气象因子与流行性腮腺炎发病关联的时间序列研究

Time series study of relationship between meteorological factors and mumps incidence

目的研究气象因子与流行性腮腺炎（流腮）发病的关联性。方法采用时间序列方法，利用广州市2005-2012年全人群每日流腮发病人数的数据和同期的气温、相对湿度和气压、风速等主要气象资料，应用分布滞后非线性模型分析气象因子与流腮发病的关联性。结果广州市2005-2012年共报告流腮49760例，日最高、日平均、日最低气温中位数分别为28．3、24．2和21．2℃；日平均相对湿度中位数为75．0％；日平均日照时间中位数为3．9h；日平均风速中位数为1．5m／s；日平均气压中位数为1007．1hPa。Spearman等级相关分析结果，气温（日最高、日平均、日最低气温）、日平均相对湿度、日平均风速与流腮的发病呈正相关（r=0．305、0．314、0．321、0．207、0．215．均P〈0．01），日平均气压与流腮的发病呈负相关（r=-0．460，P〈0．01）。日平均气温为34．2℃，滞后0d时相对危险度（RR）最大，为1．05（95％CI：1．02—1．10）。日平均相对湿度为99％，滞后24d时RR值最大，为1．39（95％CI：1．03～1．89）。以各气象因子自身的中位数为参照值，日平均气温、日平均相对湿度的第99百分位数（31．7℃、95％）在总滞后时间30、24d对流腮发病的RR分别为1．81（1．41-2．32）、1．28（1．02—1．59）。气温对流腮发病的效应中，女性所受的热效应和冷效应均大于男性，热效应随着年龄的增长而增大。结论平均气温、相对湿度等气象因子可能是流腮发病的重要影响因素，夏季应对易感人群给予更多的关注。

Objective To explore the relationship between meteorological factors and the inci- dence of mumps. Methods Based on the data of daily number of reported mumps cases and meteorological data including temperature, relative humidity, atmospheric pressure and wind velocity in Guangzhou during 2005- 2012, the relationship between meteorological factors and mumps incidence was explored using a distributed lag non-linear time series model. Results There were 49 760 mumps cases reported in Guang- zhou during 2005 -2012. The medians of daily average maximum, mean, and minimum temperature were 28.3, 24.2, and 21.2 ℃, respectively. The medians of average relative humidity, average sunshine hours, average wind velocity, and average atmospheric pressure were 75.0%, 3.9 h, 1.5 m/s, and 1 007.1 hPa. The Spearman rank correlation analysis and the constructed model showed that mean tempera- ture, relative humidity and wind velocity were positively associated with the incidence of mumps, whereas atmospheric pressure was inversely associated with it. The risk was highest when daily mean temperature was 34.2℃ on lag 0 day as the relative risk （RR） was 1.05 （95% CI, 1.02 - 1.10） ; when relative hu- midity was 99% on lag 24 days, the RR was 1.39 （95% CI, 1.03 - 1.89） as the highest. Taking the me-dian of each meteorological factor itself as the reference value, the RRs of the 99th percentile （31.7 ℃, 95% ）of daily mean temperature and relative humidity were 1.81 （95% CI, 1.41 -2.32）, 1.28 （95% CI, 1.02 - 1.59） , respectively, in the total lag time of 30 and 24 days to the mumps incidence. Both hot and cold effects were larger in females than those in males, and the hot effect increased with age. Conclusion Mean temperature, relative humidity might be important predictors of the incidence of mumps in Guang- zhou. More attention should be paid to the susceptible population during the summer.