亚热带大都市炎热夜晚与夜间过量高温相关的住院风险:2000-2019 年香港时间序列研究

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-08-12 DOI:10.1016/j.lanwpc.2024.101168
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引用次数: 0

摘要

方法收集了香港 2000-19 年炎热季节(5 月至 10 月)的每日住院、气象(包括每小时)和空气污染数据。我们得出了三个热夜指标:HNday28 °C,每日最低气温≥28 °C,这是政府对热夜的定义;HNe,热夜过量,由夜间每小时气温超过 28 °C的热量过量总和计算得出;HNday90th,以 HNe 的第 90 个百分位数(17.7 °C⋅h)为分界线划分的热夜。我们利用分布式滞后非线性模型进行了时间序列回归,以检验热夜指标与各种住院情况之间的关联。研究结果在 3680 个研究日期间,共记录了 5,002,114 例非癌症非外部住院 (NCNE)。其中有一半(1874 天)的研究日经历了夜间过热(HNe>0),平均值(标度)为 8.0 (6.8) °C⋅h;根据 HNday28 °C 和 HNday90th 分别确定了 499 个和 187 个热夜。极端 HNe(第 99 百分位数 vs 0 ℃-h)与滞后 0-4 天的 NCNE 住院率显著相关,总体增加了 3.1% [95% 置信区间:1.5%, 4.8%],对老年人(5.3% [3.2%, 7.4%])、社会经济地位较低者(5.3% [2.8%, 8.0%])和循环系统入院者(3.4% [0.2%, 6.8%])的影响更大。与官方的 HNday28 °C 相比,反映极端 HNe 的 HNday90th 能更好地识别危险的高温之夜。在定义与公共卫生相关的炎热夜晚时,应考虑夜间热强度。
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The risk of hospitalization associated with hot nights and excess nighttime heat in a subtropical metropolis: a time-series study in Hong Kong, 2000–2019

Background

Recent studies showed increased mortality risks after hot nights, but their effect on hospitalizations, especially in vulnerable populations, remains under-studied.

Methods

Daily hospitalization, meteorological (including hourly), and air pollution data were collected for the hot seasons (May–October) of 2000–19 in Hong Kong. We derived three hot-night metrics: HNday28 °C, daily minimum temperature ≥28 °C, the governmental definition of hot nights; HNe, hot night excess calculated by summing heat excess of hourly temperatures above 28 °C at night; and HNday90th, hot nights classified using the 90th percentile HNe (17.7 °C⋅h) as a cutoff. We fitted time-series regression with distributed lag nonlinear models to examine the associations of hot-night metrics with various hospitalizations.

Findings

During the 3680 study days, 5,002,114 non-cancer non-external (NCNE) hospitalizations were recorded. Half (1874) of the days experienced excess nighttime heat (HNe>0) with a mean (SD) of 8.0 (6.8) °C⋅h; 499 and 187 hot nights were identified by HNday28 °C and HNday90th, respectively. Extreme HNe (99th percentile vs 0 °C⋅h) was significantly associated with increased NCNE hospitalizations over lag 0–4 days by 3.1% [95% confidence interval: 1.5%, 4.8%] overall, with enhanced effects in elderly (5.3% [3.2%, 7.4%]), low-SES individuals (5.3% [2.8%, 8.0%]), and circulatory admissions (3.4% [0.2%, 6.8%]). HNday90th, reflecting extreme HNe, better identified hazardous hot nights than the official HNday28 °C.

Interpretation

Excessive nighttime heat is significantly associated with increased hospitalizations, particularly affecting the elderly and socioeconomically disadvantaged individuals. Nighttime heat intensity should be incorporated in defining hot nights with public health relevance.

Funding

British Heart Foundation.

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来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
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