2016—2021年合肥市极端气温与循环系统疾病死亡的时间序列分析

Time series analysis of extreme air temperatures and mortality from circulatory diseases in Hefei,China,2016—2021

目的探讨合肥市极端气温对居民循环系统疾病死亡的影响及不同人群的敏感性分析。方法收集合肥市2016—2021年逐日气象资料、大气污染物监测资料及循环系统疾病死亡数据。采用基于广义相加模型的分布滞后非线性模型(distributed lag non-linear model,DLNM),评估极端气温对不同性别、年龄人群循环系统疾病死亡影响以及对循环系统主要疾病死亡的滞后效应和累积效应。以日均气温中位数(17.7℃)为对照,计算极端气温的相对危险度(RR)。结果合肥市极端气温对居民循环系统疾病死亡具有显著影响。极端低温对循环系统疾病死亡影响滞后时间长,lag4时达到最大,RR(95%CI)为1.067(1.039,1.095),且不同人群的死亡风险均明显增加。极端高温对循环系统疾病死亡的影响在当天达到最大,RR(95%CI)为1.088(1.020,1.160),持续时间短;≥65岁、女性和脑血管病患者也均在当日效应最大,且效应具有统计学意义,而对其他人群无明显影响。极端气温对不同人群的冷效应均高于热效应,低温对<65岁人群的死亡风险明显高于≥65岁人群,热效应则相反;女性冷效应和热效应均高于男性;脑血管病人群冷效应和热效应也均高于缺血性心脏病人群。结论合肥市极端气温可能增加居民循环系统疾病死亡风险,冷效应影响更大,不同人群对冷热效应的敏感性有差别。

Objective To explore the effects of extreme air temperatures on the mortality from circulatory diseases and the susceptibility of different populations in Hefei,China.Methods The daily data on meteorological factors,air pollutants,and mortality due to circulatory diseases in Hefei from 2016 to 2021 were collected.A distributed lag nonlinear model combined with a generalized additive model was applied to evaluate the effects of extreme air temperatures on the total deaths from circulatory diseases as well as the lag effects and cumulative effects on the deaths from major circulatory diseases in populations of different sexes and ages.In comparison with the median of daily average temperature(17.7℃),the relative risk(RR)at extreme temperatures was calculated.Results Extreme air temperatures significantly affected the deaths from circulatory diseases in Hefei.Extreme low temperatures had long-lasting lag effects on the deaths from circulatory diseases,reaching the highest at lag 4(RR=1.067,95%confidence interval[CI]:1.039-1.095);extreme low temperatures significantly increased the death risk for all populations.At extreme high temperatures,the effect on the deaths from circulatory diseases peaked on the same day(RR=1.088,95%CI:1.020-1.160)with a short duration;the effects peaked on the same day for people over 65 years old,females,and people with cerebrovascular diseases,which were statistically significant,with no significant differences for other populations.For different populations,the cold effects of extreme temperatures were all higher than the heat effects.Low temperatures posed a significantly higher death risk for people<65 years old than those≥65 years old,while high temperatures produced the opposite effect.The cold effect and heat effect for females were both greater than those for males.The cold effect and heat effect were also greater in people with cerebrovascular disease than in those with ischemic heart disease.Conclusion Extreme air temperatures in Hefei can significantly increase the death risk due to circulatory diseases,and the cold effect is greater than the heat effect.The susceptibility to the heat and cold effects varies among different populations.