2014—2019年武汉市高温过程中环境因子气象及大气污染因子对心脑血管疾病死亡人数的影响

Effects of environmental factors on the death of cardiovascular and cerebrovascular diseases during the high temperature process in Wuhan in 2014-2019

目的探讨武汉市高温过程中气象和大气污染因子对居民心脑血管疾病(cardiovascular and cerebrovascular diseases,CVD)死亡风险的影响,以确定高温过程下影响CVD的关键时期及阈值。方法利用武汉市2014—2019年高温过程期间每日的CVD死亡资料和同期气象、大气污染物浓度资料,运用基于Poisson分布的广义相加模型评估最高气温、平均气温、最低气温、人体舒适度和PM_(10)与日CVD死亡人数的相关性,得到增加CVD死亡风险的气象及大气污染物浓度的高影响因子及阈值。结果(1)年首次高温过程CVD死亡风险最高,首次高温过程平均CVD超额死亡率达21.7%;(2)当最高气温达36.7℃、最低气温达25.3℃,CVD死亡风险相对危险度值显著升高;(3)高温过程中平均气温、最高气温和PM_(10)是增加CVD死亡人数风险的重要环境因子,相对危险度分别为1.14((95%CI):1.11~1.17)、1.11((95%CI):1.08~1.15、1.06(95%:1.02~1.09))。结论武汉市高温过程下CVD死亡风险增高,年内首次高温过程CVD死亡风险最高,应加强首次高温过程CVD风险的预报和预警工作,重视高温暴露时间长的特殊人群的健康保护工作。

Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases(CVD)in Wuhan during the course of high temperature.Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected.The generalized additive models(GAM)were used to obtain the characteristics of meteorological factors,atmospheric pollutant concentrations,high impact factors and thresholds affecting the relative risk of CVD death.Results The analysis results showed that:(1)When the maximum temperature reached 36.7℃ and the lowest temperature reached 25.3℃,the relative risk of CVD death increased significantly;(2)The risk of CVD death during the first high temperature process was the largest,and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%;and(3)The average temperature,maximum temperature and PM_(10) during the course of high temperature were important environmental factors that increased the risk of CVD deaths,and the relative risks were 1.14(95% confidence interval(95%CI):1.11-1.17),1.11(95% confidence interval(95%CI):1.08-1.15),and 1.06(95% confidence interval(95%CI):1.02-1.09),respectively.Conclusion Temperature and PM_(10) are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019,with the first annual high temperature process having the greatest impact on the risk of CVD death.