基于分布滞后非线性模型评估镇江市日均气温对居民死亡风险的影响

Influence of daily average temperature on the risk of resident mortality in Zhenjiang,China:an assessment based on a distributed lag nonlinear model

目的探索镇江市日均气温与居民每日死亡数的关联。方法采用分布滞后非线性模型拟合镇江市2015—2021年逐日死亡数据、气象数据和大气污染物数据,分析日均气温对人群日死亡数影响的滞后效应和累积效应。结果镇江市日均温度与死亡呈现近似“U”形曲线。热效应为急性短期效应,气温对非意外总死亡、循环和呼吸系统疾病死亡的热效应均在当天表现出最大热效应,RR值分别为1.19(95%CI:1.13~1.25)、1.46(95%CI:1.32~1.61)、1.59(95%CI:1.27~2.00)。冷效应呈现滞后特点,气温对非意外总死亡、循环系统疾病死亡的冷效应持续到第11天,最大RR值分别为1.08(95%CI:1.05~1.10)、1.07(95%CI:1.02~1.11)。非意外总死亡、循环系统疾病死亡的累积冷效应分别在滞后30天和20天达到最大值,而气温对不同死因别死亡人数的累积热效应则都在滞后3天达到最大值。结论镇江市气温过高或过低均会增加居民死亡风险,存在滞后效应。

Objective To investigate the relationship between daily average temperature and the daily mortality of residents in Zhenjiang,China.Methods A distributed lag nonlinear model was performed to fit data of daily mortality,meteorology and air pollution in Zhenjiang from 2015 to 2021,so as to analyze the lag and cumulative effects of daily average temperature on daily mortality.Results A U-shaped relationship was observed between daily average temperature and daily mortality.The thermal effects of high temperature were acute short-term,and reached the highest at lag 0 d for total non-accidental,cardiovascular and respiratory mortalities,with risk ratio(RR)values of 1.19(95%confidence interval[CI]:1.13-1.25),1.46(95%CI:1.32-1.61)and 1.59(95%CI:1.27-2.00),respectively.On the other hand,there was a lag effect of cold temperature on mortality,which lasted until the 11th day for total non-accidental and cardiovascular mortalities,with maximum RR values of 1.08(95%CI:1.05-1.10)and 1.07(95%CI:1.02-1.11),respectively.The cumulative cold effects of low temperature on total non-accidental and cardiovascular mortalities reached their maximum at lag 30 d and lag 20 d,respectively,while the cumulative thermal effects of high temperature on total non-accidental,cardiovascular,and respiratory mortalities all reached their maximum at lag 3 d.Conclusion Exposure to high or low temperature is significantly associated with increased risk of resident mortality in Zhenjiang,and there is a lag effect.