潍坊市气象因素对肾综合征出血热发病影响研究

Relationship between meteorological factors and hemorrhagic fever with renal syndrome in Weifang

目的探讨山东省潍坊市气象因素对肾综合征出血热(HFRS)发病的影响,为其防控提供理论依据。方法收集潍坊市2005—2015年肾综合征出血热每日报告发病数据及同期气象数据,利用分布滞后非线性模型分析气象因素与肾综合征出血热发病的剂量-反应关系。结果 2005—2015年潍坊市肾综合征出血热共报告发病2 459例,其中男性多于女性,性别比为2.62∶1;发病集中于20~70岁年龄组(占78.05%);发病人群以农民最多,占81.64%,其次为工人、学生。各气象因素中气温、相对湿度、降水量与HFRS发病数呈负相关关系(P<0.05),而平均气压与该发病数呈正相关(P<0.05)。HFRS发病风险与气温的反应关系呈倒"U"型,以气温中位数15℃为参照,在日平均气温为10℃时滞后0 d的相对危险度(RR)达到1.06(95%CI:1.03~1.19),HFRS发病风险最高。以相对湿度中位数66%为参照,最大日平均相对湿度(100%)时滞后5 d的HFRS发病风险最高,RR值为1.03(95%CI:1.02~1.09);日平均相对湿度为53%时0~30 d的累积滞后效应的RR值达到1.56(95%CI:1.09~2.48)。结论气象因素对肾综合征出血热发病的影响呈非线性,且存在滞后效应。

Objective To investigate the influence of meteorological factors on the incidence of hemorrhagic fever with renal syndrome（HFRS） in Weifang, Shandong province and to provide scientific guidance for the prevention and control of HFRS.Methods The daily HFRS cases and the meteorological variables were collected from 1 January, 2005 to 31 December, 2015,Weifang. The relationship between meteorological factors and HFRS and their lag effects were analyzed by non-linear distribution model（DLNM）. Results There were 2 459 cases of HFRS in Weifang from 2005 to 2015, among which male incidence was more than female incidence, with the sex ratio of 2.62∶1; 78.05% cases occurred in population aged 20-70; And the farmers had the highest proportion of incidence, accounted for 81.64%, followed by workers and students. Among meteorological factors, temperatures, relative humidity and precipitation were negatively correlated with daily HFRS incidence（P〈0.05）, while the air pressure was positively correlated（P〈0.05）. The curve of the relationship between the risk of HFRS and the temperature showed an inverted U shape.The highest risk of HFRS incidence was found at daily mean temperature of 10 ℃（lag0） compared with the median temperature（15 ℃） [RR： 1.06（95%CI： 1.03-1.19）], and at daily average relative humidity（RH） of 100%（lag5） compared with the median RH（66%） [RR：1.03（95%CI： 1.02-1.09）]. The accumulative RR was 1.56（95%CI： 1.09-2.48） at daily mean RH（53%） compared with the median RH（66%）. Conclusion The influence of meteorological factors on HFRS is non-linear, with a lagging effect