Excess Winter Mortality and Cold Temperatures in a Subtropical City, Guangzhou, China

作者：Chun‐Quan Ou, Yun-Feng Song, Jun Yang, Patsy Yuen-Kwan Chau, Lin Yang, Ping-Yan Chen, Chit-Ming Wong · 发表于：PLoS ONE · 年份：2013 · DOI：10.1371/journal.pone.0077150 · 被引用次数：61 · 研究领域：Climate Change and Health Impacts、Air Quality and Health Impacts、Climate variability and models

BACKGROUND: A significant increase in mortality was observed during cold winters in many temperate regions. However, there is a lack of evidence from tropical and subtropical regions, and the influence of ambient temperatures on seasonal variation of mortality was not well documented. METHODS: This study included 213,737 registered deaths from January 2003 to December 2011 in Guangzhou, a subtropical city in Southern China. Excess winter mortality was calculated by the excess percentage of monthly mortality in winters over that of non-winter months. A generalized linear model with a quasi-Poisson distribution was applied to analyze the association between monthly mean temperature and mortality, after controlling for other meteorological measures and air pollution. RESULTS: The mortality rate in the winter was 26% higher than the average rate in other seasons. On average, there were 1,848 excess winter deaths annually, with around half (52%) from cardiovascular diseases and a quarter (24%) from respiratory diseases. Excess winter mortality was higher in the elderly, females and those with low education level than the young, males and those with high education level, respectively. A much larger winter increase was observed in out-of-hospital mortality compared to in-hospital mortality (45% vs. 17%). We found a significant negative correlation of annual excess winter mortality with average winter temperature (rs=-0.738, P=0.037), but not with air pollution levels. A 1 °C decreas...