单位：[a]Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, 288 Herston Road, Brisbane, 4006, Queensland, Australia[b]Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, 2 East Yinghua Road, Beijing 100029, China[c]Institute for Disease Control and Prevention, Academy of Military Medical Science, 20 East Road, Fengtai District, Beijing, 102206, China[d]First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi, China[e]Shenzhen People's Hospital, 1017 North Dongmen Road, Shenzhen, 518020, Guangdong, China深圳市人民医院深圳医学信息中心[f]Respiratory and Critical Care Department, Sir Run Run Shaw Hospital, Zhejiang University, 3 East Qingchun Road Hangzhou, 310016, Zhejiang, China[g]Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, 266011, Shandong, China[h]First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China[i]School of Public Health, Curtin University, Kent Street, Perth, 6102, Western Australia, Australia
Background: The association between ambient temperature and mortality has been well documented worldwide. However, limited data are available on nonfatal health outcomes, such as emergency department visits (EDVs), particularly from China. Objectives: To examine the temperature-EDV association in 12 Chinese cities; and to assess the modification effects by region, gender and age. Methods: Daily meteorological data and non-accidental EDVs were collected during 2011-2014. Poisson regression with distributed lag non-linear model was applied to examine the temperature-lag-EDV association in each city. The effect estimates were pooled using multivariate meta-analysis at the national and regional level. Stratified analyses were performed by gender and age-groups. Sensitivity analyses adjusting for air pollution and relative humidity were conducted. Results: A total of 4,443,127 EDVs were collected from the 12 cities. Both cold and hot temperatures were associated with increased risk of EDVs, with minimum-mortality temperature located at 64th percentile of temperature. The effect of cold temperature appeared on day 2 and persisted until day 30, causing a cumulative relative risk (RR) of 1.80 (1.54, 2.11). The effect of hot temperature appeared immediately and lasted until day 3, with a cumulative RR of 1.15 (1.03,1.29). The effect of temperature on EDVs was similar in male and female but was attenuated with increasing age. The effect of cold temperature on EDVs was greater in southern areas of the country whereas the hot effect was greater in northern cities. The association was robust to a large range of sensitivity analyses. Conclusions: In China, there is a U-shaped association between temperature and risk of EDVs that is independent of air pollution and humidity. The temperature-EDV association varies with latitude and age-groups but is not affected by gender. Forecasting models for hospital emergency departments may be improved if temperature is included as an independent predictor. (C) 2017 Elsevier Ltd. All rights reserved.
基金：
Career Development Fellowship of Australian National Health and Medical Research CouncilNational Health and Medical Research Council of Australia [APP1107107]
第一作者单位：[a]Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, 288 Herston Road, Brisbane, 4006, Queensland, Australia
共同第一作者：
通讯作者：
通讯机构：[a]Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, 288 Herston Road, Brisbane, 4006, Queensland, Australia[*1]Room 227, School of Public Health, The University of Queensland, Herston Rd, Herston, Queensland, 4006, Australia
推荐引用方式(GB/T 7714)：
Qi Zhao,Yongming Zhang,Wenyi Zhang,et al.Ambient temperature and emergency department visits: Time-series analysis in 12 Chinese cities[J].ENVIRONMENTAL POLLUTION.2017,224:310-316.doi:10.1016/j.envpol.2017.02.010.
APA：
Qi Zhao,Yongming Zhang,Wenyi Zhang,Shanshan Li,Gongbo Chen...&Yuming Guo.(2017).Ambient temperature and emergency department visits: Time-series analysis in 12 Chinese cities.ENVIRONMENTAL POLLUTION,224,
MLA：
Qi Zhao,et al."Ambient temperature and emergency department visits: Time-series analysis in 12 Chinese cities".ENVIRONMENTAL POLLUTION 224.(2017):310-316
