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日均气温与呼吸系统疾病日入院人次相关性的时间序列分析
作者:张越 阚海东 彭丽 刘媛 王伟炳

摘要:

目的  定量分析和评价上海市日均气温对呼吸系统疾病入院人次的影响。方法  收集上海市居民2006年1月至2011年12月呼吸系统疾病住院患者病例资料、同期上海市气象因素及大气污染物数据。采用广义相加模型,控制长期趋势、短期波动、星期几效应等混杂因素,分析日均气温与呼吸系统疾病入院人次的暴露-反应关系。结果  日均气温与呼吸系统疾病日入院人次间呈现"J"形关系,入院风险最低温度为25 ℃。总人群低温时滞后30 d情况下呼吸系统疾病入院的超额危险度(ER)为3.00%(95%CI: 2.54%~3.45%),男性为3.00%(95%CI: 2.55%~3.45%),女性为3.02%(95%CI: 2.51%~3.49%);总人群高温时滞后30 d的呼吸系统疾病ER为2.15%(95%CI: 0.67%~3.66%),男性1.86%(95%CI: 0.39%~3.34%),女性2.57%(95%CI: 0.82%~4.36%)。<45、45~65、65~75、≥75岁居民日均气温与呼吸系统疾病入院风险最低温度分别为14 ℃、20 ℃、25 ℃和28 ℃。对于45岁以上人群,低温ER随着年龄的增大而增大,高温对于65岁以下人群的健康影响明显。结论  低温和高温均造成呼吸系统疾病入院风险增加,存在滞后效应。低温影响持续时间更长且效应更大,不同性别、年龄组人群的气温效应存在差异。

关键词:呼吸系统;温度;广义相加模型;时间序列分析

Abstract:

Objective  To quantitatively evaluate the effects of daily mean temperature on respiratory diseases.Methods  Based on the data of daily hospital admissions for respiratory diseases, meteorological parameters and air pollution in Shanghai between January 2006 and December 2011, we used a generalized additive model (GAM) to explore the effects of daily mean temperature on hospital admissions on respiratory diseases adjusted for the secular trend, seasonal trend, day of week and other confounders.Results  A J-shaped relationship was found between daily mean temperature and respiratory disease and the optimum temperature (OT) corresponding to low risk of respiratory hospital admissions was about 25 ℃. For cold effects over lag 0-30 days, the overall excess risk (ER) of hospital admission associated with 1 ℃ below the OT was 3.00% (95%CI: 2.54%-3.45%), 3.00% (95%CI: 2.55%-3.45%) and 3.02% (95%CI: 2.51%-3.49%) for overall, males and females, respectively. For hot effects over lag 0-30 days, the overall excess risk (ER) was 2.15% (95%CI: 0.67%-3.66%), 1.86% (95%CI: 0.39%-3.34%) and 2.57% (95%CI: 0.82%-4.36%) for overall, males and females, respectively. The optimum temperature between daily mean temperature and respiratory disease were 14 ℃, 20 ℃, 25 ℃ and 28 ℃ in different age groups. The effect of low temperature increased with age for the people above 45 years old; however the effect of high temperature was significant for the people under 65 years old.Conclusions  Both of higher temperature and lower temperature resulted in ER of respiratory hospital admissions increase with lag effects. The effects of lower temperature lagged longer and stronger than higher temperature. Different age group and gender shows different effects.

Key words: Respiratory system;Temperature;Generalized additive model;Time-serie

发表日期:2014/9

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2014.09.010.F901

    10.3760/cma.j.issn.0253-9624.2014.09.010.F901

  • 10.3760/cma.j.issn.0253-9624.2014.09.010.T001:表1 2006–2011年上海市呼吸系统疾病日入院人次、大气污染物及气象因素

    10.3760/cma.j.issn.0253-9624.2014.09.010.T001:表1 2006–2011年上海市呼吸系统疾病日入院人次、大气污染物及气象因素

  • 10.3760/cma.j.issn.0253-9624.2014.09.010.F001:图1 日均气温与呼吸系统疾病日入院人次的暴露-反应关系

    10.3760/cma.j.issn.0253-9624.2014.09.010.F001:图1 日均气温与呼吸系统疾病日入院人次的暴露-反应关系

  • 10.3760/cma.j.issn.0253-9624.2014.09.010.T002:表2 不同性别日均气温每变化1 ℃与呼吸系统疾病ER值变化分析

    10.3760/cma.j.issn.0253-9624.2014.09.010.T002:表2 不同性别日均气温每变化1 ℃与呼吸系统疾病ER值变化分析

  • 10.3760/cma.j.issn.0253-9624.2014.09.010.F002:图2 不同年龄层日均气温与呼吸系统疾病日入院人次的暴露-反应关系

    10.3760/cma.j.issn.0253-9624.2014.09.010.F002:图2 不同年龄层日均气温与呼吸系统疾病日入院人次的暴露-反应关系

  • 10.3760/cma.j.issn.0253-9624.2014.09.010.T003:表3 不同年龄日均气温每变化1 ℃与呼吸系统疾病ER值变化分析

    10.3760/cma.j.issn.0253-9624.2014.09.010.T003:表3 不同年龄日均气温每变化1 ℃与呼吸系统疾病ER值变化分析

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