發(fā)布時間：2018-06-13 14:24

  本文選題：氣象因素 + 不同死因　； 參考：《南方醫(yī)科大學(xué)》2013年碩士論文

【摘要】：研究背景 在全球氣候變化的議題下,氣象因素對健康的影響越來越引起政府、氣象研究者和公眾的關(guān)注。而氣候變化會增加極端氣象事件(如：熱浪、寒流、水災(zāi)等)發(fā)生頻率及持續(xù)的時間。 以往氣象流行病學(xué)的研究指出氣溫對居民死亡有顯著影響。但這些研究主要集中在溫帶的發(fā)達(dá)國家,而來自發(fā)展中國家,尤其是對熱帶、亞熱帶地區(qū)的相關(guān)研究非常稀少。實(shí)際上,由于較弱的應(yīng)對氣候變化的能力以及較差的生活環(huán)境,這些地區(qū)的人群更容易受氣候變化的影響。故為了更好的評估氣候變化對全人類的影響,來自不同地區(qū),尤其是熱帶、亞熱帶地區(qū)的研究顯得非常必要。 以往氣象健康研究重點(diǎn)放在氣溫上,即日均溫度、日最高溫度和日最低溫度,而忽略了其他氣象因素,像日溫差、相對濕度、大氣氣壓等。其中日溫差(日最高溫度與日最低溫度之差)被認(rèn)為評估全球氣候變化非常重要的氣象指標(biāo)。同樣,相對濕度、大氣氣壓也是非常重要的氣象因素。 目標(biāo) 研究氣象因素與廣州市居民死亡的關(guān)系。其中氣象因素包括：日溫差、日均溫度、相對濕度、大氣氣壓、熱浪。本研究還將探討氣溫與其它氣象因素的交互效應(yīng),以及不同氣象因素的敏感人群。 方法 數(shù)據(jù)來源 2003-2007年死亡數(shù)據(jù)來自于廣東省衛(wèi)生局,2008-2011年死亡的數(shù)據(jù)來自廣州市疾病預(yù)防控制中心。死亡數(shù)據(jù)包括個體基本信息,如：性別、出生日期、死亡日期、教育程度、職業(yè)水平等。 氣象數(shù)據(jù)來自于國家氣象數(shù)據(jù)共享中心,其中包括日均溫度、日最高溫度、日最低溫度、相對濕度、大氣氣壓等。而空氣污染的數(shù)據(jù)(如：NO2、SO2、PM10)則來自于廣州市環(huán)保局。 數(shù)據(jù)分析 本研究采用分布滯后非線性模型來評估溫度與死亡非線性的關(guān)系以及溫度滯后效應(yīng)。日溫度、相對濕度、大氣氣壓的影響,同樣采用分布滯后非線性模型來擬合,同時控制氣溫、空氣污染、季節(jié)趨勢和星期幾、節(jié)假日效應(yīng)等混雜因素。日溫差、相對濕度、大氣氣壓與溫度的交互效應(yīng),本研究分別用二變量的三次樣條函數(shù)來擬合。而熱浪影響,通過計(jì)算熱浪超額死亡人數(shù)以及熱浪時期與對照時期死亡率之比來評估。 結(jié)果 高溫的影響急促但一般局限在5天內(nèi),而低溫的影響可持續(xù)12天。高溫影響,即氣溫從第90百分位數(shù)變化到第99百分位數(shù)引起居民非意外死因的死亡率上升15.46%(95%CI：10.05%-20.87%),而低溫影響,即第10百分位數(shù)下降到第1百分位數(shù)則引起居民非意外死因的死亡率上升20.39%(95%CI：11.78-29.01%)。與非意外死因比較,氣溫對心腦血管-呼吸系統(tǒng)疾病的患者影響更加顯著。在年齡組中,老年人更容易受低溫與高溫的影響。女性更易受高溫的影響。教育程度和職業(yè)情況同樣是高溫與低溫的修正效應(yīng)。 日溫差的影響急促一般可持續(xù)4天。日溫差每變化1℃引起居民非意外死因的死亡率上升0.47%(95%CI：0.01%-0.93%)。在不同死因中,中風(fēng)患者更易受日溫差的影響。與男性、年輕人、教育程度相對高的人群比較,女性、老年人、教育程度低下的人群更易受日溫差的影響。低于22℃時,氣溫與日溫差存在著交互效應(yīng)。 相對濕度、大氣氣壓與死亡呈現(xiàn)非線性單調(diào)的關(guān)系。低濕度、低氣壓是居民死亡危險因素,特別是對心血管疾病的患者。而與小于75歲的年輕人、男性、教育水平高的人群比較,大于75歲的老年人、女性、沒接受教育者更易受低濕度、低氣壓的影響。而氣壓特別高的時,一樣能引起死亡的增加。 2003-2006年,我們得到2005年6月12日到21日共9天的熱浪時期。在這個熱浪時期,超額死亡人數(shù)達(dá)到145人。熱浪對非意外死因人群有顯著影響(RR-1.23,95%CI:1.11-1.37)。而與非意外死因比較,熱浪對心血管疾病、呼吸系統(tǒng)疾病患者的影響更加顯著。女性、老年人和社會經(jīng)濟(jì)地位低下的人群是熱浪的敏感人群。 結(jié)論 低溫和高溫、日溫差、低濕度和低氣壓對居民死亡有顯著性影響,導(dǎo)致居民死亡風(fēng)險增加。在低溫時,溫度與日溫差有交互效應(yīng),低濕度、低氣壓同樣與溫度存在交互效應(yīng)。女性、老年人、社會經(jīng)濟(jì)地位相對低下者、心腦血管-呼吸系統(tǒng)疾病的患者為本研究氣象因素的敏感人群。 本研究強(qiáng)調(diào)大眾加強(qiáng)對氣象因素危害防范的重要性。更重要的是,本研究提示即使在亞熱帶地區(qū),低溫同樣是死亡重要的危險因素,這為冬天在南方集中供暖的議題提供有力的證據(jù)。還有本研究為針對敏感人群提供保護(hù)措施和建立熱浪和較大日溫差的早期預(yù)警提供依據(jù)。
[Abstract]:Research background
On the issue of global climate change, the impact of meteorological factors on health is becoming more and more concerned by the government, the meteorological researchers and the public. And climate change will increase the frequency and duration of extreme weather events, such as heat waves, cold currents, floods and so on.
Previous studies of meteorological epidemiology have pointed out that temperature has a significant impact on Residents' deaths. However, these studies are mainly concentrated in developed countries in temperate regions, while related studies from developing countries, especially in tropical and subtropical areas, are rare. In fact, the weak ability to cope with climate change and a poor living environment, People in some regions are more likely to be affected by climate change. So, in order to better assess the impact of climate change on all human beings, research from different regions, especially in the tropics and subtropics, is very necessary.
