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    2017—2023年热浪对衡阳市居民住院影响的病例交叉研究

    A case-crossover study on the impact of heatwaves on daily hospital admissions among residents in Hengyang, China, 2017—2023

      摘要
    • 摘要:
      目的 评估热浪与湖南省衡阳市居民特定病因住院率的关联。
      方法 基于2017—2023年夏季(6—9月)在衡阳市市区收集的逐日气象、空气污染物数据和6家三级医院住院数据, 采用病例交叉设计评估热浪与特定病因住院率的关联, 采用最长滞后期为7 d的分布滞后非线性模型(distributed lag non-linear model, DLNM)来评估滞后效应。
      结果 热浪对非意外疾病、呼吸系统疾病、心脑血管疾病住院的影响分别在lag04、lag06、lag06 d时最大, RR分别为1.16(1.04, 1.29)、1.33(1.08, 1.62)、1.34(1.13, 1.59)。热浪对男性非意外疾病、呼吸系统疾病、心脑血管疾病住院的影响分别在lag04、lag06、lag05 d时最大, RR分别为1.15(1.02, 1.29)、1.39(1.10, 1.76)、1.21(1.01, 1.45)。热浪对女性非意外疾病、心脑血管疾病住院的影响分别在lag05、lag06 d时最大, RR分别为1.17(1.02, 1.34)、1.55(1.22, 1.95), 对女性呼吸系统疾病住院的影响无统计学意义。热浪仅对 < 65岁人群非意外疾病住院的影响有统计学意义, 在lag03 d最大, RR为1.11(1.01, 1.23), 对 < 65岁人群呼吸系统疾病、心脑血管疾病住院的影响无统计学意义。热浪对≥65岁人群非意外疾病、呼吸系统疾病、心脑血管疾病住院的影响分别在lag05、lag07、lag06 d时最大, RR分别为1.26(1.08, 1.46)、1.63(1.15, 2.32)、1.39(1.14, 1.69)。热浪对非意外疾病、呼吸系统疾病和心脑血管疾病影响的性别差异、年龄差异均无统计学意义(z为-1.532~0.749, P>0.05)。
      结论 衡阳地区的热浪可引起居民非意外疾病、呼吸系统疾病和心脑血管疾病的住院风险增加。应加强高温预警系统的建设和完善, 及时向公众发布高温预警信息。

       

      Abstract:
      Objective To assess the association of heatwaves with hospital admissions for specific causes among residents in Hengyang, Hunan Province, China.
      Methods Based on daily meteorological and air pollutant data as well as hospitalization data from six tertiary hospitals in urban Hengyang from June to September of 2017 to 2023, a case-crossover design was used to evaluate the relationship between heatwaves and hospital admissions for specific causes. Lag effects were assessed using a distributed lag non-linear model with a maximum lag of 7 days.
      Results The maximum impacts of heatwaves on hospitalizations due to non-accidental diseases, respiratory diseases, and cardiovascular and cerebrovascular diseases occurred at lag04, lag06, and lag06 days, with relative risks (RR) of 1.16 (1.04, 1.29), 1.33 (1.08, 1.62), and 1.34 (1.13, 1.59), respectively. In sex-stratified analyses, for males, the maximum effects of heatwaves on hospitalizations for non-accidental diseases, respiratory diseases, and cardiovascular and cerebrovascular diseases were observed at lag04, lag06, and lag05 days, with corresponding RR values of 1.15 (1.02, 1.29), 1.39 (1.10, 1.76), and 1.21 (1.01, 1.45), respectively. For females, the maximum effects of heatwaves on hospitalizations for non-accidental diseases and cardiovascular and cerebrovascular diseases occurred at lag05 and lag06 days, with RR of 1.17 (1.02, 1.34) and 1.55 (1.22, 1.95), respectively. However, the effect of heatwaves on hospitalizations for respiratory diseases in females was not statistically significant. In the age-specific analyses, heatwaves only had a statistically significant impact on hospitalizations for non-accidental diseases in the population aged 0 to less than 65 years, with the maximum effect at lag03 day (RR=1.11;1.01, 1.23). No statistically significant effects were found on hospitalizations for respiratory diseases or cardiovascular and cerebrovascular diseases in this age group. For the population aged 65 years and above, the maximum impacts of heatwaves on hospitalizations due to non-accidental diseases, respiratory diseases, and cardiovascular and cerebrovascular diseases were observed at lag05, lag07, and lag06 days, with RR values of 1.26 (1.08, 1.46), 1.63 (1.15, 2.32), and 1.39 (1.14, 1.69), respectively. There were no statistically significant gender or age differences in the effects of heatwaves on non-accidental diseases, respiratory diseases, or cardiovascular and cerebrovascular diseases (z-values ranged from -1.532 to 0.749, all P>0.05).
      Conclusion Heatwaves in Hengyang may increase hospitalization risks for non-accidental, respiratory, and cardio-cerebrovascular diseases among residents. We recommend to construct and improve high-temperature early warning systems to timely provide high-temperature early warning information to the public.

       

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