气温对2007～2013年济南市人群慢性非传染性疾病死亡的归因风险研究

Impacts of ambient temperature on chronic non-communicable disease mortality in Jinan City,China during 2007-2013: an attributable risk study

目的采用归因风险评估分析气温与健康结局之间的关系,补充公共卫生学方面的证据。方法收集济南市2007~2013年逐日气温与非意外死亡、心血管疾病死亡和呼吸系统疾病死亡的逐日死亡数据,采用分布滞后非线性模型的归因风险评估方法,分析气温暴露造成人群死亡的归因风险,并进一步探索气温对敏感人群的风险。结果济南市日均气温与非意外死亡/心血管疾病死亡/呼吸系统疾病死亡的累积暴露-反应关系曲线近似呈U型;由气温导致的归因风险比例分别为13.2%(95%CI:9.6~16.8)/17.0%(95%CI:12.6~20.8)/27.8%(95%CI:-2.5~50.5)。低温对女性、老年人和教育水平较低者影响较大。结论高温或低温均可增加人群不同疾病死亡风险,但是低温效应的归因比例高于高温的作用。

Objective To supplement the public health evidence by assessing the relationship between temperature and health adopting attributable risk assessment. Methods Daily data on temperature and non-accidental/cardiovascular/respiratory mortality outcomes were obtained from 2007 to 2013. Attributable risk assessment by distributed lag non-linear model was used to estimate the relationship of different disease mortality with temperature,and further to explore the risks of temperature on susceptible population. Results The overall cumulative exposure-response curve of temperaturemortality relationship was U-shaped. In total,ambient temperature was attributable 13. 2%（ 95%CI： 9. 6-16. 8）/17. 0%（ 95%CI： 12. 6-20. 8）/27. 8%（ 95% CI：-2. 5-50. 5） to death risks for non-accidental/cardiovascular/respiratory disease,respectively. Females,people ≥65 years and people with low educated level were more vulnerable. Conclusion Both heat and cold are associated with an increased risk of daily mortality,but most mortality burdens are caused by cold.