宜昌市夏季极端降水敏感性疾病和脆弱人群的筛选

Determination of sensitive diseases and vulnerable populations under extreme precipitation in summer in Yichang,China

目的分析宜昌市夏季极端降水对急诊数量的影响,筛选敏感性疾病并探究脆弱人群。方法本研究利用宜昌市2014—2019年6—8月气象数据和2家综合医院急诊数据,采用泊松广义线性模型结合分布滞后非线性模型,研究夏季极端降水(≥100 mm)与不同系统疾病急诊数的关系,筛选极端降水敏感性疾病,并进一步探讨对不同个体特征人群的滞后效应。结果共收集到研究期间宜昌市67492例急诊病例,极端降水对总人群、皮肤和皮下组织疾病、肌肉骨骼系统和结缔组织疾病、消化系统疾病的日急诊数的影响具有统计学意义,滞后天数为14 d,累积相对风险度(the cumulative relative risk,CRR)分别为1.401(95%CI:1.108~2.772)、3.267(95%CI:1.407~7.587)、2.639(95%CI:1.170~5.953)、2.435(95%CI:1.368~4.335)。男性、女性、(18~59)岁和≥60岁年龄组的CRR分别为1.403(95%CI:1.087~1.811)、1.400(95%CI:1.046~1.873)、1.329(95%CI:1.040~1.698)、1.587(95%CI:1.075~2.343)。结论极端降水可显著增加总人群的急诊风险,皮肤和皮下组织疾病、肌肉骨骼系统和结缔组织疾病、消化系统疾病为敏感性疾病,男性、女性普遍易感,18岁以上成人为脆弱人群。

Objective To analyze the influence of extreme precipitation in summer on the number of emergency visits in Yichang,China,and to determine sensitive diseases and vulnerable populations.Methods Based on data about meteorological factors and emergency visits of two general hospitals in Yichang from June-Auguest,2014 to 2019,a Poisson generalized linear model combined with a distribution lag nonlinear model was used to analyze the relationship between extreme precipitation(≥100 mm)in summer and the number of emergency visits for diseases of different systems,screen extreme precipitation-sensitive diseases,and explore the lag effects in populations with different characteristics.Results A total of 67492 emergency cases were collected in Yichang during the study period.Extreme precipitation showed significant effects on the daily emergency visits in the total population and for skin and subcutaneous tissue diseases,musculoskeletal system and connective tissue diseases,and digestive system diseases,with the cumulative relative risk(CRR)at lag 14 days being 1.401(95%confidence interval[CI]:1.108-2.772),3.267(95%CI:1.407-7.587),2.639(95%CI:1.170-5.953),and 2.435(95%CI:1.368-4.335),respectively.The CRR for males,females,18 to 59-year-olds,and≥60-year-olds were 1.403(95%CI:1.087-1.811),1.400(95%CI:1.046-1.873),1.329(95%CI:1.040-1.698),and 1.587(95%CI:1.075-2.343),respectively.Conclusion Extreme precipitation can significantly increase the risk of emergency visits in the total population.Skin and subcutaneous tissue disorders,musculoskeletal system and connective tissue disorders,and digestive system disorders are sensitive diseases,and males,females,and people over 18 years of age are vulnerable populations.