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The mediatory role of water quality on the association between extreme precipitation events and infectious diarrhea in the Yangtze River Basin,China

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Fundamental Research 2024年第3期4卷 495-504页

作者： Junfeng Yu Liang Zhao Xin-Zhong Liang Hung Chak Ho Masahiro Hashizume cunrui huang School of Public Health Sun Yat-sen UniversityGuangzhou 510080China The State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics(LASG) Institute of Atmospheric PhysicsChinese Academy of SciencesBeijing 100029China Department of Atmospheric and Oceanic Science University of MarylandCollege ParkMD 20740USA Department of Public and International Affairs City University of Hong KongHong Kong 999077China Department of Global Health Policy Graduate School of MedicineThe University of TokyoTokyo 113-0033Japan Vanke School of Public Health Tsinghua UniversityBeijing 100084China Institute of Healthy China Tsinghua UniversityBeijing 100084China

Extreme precipitation is exacerbating the burden of infectious diarrhea in the context of climate change,it is necessary to identify the critical and easy-to-intervene intermediate factors for public health strategies.Water quality may be the most important mediator,while relevant empirical evidence is limited.This study aimed to examine the role of water quality in the process of infectious diarrhea caused by extreme precipitation.Weekly infectious diarrhea cases,meteorological factors and water quality data in Yangtze River Basin in China between October 29,2007 to February 19,2017 were obtained.Two-stage statistical models were used to estimate city-specific extreme precipitation,water quality and infectious diarrhea relationships that were pooled to derive regional estimates.A causal mediation analysis was used to assess the mediation effect of water quality.In Yangtze River Basin,extreme precipitation events had a significant impact on infectious diarrhea(Incidence Rate Ratios[IRR]:1.027,95%Confidence Interval[CI]:1.013~1.041).After extreme precipitation events,the dissolved oxygen(DO)in surface water decreased(-0.123 mg/L,95%CI:-0.159 mg/L~-0.086 mg/L),while the un-ionized ammonia(NH(3)-N)increased(0.004 mg/L,95%CI:0.001 mg/L~0.006 mg/L).The combined overall effect of DO and NH(3)-N on infectious diarrhea showed that both low and high concentrations were associated with an increased risk of infectious diarrhea.The causal mediation analysis showed that the mediation proportion of the two water quality indexes(DO and NH(3)-N)is 70.54%(P<0.001).To reduce the health effects of extreme precipitation,in contrast to current population-oriented health strategies,those that take into account more direct and easy-to-intervene water quality indicators should be encouraged by future policies.

关键词： Extreme precipitation Infectious diarrhea Water quality Dissolved oxygen Un-ionized ammonia Mediation analysis

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An overview for monitoring and prediction of pathogenic microorganisms in the atmosphere

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Fundamental Research 2024年第3期4卷 430-441页

作者： Jianping huang Danfeng Wang Yongguan Zhu Zifeng Yang Maosheng Yao Xiaoming Shi Taicheng An Qiang Zhang cunrui huang Xinhui Bi Jiang Li Zifa Wang Yongqin Liu Guibing Zhu Siyu Chen Jian Hang Xinghua Qiu Weiwei Deng Huaiyu Tian Tengfei Zhang Tianmu Chen Sijin Liu Xinbo Lian Bin Chen Beidou Zhang Yingjie Zhao Rui Wang Han Li Collaborative Innovation Center for Western Ecological Safety College of Atmospheric SciencesLanzhou UniversityLanzhou 730000China Research Center for Eco-Environmental Sciences Chinese Academy of SciencesBeijing 100085China National Clinical Research Center for Respiratory Disease Guangzhou Institute of Respiratory HealthFirst Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease(Guangzhou Medical University)Guangzhou 510230China College of Environmental Sciences and Engineering Peking UniversityBeijing 100871China China CDC Key Laboratory of Environment and Population Health National Institute of Environmental HealthChinese Center for Disease Control and PreventionBeijing 100021China Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health School of Environmental Science and EngineeringInstitute of Environmental Health and Pollution ControlGuangdong University of TechnologyGuangzhou 510006China Ministry of Education Key Laboratory for Earth System Modeling Department of Earth System ScienceTsinghua UniversityBeijing 100084China Vanke School of Public Health Tsinghua UniversityBeijing 100084China State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Protection and Resources Utilization Guangzhou Institute of GeochemistryChinese Academy of SciencesGuangzhou 510640China National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry Institute of Atmospheric PhysicsChinese Academy of SciencesBeijing 100029China Center for Pan-third Pole Environment Lanzhou UniversityLanzhou 730000China College of Atmospheric Sciences Lanzhou UniversityLanzhou 730000China School of Atmospheric Sciences Sun Yat-sen Universityand Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)Zhuhai 510640

