厦门市流行性感冒发病与气象因素影响

Effect of meteorological factors on influenza incidence in Xiamen city

目的探讨福建省厦门市气象因素对流行性感冒的影响,为预警预测和防控提供理论依据。方法对2013年1月-2019年2月厦门市日均本站气压、日本站气压差、日均相对湿度、日均气温、日均气温差、日照时数等气象因素与日流行性感冒发病数进行相关性和分布滞后非线性模型分析。结果厦门市2013年1月-2019年2月共报告流行性感冒10573例,男女性别比1.29∶1,4~岁组和0~岁组占比居前,依次为52.44%和32.19%。日均本站气压、日本站气压差与流行性感冒发病呈正相关(r>0),日均气温、日照时数与流行性感冒发病呈负相关(r<0)。低气压(<980hPa)滞后0~5d时是流行性感冒发病的危险因素,气压999hPa滞后4d发病风险最高(RR=1.05,95%CI=1.01~1.11)。气压差>18hPa对流行性感冒发病是危险因素,随气压差的增加而增加,<3hPa也是危险因素,总体呈现“U”型。气温<9°C和>23°C对流行性感冒发病是危险因素,呈现“U”型,日均气温1°C滞后4d时发病风险最高(RR=2.40,95%CI=1.01~5.71)。日照1~5h和11~13h滞后1~15d对流行性感冒发病是危险因素,日照13h滞后15d发病风险最高(RR=8.79,95%CI=1.22~63.30)。低气压975hPa经滞后0~15d对4~岁组儿童累计效应有统计学意义(RR=7.82,95%CI=6.40~9.55);气压差5hPa滞后0~15d对60~岁组老年人流行性感冒发病累积效应最高(RR=3.69,95%CI=1.56~8.68);低温1°C和高温31°C滞后0~15d对13~岁组人群和4~岁组儿童均有显著性累积效应,前者较高(RR=40.82,95%CI=3.53~554.19);日照13h滞后0~15d对4~岁组儿童累积效应最为显著(RR=20.41,95%CI=4.12~99.34)。结论日均本站气压、日本站气压差、日均气温、日照时数等气象因素影响厦门市流行性感冒发病,且具有一定的滞后性,可以考虑为预警预测和防控提供理论依据。

Objective To explore the impact of meteorological factors on influenza incidence in Xiamen city of Fujian province and to provide evidences for prediction and early warning of influenza epidemic. Methods The data on daily meteorological factors such as average atmospheric pressure, atmospheric pressure difference, relative humidity, temperature, temperature difference and sunshine hours and the data on daily number of influenza incidence reported in Xiamen city during January 2013 to February 2019 were collected and analyzed using correlation and distributed lag nonlinear model. Results Totally 10 573 influenza cases were reported in the city during the period;the male to female ratio of the cases was 1.29 ∶ 1 and 52.44% and 32.19% of the cases were 4-12 and 0-3 years old children. The daily atmospheric pressure and pressure difference were positively correlated with the incidence of influenza (r > 0), but the daily average temperature and sunshine hours were reversely correlated with the incidence (r < 0). Low atmospheric pressure (< 980 hPa) was a lag 0-5 day risk factor for influenza incidents, with the highest lag 4-day risk correlated with an atmospheric pressure of 999 hPa (relative risk [RR]= 1.05, 95% confidence interval [95% CI]: 1.01-1.11). A ‘U’ shaped correlation between atmospheric pressure difference and influenza incidence was observed and both the atmospheric pressure difference of > 18 hPa and < 3 hPa were risk factors for influenza incidence. There was also a ‘U’ shaped correlation between average daily temperature and influenza incidence and both a daily temperatures of < 9 °C and > 23 °C were risk factors for influenza incidents, with the highest lag 4-day risk (RR = 2.40, 95% CI: 1.01-5.71) for the average daily temperature of 1 °C. The sunshine time of 1-5 hours and 11-13 hours showed lag 1-15-day risks for influenza incidents and the highest risk was for lag 15-day sunshine time of 13 hours (RR = 8.79, 95% CI: 1.22-63.30). The cumulative effect of low atmospheric pressure of 975 hPa showed a significant lag 0-15-day cumulative risk of influenza incidents among children aged 4-12 year (RR = 7.82, 95% CI: 6.40-9.55). The difference in daily atmospheric pressure of 5 hPa showed the highest lag 0-15-day cumulative risk of influenza incident among the people aged 60 years and above (RR = 3.69, 95% CI: 1.56-8.68). Significant lag 0-15-day cumulative risk of influenza incidents related to low temperature of 1 °C was observed among the people aged 13-59 years (RR = 40.82, 95% CI: 3.53-554.19) and that related to high temperature of 31 °C was observed among those aged 4-12 years. The most significant lag 0-15-day cumulative risk of influenza incident (RR = 20.41, 95% CI : 4.12-99.34) related to daily sunshine time of 13 hours was observed among 4-12 years old children. Conclusion Meteorological factors including daily average atmospheric pressure, daily atmospheric pressure difference, daily average temperature and sunshine hours have lag influence on the incidence of influenza in Xiamen city and the results need to be concerned in early warning and prevention of influenza epidemic.