秦皇岛市气温及其变化对居民死亡风险的影响研究

Effects of temperature and temperature change on mortality of residents in Qinhuangdao,China

气温及其变化是影响人群健康特别是死亡的重要环境危险因素。为了揭示气温对秦皇岛市居民死亡人数的影响,基于2014—2020年该市各区、县逐日气象资料和居民死亡资料,采用广义相加模型(GAM)和分布滞后非线性模型(DLNM)研究了气温、气温日较差和24 h变温对非意外死亡、循环系统疾病死亡、呼吸系统疾病死亡人数的影响。按性别、年龄分层建模,使用相对危险度(Relative Risk,RR)量化了暴露在特定气温变化状态下的死亡风险。采用非参数双变量响应模型分析了气温与变温的协同影响效应。结果显示:(1)秦皇岛市居民非意外死亡、循环系统疾病死亡、呼吸系统疾病死亡人数全年峰值均出现在最冷的1月,气温对3类死亡人数的影响以冷效应为主且具有滞后效应,而高温具有即时效应。(2)气温日较差与非意外死亡、循环系统疾病死亡的总体暴露反应曲线呈“U”型分布,较大的气温日较差与上述两类死亡存在显著的风险效应,其中循环系统疾病死亡受影响最大,大的气温日较差(19℃)累积3 d相对危险度为1.27,其95%的置信区间(95%CI)为1.15—1.4,而其对呼吸系统疾病死亡的风险效应未通过显著性检验。(3)24 h变温对非意外死亡、循环系统疾病死亡总体影响效应的暴露曲线呈非线性递增趋势,其中正变温呈现显著的风险效应。(4)性别、年龄分组结果显示,女性对气温变化更敏感,男性对气温变化存在一定的滞后效应,老年人群更容易受到气温变化的影响。(5)低温与变温的协同作用加剧了死亡风险。总体上,冬季低温背景与大幅度气温变化相叠加对当地老年居民死亡影响风险最大,应予适时重点预防。

Temperature and temperature changes are important environmental risk factors that affect human health, especially mortality. This study investigates impacts of temperature and temperature changes on mortality of residents in Qinhuangdao based on daily meteorological data and resident mortality data for all districts and counties in Qinhuangdao from 2014 to 2020. The generalized additive model(GAM) and the distributed lag nonlinear model(DLNM) are used to explore the impacts of temperature and temperature changes on the number of non-accidental mortality and cardiovascular and respiratory mortality from three perspectives of temperature, diurnal temperature change(DTR) and temperature change between neighboring days(TCN). The modeling study is stratified by sex and age, and the relative risk(RR) is used to quantify the mortality risk of exposure to specific temperature changes. In addition, a non-parametric bivariate response surface model is used to explore the interaction between temperature and temperature change. The results are as follows:(1) The annual peak of non-accidental mortality, cardiovascular mortality and respiratory mortality in Qinhuangdao occurs in January, the coldest month of the year. The impact of temperature on the three types of deaths is mainly dominated by lagged cold effects, while high temperature has immediate effects.(2) The overall exposure response curve of DTR and non-accidental and cardiovascular mortality shows a U-shaped distribution, and high DTR has significant risk effects on the above two types of deaths. Among them, cardiovascular mortality is most affected, and the cumulative3 d relative risk of extremely large DTR(19℃) is 1.27(95%CI:1.15—1.4), while the risk effect of respiratory mortality cannot pass the significance test.(3) The exposure curve of the overall effect of TCN on non-accidental mortality and circulatory mortality shows a nonlinear increasing trend, and positive TCN has significant risk effects.(4) In terms of sex and age grouping, famale are more sensitive to temperature changes, while temperature changes have a lagged effect on male, and the elderly are more susceptible to temperature changes.(5) The synergistic effect of low temperature and temperature change exacerbates the mortality risk. The effect of temperature and its changes on the mortality of the three types is mainly the cold effect in Qinhuangdao. Particularly, the combination of low temperature background in winter and large temperature changes has the greatest impact on mortality risk of local elderly residents, and they should be protected in a timely manner.