Corona virus disease 2019(COVID-19)has exerted a profound adverse impact on human health.Studies have demonstrated that aerosol transmission is one of the major transmission routes of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Pathogenic microorganisms such as SARS-CoV-2 can survive in the air and cause widespread infection among people.Early monitoring of pathogenic microorganism transmission in the atmosphere and accurate epidemic prediction are the frontier guarantee for preventing large-scale epidemic outbreaks.Monitoring of pathogenic microorganisms in the air,especially in densely populated areas,may raise the possibility to detect viruses before people are widely infected and contain the epidemic at an earlier stage.The multi-scale coupled accurate epidemic prediction system can provide support for governments to analyze the epidemic situation,allocate health resources,and formulate epidemic response policies.This review first elaborates on the effects of the atmospheric environment on pathogenic microorganism transmission,which lays a theoretical foundation for the monitoring and prediction of epidemic development.Secondly,the monitoring technique development and the necessity of monitoring pathogenic microorganisms in the atmosphere are summarized and emphasized.Subsequently,this review introduces the major epidemic prediction methods and highlights the significance to realize a multi-scale coupled epidemic prediction system by strengthening the multidisciplinary cooperation of epidemiology,atmospheric sciences,environmental sciences,sociology,demography,etc.By summarizing the achievements and challenges in monitoring and prediction of pathogenic microorganism transmission in the atmosphere,this review proposes suggestions for epidemic response,namely,the establishment of an integrated monitoring and prediction platform for pathogenic microorganism transmission in the atmosphere.

关键词： Aerosol transmission Epidemic monitoring methods Epidemic prediction modelsEpidemic response Multidisciplinary cooperation

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离散选择实验在卫生人力资源领域的应用进展

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中国全科医学 2024年第25期27卷 3184-3191页

作者：包美玲黄存瑞王皓翔贵州医科大学公共卫生与健康学院贵州省贵阳市550004 中山大学公共卫生学院广东省广州市510080 清华大学万科公共卫生与健康学院北京市100084 郑州大学公共卫生学院河南省郑州市450001

背景运用离散选择实验(DCE)对卫生人员工作选择倾向性进行研究,可以为制定农村及偏远地区吸引和留用卫生人员相关政策提供科学且有效的依据。目的对DCE应用于卫生人力资源领域的研究进行梳理、总结和归纳,以期为将来的相关研究提供参考... 详细信息

