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[背景]有大量而且越来越多的文献研究了极端高温对死亡率的影响,并得出大气中臭氧的不同作用的概念,如作为混杂因素、效应修饰因子或共同暴露因素。因此,对于温度和臭氧在导致死亡中的作用尚缺乏共识。[目的]采用无回路有向环图(DAGs)研究高温相关死亡率,以图解方式表达研究问题背后的意图,并对现有的分析方法提出深入的见解。[讨论]示意图中编码的研究意图表明,臭氧在温度与死亡率研究中起到一个因果中间介质的作用,受温度的影响,也可以影响死亡率,而非一个混杂因素。[结论]本文讨论了这种因果结构所隐含的问题,并提出今后的工作方向:进一步阐明空气污染物在极端温度流行病学研究中的作用。
[Background] There is a large and growing body of literature that studies the effects of extreme heat on mortality and come up with concepts for the different roles of ozone in the atmosphere, such as confounders, effect modifiers or co-exposure factors. Therefore, there is a lack of consensus on the role of temperature and ozone in causing death. [Objective] To study the high temperature-related mortality rate using circle-free directed cyclic maps (DAGs), express the intent behind the research questions graphically, and put forward deep insights on the existing analysis methods. [DISCUSSION] The intent of the code, coded in the schematic diagram, shows that ozone plays a role as a causal intermediate in the study of temperature and mortality and that the effects of temperature can also affect mortality rather than confounding factors. [Conclusion] This paper discusses the problems implied by this causal structure and proposes future work directions: to further elucidate the role of air pollutants in epidemiological studies of extreme temperatures.