兰州市气温和风速对肺结核发病的影响研究

Effect of Air Temperature and Wind Speed on the Incidence of Tuberculosis in Lanzhou

目的探讨气温和风速对兰州市肺结核病发病的影响及敏感人群。方法收集2008—2016年兰州市肺结核逐日发病人数和同期气象资料,采用分布滞后非线性模型(DLNM)进行温度和风速与肺结核发病的关联性研究。结果 2008—2016年兰州市共报告肺结核16 996例,男女性别比为1.56∶1,以(36~64)岁患者最多(40.92%)。气温与肺结核的发病呈非线性关系。以年平均气温(11.11℃)为参照,低温效应呈倒U形,在-9℃,间隔6 d时最为显著,RR值为1.14(95%CI:1.02~1.26);低温(T=-5.2℃)累计效应在间隔14 d达最大值,男性(36~64)岁人群和65岁及以上人群RR(95%CI)分别为1.30(1.11~1.53)、1.30(1.10~1.55)和1.25(1.06~1.46)。高温效应呈S型,在28.0℃,间隔3 d时RR值最大,为1.13(95%CI:1.01~1.26);高温(T=20.1℃)累计效应在间隔5 d达最大值,男性(36~64)岁人群RR(95%CI)分别为1.31(1.00~1.71)、1.51(1.14~2.00)。风速与肺结核的风险效应呈正向关联。结论高温和低温均增加人群肺结核发病危险性,低温效应持续时间较高温长。低温主要影响男性、青壮年和老年人,高温主要影响男性和青壮年。风速增大也会使肺结核发病风险升高。

Objectives To explore the effect of air temperature and wind speed on incidence of tuberculosis and sensitive population.Methods The data of daily reported tuberculosis cases in Lanzhou from 2008 to 2016 and the meteorological data at the same period were collected and integrated.The distributed lag nonlinear model(DLNM） was fitted to reveal the relationship between the mean air temperature and the incidence of tuberculosis cases.Results A total of 16 996 cases were reported from 2008 to 2016,the ratio of male to female was 1.56 and most of patients(40.92%） were in the age of(36-64） years.There was a non-linear relationship between the mean air temperature and the number of tuberculosis cases.Taking the mean air temperature(11.11℃） as a reference,the exposure-response relationship between low-temperature effect and the number of tuberculosis cases was in an inverted U-shape,and the relative risks(RR） was the highest(1.14; 95% CI： 1.02-1.26） while the air temperature was-9℃ with a 6 day lag time.The highest accumulative effect of low temperature（-5.2℃） was lagged for 14 days,and the RR for the male,(36-64） year-old people and the elders were 1.30(1.11-1.53）,1.30(1.10-1.55） and 1.25(1.06-1.46）,respectively.The exposure-response relationship between high temperature and the daily cases of tuberculosis was in a S-shape,and the highest RR was 1.13(1.01-1.26） when the mean temperature was 28℃ with a 3 day lag time.The accumulative effect of high temperature(20.1℃） was the highest on 5 day lag time,and the RR for the male and (36-64） year-old people were 1.31(1.00-1.71） and 1.51(1.14-2.00）,respectively.The association of wind speed and the risk effects of tuberculosis was roughly positive.Conclusions Low and high temperature increased the risk of tuberculosis.The effect of low temperature lasted longer than that of high temperature.The male,(36-64） year-old people and the elders were sensitive to low temperature,and high temperature mainly affected men and young adults.High wind speed also increased the risk of tuberculosis.