag effect of cold temperature, and the immediate effect of hot temperature is not significant. In Beipiao City and Xifeng County, 27.0%(95% confidence interval: 20.3%-32.9%) and 29.0%(95% confidence interval: 22.1%-35.0%) of respiratory system hospitalizations were attributed to temperature, respectively, and the disease risk was mainly moderate cold temperature. The incidence of Beipiao City and Xifeng County was attributed to moderate cold temperature accounted for 25.9%(95% confidence interval: 19.5%-31.5%) and 28.1%(95%confidence interval: 21.5%-33.9%), respectively. In terms of age distribution, compared with the adult group, the percentage of diseases attributable to moderate cold is higher in the children group and the elderly group. In addition, the elderly group is also more sensitive to extreme low temperatures. In terms of gender stratification, women are more susceptible to low temperature than men. The temperature of the two county-level cities in Liaoning Province has different effects on different groups of people, the risk of disease caused by temperature on women and elderly residents is high.