On the estimation of heat-intensity and heat-duration effects in time series models of temperature-related mortality in Stockholm, Sweden 英文参考文献.docVIP

Rocklovetal.EnvironmentalHealth2012,11:23 /content/11/1/23 RESEARCH OpenAccess Ontheestimationofheat-intensityand heat-durationeffectsintimeseriesmodelsof temperature-relatedmortalityinStockholm, Sweden JoacimRocklov1*,AdrianGBarnett2andAlistairWoodward3 Abstract Background:Weexaminetheeffectofheatwavesonmortality,overandabovewhatwouldbepredictedonthe basisoftemperaturealone. Methods:Presentmodelingapproachesmaynotfullycaptureextraeffectsrelatingtoheatwaveduration,possibly becausethemechanismsofactionandthepopulationatriskaredifferentundermoreextremeconditions. Modelingsuchextraeffectscanbeachievedusingthecommonlyleft-outeffect-modificationbetweenthelagsof temperatureindistributedlagmodels. Results:UsingdatafromStockholm,Sweden,andavarietyofmodelingapproaches,wefoundthatheatwave effectsamounttoastableandstatisticallysignificant8.1-11.6%increaseinexcessdeathsperheatwaveday.The effectsexplicitlyrelatingtoheatwaveduration(2.0–3.9%excessdeathsperday)weremoresensitivetothedegrees offreedomallowedforintheoveralltemperature-mortalityrelationship.However,allowingforaverylargenumber ofdegreesoffreedomindicatedover-fittingtheoveralltemperature-mortalityrelationship. Conclusions:Modelingadditionalheatwaveeffects,e.g.betweenlageffect-modification,cangiveabetter descriptionoftheeffectsfromextremetemperatures,particularlyinthenon-elderlypopulation.Wespeculatethatit isbiologicallyplausibletodifferentiateeffectsfromheatandheatwaveduration. Background time series studies, assuming the association between Heatstresscanleadtofatalconsequencesdueto:dehydra- temperature and mortality is non-linear, report associa- tion; increased cardiovascular stress; kidney dysfunction; tions between heat and mortality that are immediate or andelectrolytedisorders[1,2].Atapopulationlevel,many delayedbyuptoaweek[4,5].However,thevalidityofthis studies show mortality tends torise with highertempera- approach is challenged by research that reports an add- tures [3]. Two approaches are generall