背景运用离散选择实验(DCE)对卫生人员工作选择倾向性进行研究,可以为制定农村及偏远地区吸引和留用卫生人员相关政策提供科学且有效的依据。目的对DCE应用于卫生人力资源领域的研究进行梳理、总结和归纳,以期为将来的相关研究提供参考。方法于2022年2—4月,系统检索Web of Science、PubMed、中国知网、万方数据知识服务平台、维普网中与DCE应用于卫生人力资源领域相关的文献。提取纳入文献的研究对象、分析模型、选择项设置及研究结果等。结果最终纳入44篇文献,文献发表时间为2000—2020年。研究对象主要为在职卫生工作者、学生;纳入文献中,6篇是标签式,其余为一般式;属性数量为4~8个;水平数量以2~4个居多(88.6%,39/44)。高收入国家的研究中将全科医生团队合作、工作量作为工作属性;中低收入国家的研究中工作属性选择最多的是住房(21次),其次是设施、药物等的配备(19次)、学习/培训机会(16次)。各文献的工作属性均纳入了收入(工资)。形成的工作属性框架包含4个层面:社会层面,包括医院规模、社会支持/尊重、身份确认(编制或成为永久员工);工作层面,包括工作地点、工作条件、工作量、工作(管理)氛围、团队合作、上级指导(针对基层卫生工作者);职业发展层面,包括晋升年限、培训(继续教育)机会、学术和研究机会;生活层面,包括收入、住房、交通、子女教育。分析模型运用最多的是Mixed Logit Model(19次),其次是Conditional Logit Model(9次)、Generalized Multinomial Logit Model(3次)。结论该领域研究结果的异质性较大,难以得出统一结论。而且DCE在卫生人力资源领域的应用仍需进一步在全球范围内推广,相关研究十分有限,得到的证据尚需进一步研究的证实。

关键词：离散选择实验卫生人力卫生人员职业选择研究方法

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Urban structure and the risk of influenza A(H1N1) outbreaks in municipal districts

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Chinese Science Bulletin 2014年第5期59卷 554-562页

作者： Hong Xiao Xiaoling Lin Gerardo Chowell cunrui huang Lidong Gao Biyun Chen Zheng Wang Liang Zhou Xinguang He Haining Liu Xixing Zhang Huisuo Yang College of Resources and Environment Science Hunan Normal University Mathematical Computational and Modeling Sciences CenterSchool of Human Evolution and Social Change Arizona State University Division of International Epidemiology and Population Studies Fogarty International Center National Institutes of Health Centre for Environment and Population Health School of Environment Griffith University Hunan Provincial Center for Disease Control and Prevention Department of Respiratory and Critical Care Medicine Beijing Institute of Respiratory Medicine Beijing Chaoyang Hospital Affiliated to Capital Medical University Changsha Municipal Center for Disease Prevention and Control Center for Disease Control and Prevention of Beijing Military Region

Changsha was one of the most affected areas during the 2009 A(H1N1)influenza pandemic in China.Here,we analyze the spatial–temporal dynamics of the 2009 pandemic across Changsha municipal districts,evaluate the relationship between case incidence and the local urban spatial structure and predict high-risk areas of influenza A(H1N1).We obtained epidemiological data on all cases of influenza A(H1N1)reported across municipal districts in Changsha during period May 2009–December 2010 and data on population density and basic geographic characteristics for 239 primary schools,97 middle schools,347 universities,96 malls and markets,674 business districts and 121 hospitals.Spatial–temporal K functions,proximity models and logistic regression were used to analyze the spatial distribution pattern of influenza A(H1N1)incidence and the association between influenza A(H1N1)cases and spatial risk factors and predict the infection risks.We found that the 2009 influenza A(H1N1)was driven by a transmission wave from the center of the study area to surrounding areas and reported cases increased significantly after September 2009.We also found that the distribution of influenza A(H1N1)cases was associated with population density and the presence of nearest public places,especially universities(OR=10.166).The final predictive risk map based on the multivariate logistic analysis showed high-risk areas concentrated in the center areas of the study area associated with high population density.Our findings support the identification of spatial risk factors and highrisk areas to guide the prioritization of preventive and mitigation efforts against future influenza pandemics.

关键词：风险图流感甲型城市结构 Logistic回归分析 logistic回归城市空间结构爆发

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IPCC AR6报告解读:气候变化与人类健康

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气候变化研究进展 2022年第4期18卷 442-451页

作者：黄存瑞刘起勇清华大学万科公共卫生与健康学院北京100084 中国疾病预防控制中心传染病预防控制所北京102206

IPCC近期发布了第六次评估报告(AR6)第二工作组(WGII)报告《气候变化:影响、适应和脆弱性》,其中第7章“健康、福祉和不断变化的社区结构”评估了气候变化对人类健康和福祉的当前影响以及未来风险,提出了应对气候变化的解决方案和适应... 详细信息