The previous research on Meteorological health focused on the temperature, the daily average temperature, the highest daily temperature and the lowest daily temperature, while ignoring other meteorological factors, such as the daily temperature difference, the relative humidity, the atmospheric pressure, etc. among them, the daily temperature difference (the difference between the daily maximum temperature and the daily minimum temperature) is considered to be a very important meteorological index for evaluating the global climate change. Humidity and atmospheric pressure are also important meteorological factors.
target
The meteorological factors including daily temperature difference, daily temperature, relative humidity, atmospheric pressure, heat wave, and the interaction effects of temperature and other meteorological factors, and sensitive people of different meteorological factors are also discussed.
Method
data sources
The 2003-2007 year death data came from the Guangdong Provincial Health Bureau, and 2008-2011 years of death data came from the Guangzhou Center for Disease Control and prevention. Death data included basic individual information, such as sex, date of birth, death date, education, and professional level.
The weather data comes from the national meteorological data sharing center, which includes daily average temperature, daily maximum temperature, daily minimum temperature, relative humidity, atmospheric pressure and so on. Air pollution data (such as NO2, SO2, PM10) comes from the Guangzhou Environmental Protection Bureau.
Data analysis
The distribution lag nonlinear model is used to evaluate the relationship between temperature and death nonlinearity and the effect of temperature lag. The influence of daily temperature, relative humidity and atmospheric pressure is also used to fit the distribution lag nonlinear model, and control temperature, air pollution, seasonal trend and week, holiday effect and other confounding factors. The interaction effect of the difference, relative humidity, atmospheric pressure and temperature, this study was fitted with the three spline function of the two variable, and the heat wave effect was evaluated by calculating the excess death rate of heat wave and the ratio of the mortality in the heat wave period to the control period.
Result
The effect of high temperature is rapid, but generally limited to 5 days, and the influence of low temperature is sustainable for 12 days. The effect of high temperature, that is, the mortality of non accidental death caused by the change of temperature from ninetieth percentile to ninety-ninth percentile increases by 15.46% (95%CI:10.05%-20.87%), and the influence of low temperature, that is, the tenth percentile to first percentile, is caused by the residents. The mortality rate of non accidental death increased by 20.39% (95%CI:11.78-29.01%). Compared with non accidental death, the temperature has more significant impact on patients with cardio cerebrovascular respiratory disease. In age groups, older people are more susceptible to low temperature and high temperature. Women are more susceptible to the influence of high temperature. Education and occupation are also high temperature and low temperature. The correction effect.
