最高气温对呼吸系统疾病急诊人次的影响研究

采用基于时间序列的半参数的广义相加模型，在控制星期几效应、长期趋势、气象要素等混杂因素后，分析2009~2012年北京市日最高气温与四类呼吸系统疾病急诊人次的暴露-反应关系，探讨日最高气温对人群健康的影响，并考虑了不同年龄和性别人群分层以及0~6d的滞后效应.结果表明：日最高气温对呼吸系统疾病急诊存在0~1d滞后效应，男性急诊人次均要高于女性；日最高气温每上升1℃，男性上呼吸道感染和支气管炎急诊人次分别增加2.10%和2.14%，女性肺炎、哮喘和支气管炎急诊人次分别增加2.00%、4.21%和2.95%.对性别而言，日最高气温每上升1℃，小于15岁人群支气管炎急诊人次增加3.60%；15~59岁人群支气管炎急诊人次增加2.16%；对60~74岁年龄段急诊人次无显著统计学意义；≥75岁人群肺炎和哮喘急诊人次分别增加2.69%和8.05%.

A study on the impact of daily maximum temperature on the hospital emergency room visits due to respiratory diseases

Based on the daily maximum temperature data and hospital Emergency Room (ER) visit records from 2009 to 2012, we analyzed the climatic impact on the onset of the four types of common respiratory diseases (i.e., upper respiratory tract infection, bronchitis, pneumonia, and asthma) in Beijing, China. We used a time-series-based semi-parametric generalized additive model. We controlled the confounding factors, such as weekday effect, long-term trend, and other meteorological elements, and we also factored in age-gender differences and the lagging effect within a week. The results showed that the lagging effect of daily maximum temperature on the number of ER visits due to respiratory diseases was within one day. The number of male patients was generally higher than that of female patients. For each 1℃ increase in daily maximum temperature, the number of ER visits due to upper respiratory tract infection and bronchitis would increase by 2.10% and 2.14%, respectively, for the male subgroup; and the number of ER visits due to pneumonia, asthma, and bronchitis would increase by 2.00%, 4.21%, and 2.95%, respectively, for the female subgroup. Within the four different age subgroups, the increase in the number of ER visits due to respiratory diseases per 1℃ increase in daily maximum temperature was statistically significant with the exception of the 60-74age group. In particular, when daily maximum temperature increased by 1℃, the number of ER visits due to bronchitis would increase by 3.60% and 2.16% for the below-15 and the 15~59age group, respectively; the number of ER visits due to pneumonia and asthma would increase by 2.69% and 8.05%, respectively, for the over-75age group.