Background

Climate change is a severe public health challenge. Understanding to what extent fatal and non-fatal consequences of specific diseases are associated with temperature may help to improve the effectiveness of preventive public health efforts. This study examines the effects of temperature on deaths and hospital admissions by cardiovascular and respiratory diseases, empathizing the difference between mortality and morbidity.

Methods

Daily counts for mortality and hospital admissions by cardiovascular and respiratory diseases were collected for the 52 provincial capital cities in Spain, between 1990 and 2014. The association with temperature in each city was investigated by means of distributed lag non-linear models using quasi-Poisson regression. City-specific exposure-response curves were pooled by multivariate random-effects meta-analysis to obtain countrywide risk estimates of mortality and hospitalizations due to heat and cold, and attributable fractions were computed.

Results

Heat and cold exposure were identified to be associated with increased risk of cardiovascular and respiratory mortality. Heat was not found to have an impact on hospital admissions. The estimated fraction of mortality attributable to cold was of greater magnitude in hospitalizations (17.5% for cardiovascular and 12.5% for respiratory diseases) compared to deaths (9% and 2.7%, respectively).

Conclusions

There were noteworthy differences between temperature-related mortality and hospital admissions regarding cardiovascular and respiratory diseases, hence reinforcing the convenience of cause-specific measures to prevent temperature-related deaths.

中文翻译：

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西班牙52个城市与温度相关的死亡率和因心血管和呼吸系统疾病而住院的对比模式

背景

气候变化是严峻的公共卫生挑战。了解特定疾病的致命和非致命后果与体温有多大关系，可能有助于提高预防性公共卫生工作的有效性。这项研究检查了温度对心血管和呼吸系统疾病导致的死亡和住院人数的影响，强调了死亡率和发病率之间的差异。

方法

在1990年至2014年之间，收集了西班牙52个省会城市的心血管疾病和呼吸道疾病死亡率和住院日数。通过使用准泊松分布的滞后非线性模型，研究了每个城市与温度的相关性回归。通过多元随机效应荟萃分析汇总特定城市的暴露-反应曲线，以获取全国范围内因热和冷引起的死亡率和住院治疗的风险估计，并计算归因分数。

结果

确认热和冷暴露与心血管和呼吸系统死亡的风险增加有关。没有发现热量对住院人数有影响。相比死亡（分别为9％和2.7％），住院期间因感冒导致的死亡率估计更高（心血管疾病为17.5％，呼吸系统疾病为12.5％）。

结论

在与温度有关的死亡率与因心血管疾病和呼吸道疾病入院的住院之间存在显着差异，因此加强了针对特定原因的预防与温度有关的死亡的措施的便利性。