The impact of diurnal temperature difference is generally sustainable for 4 days. The mortality rate of non accidental death caused by daily temperature difference of 1 degrees centigrade increases by 0.47% (95%CI:0.01%-0.93%). In different causes of death, stroke patients are more susceptible to the influence of day temperature difference. Compared with men, young people, higher education level, women, elderly people, and low education people It is more susceptible to the difference of temperature. There is an interaction effect between temperature and daily temperature difference below 22.
Relative humidity, atmospheric pressure is a nonlinear monotonous relationship with death. Low humidity and low pressure are the risk factors for death of residents, especially for cardiovascular disease. Compared with young people younger than 75 years old, male and higher education, older people older than 75 years old, women who are not educated are more susceptible to low humidity and low pressure. And when the air pressure is very high, it can also cause death increase.
2003-2006 years, we received a period of 9 days of heat waves from June 12, 2005 to 21. During this heat wave, the number of excess deaths reached 145. Heat waves had a significant impact on non accidental causes of death (RR-1.23,95%CI:1.11-1.37). Compared with the non accidental cause of death, the impact of heat waves on cardiovascular disease and respiratory disease was more significant. Sex, the elderly and socioeconomic status are sensitive populations of heat waves.
conclusion
Low temperature and high temperature, diurnal temperature difference, low humidity and low pressure have a significant influence on the death of residents, which leads to increased risk of death. At low temperature, there is interaction effect between temperature and daily temperature difference. Low humidity and low pressure also have interaction effects with temperature. Women, elderly people, social economic status relatively low, cardiovascular and respiratory system diseases The patient was a sensitive group of meteorological factors in this study.
More importantly, this study suggests that even in subtropical areas, low temperature is also an important risk factor for death, which provides strong evidence for the issue of central heating in the south in the winter. And this study provides protection measures and heat waves for sensitive people. The early warning of the temperature difference of the larger day provides the basis.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R122.26

【共引文獻(xiàn)】

相關(guān)期刊論文 前1條

1 YANG Jun;LIU Hua Zhang;OU Chun Quan;LIN Guo Zhen;DING Yan;ZHOU Qin;SHEN Ji Chuan;CHEN Ping Yan;;Impact of Heat Wave in 2005 on Mortality in Guangzhou, China[J];Biomedical and Environmental Sciences;2013年08期

相關(guān)碩士學(xué)位論文 前1條

1 潘曉紅;我國東部地區(qū)30年夏季（6-9月）高溫悶熱天氣研究[D];上海師范大學(xué);2010年

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本文編號：2014318