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隔日温差对居民寿命损失年的影响及其归因分值：基于2013—2017年云南省数据

Effect of temperature change between neighboring days on years of life lost and attribution in Yunnan Province, 2013-2017

    摘要
  • 摘要:
    背景 在全球气候变暖的大背景下，温度变异对人体健康的影响受到关注。
    目的 探讨隔日温差（TCN）对居民非意外死亡寿命损失年（YLL）的影响，定量评估可归因于TCN的人群寿命损失年百分比。
    方法 收集云南省2013-2017年56个区县的每日非意外死亡数据与气象数据资料，根据寿命表计算YLL率（每10万人口YLL值），采用分布滞后非线性模型和meta分析结合的两阶段分析方法，以4-9月份为暖季，其余时间为冷季，分别建立冷、暖季TCN与人群YLL率的暴露反应关系，并计算归因分值（AF）。
    结果 冷、暖季TCN中位数均为0.1℃。与TCN=0℃相比：暖季TCN平均每降低1℃，YLL率及其95%CI降低2.00/10万（0.28/10万~8.71/10万）；隔日升温1.4℃以内时可引起YLL率的增加，TCN=1.4℃时YLL率及其95%CI增加2.15/10万（0.04/10万~4.26/10万）。冷季隔日降温9.2℃以内时可引起YLL率的降低，TCN=9.2℃时YLL率及其95%CI降低8.78/10万（0.64/10万~16.45/10万）。老年人（≥ 65岁）较中青年人（0~64岁）更易受TCN的影响，暖季TCN平均每变化1℃，中青年和老年人的YLL率平均改变1.18/10万、5.18/10万，冷季则分别为0.79/10万和8.82/10万。暖季TCN下降对男性的作用大于女性，冷季TCN下降幅度超过7.61℃后对女性的影响更大。隔日降温引起可归因于TCN的YLL下降，隔日升温均引起归因YLL上升，中等降温（TCN为P2.5~0℃）的影响最大（暖季AF=-5.76%，95%CI：-7.10%~-4.49%；冷季AF=-3.98%，95%CI：-5.83%~-2.07%）。
    结论 隔日温度升高对居民寿命损失存在不良影响。

     

    Abstract:
    Background In the context of global climate change, the health effect of temperature change has been a focus.
    Objective This study is designed to investigate the impact of temperature change between neighboring days (TCN) on the years of life lost (YLL) of residents in Yunnan Province, and quantitatively assess the proportion of YLL attributed to TCN.
    Methods We collected the daily non-accidental death records and meteorological data of 56 districts or counties in Yunnan Province from 2013 to 2017, and calculated the YLL rate (YLL per 105 inhabitants) based on the life table. We defined April through September as warm season and the other months as cold season, then we established exposure-response relationships between TCN and YLL respectively in the two seasons and calculated attributable fraction (AF) by using two-stage analysis method combining a distributed lag nonlinear model and a metaanalysis.
    Results The medians of TCN in both cold and warm seasons were 0.1℃. Compared with TCN=0℃, in warm season, for every 1℃ decrease of TCN, the YLL rate was decreased by 2.00/105 (95% CI:0.28/105-8.71/105); temperature increase between neighboring days (≤ 1.4℃) increased the YLL rate, and when TCN=1.4℃, the YLL rate was increased by 2.15/105 (95% CI:0.04/105-4.26/105). In cold season, temperature decrease between neighboring days (≤ 9.2℃) reduced the YLL rate, and when TCN=9.2℃, the YLL rate was decreased by 8.78/105 (95% CI:0.64/105-16.45/105). The elderly (≥ 65 years old) were more likely to be affected by TCN than the young (0-64 years old). For every 1℃ change of TCN, the YLL rates of the young and elderly residents changed 1.18/105 and 5.18/105 in warm season on average respectively, while 0.79/105 and 8.82/105 in cold season respectively. TCN decrease between neighboring days in warm season had a greater impact on males than on females; however, when the TCN decreased more than 7.61℃ in cold season, females were more susceptible. Temperature decrease between neighboring days gave rise to the YLL decrease attributable to TCN, and temperature increase between neighboring days caused the YLL increase attributable to TCN. Moderate cooling (TCN:P2.5-0℃) had the greatest effect on AF (warm season, AF=-5.76%, 95%CI:-7.10%--4.49%; cold season, AF=-3.98%, 95%CI:-5.83%--2.07%).
    Conclusion Temperature increase between neighboring days has an adverse impact on the years of life lost in selected residents.

     

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