绍兴市气温对其他感染性腹泻发病影响及归因风险评估

Impact of ambient temperature on other infectious diarrhea incidence and its attributable risk in Shaoxing city

目的了解浙江省绍兴市气温对其他感染性腹泻发病的影响及其归因风险,为其他感染性腹泻的预防控制提供参考依据。方法收集绍兴市2014年1月1日—2016年12月31日其他感染性腹泻日发病数据和同期气象资料,采用分布滞后非线性模型(DLNM)分析气温对其他感染性腹泻发病的影响,并基于DLNM的归因风险评估方法分析气温暴露造成人群发病的归因分值和归因发病数。结果绍兴市2014—2016年共报告其他感染性腹泻42480例;温度过高或过低均会增加其他感染性腹泻的发病风险,当温度为3.6℃时,30 d滞后的累积效应值最高,累积RR值为4.820(95%CI=2.857~8.132);归因于气温暴露造成的其他感染性腹泻发病数为15335(95%CI=11896~17533)例,占总发病数的36.10%(95%CI=28.23%~41.66%);低温的归因分值为5.09%(95%CI=4.29%~5.60%),大于高温归因分值的2.61%(95%CI=0.89%~3.86%);高温时,女性和≥15岁人群为其他感染性腹泻的易感人群。结论高温和低温均会增加其他感染性腹泻的发病风险,且低温的归因风险更大;在高温时,应对女性和≥15岁人群等易感人群加强防护措施以减少其他感染性腹泻的发生。

Objective To examine the impact of ambient temperature on other infectious diarrhea incidence(OIDI)and the impact′s attributable risk of OIDI in Shaoxing city,Zhejiang province for providing evidences to the prevention and control of the disease.Methods Daily data on OIDI and meteorological factors in Shaoxing city were collected for the period from January 2014 through December 2016.The impact of daily average ambient temperature(DAAT)on OIDI was analyzed using the distributed lag non-linear model(DLNM).Fraction and number of OIDI attributable to DAAT were estimated based on the results of DLNM analysis.Results A total of 42480 of OIDI were reported during the 3-year period in the city.Both high and low DAAT were associated with an increased risk of OIDI.The DAAT of 3.6℃was associated to the highest lag 30 day cumulative effect on OIDI,with a cumulative relative risk(RR)of 4.820(95%confidence interval[95%CI]:2.857-8.132).The total number of OIDI attributed to the influence of DAAT was 15335(95%CI:11896–17533),accounting for 36.10%(95%CI:28.23%-41.66%)of all OIDI.The fraction of attributable risk of OIDI for low DAAT was 5.09%(95%CI:4.29%-5.60%),higher than that(2.61%[95%CI:0.89%-3.86%])for high DAAT.The females and the people≥15 years old were vulnerable populations of OIDI associated with high DAAT.Conclusion Both high and low daily average ambient temperature could increase the risk of other infectious diarrhea incidence and the attributable risk of infectious diarrhea for low daily average ambient temperature is greater than that for high average ambient temperature but females and the people aged 15 years and above are vulnerable to other infectious diarrhea incidence associated with high average ambient temperature.