臺灣地區氣象溫度指標與死亡及就醫相關性研究

全球氣候變遷的健康影響是目前相當受國際重視，為許多專家學者投入的重要研究議題。其中，溫度變化曾造成眾多國家群眾健康損失。因此，本研究的目的是為探討臺灣各地區群眾健康與溫度異常之相關性。使用的研究資料包括1997-2008年死亡登記檔之死亡資料、全民健康保險資料庫2000-2008年之就醫資料、1997-2008年大氣環境三項指標性空氣污染物(PM10、O3、NO2)濃度資料和1997-2008年氣象局提供之溫度、相對濕度、風速、氣壓等氣象資料。本研究探討了全年齡與65歲以上老年人口之全死因(all causes)及心血管疾病(cardiovascular disease, CVD)與呼吸道系統疾病(respiratory disease, RESP)死亡及就醫人數之相關性分析。研究使用平均溫度(average temperature, Tavg.)、酷熱指數(heat index, HI)、濕熱指數(humidex, HMI)、風寒指數(wind chill index, WCI) 、舒適度指數(temperature humidity index, THI)及綜合溫度熱指數(wet-bulb globe temperature, WBGT)等七種溫度相關指數，利用遞延分配模式(distributed lag model, DLM)，分析各地區溫度相關指數每增溫1°C於熱季(五月至十月)死亡累加14日及降溫1°C於冷季(十一月至四月)死亡累加21日之風險，與熱季就醫累加7日及冷季就醫累加14日之風險。最終將風險因子估計值以指數轉換得到相對風險(relative risk, RR)及95%信賴區間(confidence intervals, CI)。熱季期間，台北地區酷熱指數每增加1°C對65歲以上族群全死因及心血管死亡之RR分別為1.05 (95% CI:1.04-1.07)及1.09 (95% CI:1.06-1.13)。桃竹苗地區平均溫度每增加1°C對全年齡族群呼吸道死亡之RR為1.05 (95% CI:1.02-1.08)。在中彰投及宜基地區則無明顯相關性，其他地區則以舒適度指數分析較為顯著，尤其在花東地區對全年齡心血管死亡之RR為1.14 (95% CI:1.07-1.22)最顯著。而低溫效應部分，各地區分析結果，以舒適度指數為最顯著，且老年人影響較大。顯示臺灣老年人族群暴露極端高低溫，造成全死因及心血管死亡顯著的風險。

關鍵字

溫度指數；死亡率；就醫率；心肺；臺灣

並列摘要

The health impact associated with extreme temperature is an issue of importance worldwide. The risk of a specific disease varies with the extreme temperature, the studied area and the definition of temperature index. This study aims to investigate the associations between various temperature indexes and mortality from and morbidity of all causes, circulatory and respiratory diseases for all-age and the elderly populations from 1997 to 2008 in Taiwan. Mortality and morbidity risks associated with temperature indexes (average temperature, heat Index, humidex, wind chill index, temperature humidity index, apparent temperature, wet-bulb globe temperature) were evaluated using distributed lag non-linear model after controlling for season, daily concentrations of PM10, O3, NO2, day of the week and holiday effects in models. The mortality risks were measured for 14 lag-days in hot season (May to October) and 21 lag-days in cold seasons (November to April) and morbidity risks were measured for 7 lag-days in hot season and 14 lag-days in cold season as temperature index increase per unit over the threshold (i.e. average temperature range for the lowest mortality and morbidity). Relative risks (RR) and 95% confidence intervals (CI) were estimated from exponential of estimated model coefficients. Relative risks were 1.05 (95% CI: 1.04-1.07) and 1.09 (95% CI: 1.06-1.13) for mortality from all causes and circulatory diseases, respectively, as heat index increased 1 unit in hot season in Taipei. Relative risk was 1.05 (95% CI: 1.04-1.07) for mortality from respiratory diseases, as average temperature increased 1 unit in northern Taiwan. Relative risk was 1.14 (95% CI: 1.07-1.22) for mortality from circulatory diseases as temperature humidity index increased 1 unit in east Taiwan. The mortality risk was higher in the cold season than in the hot season. On conclusion, elevated mortality risks of all causes and circulatory diseases for the elderly in Taiwan. One associated with the exposure to the extreme heat and cold.

並列關鍵字

Temperature index ； mortality ； Taiwan ； cardiopulmonary ； morbidity

參考文獻

6. Busch JF. Thermal responses to the Thai office environment. ASHRAE Transactions 96 (1). 1990:859-872.

7. Twisk JW, Kemper HC, Van Mechelen W, Post GB. Clustering of risk factors for coronary heart disease. the longitudinal relationship with lifestyle. Ann Epidemiol. 2001;11(3):157-165.

9. Pan WH, Li LA, Tsai MJ. Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly Chinese. Lancet. 1995;345(8946):353-355.

10. Gyllerup S, Lanke J, Lindholm LH, Schersten B. High coronary mortality in cold regions of Sweden. J Intern Med. 1991;230(6):479-485.

13. Donaldson GC, Keatinge WR. Mortality related to cold weather in elderly people in southeast England, 1979-94. BMJ. 1997;315(7115):1055-1056.

國際替代計量

臺灣地區氣象溫度指標與死亡及就醫相關性研究

全文下載

主題瀏覽