高温与上海市中暑报告病例的关联性
Relationship between high temperature and heat stroke cases reported in Shanghai
-
摘要:
背景 中暑是凶险的热致疾病，在全球气候变暖的背景下有必要深入探讨高温对人群中暑的影响。
目的 了解2013—2022年上海市高温中暑报告病例的流行病学特征，探讨人群中暑期间的日均气温阈值和效应关联，发现易感人群，为制定社会公共政策提供数据支撑。
方法 收集2013—2022年上海市高温中暑报告病例，采用分段回归模型、分布滞后非线性模型等方法，分析中暑的日均气温阈值、滞后效应、易感人群。
结果 2013—2022年间的6—8月上海市共报告中暑病例3479例，男女性别比为3.34。日均气温与中暑发病显著相关，其阈值为33.1 ℃，暴露当天引发中暑的风险最高，且持续到滞后第2天。极端高温（33.1 ℃）累积效应在滞后2 d达到最高，以日平均气温中位数28.1 ℃为参照值，此时总人群相对危险度RR（95%CI）为25.32（17.49~36.64）；男性和女性分别为26.33（17.78~38.98）和25.20（12.52~50.72），效应差异无统计学意义（
P ＞0.05）；45~64岁、65岁及以上的效应RR（95%CI）分别为25.17（15.54~40.78）和76.98（34.80~170.30），高于16~44岁组（RR=20.22；95%CI：12.22~33.44），差异有统计学意义（P ＜0.05）；城区的效应值（RR=49.09；95%CI：19.60~122.95）高于郊区（RR=23.65；95%CI：16.13~34.67），差异有统计学意义（P ＜0.05）。结论 高温与上海市人群中暑报告病例的关联显著，日均气温的影响阈值为33.1 ℃，中老年和城区居民的风险相对较高。
Abstract:Background Heat stroke is a severe heat-related illness, and it is necessary to explain in depth the effect of high temperature on heat stroke in the context of global warming.
Objective To describe the epidemiological characteristics of reported heat stroke cases in Shanghai from 2013 to 2022, analyze the influence of daily mean temperature threshold on heat stroke, and identify susceptible populations, so as to provide data support for the development of relevant social and public policies.
Methods Data from case reports on heat stroke were collected in Shanghai from 2013 to 2022. Heat stroke associated daily mean temperature threshold, lag effects, and susceptible populations were estimated using piecewise regression model and distributed lag non-linear model.
Results Among the 3479 cases reported from June to August of 2013—2022 in Shanghai, the male-to-female ratio was 3.34. A positive association between daily mean temperature and heat stroke was found, the association was strongest on the day of exposure and persisted until lag day 2, with an estimated threshold at 33.1 ℃. Using the median value of daily mean temperature as the reference value (28.1 ℃), the peak cumulative effect of extreme high temperature (33.1 ℃) appeared at lag 0-2 days with a relative risk (RR) value and its 95%CI of 25.32 (17.49-36.64) for all included cases; the RRs for male and female were 26.33 (17.78, 38.98) and 25.20 (12.52, 50.72), respectively, and no statistically significant difference was found between sexes (
P ＞0.05); the RRs were much greater in population aged 45-64 years (25.17, 95%CI: 15.54, 40.78) and 65 years and above (76.98, 95%CI: 34.80, 170.30), significantly higher than the values in those aged 16-44 years (20.22, 95%CI: 12.22, 33.44) (P ＜0.05); urban areas showed a greater RR (49.09, 95%CI: 19.60, 122.95) than rural areas (23.65, 95%CI: 16.13, 34.67) (P ＜0.05).Conclusion High temperature is significantly associated with heat stroke cases reported in Shanghai, with a threshold of 33.1℃ for daily mean temperature. The middle-aged and elderly adults and urban residents are more vulnerable to heat stress than those younger and living in rural areas.
下载:
