極端氣溫對台灣都會區65歲以上族群心肺疾病死亡之風險趨勢分析

A Chronological Study of Mortality Risks Associated with Extreme Temperature for Elderly Populations in Metropolitan Areas of Taiwan

10.6288/TJPH2011-30-03-08

林于凱(Yu-Kai Lin)；吳祐誠(Yu-Chung Wu)；黃鈴雅(Ling-Ya Huang)；林嘉明(Chia-Ming Lin)；吳聰能(Trong-Neng Wu)；周昌弘(Chang-Hung Chou)；宋鴻樟(Fung-Chang Sung)；王玉純(Yu-Chun Wang)

心血管 ； 呼吸道 ； 死亡 ； 溫度 ； cardiovascular ； respiratory ； mortality ； temperature

台灣公共衛生雜誌

30卷3期（2011 / 06 / 15）

277 - 289

繁體中文

Objectives: To evaluate the mortality risks from all causes as well as cardiorespiratory diseases associated with extreme temperatures among the elderly in the Taipei, Taichung and Kaohsiung areas of Taiwan from 1994-2008. Methods: We used the distributed lag model to analyze the 7-day cumulative mortality risks associated with 1℃ daily average temperature increases above 30℃ and the 21-day cumulative mortality risks associated with 1℃ daily average temperature decreases below 18℃ in the study areas. Relative risks associated with extreme temperature (＞95% and ＜5%) for more than 3 consecutive days were also evaluated. Results: Taipei had a significant 5% excess mortality from all causes as well as cardiovascular diseases as daily average temperature above 30℃ with each 1℃ rise. Low temperature resulted in higher risks in Kaohsiung where the relative risk was 1.07 (95% CI: 1.05-1.10) for mortality from all causes and 1.09 (95% CI: 1.03-1.04) for mortality from cardiovascular diseases as the daily average temperature below 18℃ decreased by each 1℃. We observed adaption for high temperature but not cold temperature. No significant associations were observed between temperature changes of 1℃ and mortality from respiratory diseases. Conclusions: Cumulative mortality risks from all causes and cardiovascular diseases were significantly associated with high and low temperatures in metropolitan areas of Taiwan. The impact of each 1℃ temperature change appeared to be greater for people in the Taipei area than for those in other areas.

Objectives: To evaluate the mortality risks from all causes as well as cardiorespiratory diseases associated with extreme temperatures among the elderly in the Taipei, Taichung and Kaohsiung areas of Taiwan from 1994-2008. Methods: We used the distributed lag model to analyze the 7-day cumulative mortality risks associated with 1℃ daily average temperature increases above 30℃ and the 21-day cumulative mortality risks associated with 1℃ daily average temperature decreases below 18℃ in the study areas. Relative risks associated with extreme temperature (＞95% and ＜5%) for more than 3 consecutive days were also evaluated. Results: Taipei had a significant 5% excess mortality from all causes as well as cardiovascular diseases as daily average temperature above 30℃ with each 1℃ rise. Low temperature resulted in higher risks in Kaohsiung where the relative risk was 1.07 (95% CI: 1.05-1.10) for mortality from all causes and 1.09 (95% CI: 1.03-1.04) for mortality from cardiovascular diseases as the daily average temperature below 18℃ decreased by each 1℃. We observed adaption for high temperature but not cold temperature. No significant associations were observed between temperature changes of 1℃ and mortality from respiratory diseases. Conclusions: Cumulative mortality risks from all causes and cardiovascular diseases were significantly associated with high and low temperatures in metropolitan areas of Taiwan. The impact of each 1℃ temperature change appeared to be greater for people in the Taipei area than for those in other areas.

1. 內政部統計處：2000年台灣土地面積與人口密度。http://www.moi.gov.tw/stat/. 引用2010/06/30。Department of Statistics, Ministry of the Interior.Taiwan's land area and population density, 2000.Available at: http://www.moi.gov.tw/stat/. Accessed June 30, 2010. [In Chinese]
2. 行政院主計處：2000年統計資料。http://www.dgbas.gov.tw/mp.asp?mp=1。引用2010/06/30。Directorate-Genral of Budget, Accounting and Statistics, Executive Yuan, R.O.C. (Taiwan). National statistics, 2000. Available at: http://www.dgbas.gov.tw/mp.asp?mp=1. Accessed June 30, 2010. [In Chinese]
3. 內政部營建署：台閩地區住宅狀況調查。台北：內政部營建署，2006。Construction and Planning Agency, Ministry of the Interior. Residence Status Survey in the Taiwan-Fukien Area. Taipei: Construction and Planning Agency,Ministry of the Interior, 2006. [In Chinese]
4. Alberdi, JC,Diaz, J,Montero, JC,Miron, I(1998).Daily mortality in Madrid community 1986-1992: relationship with meteorological variables.Eur J Epidemiol,14,571-8.
5. Almeida, SP,Casimiro, E,Calheiros, J(2010).Effects of apparent temperature on daily mortality in Lisbon and Oporto, Portugal.Environ Health,9,12.
6. Analitis, A,Katsouyanni, K,Biggeri, A(2008).Effects of cold weather on mortality: results from 15 European cities within the PHEWE project.Am J Epidemiol,168,1397-408.
7. Anderson, BG,Bell, ML(2009).Weather-related mortality: how heat, cold, and heat waves affect mortality in the United States.Epidemiology,20,205-13.
8. Anderson, TW,Le Riche, WH(1970).Cold weather and myocardial infarction.Lancet,1,291-6.
9. Aylin, P,Morris, S,Wakefield, J,Grossinho, A,Jarup, L,Elliott, P(2001).Temperature, housing, deprivation and their relationship to excess winter mortality in Great Britain, 1986-1996.Int J Epidemiol,30,1100-8.
10. Baccini, M,Biggeri, A,Accetta, G(2008).Heat effects on mortality in 15 European cities.Epidemiology,19,711-9.
11. Barnett, AG(2007).Temperature and cardiovascular deaths in the US elderly: changes over time.Epidemiology,18,369-72.
12. Basu, R(2009).High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008.Environ Health,8,40.
13. Braga, AL,Zanobetti, A,Schwartz, J(2000).Do respiratory epidemics confound the association between air pollution and daily deaths?.Eur Respir J,16,723-8.
14. Braga, ALF,Zanobetti, A,Schwartz, J(2002).The effect of weather on respiratory and cardiovascular deaths in 12 US cities.Environ Health Perspect,110,859-63.
15. Centers for Disease Control and Prevention (CDC)(1997).Heat-related deaths- Dallas, Wichita, and Cooke counties, Texas, and United States, 1996.MMWR Morb Mortal Wkly Rep,46,528-31.
16. Chestnut, LG,Breffle, WS,Smith, JB,Kalkstein, LS(1998).Analysis of differences in hot-weather-related mortality across 44 U.S. metropolitan areas.Environ Sci Pol,1,59-70.
17. Curriero, FC,Heiner, KS,Samet, JM,Zeger, SL,Strug, L,Patz, JA(2002).Temperature and mortality in 11 cities of the eastern United States.Am J Epidemiol,155,80-7.
18. Davis, RE,Knappenberger, PC,Michaels, PJ,Novicoff, WM(2003).Changing heat-related mortality in the United States.Environ Health Perspect,111,1712-8.
19. Diaz, J,Garcia, R,Velazquez de Castro, F,Hernandez, E,Lopez, C,Otero, A(2002).Effects of extremely hot days on people older than 65 years in Seville (Spain) from 1986 to 1997.Int J Biometeorol,46,145-9.
20. Ha, J,Yoon, J,Kim, H(2009).Relationship between winter temperature and mortality in Seoul, South Korea, from 1994 to 2006.Sci Total Environ,407,2158-64.
21. Hajat, S,Armstrong, B,Baccini, M(2006).Impact of high temperatures on mortality: is there an added heat wave effect?.Epidemiology,17,632-8.
22. Hajat, S,Kovats, RS,Atkinson, RW,Haines, A(2002).Impact of hot temperatures on death in London: a time series approach.J Epidemiol Community Health,56,367-72.
23. Jansen, AG,Sanders, EA,Hoes, AW,van Loon, AM,Hak, E(2007).Influenza- and respiratory syncytial virus-associated mortality and hospitalisations.Eur Respir J,30,1158-66.
24. Kalkstein, LS,Greene, JS(1997).An evaluation of climate/mortality relationships in large U.S. cities and the possible impacts of a climate change.Environ Health Perspect,105,84-93.
25. Knowlton, K,Lynn, B,Goldberg, RA(2007).Projecting heat-related mortality impacts under a changing climate in the New York City region.Am J Publ Health,97,2028-34.
26. Kunst, AE,Looman, CW,Mackenbach, JP(1993).Outdoor air temperature and mortality in The Netherlands: a timeseries analysis.Am J Epidemiol,137,331-41.
27. Martens, WJM(1998).Climate change, thermal stress and mortality changes.Soc Sci Med,46,331-44.
28. McMichael, AJ,Wilkinson, P,Kovats, RS(2008).International study of temperature, heat and urban mortality: the 'ISOTHURM' project.Int J Epidemiol,37,1121-31.
29. Medina-Ramon, M,Schwartz, J(2007).Temperature, temperature extremes, and mortality: a study of acclimatization and effect modification in 50 United States cities.Occup Environ Med,64,827-33.
30. Naughton, MP,Henderson, A,Mirabelli, MC(2002).Heat-related mortality during a 1999 heat wave in Chicago.Am J Prev Med,22,221-7.
31. O''Neill, MS,Ebi, KL(2009).Temperature extremes and health: impacts of climate variability and change in the United States.J Occup Environ Med,51,13-25.
32. O''Neill, MS,Zanobetti, A,Schwartz, J(2005).Disparities by race in heat-related mortality in four US cities: the role of air conditioning prevalence.J Urban Health,82,191-7.
33. Pan, WH,Li, LA,Tsai, MJ(1995).Temperature extremes and mortality from coronary heart-disease and cerebral infarction in elderly Chinese.Lancet,345,353-5.
34. Pattenden, S,Nikiforov, B,Armstrong, BG(2003).Mortality and temperature in Sofia and London.J Epidemiol Community Health,57,628-33.
35. Peng, RD,Dominici, F(2008).Statistical Methods for Environmental Epidemiology with R-A Case Study in Air Pollution and Health.New York:Springer.
36. Rogot, E,Sorlie, PD,Backlund, E(1992).Air-conditioning and mortality in hot weather.Am J Epidemiol,136,106-16.
37. Semenza, JC,Rubin, CH,Falter, KH(1996).Heat-related deaths during the July 1995 heat wave in Chicago.N Engl J Med,335,84-90.
38. The Eurowinter Group(1997).Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe.Lancet,349,1341-6.
39. Zanobetti, A,Wand, MP,Schwartz, J,Ryan, LM(2000).Generalized additive distributed lag models: quantifying mortality displacement.Biostatistics,1,279-92.
40. 宋鴻樟(2009)。,台北=Taipei:行政院國家永續發展委員=National Council for Sustainable Development, Executive Yuan, R.O.C.(Taiwan)。

1. 俞菘維、林沛練、林于凱、王玉純(2015)。台灣不同地區之氣溫與全死因及心血管疾病死亡風險之相關分析。臺灣公共衛生雜誌，34(1)，103-114。