Burden of non-accidental mortality attributable to ambient temperatures: a time series study in a high plateau area of southwest China

作者：Changyu Deng, Zan Ding, LI Liu-jiu, Yanfang Wang, Pi Guo, Shaoyi Yang, Ju Liu, Yue Wang, Qingying Zhang · 发表于：BMJ Open · 年份：2019 · DOI：10.1136/bmjopen-2018-024708 · 被引用次数：27 · 研究领域：Climate Change and Health Impacts、Thermal Regulation in Medicine、Burn Injury Management and Outcomes

OBJECTIVE: To examine the total non-accidental mortality burden attributable to ambient temperatures and assess the effect modification of the burden by specific causes of death and individual characteristics in a high plateau area in southwest China. METHODS: Using daily mortality and meteorological data from 2009 to 2016, we applied a quasi-Poisson model combined with a distributed lag non-linear model to estimate the temperature-mortality association with the assessment of attributable fraction and number. We calculated attributable fractions and deaths with 95% empirical CIs (eCIs), that were due to cold and heat, defined as temperatures below and above the median temperature, and for mild and extreme temperatures, defined by cut-offs at the 2.5th and 97.5th temperature percentiles. RESULTS: We analysed 89 467 non-accidental deaths; 4131 were attributable to overall temperatures, with an attributable fraction of 4.75% (95% eCI 2.33% to 6.79%). Most of the mortality burden was caused by cold (4.08%; 0.86% to 7.12%), whereas the burden due to heat was low and non-significant (0.67%; -2.44% to 3.64%). Extreme cold (1.17%; 0.58% to 1.69%) was responsible for 24.6% (ie, 1.17% divided by 4.75%) of the total death burden. In the stratification analyses, attributable risk due to cold was higher for cardiovascular than respiratory disease (6.18% vs 3.50%). We found a trend of risk of increased death due to ambient temperatures with increasing age, with attributable fractions of 1....