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目的探讨热浪对济南市居民非意外死亡及主要死因别死亡的影响及其特征。方法收集济南市2013年5—8月和2014年5—8月的逐日死亡资料和气象资料,应用生态学分析比较热浪期与非热浪期非意外死亡及主要死因别死亡情况,采用广义相加模型对热浪死亡效应进行评估。结果研究期间济南市共发生4次热浪,共19 d。热浪期非意外死亡、循环系统疾病、呼吸系统疾病、肿瘤、脑血管疾病和急性心肌梗死的日均死亡人数均高于非热浪期,差异有统计学意义(P<0.05)。广义相加模型结果显示,热浪对非意外死亡、循环系统疾病、脑血管疾病、急性心肌梗死的死亡有影响,并存在滞后效应,最佳滞后期分别为2、2、1、1 d,对应的OR(95%CI)分别为2.07(1.73~2.71),1.68(1.30~2.21),1.52(1.36~2.14),1.38(1.12~2.87)。结论热浪能明显增加济南市居民非意外死亡、循环系统疾病、脑血管疾病、急性心肌梗死的死亡风险,该效应发生迅速且有明显的滞后期。
Objective To investigate the effects and characteristics of heatwave on non-accidental death and major causes of death among residents in Jinan City. Methods Daily mortality data and meteorological data of Jinan City from May to August in 2013 and May to August in 2014 were collected and compared with non-accidental and non-fatal deaths in heat and non-heat waves by using ecological analysis. The model evaluates the effects of heat waves on death. Results Four heat waves occurred in Jinan City during the study period, totaling 19 days. The average daily deaths of non-accidental deaths, circulatory diseases, respiratory diseases, tumors, cerebrovascular diseases and acute myocardial infarction during heatwave were higher than those of non-heatwave. The difference was statistically significant (P <0.05). The results of generalized additive model show that the heat wave has an impact on the death of non-accidental death, circulatory system disease, cerebrovascular disease and acute myocardial infarction with lag effect, the best lag period is respectively 2,2,1,1 d OR (95% CI) were 2.07 (1.73-2.71), 1.68 (1.30-2.21), 1.52 (1.36-2.14) and 1.38 (1.12-2.87), respectively. Conclusion Heat waves can significantly increase the death risk of non-accidental deaths, circulatory diseases, cerebrovascular diseases and acute myocardial infarction in Jinan residents. The effects of this heat wave are rapid and have a significant lag period.