石家庄高温、热浪和闷热天气对心脑血管疾病死亡人数的影响

付桂琴; 陆倩; 张亚男

doi:10.11676/qxxb2022.032

石家庄高温、热浪和闷热天气对心脑血管疾病死亡人数的影响

doi: 10.11676/qxxb2022.032

付桂琴^{1, 2,},
陆倩³,
张亚男¹

1.
河北省气象服务中心，石家庄，050021
2.
河北省气象与生态环境重点实验室，石家庄，050021
3.
承德气象服务中心，承德，067000

基金项目: 国家重点研发计划项目（2016YFA0602004）、国家自然科学基金项目（4217584）、河北省健康气象研发项目（FW202150）

详细信息

作者简介:
付桂琴，主要从事健康气象等应用气象研究。E-mail：fgq84@tom.com

中图分类号: P49
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出版历程
- 收稿日期: 2021-12-02
- 录用日期: 2022-04-21
- 修回日期: 2022-03-22
- 网络出版日期: 2022-04-12

Analysis of the influence of high temperature, heatwave and sweltering weather on the death number of cardiovascular and cerebrovascular diseases in Shijiazhuang

FU Guiqin^{1, 2
,},
LU Qian³,
ZHANG Yanan¹

1.
Hebei Meteorological Service Center，Shijiazhuang 050021，China
2.
Key Laboratory of Meteorology and Ecological Environment of Hebei Province，Shijiazhuang 050021，China
3.
Chengde Meteorological Service of Hebei Province，Chengde 067000，China

摘要

摘要: 评价高温、热浪、闷热不同热感天气暴露对心脑血管疾病死亡人数的影响。采用广义相加模型（GAM）、平滑曲线阈值效应方法，在控制了时间序列长期趋势、季节效应、节假日效应的混杂影响后，分析了2010—2016年的6—8月石家庄高温、热浪、闷热不同热感天气暴露对心脑血管疾病死亡人数的影响，并分析了男女性别的分人群效应。研究期间收集到心脑血管疾病死亡总计6552人，日均死亡10.2人，日死亡最多为40.0人。对应期间出现高温日98 d，热浪日58 d，闷热日79 d。相对于非高温、热浪、闷热日，高温、热浪、闷热天气对心脑血管疾病死亡人数影响的相对危险度分别为1.086（95%置信区间（95%CI）：1.013—1.164）、1.252（95%CI：1.101—1.442）、1.100（95%CI：1.020—1.185），其最大滞后效应分别为3 d、1 d、0 d，对应死亡人数增加的风险分别为12.2%、31.8%、10.0%，且对女性的影响风险均大于男性。高温、热浪、闷热天气均可导致心脑血管疾病死亡风险的增加，归因滞后1 d热浪死亡的风险最大，归因闷热天气死亡的风险未发现滞后效应，建议依据不同热感天气有针对性地建立健康风险管理和应对机制。
- 高温热浪闷热天气 /
- 心脑血管疾病 /
- 死亡人数 /
- 影响分析
Abstract: To evaluate the effects of exposure to high temperature, heatwave and sultry weather on the number of cardiovascular disease deaths. Using the generalized additive model (GAM) and smoothed curve threshold effect method, the relationship between different heat-sensitive weather exposures on the number of cardiovascular and cerebrovascular deaths in Shijiazhuang from June to August, 2009 to 2016 was analyzed. After controlling for the confounding effects of long-term trends in time series, seasonal effects and holiday effects, the impact of sub-population of male and female was analyzed. A total of 6552 cardiovascular and cerebrovascular deaths were collected during the study period, with an average of 10.2 deaths per day and a maximum of 40.0 deaths per day. During the corresponding period, there were 98 d of high temperature, 58 d of heatwave and 79 d of muggy day. The relative risk of the effect of hot, heatwave and sultry weather on the number of cardiovascular and cerebrovascular deaths relative to the non-hot, heatwave and sultry days was 1.086 (95%CI: 1.013—1.164), 1.252 (95%CI: 1.101—1.442) and 1.100 (95%CI: 1.020—1.185) with maximum lagged effects of 3 d, 1 d and 0 d, corresponding to an increased risk of death of 12.2%, 31.8% and 10.0%, respectively, and all with a greater risk of effect for women than men. High temperature, heatwave, and sultry weather can all lead to an increased risk of cardiovascular and cerebrovascular death, with the most significant risk of death attributable to heatwaves. No lag effect was found for the risk of death attributable to sultry weather. It was recommended that health risk management and coping mechanisms be tailored to different heat-sensitive weather.
- High temperature heat wave and sweltering weather /
- Cardiovascular and cerebrovascular diseases /
- Death number /
- Influence analyzed

HTML全文

图 1 2010—2016年6—8月石家庄平均气温（a）、最高气温（b）、闷热指数（c）与心脑血管疾病死亡人数的关系曲线（黑色实线为死亡人数，虚线为其95%置信区间）

Figure 1. Variation curves of average temperature （a），maximum temperature （b），sweltering heat index （c） and cardiovascular and cerebrovascular deaths in Shijiazhuang from June to August，2010 to 2016 （the black solid line represents the number of deaths，and the dashed line represents its 95%CI）

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表 1 2010—2016年6—8月石家庄心脑血管疾病死亡人数及气象要素统计特征

Table 1. Statistical characteristics of cardiovascular and cerebrovascular deaths and meteorological elements in Shijiazhuang from June to August，2010 to 2016

