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Total and cause-specific mortality attributable to cold spells in China:A multicity and multicounty study

Advances in Climate Change Research 2023年第6期14卷 827-835页

作者： He-Jia SONG Yi-Bin CHENG Yu WANG Yu-Shu HUANG Yan WANG Xue-Mei SU Shilu TONG Yong-Hong LI Xiao-Yuan YAO National Institute of Environmental Health Chinese Center for Disease Control and PreventionBeijing 100021China School of Public Health Institute of Environment and Population HealthAnhui Medical UniversityHefei 230032China Center for Global Health School of Public HealthNanjing Medical UniversityNanjing 211166China School of Public Health and Social Work Queensland University of TechnologyBrisbane 4000Australia Daxing Center for Disease Control and Prevention Beijing 102600China Department of Infectious Diseases Control and Prevention Jiaxing Center for Disease Control and PreventionJiaxing 314050China

Climate change has resulted in an increase in the frequency and intensity of extreme cold weather events,but few multicity or multicounty researches have explored the association between cold spells and mortality risk and burden.We collected daily data on climate,sociodemo-graphic factors and mortality in 18 cities/counties across 11 geographical regions for the period of November to March 2014-2018.A distributed lag nonlinear model was used to examine the association between cold spells and mortality after adjustment for confounding factors.Twelve definitions of cold spells were used.Multi-meta regression analysis was applied to pool the impacts over different regions.cold spells were significantly associated with all-cause mortality at lag 0-21(CRR:1.38,95%CI:1.21,1.57).In addition to respiratory diseases and cir-culatory system diseases,digestive,endocrine and nervous system diseases and injury were also affected by cold spells.The magnitude of the impacts of cold spells on mortality varied among the diseases investigated,with the highest risk estimate found for influenza and pneumonia(CRR:2.00,95%CI:1.45,2.76)and the lowest estimate found for injury(CRR:1.26,95%CI:1.09,1.46).The fraction of all-cause mortality attributable to cold spells was 2.31%(95%CI:0.90%,3.46%).Among the regional differences,the attributable burden of all-cause mortality was higher in rural areas and subtropical monsoon climate zone,with attributable fractions of 2.85%(95%CI:1.23%,4.11%)and 3.36%(95%CI:0.55%,5.35%),respectively.cold spells increased mortality from a range of diseases.Women,older adults and residents of rural areas and subtropical monsoon climate zone were more vulnerable to cold spells impacts.The findings may help to formulate preventive strategies and early warning response plans to reduce mortality burden of extreme cold events.

关键词： cold spells Distributed lag nonlinear model Attributable fraction Mortality burden Sensitive diseases

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