郑州市日均气温对居民非意外死亡影响的分布滞后非线性模型分析

Influence of average daily temperature on non-accidental deaths in Zhengzhou City based on the distributed lag non-linear model

目的:了解郑州市日均气温对居民非意外死亡的影响。方法:利用2013~2019年郑州市人群死亡个案资料,结合同期气象及大气污染指标,采用分布滞后非线性模型(DLNM),在控制长期趋势、季节趋势和其他混杂因素后,研究日均气温与每日非意外死亡、循环系统疾病死亡之间的关系。结果:郑州市日均气温与每日非意外死亡和循环系统疾病死亡的关系均呈非线性关系。冷效应具有滞后性,非意外死亡和循环系统疾病死亡均在第4天开始出现,持续至第12天。热效应表现为急性,非意外死亡和循环系统疾病死亡风险均在当天最大,持续6 d。累积冷效应随滞后时间增加而增加,非意外死亡的累积冷效应在滞后21 d达到最大,RR(95%CI)为1.398(1.115~1.752);累积热效应在滞后11 d达到最大,RR(95%CI)为1.178(1.070~1.297)。循环系统疾病死亡的累积冷效应在滞后16 d达到最大,RR(95%CI)为1.301(1.010~1.675);累积热效应在滞后9 d达到最大,RR(95%CI)为1.239(1.097~1.398)。结论:郑州市日均气温影响居民非意外和循环系统疾病死亡,且存在累积效应。

Aim:To understand the impact of average daily temperature on non-accidental deaths in Zhengzhou City.Methods:After controlling long-term trends,seasonal trends and other confounding factors,the relationships between average daily temperature and the daily non-accidental deaths as well as the deaths from circulatory diseases in Zhengzhou City from 2013 to 2019 were studied based on the distributed lag non-linear model(DLNM),in which the meteorological and air pollution indexes in the same period were also included.Results:The relationship between average daily temperature and the non-accidental deaths was non-linear,it was the same with the relationship between the daily temperature and the deaths from circulatory diseases.The cold effects on non-accidental deaths and the deaths from circulatory diseases both appeared at the 4th day and lasted to the 12th day.The heat effect on non-accidental deaths and the deaths from circulatory diseases was the highest on the same day,respectively,lasting for 6 days.The cumulative cold effect increased with the increase of lag time.The cumulative cold effect on non-accidental deaths reached the maximum after 21 days,the corresponding RR(95%CI)were 1.398(1.115-1.752),the cumulative heat effect reached the maximum after 11 days,the corresponding RR(95%CI)were 1.178(1.070-1.297),the cumulative cold effect circulatory disease deaths reached the maximum after 16 days,the corresponding RR(95%CI)were 1.301(1.010-1.675),and the cumulative heat effect reached the maximum after 9 days,the corresponding RR(95%CI)were 1.239(1.097-1.398).Conclusion:Average daily temperature has a cumulative effect on non-accidental and circulatory diseases deaths in Zhengzhou City.