تعهد نامه
مجله پژوهش در بهداشت محیط

مجله پژوهش در بهداشت محیط

بررسی ارتباط بین تغییرات آب و هوا بر موارد ابتلا و مرگ و میر در اثر بیماری های قلبی عروقی در مشهد از سال 93 تا 98

نوع مقاله : مقالات پژوهشی

نویسندگان
1 کارشناسی ارشد، گروه مهندسی بهداشت محیط، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
2 استاد، گروه مهندسی بهداشت محیط، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
3 دانشیار، گروه مهندسی بهداشت محیط، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
4 استادیار، گروه اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
چکیده
زمینه و هدف: بیماری‌های قلبی‌عروقی از علل اصلی مرگ‌ومیر در جهان و ایران هستند. این مطالعه به بررسی ارتباط شاخص‌های اقلیمی با مرگ‌ومیر ناشی از این بیماری‌ها در مشهد طی سال‌های 1393تا 1398پرداخت.

مواد و روش‌ها: این مطالعه اکولوژیک سری زمانی با استفاده از داده‌های شش‌ساله هواشناسی مشهد شامل دماها، رطوبت، باد، بارش روزانه، نقطه شبنم و ساعات آفتابی انجام شد. داده‌های سلامت از سامانه‌های سینا، ثبت علل فوت و HIS استخراج گردید. تحلیل آماری با مدل‌های پواسن و معادلات تخمین‌زننده تعمیم‌یافته (GEE) صورت گرفت.

یافته‌ها: مدل GEE نشان داد حداقل دمای روزانه عامل خطر اصلی و مرتبط با افزایش موارد ابتلا و مرگ بود.( 0/02=p<0/001 ,β )که نشانگر اثر دمای شبانه بر استرس قلبی است. بارندگی روزانه اثر محافظتی قابل توجهی داشت( 0/009-=p=0/01 ,β ) نقطه شبنم نیز تأثیر منفی اندکی نشان داد ( 0/008-=p=0/04 ,β ). سرعت باد، رطوبت نسبی و ساعات آفتابی ارتباط معناداری نداشتند. مرگ‌ومیر در زمستان و تابستان به اوج رسید و در مردان و سنین بالای 80 سال بیشتر بود. روند مرگ و میر نوسانی بود، با بیشترین نرخ در سال 1393(114/42در هر 100هزار نفر) و کمترین در 1398( 12/91).

نتیجه‌گیری: نوسانات دما و بارش روزانه بر خطر بیماری‌های قلبی‌عروقی اثرگذارند و باید در سامانه‌های هشدار زودهنگام بهداشت عمومی لحاظ شوند.
کلیدواژه‌ها

عنوان مقاله English

Investigation of the Relationship between Climate Change and the Incidence and Mortality of Cardiovascular Diseases in Mashhad from 2014 to 2019

نویسندگان English

Atiye Memariani 1
Ali Asghar Najafpoor 2
Maryam Sarkhosh 3
Ehsan Mousa Farkhani 4
1 MSc in Environmental Health Engineering, Department of Environmental Health, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Professor, Department of Environmental Health, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate Professor, Department of Environmental Health, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant Professor, Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده English

Background and Objective: Cardiovascular diseases (CVDs) are leading causes of mortality globally and in Iran. This study investigated climatic indices and CVD mortality in Mashhad, Iran (1393–1398 Solar Hijri).

Materials and Methods: In this time-series ecological study, meteorological data were obtained from the Mashhad Meteorological Organization. Examined variables included temperatures, relative humidity, wind speed, precipitation, dew point, and sunshine duration. Health data were collected from SINA, Cause of Death Registry, and HIS systems. Poisson models and Generalized Estimating Equations (GEE) were applied.

Results: The GEE model revealed key significant associations between climatic factors and CVD incidence and mortality. Minimum daily temperature was identified as a primary risk factor, significantly associated with an increase in CVD cases and mortality (β = 0.02, P<0.001), underscoring the adverse impact of elevated nighttime temperatures on cardiovascular strain. Daily precipitation exerted a notable protective effect (β=-0.009, P=0.01. The dew point also showed a slight negative association (β=-0.008, P=0.04). Other meteorological variables—including mean wind speed (β=-0.015, P=0.15), mean relative humidity (β=0.002, P=0.16), and sunshine duration (β=-0.004, P=0.30)— were not statistically significant. Mortality peaked in winter and summer. Mortality was predominantly higher among men and individuals aged 80 years and older. The mortality trend fluctuated over the study period, peaking in 2014–2015 (114.42 per 100,000 population) and reaching its lowest level in 2019–2020 (19/12 per 100,000 population).

Conclusion: Temperature fluctuations and daily precipitation significantly influence cardiovascular disease risk and should be integrated into public health early-warning systems.



Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

کلیدواژه‌ها English

Cardiovascular diseases
Climate
Temperature
Humidity
Precipitation
1. Borghei Y, Moghadamnia MT, Emami Sigaroudi A, Kazemnezhad Leili E. Relationship of Humidity and Atmospheric Pressure With the Risk of Out-of-hospital Cardiac Arrest. Journal of Holistic Nursing And Midwifery. 2020;30(4):224-32. https://doi.org/10.32598/jhnm.30.4.2036
2. Cheng J, Xu Z, Bambrick H, Prescott V, Wang N, Zhang Y, et al. Cardiorespiratory effects of heatwaves: A systematic review and meta-analysis of global epidemiological evidence. Environ Res. 2019;177:108610. https://doi.org/10.1016/j.envres.2019.108610 PMid:31376629
3. Li M, Shaw BA, Zhang W, Vásquez E, Lin S. Impact of Extremely Hot Days on Emergency Department Visits for Cardiovascular Disease among Older Adults in New York State. Int J Environ Res Public Health. 2019;16(12):2119. https://doi.org/10.3390/ijerph16122119 PMid:31207990 PMCid:PMC6617208
4. Sharif Nia H, Gorgulu O, Naghavi N, Froelicher ES, Fomani FK, Goudarzian AH, et al. A time-series prediction model of acute myocardial infarction in northern of Iran: the risk of climate change and religious mourning. BMC Cardiovasc Disord. 2021;21(1):563. https://doi.org/10.1186/s12872-021-02372-0 PMid:34814834
5. Shen YS, Lung SC. Can green structure reduce the mortality of cardiovascular diseases? Sci Total Environ. 2016;566-567:1159-67. https://doi.org/10.1016/j.scitotenv.2016.05.159 PMid:27282496
6. Chan K, Ban J, Ma Y, Chen K. Association of exposure to extreme rainfall events with cause-specific mortality in North Carolina, US. Environ Res Lett. 2024;19(4):044006. https://doi.org/10.1088/1748-9326/ad2dd2
7. Panah H, Fard A, Golshahi J. Investigating the effect of heatwaves on the number of cardiovascular visits in Bandar Abbas. Journal of Gorgan University of Medical Sciences. 2015;17(3):104-10. [In Persian]
8. Chen X, Hu Z, Wang J. PS-P03-8: Influence of average air temperature, pressure and air relative humidity on blood pressure. J Hypertens. 2023;41(Suppl 1):e390. https://doi.org/10.1097/01.hjh.0000915216.02267.3c
9. Kulichkov SN, Bush GA, Alekhin AI, Perepelkin VG, Ginzburg AS, Ageev FT, et al. On the Influence of Air Pressure Fluctuations on the Hospitalization of Patients with Cardiovascular Diseases. Russ Meteorol Hydrol. 2024;49(2):99-105. https://doi.org/10.3103/S106837392402002X
10. Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol. 2022;14(3):152-69. https://doi.org/10.4330/wjc.v14.i3.152 PMid:35432772 PMCid:PMC8968453
11. Kapil V, Gupta AK. Solar UV Radiation: A Potential Modifiable Risk Factor for Hypertension. J Am Heart Assoc. 2020;9(5):e015627. https://doi.org/10.1161/JAHA.120.015627 PMid:32106745 PMCid:PMC7335549
12. Kim M, Sung JH, Jang ES, Kim DH, You SC, Hwang KK, et al. Long-time exposure to sunlight is associated with the risk of sudden cardiac arrest and coronary heart disease. EP Europace. 2024;26(Suppl 1):euae102. https://doi.org/10.1093/europace/euae102.376 PMCid:PMC11118960
13. Scragg R, Rahman J, Thornley S. Association of sun and UV exposure with blood pressure and cardiovascular disease: A systematic review. J Steroid Biochem Mol Biol. 2019;187:68-75. https://doi.org/10.1016/j.jsbmb.2018.11.002 PMid:30412763
14. Vaiciulis V, Vencloviene J, Kiznys D, Luksiene D, Krančiukaitė-Butylkinienė D, Radisauskas R. Associations between Space Weather Events and the Incidence of Acute Myocardial Infarction and Deaths from Ischemic Heart Disease. Atmosphere. 2021;12(3):306. https://doi.org/10.3390/atmos12030306
15. Pan R, Okada A, Yamana H, Yasunaga H, Kumazawa R, Matsui H, et al. Association between ambient temperature and cause-specific cardiovascular disease admissions in Japan: A nationwide study. Environ Res. 2023;225:115610. https://doi.org/10.1016/j.envres.2023.115610 PMid:36871945
16. Zhao Q, Li S, Coelho MSZS, Saldiva PHN, Hu K, Huxley RR, et al. Temperature variability and hospitalization for ischaemic heart disease in Brazil: A nationwide case-crossover study during 2000-2015. Sci Total Environ. 2019;664:707-12. https://doi.org/10.1016/j.scitotenv.2019.02.066 PMid:30763851
17. Kouis P, Kakkoura M, Ziogas K, Paschalidou A, Papatheodorou SI. The effect of ambient air temperature on cardiovascular and respiratory mortality in Thessaloniki, Greece. Sci Total Environ. 2019;647:1351-8. https://doi.org/10.1016/j.scitotenv.2018.08.106 PMid:30180342
18. Pourshaikhian M, Moghadamnia MT, Yekaninejad MS, Ghanbari A, Rashti AS, Afraz kamachli S. The effects of meteorological variables on ambulance attendance for cardiovascular diseases in Rasht, Iran. J Therm Biol. 2019;83:150-6. https://doi.org/10.1016/j.jtherbio.2019.05.002 PMid:31331513
19. Ratajczak J, Łach P, Szczerbiński S, Paciorek P, Karlowska-Pik J, Ziemkiewicz B, et al. Atmospheric conditions and the occurrence of out-of-hospital cardiac arrest in Poland - preliminary analysis of poorly understood phenomena. Med Res J. 2018;3(3):121-6. https://doi.org/10.5603/MRJ.a2018.0019

مقالات آماده انتشار، پذیرفته شده
انتشار آنلاین از 18 مهر 1405