上海市浦东新区居民非意外死亡与日均气温相关性的时间序列研究

目的 了解日均气温对浦东新区居民非意外死亡的影响。方法 收集2005—2019年浦东新区气象资料、居民非意外死亡资料以及上海市大气污染物资料,利用分布滞后非线性模型,评估日均气温对浦东新区居民非意外死亡的影响及累积性与滞后性。结果 高温与低温均导致居民非意外死亡、心脑血管疾病及呼吸系统疾病死亡风险上升。以中位温度(P₅₀, 18.2 ℃)为参照,高温(P₉₅, 30.1 ℃)对居民非意外死亡、心脑血管疾病及呼吸系统疾病死亡累积2 d(Lag0～1 d)效应的RR值及其95%CI分别为1.28(1.23～1.33)、1.32(1.24～1.41)及1.45(1.28～1.64); 低温(P₅, 3.0 ℃)对居民非意外死亡与心脑血管疾病死亡的影响在累积22 d(Lag0～21 d)的RR值及其95%CI分别为1.22(1.11～1.35)与1.37(1.17～1.60),对呼吸系统疾病的影响在在累积15 d(Lag0～14 d)的RR值及其95%CI为1.27(1.01～1.59)。低温对<75岁人群非意外死亡的影响不显著; 高温对≥75岁人群的影响显著高于<75岁人群。小学及以下文化水平人群受高温及低温的影响显著高于中学及以上文化人群。结论 高温与低温均增加浦东新区居民非意外死亡风险。≥75岁人群与小学及以下文化人群对气温的影响更为敏感。

A time series study on association between temperature and non-accidental mortality in Pudong New Area,Shanghai

Objective To explore the impact of ambient temperature on daily non-accidental mortality in Pudong New Area. Methods The data including the concentration of air pollutants in Shanghai, meteorological data and daily non-accidental death in Pudong New Area from January 1, 2005 to December 31, 2019 were collected. A distributed lag non-linear model was performed to evaluate the impact of average daily air temperature on daily non-accidental mortality, and the lagging effect and cumulative effect were also assessed. Results Low and high temperature were positively associated with the risk of non-accidental, cardio-cerebral vascular disease and respiratory disease mortality. Versus P50(18.2 ℃)of daily median temperature, the cumulative RR and the 95%CI at P₉₅(30.1 ℃)were 1.28(1.23-1.33), 1.32(1.24-1.41)and 1.45(1.28-1.64)on two days lag(Lag0-1d), respectively. For non-accidental and cardio-cerebral vascular disease mortality, the cumulative RR and the 95%CI at P5(3.0 ℃)were 1.22(1.11-1.35)and 1.37(1.17-1.60)on twenty-two days lag(Lag0-21d), respectively. For respiratory disease mortality, the cumulative RR and the 95%CI was 1.27(1.01-1.59)at P5(3.0 ℃)on fifteen days lag(Lag 0-14 d). No significant impact of low temperature was observed on the population<75 years old, and the impact of high temperature on the population ≥75 years old was significantly higher than that on the population <75 years old. The impact of both high temperature and low temperature on the population without secondary school education were substantially higher than those on the population with secondary school education and above. Conclusion Both the low and high temperature were positively associated with the increase of non-accidental mortality risk. The people ≥75 years old and population without secondary school education were more susceptible to temperature.