		均值	标准差	min	P25	P50	P75	max
心脑血管疾病死亡人数	总人数（人）	10.2	5.3	0.0	6.0	10.0	14.0	40.0
	男（人）	5.6	3.2	0.0	3.0	5.0	8.0	21.0
	女（人）	4.5	3.0	0.0	2.0	4.0	7.0	19.0
气象要素	T（℃）	27.0	2.6	19.4	25.2	27.2	28.8	34.3
	T_g（℃）	31.8	3.3	21.1	29.6	32.1	34.0	41.8
	RH（%）	65.0	15.8	19.0	54.0	66.0	77.0	99.0
	I	76.0	3.4	66.5	73.6	76.2	78.3	86.8
注：min为最小值；max为最大值；P25为25%分位数，依此类推。

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表 2 2010—2016年6—8月石家庄高温、热浪、闷热日数及对应死亡人数特征

Table 2. Statistical characteristics of high temperature，heatwave，and sweltering weather days and cardiovascular and cerebrovascular deaths in Shijiazhuang from June to August，2010 to 2016

天气分类	日数（d）	占比（%）	年均日数（d）	死亡人数日均值
天气分类	日数（d）	占比（%）	年均日数（d）	总人数（人）	男（人）	女（人）
非高温	546	84.8	78.0	9.6	5.3	4.3
高温	98	15.2	14.0	13.3	7.3	6.0
非热浪	586	91.0	83.7	10.0	5.6	4.5
热浪	58	9.0	8.3	13.5	7.5	6.0
非闷热	565	87.7	80.7	9.7	5.4	4.3
闷热	79	12.3	11.3	13.9	7.6	6.3

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表 3 2010—2016年6—8月石家庄高温、热浪、闷热天气对心脑血管疾病死亡人数及不同性别影响的相对危险度及95%置信区间

Table 3. Relative risk and 95%CI for the effect of high temperature，heat wave and sweltering weather on the number of cardiovascular and cerebrovascular disease deaths and gender in Shijiazhuang from June to August，2010 to 2016

项目	要素		RR（95%CI）
项目	要素	总人数	男	女
连续变量	T（℃）	1.009 （0.999—1.018）	0.999 （0.987—1.012）	1.020 （1.006—1.035）^*
	T_g（℃）	1.008 （1.001—1.016）^*	1.000 （0.990—1.010）	1.019 （1.008—1.031）^*
	I	1.006 （0.999—1.014）	0.999 （0.989—1.009）	1.015 （1.004—1.027）^*
阈值	T≥29.0（℃）	1.064 （1.006—1.125）^*	1.034 （0.958—1.116）^*	1.099 （1.014—1.192）^*
阈值	I≥80	1.076 （1.024—1.130）^*	1.082 （1.013—1.156）^*	1.069 （0.994—1.150）^*
分层变量	高温	1.086 （1.013—1.164）^*	1.016 （0.924— 1.117）	1.177 （1.063—1.303）^*
	热浪	1.252 （1.101—1.422）^*	1.216 （1.023—1.444）^*	1.298 （1.073—1.571）^*
	闷热	1.100 （1.020— 1.185）^*	1.081 （0.978—1.196）	1.122 （1.004—1.254）^*
注：*代表 P＜0.05。

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表 4 2010—2016年6—8月石家庄高温、热浪、闷热天气不同滞后天数对心脑血管疾病死亡人数影响的相对危险度及95%置信区间

Table 4. Relative risk and 95%CI for the effect of different lag days of high temperature，heatwave and sweltering weather on the number of cardiovascular and cerebrovascular disease deaths in Shijiazhuang from June to August，2010 to 2016

	滞后天数（d）		RR（95%CI）
	滞后天数（d）	总人数	男	女
高温	0	1.086 （1.013—1.164）^*	1.016 （0.924—1.117）	1.177 （1.063—1.303）^*
	1	1.116 （1.041—1.195）^*	1.102 （1.005—1.209）^*	1.132 （1.021—1.256）^*
	2	1.035 （0.965—1.110）	1.049 （0.956—1.152）	1.016 （0.914—1.131）
	3	1.122 （1.048—1.201）^*	1.139 （1.040—1.247）^*	1.100 （0.992—1.220）^*
	4	1.072 （1.001—1.148）^*	1.066 （0.972—1.169）	1.080 （0.974—1.198）
	5	1.013 （0.945—1.086）	0.993 （0.905—1.091）	1.039 （0.937—1.153）
热浪	0	1.251 （1.101—1.422）^*	1.216 （1.023—1.444）^*	1.298 （1.073—1.571）^*
	1	1.318 （1.164—1.493）^*	1.326 （1.124—1.564）^*	1.309 （1.083—1.581）^*
	2	1.298 （1.150—1.466）^*	1.358 （1.159—1.592）^*	1.222 （1.012—1.475）^*
	3	1.225 （1.085—1.382）^*	1.257 （1.072—1.474）^*	1.183 （0.983—1.424）
	4	1.062 （0.937—1.203）	1.076 （0.912—1.270）	1.044 （0.863—1.262）
	5	0.937 （0.824—1.065）	0.924 （0.778—1.098）	0.954 （0.787—1.157）
闷热	0	1.100 （1.020—1.185）^*	1.081 （0.977—1.196）	1.122 （1.004—1.254）^*
	1	1.046 （0.970—1.128）	1.013 （0.914—1.122）	1.088 （0.973—1.216）
	2	1.011 （0.937—1.092）	1.021 （0.921—1.131）	1.000 （0.891—1.122）
	3	0.983 （0.910—1.063）	0.960 （0.864—1.066）	1.013 （0.903—1.136）
	4	1.089 （1.010—1.174）^*	1.114 （1.007—1.231）^*	1.058 （0.944—1.186）
	5	1.013 （0.938—1.095）	1.078 （0.974—1.194）	0.935 （0.830—1.053）
注：*代表P＜0.05。

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