中华流行病学杂志  2017, Vol. 38 Issue (11): 1523-1527   PDF    
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2017.11.017
中华医学会主办。
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文章信息

张衡, 赵科伕, 何睿欣, 赵德胜, 谢明玉, 王舒思, 白丽君, 程强, 张言武, 苏虹.
Zhang Heng, Zhao Kefu, He Ruixin, Zhao Desheng, Xie Mingyu, Wang Shusi, Bai Lijun, Cheng Qiang, Zhang Yanwu, Su Hong.
温湿指数对合肥市细菌性痢疾影响的时间序列研究
Influence of humidex on incidence of bacillary dysentery in Hefei:a time-series study
中华流行病学杂志, 2017, 38(11): 1523-1527
Chinese Journal of Epidemiology, 2017, 38(11): 1523-1527
http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2017.11.017

文章历史

收稿日期: 2017-05-07
温湿指数对合肥市细菌性痢疾影响的时间序列研究
张衡1, 赵科伕2, 何睿欣3, 赵德胜1, 谢明玉1, 王舒思1, 白丽君1, 程强1, 张言武1, 苏虹1     
1. 230032 合肥, 安徽医科大学公共卫生学院流行病与卫生统计学系 重大自身免疫性疾病安徽省重点实验室;
2. 230061 合肥市疾病预防控制中心应急办;
3. 610041 成都, 四川大学华西临床医学院
摘要: 目的 探讨温度和湿度的共同作用指标——温湿指数对细菌性痢疾发病的影响。方法 收集2006年1月1日至2013年12月31日合肥市细菌性痢疾每日发病资料及同期的气象资料,并计算出温湿指数,采用分布滞后非线性模型分析温湿指数与细菌性痢疾发病的关系,调整季节性和长期趋势、星期几效应和其他气象因素的影响。同时,按性别、年龄和居住地进行亚组分析。结果 细菌性痢疾的发病风险随着温湿指数增大而增加。高温湿指数(P90)对细菌性痢疾发病影响的危害效应于滞后2 d产生,在滞后4 d达到最大(RR=1.063,95% CI:1.037~1.090)。亚组分析发现在滞后2~5 d,高温湿指数对各组人群均有影响。结论 高温湿指数能增加细菌性痢疾发病的风险,并存在滞后效应。
关键词: 细菌性痢疾     温湿指数     分布滞后非线性模型    
Influence of humidex on incidence of bacillary dysentery in Hefei:a time-series study
Zhang Heng1, Zhao Kefu2, He Ruixin3, Zhao Desheng1, Xie Mingyu1, Wang Shusi1, Bai Lijun1, Cheng Qiang1, Zhang Yanwu1, Su Hong1     
1. Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei 230032, China;
2. Office of Emergency Management, Hefei Center for Disease Control and Prevention, Hefei 230061, China;
3. West China School of Medicine, Sichuan University, Chengdu 610041, China
Corresponding author: Su Hong, Email:suhong5151@sina.com
Abstract: Objective To investigate the effect of humidex combined with mean temperature and relative humidity on the incidence of bacillary dysentery in Hefei. Methods Daily counts of bacillary dysentery cases and weather data in Hefei were collected from January 1, 2006 to December 31, 2013. Then, the humidex was calculated from temperature and relative humidity. A Poisson generalized linear regression combined with distributed lag non-linear model was applied to analyze the relationship between humidex and the incidence of bacillary dysentery, after adjusting for long-term and seasonal trends, day of week and other weather confounders. Stratified analyses by gender, age and address were also conducted. Results The risk of bacillary dysentery increased with the rise of humidex. The adverse effect of high humidex (90 percentile of humidex) appeared in 2-days lag and it was the largest at 4-days lag (RR=1.063, 95% CI:1.037-1.090). Subgroup analyses indicated that all groups were affected by high humidex at lag 2-5 days. Conclusion High humidex could significantly increase the risk of bacillary dysentery, and the lagged effects were observed.
Key words: Bacillary dysentery     Humidex     Distributed lag nonlinear model    

细菌性痢疾发病存在明显的季节性,一般在夏秋季高发[1]。当前,虽已有研究表明温度和相对湿度与细菌性痢疾的发病存在关联,但这些研究往往是在分析模型中控制温度或者相对湿度的影响,探讨另一个气象因素与疾病之间的关系[2-3]。在不同的湿度条件下,人体对同一环境温度会产生完全不同的体感温度[4]。因此,有必要开展相关研究探讨温度和相对湿度共同作用下,人群发生细菌性痢疾的风险。加拿大气象局将温度和相对湿度相结合制定出一个综合指标,称为温湿指数(Humidex,https://en.wikipedia.org/wiki/Humidex),用来反映人体对外界环境温度的感觉。有研究发现,温湿指数增加会导致手足口病的发病风险增加,且其效应受到年龄、居住地等个体特征的影响[5]。本研究收集2006-2013年合肥市每日细菌性痢疾发病数和同期的每日气象数据,利用分布滞后非线性模型(distributed lag non-linear model,DLNM)分析温度与湿度的联合作用(即温湿指数)对细菌性