[Impact of heat and cold on cause -specific mortality in Italy].

IF 1.2 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Epidemiologia & Prevenzione Pub Date : 2023-11-01 DOI:10.19191/EP23.6.S3.004

Chiara Di Blasi, Massimo Stafoggia, Claudio Gariazzo, Paola Michelozzi, Manuela De Sario, Alessandro Marinaccio, Sara Maio, Giovanni Viegi, Francesca De' Donato

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引用次数: 0

Abstract

Objectives: to estimate the impact of daily exposure to extreme air temperatures (heat and cold) on cause-specific mortality in Italy and to evaluate the differences in the association between urban, suburban and rural municipalities.

Design: time series analyses with two-stage approach were applied: in the first stage, multiple Poisson regression models and distributed lag non-linear models (DLNM) were used to define the association between temperature and mortality; in the second one, meta-analytic results were obtained by adopting BLUP (Best Linear Unbiased Prediction) coefficients at provincial level, which were then used to estimate the Attributable Fractions of cause-specific deaths.

Setting and participants: cause-specific deaths from 2006to 2015 in Italy have been analysed by region and overall.

Main outcome measures: 5,648,299 total deaths included. Fractions (and relative 95% empirical confidence interval) of deaths attributable to increases from 75th to 99th percentiles of temperature, for heat, and decreases from 25th to 1st percentile, for cold.

Results: the overall impact of air temperature on causespecificmortality is higher for heat than for cold. When considering heat, the attributable fraction is higher for diseases of the central nervous system (3.6% 95% CI 1.9-4.9) and mental health disease (3.1% 95% CI 1.7-4.4), while considering cold, ischemic disease (1.3% 95% CI 1.1-1.6) and diabetes (1.3% 95% CI 0.7-1.8) showed the greater impact. By urbanization level, similar impacts were found for cold temperature, while for heat there was an indication of higher vulnerability in rural areas emerged.

Conclusions: results are relevant for the implementation and promotion of preventive measures according to climate change related increase in temperature. The available evidence can provide the basis to identify vulnerable areas and population subgroups to which address current and future heat and cold adaptation plans in Italy.

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[冷热对意大利特定病因死亡率的影响]。

目标：估计意大利每天暴露于极端气温（高温和低温）对特定病因死亡率的影响，并评估城市、郊区和农村之间的关联差异。设计：采用两阶段方法进行时间序列分析：在第一阶段，使用多重泊松回归模型和分布式滞后非线性模型（DLNM）来确定温度与死亡率之间的关系；在第二阶段，采用省一级的最佳线性无偏预测系数（BLUP）得出元分析结果，然后用于估算特定死因的可归因比例。研究地点和参与者：按地区和总体分析了意大利 2006 年至 2015 年的特定死因死亡人数：主要结果测量：共纳入 5,648,299 例死亡。结果：气温对特定死因死亡率的总体影响在高温下高于在低温下。在高温条件下，中枢神经系统疾病（3.6% 95% CI 1.9-4.9）和精神疾病（3.1% 95% CI 1.7-4.4）的可归因比例更高，而在寒冷条件下，缺血性疾病（1.3% 95% CI 1.1-1.6）和糖尿病（1.3% 95% CI 0.7-1.8）的影响更大。从城市化水平来看，对低温的影响类似，而对高温的影响则表明农村地区更容易受到影响。结论：研究结果对实施和推广与气候变化相关的气温升高预防措施具有重要意义。现有证据可为确定意大利当前和未来的冷热适应计划所针对的脆弱地区和人口亚群提供依据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiologia & Prevenzione 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.60

自引率

14.30%

发文量

审稿时长

>12 weeks

期刊介绍： Epidemiologia & Prevenzione, oggi organo della Associazione italiana di epidemiologia, raccoglie buona parte delle migliori e originali esperienze italiane di ricerca epidemiologica e di studio degli interventi per la prevenzione e la sanità pubblica. La rivista – indicizzata su Medline e dotata di Impact Factor – è un canale importante anche per la segnalazione al pubblico internazionale di contributi che altrimenti circolerebbero soltanto in Italia. E&P in questi decenni ha svolto una funzione di riferimento per la sanità pubblica ma anche per i cittadini e le loro diverse forme di aggregazione. Il principio che l’ha ispirata era, e rimane, che l’epidemiologia ha senso se è funzionale alla prevenzione e alla sanità pubblica e che la prevenzione ha ben poche possibilità di realizzarsi se non si fonda su valide basi scientifiche e se non c’è la partecipazione di tutti i soggetti interessati. Modalità di comunicazione aggiornate, metodologia statistica ed epidemiologica rigorosa, validità degli studi e solidità delle interpretazioni dei risultati sono la solida matrice su cui E&P è costruita. A questa si accompagna una forte responsabilità etica verso la salute pubblica, che oggi ha ampliato in forma irreversibile il suo orizzonte, e include in forma sempre più consapevole non solo gli esseri umani, ma l’intero pianeta e le modificazioni che l’uomo apporta all’universo in cui vive. L’ambizione è che l’offerta di nuovi strumenti di comunicazione, informazione e formazione, soprattutto attraverso l''uso di internet, renda la rivista non solo un tradizionale veicolo di contenuti e analisi scientifiche, ma anche un potente strumento a disposizione di una comunità di interessi e di valori che ha a cuore la salute pubblica.