我国各区域非适宜气温相关的心血管疾病的超额死亡风险评估

Risk of excess cardiovascular disease mortality related with non-optimal temperature in different geographic regions of China

目的定量评估我国七大地理区域人群非适宜气温相关的心血管疾病死亡的超额死亡数。方法基于我国2013—2018年180个区县的温度暴露和死亡数据,运用时间序列研究拟合各区域的温度与心血管疾病死亡的暴露—反应关系曲线,评估我国2015和2020年非适宜气温、低温、高温相关的心血管疾病超额死亡数。结果2015和2020年,我国因非适宜温度暴露导致的心血管疾病死亡的超额死亡人数分别为39.6万(29/10万)和42.5万(30/10万),大部分可归因于低温(76.5%和62.8%)。相较于2015年,2020年我国人群非适宜气温暴露相关的心血管疾病超额死亡数增加了7.3%,其中高温相关的超额死亡数增加了70.0%,而低温相关的超额死亡数下降了11.9%。非适宜气温相关的心血管疾病的超额死亡数的高值区为华东地区。结论2015—2020年非适宜气温对我国心血管疾病患病人群造成严重的疾病负担,并且存在增加的趋势。随着未来气候变化趋势加重,我国需针对地区间气候和人口特征差异,对各地区采取相应的适应性政策来进行人群防护。

Objective To quantitatively estimate the number of cardiovascular disease mortality related with non-optimal temperature in seven geographic regions of China.Methods Based on the data of temperature exposure and deaths in 180 districts and counties of China from 2013 to 2018,the exposure-response curves for temperature and cardiovascular disease mortality were fitted by a time series method in each geographic region,and then the numbers of excess deaths due to cardiovascular diseases related with non-optimal-,cold-,and heat-temperature were estimated in China in 2015 and 2020.Results There were 396 thousand(29/100000)and 425 thousand excess deaths(30/100000)due to cardiovascular diseases related to non-optimal temperature exposure,which were mainly attributed to cold temperature(76.5%and 62.8%)in 2015 and 2020,respectively.Compared with 2015,the number of excess deaths of cardiovascular diseases related to non-optimal temperature exposure in China increased by 7.3%in 2020,of which the number of heat-related excess cardiovascular disease deaths increased by 70.0%,while the number of cold-related excess cardiovascular disease deaths decreased by 11.9%.Among the seven geographic regions,Eastern China had the highest number of excess cardiovascular disease deaths related to non-optimal temperature.Conclusion Non-optimal temperature seriously threatened the health of the population with cardiovascular diseases from 2015 to 2020 in China,which showed an increasing trend in the number of excess deaths.With the aggravation of climate change in the future,it is necessary to take corresponding policies for population protection in each region based on the differences in climate and demographic features across regions.