IPCC近期发布了第六次评估报告(AR6)第二工作组(WGII)报告《气候变化:影响、适应和脆弱性》,其中第7章“健康、福祉和不断变化的社区结构”评估了气候变化对人类健康和福祉的当前影响以及未来风险,提出了应对气候变化的解决方案和适应策略。报告明确指出,气候变化对气候敏感传染病和慢性非传染性疾病,以及精神心理健康等的威胁正在增加,并表现出复合暴露和连锁事件的风险,且预计未来风险还会随着全球变暖而进一步加剧。实施积极和有效的气候变化适应措施并快速采取行动,将会在很大程度上减少和避免气候变化导致的健康风险,但不会完全消除所有风险。报告凸显了气候变化健康影响的严重性和紧迫性,未来需要加大对健康领域适应气候变化的科技创新、规划、行动和资金支持。

关键词：气候变化健康影响脆弱人群未来风险适应策略

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极端气温诱发哮喘发作的研究进展及其潜在影响机制探讨

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中华预防医学杂志 2022年第10期56卷 1452-1460页

作者：韩阿珠邓诗舟黄存瑞中山大学公共卫生学院广州510080 清华大学万科公共卫生与健康学院北京100084

哮喘作为常见的慢性呼吸系统疾病, 近年来发病率在全球范围呈逐年上升趋势。气候变化背景下, 极端天气事件的发生频率和强度都在不断增加, 大量关联性研究表明极端气温暴露会增加哮喘发作的风险, 但诱发哮喘发作的潜在影响机制仍不清楚... 详细信息

哮喘作为常见的慢性呼吸系统疾病, 近年来发病率在全球范围呈逐年上升趋势。气候变化背景下, 极端天气事件的发生频率和强度都在不断增加, 大量关联性研究表明极端气温暴露会增加哮喘发作的风险, 但诱发哮喘发作的潜在影响机制仍不清楚。本文旨在系统梳理极端气温与哮喘发作的关联性研究进展, 阐明极端气温与室内外环境因素协同以及个体脆弱性对哮喘发作的影响;探讨极端气温诱发哮喘发作的潜在影响机制, 强调免疫调节和神经调节在极端气温诱发哮喘炎症反应中的重要调节作用;并提出极端气温与环境因素相互作用诱发哮喘的发病机制框架, 以期为应对极端天气和气候变化提供科学依据。

关键词：哮喘极端气温气候变化脆弱人群影响机制

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Synergetic roadmap of carbon neutrality and clean air for China

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Environmental Science and Ecotechnology 2023年第4期16卷 1-25页

作者： Qiang Zhang Zhicong Yin Xi Lu Jicheng Gong Yu Lei Bofeng Cai Cilan Cai Qimin Chai Huopo Chen Hancheng Dai Zhanfeng Dong Guannan Geng Dabo Guan Jianlin Hu cunrui huang Jianing Kang Tiantian Li Wei Li Yongsheng Lin Jun Liu Xin Liu Zhu Liu Jinghui Ma Guofeng Shen Dan Tong Xuhui Wang Xuying Wang Zhili Wang Yang Xie Honglei Xu Tao Xue Bing Zhang Da Zhang Shaohui Zhang Shaojun Zhang Xian Zhang Bo Zheng Yixuan Zheng Tong Zhu Jinnan Wang Kebin He Ministry of Education Key Laboratory for Earth System Modelling Department of Earth System ScienceTsinghua UniversityBeijing100084China Key Laboratory of Meteorological Disaster Ministry of Education/Joint International Research Laboratory of Climate and Environment Change(ILCEC)/Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters(CIC-FEMD)Nanjing University of Information Science&TechnologyNanjing210044China State Key Joint Laboratory of Environment Simulation and Pollution Control School of EnvironmentTsinghua UniversityBeijing100084China Institute for Carbon Neutrality Tsinghua UniversityBeijing100084China State Key Joint Laboratory for Environment Simulation and Pollution Control College of Environmental Sciences and Engineering and Center for Environment and HealthPeking UniversityBeijing100871China Center of Air Quality Simulation and System Analysis Chinese Academy of Environmental PlanningBeijing100012China Center for Carbon Neutrality Chinese Academy of Environmental PlanningBeijing100012China National Center for Climate Change Strategy and International CooperationBeijing100035China Nansen-Zhu International Research Centre Institute of Atmospheric PhysicsChinese Academy of SciencesBeijing100029China College of Environmental Sciences and Engineering Peking UniversityBeijing100871China Institute of Environmental Policy Management Chinese Academy of Environmental PlanningBeijing100012China Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control School of Environmental Science and EngineeringCollaborative Innovation Center of Atmospheric Environment and Equipment TechnologyNanjing University of Information Science and TechnologyNanjing210044China Vanke School of Public Health Tsinghua UniversityBeijing100084China Center for Energy and Environmental Policy Research Beijing Institute of TechnologyBeijing100081China China CDC Key Laboratory of Environment and Population Health National Institute of En

