Sociogeographic variation in the effects of heat and cold on daily mortality in Japan
- PMID:24317342
- PMCID: PMC3872520
- DOI: 10.2188/jea.je20130051
Sociogeographic variation in the effects of heat and cold on daily mortality in Japan
Abstract
Background: Ambient temperature affects mortality in susceptible populations, but regional differences in this association remain unclear in Japan. We conducted a time-series study to examine the variation in the effects of ambient temperature on daily mortality across Japan.
Methods: A total of 731 558 all-age non-accidental deaths in 6 cities during 2002-2007 were analyzed. The association between daily mortality and ambient temperature was examined using distributed lag nonlinear models with Poisson distribution. City-specific estimates were combined using random-effects meta-analysis. Bivariate random-effects meta-regressions were used to examine the moderating effect of city characteristics.
Results: The effect of heat generally persisted for 1 to 2 days. In warmer communities, the effect of cold weather lasted for approximately 1 week. The combined increases in mortality risk due to heat (99th vs 90th percentile of city-specific temperature) and cold (first vs 10th percentile) were 2.21% (95% CI, 1.38%-3.04%) and 3.47% (1.75%-5.21%), respectively. City-specific effects based on absolute temperature changes were more heterogeneous than estimates based on relative changes, which suggests some degree of acclimatization. Northern populations with a cool climate appeared acclimatized to low temperature but were still vulnerable to extreme cold weather. Population density, average income, cost of property rental, and number of nurses appeared to influence variation in heat effect across cities.
Conclusions: We noted clear regional variation in temperature-related increases in mortality risk, which should be considered when planning preventive measures.
背景: 外気温が感受性の高い集団の死亡に影響するということはよく知られているが，日本においてその関連の地域差は明らかにされていない．本研究では外気温と日死亡に対する影響の日本国内での変動を評価するための時系列解析を実施した．
手法: 2002年から2007年までの日本の6都市での死亡データ（事故死を除く）計731,558件を解析対象とした．外気温と日死亡との関連は，結果変数である日死亡数にポアソン分布を仮定した非線形分布ラグモデルで解析した．都市ごとに推定された結果は，都市を変量効果としたメタアナリシスで併合した．また，都市ごとの共変量は，都市を変量効果とした二変量メタ回帰によって調整した．
結果: 高気温の影響は1～2日間継続し，暖かい地域での低気温の影響は1週間程度継続することが分かった．高気温によって上昇した併合死亡リスク(外気温99％点でのリスクを90％点でのリスクと比較して)は2.21％増で95％信頼区間は1.38-3.04％，低気温によって上昇した併合死亡リスク(外気温1％点でのリスクを10％点でのリスクと比較して)は3.47％増で95％信頼区間は1.75-5.21％であった．都市ごとの日死亡への影響は，外気温の絶対変化の影響の方が相対変化の影響よりばらつきが大きく，ある程度順応の影響が含まれている可能性が示された．涼しい気候の北部地域では低気温への順応がみられるが，極端に低い気温に対しては脆弱であることも示唆された．また，人口密度，平均収入，不動産賃貸料，看護師の数が都市間の外気温影響の変動に影響していることが示唆された．
結論: 外気温関連死亡リスクの上昇には明らかな地域間変動が存在した．予防策を講じる場合には，地域間変動に影響する要因を検討する必要がある．
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