张娅, 尹胜利, 杨卫红, 钟毓, 赵琦, 崔永彪. 极端高温急性健康效应的季节内差异:以山东省德州市急诊呼救数据为例[J]. 环境与职业医学, 2024, 41(8): 849-854. DOI: 10.11836/JEOM23438
引用本文: 张娅, 尹胜利, 杨卫红, 钟毓, 赵琦, 崔永彪. 极端高温急性健康效应的季节内差异:以山东省德州市急诊呼救数据为例[J]. 环境与职业医学, 2024, 41(8): 849-854. DOI: 10.11836/JEOM23438
ZHANG Ya, YIN Shengli, YANG Weihong, ZHONG Yu, ZHAO Qi, CUI Yongbiao. Intraseasonal variation in acute health effects of extreme heat: An example using emergency ambulance calls data in Dezhou City, Shandong Province, China[J]. Journal of Environmental and Occupational Medicine, 2024, 41(8): 849-854. DOI: 10.11836/JEOM23438
Citation: ZHANG Ya, YIN Shengli, YANG Weihong, ZHONG Yu, ZHAO Qi, CUI Yongbiao. Intraseasonal variation in acute health effects of extreme heat: An example using emergency ambulance calls data in Dezhou City, Shandong Province, China[J]. Journal of Environmental and Occupational Medicine, 2024, 41(8): 849-854. DOI: 10.11836/JEOM23438

极端高温急性健康效应的季节内差异:以山东省德州市急诊呼救数据为例

Intraseasonal variation in acute health effects of extreme heat: An example using emergency ambulance calls data in Dezhou City, Shandong Province, China

  • 摘要:
    背景 目前极端高温急性健康效应的季节内差异尚未得到充分研究。而急诊呼救次数(EACs)可以及时评估人群受极端高温事件影响的状况。
    目的 分析山东省德州市极端高温与每小时急诊呼救风险在夏季的季节内差异。
    方法 收集2021—2022年德州市人群全病因逐时EACs数据。按照急救地址赋值逐时气温和湿度数据(空间分辨率为0.0625°×0.0625°)。夏季定义为每年6—9月,其中6—7月为夏季早期,8—9月为夏季晚期,极端高温定义为夏季温度范围的第99百分位数。基于时间分层的病例交叉设计,使用整合分布滞后非线性模型的条件logistic回归,比较夏季早期和晚期极端高温与急诊呼救风险的逐小时关联。
    结果 研究期间共收集德州市夏季80389例EACs。模型分析结果显示,夏季逐时气温与急诊呼救风险呈“U型”,效应在滞后0~30 h内最大。以夏季最适宜温度20.0 ℃作参考,整个夏季极端高温的累积比值比(OR)(滞后0~120 h)为1.55(95%CI:1.40~1.71)。极端高温的累积效应在夏季晚期(OR=2.38,95%CI:1.91~2.97)高于夏季早期(OR=1.37,95%CI:1.22~1.54)(P<0.0001),60岁及以上年龄组在整个夏季(OR=1.98,95%CI:1.70~2.30)高于60岁以下年龄组(OR=1.23,95%CI:1.06~1.42)(P<0.0001)。
    结论 德州市夏季的极端高温与每小时急诊呼救的风险存在季节内差异,且夏季晚期急诊呼救风险高于夏季早期,提示季节内多次热暴露可能升高健康风险,且老年人受影响更大。

     

    Abstract:
    Background Intraseasonal variation in acute health effects of extreme heat remains insufficiently investigated. Emergency ambulance calls (EACs) may offer timely insights into the population's health during such extreme heat events.
    Objective To analyze intraseasonal variation in the association between extreme heat and hourly EACs during summer in Dezhou City, Shandong Province, China.
    Methods We collected data on all-cause hourly EACs in Dezhou City from 2021 to 2022 and assigned hourly temperature and humidity data (with a spatial resolution of 0.0625° × 0.0625°) to call addresses. Summer in this study was defined as from June to September each year, with June to July considered as early summer and August to September as late summer. Extreme heat was defined as the 99th percentile of the temperature range during the summer. We employed a time-stratified case-crossover design using conditional logistic regression integrating distributed-lag nonlinear models to compare the association between extreme heat and the risk of hourly EACs in both early and late summer periods.
    Results A total of 80389 EACs were recorded in Dezhou City during the study period. The analysis revealed a U-shaped association between hourly ambient temperature and EACs during summer, with the most significant effect observed at lag 0-30 h. Using the optimal temperature of 20.0°C as a reference, the cumulative odds ratio (OR) (lag 0-120 h) for extreme heat was 1.55 (95%CI: 1.40, 1.71) throughout summer. The cumulative effect of extreme heat was higher in late summer (OR=2.38, 95%CI: 1.91, 2.97) than in early summer (OR=1.37, 95%CI: 1.22, 1.54) (P<0.0001). Additionally, individuals aged 60 years and above had a higher risk throughout summer (OR=1.98, 95%CI: 1.70, 2.30) compared to those under 60 years (OR=1.23, 95%CI: 1.06, 1.42) (P<0.0001).
    Conclusion Intraseasonal variation is observed in the strength of association between extreme heat and hourly EACs during summer in Dezhou City. The higher risk observed in late summer than in early summer indicates that repeated exposures to heat may escalate health risks, and older adults are more vulnerable.

     

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