南京市日最高气温对支气管和心血管类疾病就诊人数的影响

Effect of daily maximum temperature on the number of patients with bronchial and cardiovascular diseases in Nanjing

融合应用分布滞后非线性模型(Distributed Lag Mon-linear Model,DLNM)与广义相加模型(Generalized Additive Model,GAM),在控制新冠疫情影响、节假日效应、星期效应、长期趋势以及大气污染因子等因素基础上,探究了2018—2020年南京市日最高气温与当地支气管类、心血管类疾病就诊人数的暴露反应关系,包括滞后效应和累积效应。结果表明:对于支气管类疾病,冬季为高风险期,低温的即时效应和累积效应显著;中短期累积作用下,气温越低危险性越大;长期累积作用下,10℃左右的危险性最大;高温累积效应不显著,30℃左右滞后效应显著。对于心血管类疾病,低温的即时效应和累积效应显著,11~12℃左右影响的累积效应和持续性最强;高温的滞后效应显著,温度越高,滞后效应越明显;长期暴露于高温环境的患病风险会快速增加,日最高气温32℃左右的暴露累积风险最大。针对这两类疾病,当日最高气温在22~24℃范围内,属于人体最舒适温度。

Combining the Distributed Lag Non-linear Model(DLNM) and the Generalized Additive Model(GAM),based on controlling the impacts of the COVID-19,holiday effect,week effect,long-term trend,air pollution factors and other mixed factors,this study explored the exposure response relationship between the daily maximum temperature in Nanjing and the number of local patients with bronchial and cardiovascular diseases from 2018 to 2020,including the lag effect and cumulative effect.Results indicate that for bronchial diseases,winter is a high-risk period,and the immediate and cumulative effects of low temperature are significant;under the short-term cumulative effect,the lower the temperature,the greater the danger;under long-term accumulation,the danger is the highest at around 10 ℃;the cumulative effect of high temperature is not significant,and the hysteresis effect is significant around 30 ℃.For cardiovascular diseases,the immediate and cumulative effects of low temperature are significant,with the cumulative and sustained effects being the strongest around 11-12 ℃;the hysteresis effect of high temperature is significant,and the higher the temperature,the more pronounced the hysteresis effect;the risk of illness increases rapidly when exposed to high temperature environments for a long time,with the cumulative risk of exposure being highest at around 32 ℃ per day.For these two types of diseases,the highest temperature on the day ranges from 22 to 24 ℃,which is the most comfortable temperature for the human body.