气候变化与慢性阻塞性肺病和哮喘的死亡率：2000年至2018年全球分析
2023/09/21
摘要
背景：气候变化在全球健康威胁中发挥着重要作用，尤其是在慢性阻塞性肺病（COPD）和哮喘等呼吸系统疾病方面，但气候变化对这些疾病死亡率的长期全球影响仍不清楚。
目的：本研究旨在调查气候变化对全国慢性阻塞性肺病和哮喘年龄标准化死亡率（ASMR）的影响。
方法：我们使用了2000年至2018年全球疾病负担（GBD）关于慢性阻塞性肺病和哮喘 ASMR 的数据。气候变化指数表示为温度（DPT）和相对湿度（DPRH）的偏差百分比，根据19年的温度和湿度平均值计算得出。185 个国家/地区的年气温、相对湿度和细颗粒物（PM2.5）水平来自 ERA5 和经合组织的环境统计数据库。一般线性混合效应回归模型用于研究气候变化与慢性阻塞性肺病和哮喘的 ASMR 对数（LASMR）之间的关系。
结果：在对每年的 PM2.5、SDI 水平、吸烟率和地理区域进行调整后，DPT 每增加 0.26%，慢性阻塞性肺病的 LASMR 每 100,000 人分别减少 0.016、0.017 和 0.014；哮喘的 LASMR 每 100,000 人分别减少 0.042、0.046 和 0.040。DPRH 每增加 2.68%，慢性阻塞性肺病的 LASMR 每 10 万人分别增加 0.009 和 0.011。我们观察到，在气温介于 3.8 至 29.9℃的国家/地区，DPT 与慢性阻塞性肺病的 LASMR 呈负相关，而在气温介于 -5.3 至 29.9℃ 的国家/地区，DPT 与哮喘的 LASMR 呈正相关。然而，在相对湿度为 41.2-67.2% 的国家/地区，我们发现 DPRH 与 COPD 和哮喘的 LASMR 呈正相关。
结论：适应和减缓气候变化对降低相关慢性阻塞性肺病和哮喘的死亡率至关重要，尤其是在最容易受温度和湿度波动影响的地区。
Climate change and mortality rates of COPD and asthma: A global analysis from 2000 to 2018
Tran HM, Chuang TW, Chuang HC, Tsai FJ.
Abstract
Background:Climate change plays a significant role in global health threats, particularly with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma, but the long-term global-scale impact of climate change on these diseases' mortality remains unclear.
Objective:This study aims to investigate the impact of climate change on the age-standardized mortality rates (ASMR) of COPD and asthma at national levels.
Methods:We used Global Burden of Disease (GBD) data of ASMR of COPD and asthma from 2000 to 2018. The climate change index was represented as the deviance percentage of temperature (DPT) and relative humidity (DPRH), calculated based on 19-year temperature and humidity averages. Annual temperature, RH, and fine particulate matter (PM2.5) levels in 185 countries/regions were obtained from ERA5 and the OECD's environmental statistics database. General linear mixed-effect regression models were used to examine the associations between climate change with the log of ASMR (LASMR) of COPD and asthma.
Results:After adjusting for annual PM2.5, SDI level, smoking prevalence, and geographical regions, a 0.26% increase in DPT was associated with decreases of 0.016, 0.017, and 0.014 per 100,000 people in LASMR of COPD and 0.042, 0.046, and 0.040 per 100,000 people in LASMR of asthma for both genders, males, and females. A 2.68% increase in DPRH was associated with increases of 0.009 and 0.011 per 100,000 people in LASMR of COPD. We observed a negative association of DPT with LASMR for COPD in countries/regions with temperatures ranging from 3.8 to 29.9 °C and with LASMR for asthma ranging from -5.3-29.9 °C. However, we observed a positive association of DPRH with LASMR for both COPD and asthma in the RH range of 41.2-67.2%.
Conclusion:Climate change adaptation and mitigation could be crucial in reducing the associated COPD and asthma mortality rates, particularly in regions most vulnerable to temperature and humidity fluctuations.
