在中欧和北欧的小面积尺度上,评估热对呼吸系统死亡率和位置特征的影响,作为热影响的修正因子。

IF 3.3 Q2 ENVIRONMENTAL SCIENCES
Environmental Epidemiology Pub Date : 2023-09-13 eCollection Date: 2023-10-01 DOI:10.1097/EE9.0000000000000269
Sofia Zafeiratou, Evangelia Samoli, Antonis Analitis, Antonio Gasparrini, Massimo Stafoggia, Francesca K De' Donato, Shilpa Rao, Siqi Zhang, Susanne Breitner, Pierre Masselot, Kristin Aunan, Alexandra Schneider, Klea Katsouyanni
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引用次数: 0

摘要

背景:热对呼吸系统死亡率的影响是已知的,主要来自对全市数据的时间序列研究。在国家一级或在非城市地区进行的研究数量有限。区域水平因素的影响修正尚未得到广泛研究。我们的研究评估了1996-2018年温暖时期(5月至9月)挪威、德国、英格兰和威尔士小行政区的高温对呼吸道死亡率的影响。此外,我们在EU-Horizon2020 EXHAUSTION项目的框架内,研究了几个地区级特征可能产生的影响修正。方法:收集挪威、德国、英格兰和威尔士小行政区的每日呼吸道死亡率和模拟气温数据。使用分布滞后非线性模型,通过允许过度分散的小面积特定泊松回归来评估温度-死亡率相关性。使用随机效应荟萃分析在国家层面和总体上汇总了估计值。还应用了针对年龄和性别的模型。采用多水平随机效应模型研究了区域水平因子对热效应的影响。结果:从第75个百分位到第99个百分位数的温度升高与呼吸系统死亡率增加27%(95%置信区间[CI]=19%,34%)有关,对女性的影响更大。人口密度和PM2.5浓度的增加与高温对死亡率的更强影响有关。结论:我们的研究通过确定易受伤害的亚组和亚区,加强了北欧地区热对呼吸道死亡率的不利影响的证据。这可能有助于制定有针对性的适应气候变化的政策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe.

Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe.

Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe.

Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe.

Background: Heat effects on respiratory mortality are known, mostly from time-series studies of city-wide data. A limited number of studies have been conducted at the national level or covering non-urban areas. Effect modification by area-level factors has not been extensively investigated. Our study assessed the heat effects on respiratory mortality at a small administrative area level in Norway, Germany, and England and Wales, in the warm period (May-September) within 1996-2018. Also, we examined possible effect modification by several area-level characteristics in the framework of the EU-Horizon2020 EXHAUSTION project.

Methods: Daily respiratory mortality counts and modeled air temperature data were collected for Norway, Germany, and England and Wales at a small administrative area level. The temperature-mortality association was assessed by small area-specific Poisson regression allowing for overdispersion, using distributed lag non-linear models. Estimates were pooled at the national level and overall using a random-effect meta-analysis. Age- and sex-specific models were also applied. A multilevel random-effects model was applied to investigate the modification of the heat effects by area-level factors.

Results: A rise in temperature from the 75th to 99th percentile was associated with a 27% (95% confidence interval [CI] = 19%, 34%) increase in respiratory mortality, with higher effects for females. Increased population density and PM2.5 concentrations were associated with stronger heat effects on mortality.

Conclusions: Our study strengthens the evidence of adverse heat effects on respiratory mortality in Northern Europe by identifying vulnerable subgroups and subregions. This may contribute to the development of targeted policies for adaptation to climate change.

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来源期刊
Environmental Epidemiology
Environmental Epidemiology Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.70
自引率
2.80%
发文量
71
审稿时长
25 weeks
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