It is well recognized that carbon dioxide and air pollutants share similar emission sources so that synergetic policies on climate change mitigation and air pollution control can lead to remarkable co-benefits on greenhouse gas reduction,air quality improvement,and improved health.In the context of carbon peak,carbon neutrality,and clean air policies,this perspective tracks and analyzes the process of the synergetic governance of air pollution and climate change in China by developing and monitoring 18 indicators.The 18 indicators cover the following five aspects:air pollution and associated weather-climate conditions,progress in structural transition,sources,inks,and mitigation pathway of atmospheric composition,health impacts and benefits of coordinated control,and synergetic governance system and practices.By tracking the progress in each indicator,this perspective presents the major accomplishment of coordinated control,identifies the emerging challenges toward the synergetic governance,and provides policy recommendations for designing a synergetic roadmap of Carbon Neutrality and Clean Air for China.

关键词： Carbon neutrality Clean air Synergetic roadmap

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孕期高温暴露导致早产的机制研究进展

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环境与职业医学 2022年第3期39卷 275-280页

作者：王丽云王琼黄存瑞中山大学公共卫生学院广东广州510080 清华大学万科公共卫生与健康学院北京100084

早产及其并发症是导致新生儿死亡的主要原因,也是造成全球疾病负担的围产难题。近年来,多项关联性研究发现孕期高温暴露会增加早产的发生风险,但目前学术界对于高温如何影响早产的生物学机制尚不清楚。基于此,本文对既往文献进行了系统... 详细信息

早产及其并发症是导致新生儿死亡的主要原因,也是造成全球疾病负担的围产难题。近年来,多项关联性研究发现孕期高温暴露会增加早产的发生风险,但目前学术界对于高温如何影响早产的生物学机制尚不清楚。基于此,本文对既往文献进行了系统梳理,回顾了孕期高温暴露导致早产过程中的孕妇个体脆弱性因素和环境区域修饰性因素,总结了孕期高温暴露导致早产风险的潜在生物学机制,发现孕期高温会通过氧化应激、炎症反应、生殖和泌尿系统感染、神经内分泌改变以及妊娠期合并症等机制路径,导致早产风险。基于此提出高温暴露导致早产风险机制研究中存的在问题及未来研究方向,建议今后应基于前瞻性队列研究和动物实验研究,阐明高温对不同类型早产的不良健康效应和机制,为高温天气时保障母婴健康,开展临床早产预防提供科学依据。

关键词：孕期高温早产风险机制

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加强气候变化健康影响的机制研究,提高气候变化风险应对与适应能力

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环境与职业医学 2022年第3期39卷 237-239页

作者：马文军刘涛黄存瑞暨南大学基础医学与公共卫生学院广东广州510632 广东省疾病预防控制中心广东省公共卫生研究院广东广州511430 清华大学万科公共卫生与健康学院北京100084

气候变化对人群健康的威胁已成为全球广泛关注的公共卫生问题。然而,目前关于气候变化对健康影响的机制研究多局限于生物学机制,且很多尚未定论。为此,本期推出了“气候变化与人群健康的机制研究”专栏,从不同的角度分析了不同气象因素... 详细信息