背景：气候变化在全球健康威胁中发挥着重要作用，尤其是在慢性阻塞性肺病（COPD）和哮喘等呼吸系统疾病方面，但气候变化对这些疾病死亡率的长期全球影响仍不清楚。
目的：本研究旨在调查气候变化对全国慢性阻塞性肺病和哮喘年龄标准化死亡率（ASMR）的影响。
方法：我们使用了2000年至2018年全球疾病负担（GBD）关于慢性阻塞性肺病和哮喘 ASMR 的数据。气候变化指数表示为温度（DPT）和相对湿度（DPRH）的偏差百分比，根据19年的温度和湿度平均值计算得出。185 个国家/地区的年气温、相对湿度和细颗粒物（PM2.5）水平来自 ERA5 和经合组织的环境统计数据库。一般线性混合效应回归模型用于研究气候变化与慢性阻塞性肺病和哮喘的 ASMR 对数（LASMR）之间的关系。
结果：在对每年的 PM2.5、SDI 水平、吸烟率和地理区域进行调整后，DPT 每增加 0.26%，慢性阻塞性肺病的 LASMR 每 100,000 人分别减少 0.016、0.017 和 0.014；哮喘的 LASMR 每 100,000 人分别减少 0.042、0.046 和 0.040。DPRH 每增加 2.68%，慢性阻塞性肺病的 LASMR 每 10 万人分别增加 0.009 和 0.011。我们观察到，在气温介于 3.8 至 29.9℃的国家/地区，DPT 与慢性阻塞性肺病的 LASMR 呈负相关，而在气温介于 -5.3 至 29.9℃ 的国家/地区，DPT 与哮喘的 LASMR 呈正相关。然而，在相对湿度为 41.2-67.2% 的国家/地区，我们发现 DPRH 与 COPD 和哮喘的 LASMR 呈正相关。
结论：适应和减缓气候变化对降低相关慢性阻塞性肺病和哮喘的死亡率至关重要，尤其是在最容易受温度和湿度波动影响的地区。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Environ Res. 2023 Sep 15. DOI: 10.1016/j.envres.2023.116448)
(Environ Res. 2023 Sep 15. DOI: 10.1016/j.envres.2023.116448)
Climate change and mortality rates of COPD and asthma: A global analysis from 2000 to 2018
Tran HM, Chuang TW, Chuang HC, Tsai FJ.
Abstract
Background:Climate change plays a significant role in global health threats, particularly with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma, but the long-term global-scale impact of climate change on these diseases' mortality remains unclear.
Objective:This study aims to investigate the impact of climate change on the age-standardized mortality rates (ASMR) of COPD and asthma at national levels.
Methods:We used Global Burden of Disease (GBD) data of ASMR of COPD and asthma from 2000 to 2018. The climate change index was represented as the deviance percentage of temperature (DPT) and relative humidity (DPRH), calculated based on 19-year temperature and humidity averages. Annual temperature, RH, and fine particulate matter (PM2.5) levels in 185 countries/regions were obtained from ERA5 and the OECD's environmental statistics database. General linear mixed-effect regression models were used to examine the associations between climate change with the log of ASMR (LASMR) of COPD and asthma.
Results:After adjusting for annual PM2.5, SDI level, smoking prevalence, and geographical regions, a 0.26% increase in DPT was associated with decreases of 0.016, 0.017, and 0.014 per 100,000 people in LASMR of COPD and 0.042, 0.046, and 0.040 per 100,000 people in LASMR of asthma for both genders, males, and females. A 2.68% increase in DPRH was associated with increases of 0.009 and 0.011 per 100,000 people in LASMR of COPD. We observed a negative association of DPT with LASMR for COPD in countries/regions with temperatures ranging from 3.8 to 29.9 °C and with LASMR for asthma ranging from -5.3-29.9 °C. However, we observed a positive association of DPRH with LASMR for both COPD and asthma in the RH range of 41.2-67.2%.
Conclusion:Climate change adaptation and mitigation could be crucial in reducing the associated COPD and asthma mortality rates, particularly in regions most vulnerable to temperature and humidity fluctuations.
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孕期母亲焦虑与学龄前儿童哮喘的关系：马鞍山出生队列研究
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英格兰的哮喘住院率与热暴露：2002-2019 年期间的病例交叉研究
