汪子贤, 程义斌, 李永红, 王裕, 王艳, 宋和佳, 姚孝元. 极端高温与人群门诊量关系的时间序列研究[J]. 环境卫生学杂志, 2021, 11(2): 126-133. DOI: 10.13421/j.cnki.hjwsxzz.2021.02.004
    引用本文: 汪子贤, 程义斌, 李永红, 王裕, 王艳, 宋和佳, 姚孝元. 极端高温与人群门诊量关系的时间序列研究[J]. 环境卫生学杂志, 2021, 11(2): 126-133. DOI: 10.13421/j.cnki.hjwsxzz.2021.02.004
    WANG Zixian, CHENG Yibin, LI Yonghong, WANG Yu, WANG Yan, SONG Hejia, YAO Xiaoyuan. A Time-series Study of the Association between Extremely High Temperature and Outpatient Visits[J]. Journal of Environmental Hygiene, 2021, 11(2): 126-133. DOI: 10.13421/j.cnki.hjwsxzz.2021.02.004
    Citation: WANG Zixian, CHENG Yibin, LI Yonghong, WANG Yu, WANG Yan, SONG Hejia, YAO Xiaoyuan. A Time-series Study of the Association between Extremely High Temperature and Outpatient Visits[J]. Journal of Environmental Hygiene, 2021, 11(2): 126-133. DOI: 10.13421/j.cnki.hjwsxzz.2021.02.004

    极端高温与人群门诊量关系的时间序列研究

    A Time-series Study of the Association between Extremely High Temperature and Outpatient Visits

    • 摘要:
      目的 分析我国18个区/县极端高温对人群门诊量的影响,筛选极端高温敏感性疾病,识别脆弱人群。
      方法 收集2014—2018年每日门诊、气象和空气污染数据,在控制相对湿度、长期趋势、节假日等混杂因素后,第一阶段采用分布滞后非线性模型(DLNM),估计每个地区极端高温—日门诊量的暴露反应关系,第二阶段采用多元Meta分析合并所有地区的暴露反应关系系数,分析极端高温对不同病因别、性别、年龄别日门诊量的影响。
      结果 18个区/县共收集13 045 586例门诊病例。极端高温对呼吸系统疾病、消化系统疾病、内分泌系统疾病、皮肤疾病和伤害的门诊量影响具有统计学意义,2周的累积相对危险度(CRR)分别为1.235(95%CI:1.014~1.505)、1.109(95%CI:1.012~1.215)、1.141(95%CI:1.006~1.294)、1.199(95%CI:1.064~1.351)和1.157(95%CI:1.013~1.321);极端高温对男性和女性日门诊量影响的CRR值分别为1.158(95%CI:1.033~1.302)和1.110(95%CI:1.024~1.197);极端高温对(7~17)、(18~44)和(60~74)岁人群日门诊量的影响具有统计学意义,CRR值分别为1.352(95%CI:1.087~1.683)、1.116(95%CI:1.041~1.195)和1.119(95%CI:1.016~1.232)。
      结论 极端高温可增加多种疾病发病风险,男性比女性更敏感,(7~17)、(18~44)和(60~74)岁人群为极端高温脆弱人群。

       

      Abstract:
      Objective To investigate the impact of extremely high temperature on outpatient visits in 18 districts/counties of China, and to identify diseases sensitive to extremely high temperature and vulnerable populations.
      Methods Related data in 2014-2018 were collected, including daily outpatient data, meteorological data, and air pollution data. After control for the confounding factors including relative humidity, long-term trend, and holidays/festivals, the distributed lag non-linear model was used in the first stage to estimate the exposure-respond relationship between extremely high temperature and daily outpatient visits in each region, and then in the second stage, a multivariate meta-regression analysis was used for the pooled exposure-respond coefficients of the data from all hospitals to analyze the influence of extremely high temperature on the daily outpatient visits for different etiologies, sexes, and ages.
      Results A total of 13 045 586 outpatient cases were collected. Extremely high temperature had a statistically significant effect on the daily outpatient visits of respiratory diseases, digestive diseases, endocrine diseases, skin diseases, and injury, with a 2-week accumulative relative risk (CRR) of 1.235 (95% CI: 1.014-1.505), 1.109 (95% CI: 1.012-1.215), 1.141 (95% CI: 1.006-1.294), 1.199 (95% CI: 1.064-1.351), and 1.157 (95% CI: 1.013-1.321), respectively. The CRR of the effect of extremely high temperature on male and female were 1.158 (95% CI: 1.033-1.302) and 1.110 (95% CI: 1.024-1.197), respectively. Extremely high temperature had a statistically significant effect on the age groups of 7-17, 18-44, and 60-74 years, with the CRR of 1.352 (95% CI: 1.087-1.683), 1.116 (95% CI: 1.041-1.195) and 1.119 (95% CI: 1.016-1.232), respectively.
      Conclusion Extremely high temperature can increase the risk of various diseases. Male is more sensitive to extremely high temperature than female, and, the age groups of 7-17, 18-44, and 60-74 years are vulnerable populations.

       

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