气候变化对人群健康的威胁已成为全球广泛关注的公共卫生问题。然而,目前关于气候变化对健康影响的机制研究多局限于生物学机制,且很多尚未定论。为此,本期推出了“气候变化与人群健康的机制研究”专栏,从不同的角度分析了不同气象因素(气温、降雨)导致不同健康结局(早产、死亡、腹泻、传染病等)的生物学机制、脆弱性机制、社会驱动过程和传播动力学机制,以期深化对气象因素或者气候变化对人群健康影响的认识,提高我国应对气候变化健康风险的能力,为制定有针对性的适应措施提供科学依据。

关键词：气候变化极端天气机制研究健康影响

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Ambient Temperature and Years of Life Lost:A National Study in China

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The Innovation 2021年第1期2卷 3-10页

作者： Tao Liu Chunliang Zhou Haoming Zhang Biao huang Yanjun Xu Lifeng Lin Lijun Wang Ruying Hu Zhulin Hou Yize Xiao Junhua Li Xiaojun Xu Donghui Jin Mingfang Qin Qinglong Zhao Weiwei Gong Peng Yin Yiqing Xu Jianxiong Hu Jianpeng Xiao Weilin Zeng Xing Li Siqi Chen Lingchuan Guo Zuhua Rong Yonghui Zhang cunrui huang Yaodong Du Yuming Guo Shannon Rutherford Min Yu Maigeng Zhou Wenjun Ma Guangdong Provincial Institute of Public Health Guangdong Provincial Center for Disease Control and PreventionGuangzhou511430China Hunan Provincial Center for Disease Control and Prevention Changsha410005China Yunnan Center for Disease Control and Prevention Kunming650022China Health Hazard Factors Control Department Jilin Provincial Center for Disease Control and PreventionChangchun130062China Guangdong Provincial Center for Disease Control and Prevention Guangzhou511430China The National Center for Chronic and Noncommunicable Disease Control and Prevention Beijing100050China Zhejiang Center for Disease Control and Prevention Hangzhou310051China School of Public Health Sun Yat-sen UniversityGuangzhou510080China Guangdong Provincial Climate Center Guangzhou510080China Department of Epidemiology and Preventive Medicine School of Public Health and Preventive MedicineMonash UniversityMelbourne3800Australia School of Medicine Griffith UniversityGold Coast4214Australia

Although numerous studies have investigated premature deaths attributable to temperature,effects of temperature on years of life lost(YLL)remain unclear.We estimated the relationship between temperatures and YLL,and quantified the YLL per death caused by temperature in China.We collected daily meteorological and mortality data,and calculated the daily YLL values for 364 locations(2013–2017 in Yunnan,Guangdong,Hunan,Zhejiang,and Jilin provinces,and 2006–2011 in other locations)in China.A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates(YLL/100,000 population),and a multivariate meta-analysis model was used to pool location-specific associations.Then,YLL per death caused by temperatures was calculated.The temperature and YLL rates consistently showed U-shaped associations.A mean of 1.02(95%confidence interval:0.67,1.37)YLL per death was attributable to temperature.Cold temperature caused 0.98 YLL per death with most from moderate cold(0.84).The mean YLL per death was higher in those with cardiovascular diseases(1.14),males(1.15),younger age categories(1.31 in people aged 65–74 years),and in central China(1.34)than in those with respiratory diseases(0.47),females(0.87),older people(0.85 in people R75 years old),and northern China(0.64)or southern China(1.19).The mortality burden was modified by annual temperature and temperature variability,relative humidity,latitude,longitude,altitude,education attainment,and central heating use.Temperatures caused substantial YLL per death in China,which was modified by demographic and regional characteristics.

关键词： TEMPERATURE YEARS OF LIFE LOST MORTALITY BURDEN DISTRIBUTED LAG NONLINEAR MODEL MULTIVARIATE META-ANALYSIS CHINA

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