大气氧化性污染物与气温对我国某地区人群疾病死亡影响的交互作用研究

刘英; 刘嘉彤; 王金霞; 虎勇; 董学昊; 王发选; 张亚娟

doi:10.16462/j.cnki.zhjbkz.2024.09.009

大气氧化性污染物与气温对我国某地区人群疾病死亡影响的交互作用研究

doi: 10.16462/j.cnki.zhjbkz.2024.09.009

刘英^{1, 2},
刘嘉彤³,
王金霞^{1, 2},
虎勇^{1, 2},
董学昊^{1, 2},
王发选^{1, 2},
张亚娟^{1, 2, ,}

1.
宁夏医科大学公共卫生学院职业卫生与环境卫生学系，银川 750004
2.
宁夏环境因素与慢性病控制重点实验室，银川 750004
3.
成都信息工程大学大气科学学院大气科学系，成都 610200

基金项目:

宁夏自然科学基金 2022AAC03142

详细信息

通讯作者:
张亚娟，E-mail: zhyj830515@126.com

中图分类号: R122.7
计量
- 文章访问数: 52
- HTML全文浏览量: 12
- PDF下载量: 14
- 被引次数: 0
出版历程
- 收稿日期: 2023-12-12
- 修回日期: 2024-05-17
- 网络出版日期: 2024-10-24
- 刊出日期: 2024-09-10

Interactive effects of oxidant air pollutants and temperature on disease mortality in a region of China

LIU Ying^{1, 2},
LIU Jiatong³,
WANG Jinxia^{1, 2},
HU Yong^{1, 2},
DONG Xuehao^{1, 2},
WANG Faxuan^{1, 2},
ZHANG Yajuan^{1, 2
, ,}

1.
Department of Occupational Health and Environmental Health, School of Public Health, Ningxia Medical University, Yinchuan 750004, China
2.
Key Laboratory of Environmental Factors and Chronic Diseases Control, Yinchuan 750004, China
3.
Department of Atmospheric Sciences, Chengdu University of Information Technology of Atmospheric Sciences, Chengdu 610200, China

Funds:

Ningxia Natural Science Foundation Project 2022AAC03142

More Information

Corresponding author: ZHANG Yajuan, E-mail: zhyj830515@126.com

摘要

摘要: 目的探究大气氧化性污染物与气温的单独效应，以及两者交互作用分别对我国某地区呼吸、循环系统疾病死亡的影响。方法使用2014―2018年中国某地区188 039例人群死亡数据、大气污染物日均浓度资料和同期的气象资料，采用基于Poisson分布的广义相加模型(generalized additive model, GAM)及分布滞后非线性模型(distributed lag non-linear model, DLNM)分别探讨大气氧化性污染物和气温对人群因循环、呼吸系统疾病死亡的影响，采用双变量响应面模型和分层法探究两者交互作用对循环、呼吸系统疾病死亡的影响。结果 O₃、NO₂和O_x每增加10 μg/m³对循环系统疾病死亡的累积效应最大值分别为0.82%(95% CI: 0.30%~1.34%)、1.58%(95% CI: 0.28%~2.90%)和1.11%(95% CI: 0.51%~1.72%)，对呼吸系统疾病死亡的累积效应最大值分别为0.53%(95% CI: 0.31%~1.37%)、2.66%(95% CI: 1.07%~4.27%)和1.22%(95% CI: 0.22%~2.23%)。高温和低温对2种疾病死亡影响的差异较大，高温效应即时，低温效应滞后。使用交互作用相对超额危险度(relative excess risk due to interaction, RERI)评估交互作用的大小和方向，交互作用研究结果表明，高温与高浓度的NO₂(RERI=0.118, 95% CI: 0.031~0.206)对人群循环系统疾病死亡风险有协同放大作用，低温与高浓度的O₃(RERI=0.127, 95% CI: 0.104~0.150)、和O_x(RERI=0.025, 95% CI: 0.002~0.049)对人群呼吸系统疾病死亡风险有协同放大作用。结论高温、低温和大气氧化性污染物(O₃、NO₂和O_x)均能增加人群循环、呼吸系统疾病的死亡风险，高温与高浓度的NO₂、低温与高浓度的O₃、O_x对人群循环和呼吸系统疾病死亡的风险有协同作用。
- 大气污染 /
- 大气氧化性污染物 /
- 气温 /
- 死亡风险 /
- 交互作用
Abstract: Objective To explore the individual and interactive effects of oxidant air pollutants and temperature on mortality from respiratory and circulatory diseases in a defined Chinese region. Methods Using information from 2014 to 2018 in a Chinese region, including 188 039 death cases, air pollutant concentrations, and meteorological records. A Poisson generalized additive model (GAM) and a distributed lag nonlinear model (DLNM) were applied to assess the impacts of atmospheric oxidative pollutants and temperature on mortality form respiratory and circulatory diseases. And the interactions between temperature and pollutants were evaluated using a bivariate response surface model and stratification method. Results For each 10 μg/m³ increase in O₃, NO₂, and O_x, the maximum cumulative excess risks of death from circulatory diseases were 0.82% (95% CI: 0.30%-1.34%), 1.58% (95% CI: 0.28 %-2.90 %) and 1.11% (95% CI: 0.51%-1.72%), respectively. Corresponding values for respiratory diseases were 0.53% (95%CI: 0.31%-1.37%), 2.66% (95% CI: 1.07%-4.27%) and 1.22% (95% CI: 0.22%-2.23%). The difference between the effects of high and low temperature on mortality of the two diseases was large, with an immediate effect of high temperature and a lagging effect of low temperature. The interaction effect and direction were evaluted using the relative excess risk due to interaction(RERI). Interaction studies showed that there was a synergistic amplification of the risk of death from circulatory diseases in the population by high temperature with high concentrations of NO₂ (RERI=0.118, 95% CI: 0.031-0.206). And low temperature with high concentrations of O₃ (RERI=0.127, 95% CI: 0.104-0.150), and O_x (RERI=0.025, 95% CI: 0.002-0.049) had a synergistic amplification effect on the risk of death from respiratory diseases in the population. Conclusions High temperature, low temperature and atmospheric oxidative pollutants (O₃, NO₂ and O_x) all increase the risk of death from circulatory and respiratory diseases in the population. There is a synergistic amplification of the risk of death from circulatory and respiratory diseases in the population by high temperature and high concentrations of NO₂ and low temperature and high concentrations of O₃ and O_x, respectively.
- Air pollution /
- Oxidant air pollutant /
- Ambient temperature /
- Mortality risk /
- Interactive effect

HTML全文

图 1 2014―2018年中国某地区每日死亡数据、气象因素及大气污染数据时间序列图

Figure 1. Time series of daily mortality data, meteorological factors and air pollution data for a specific region in China from 2014 to 2018

下载: 全尺寸图片幻灯片

图 2 大气污染数据和气象因素的Spearman秩相关分析

a: P＜0.05; b: P＜0.01; c: P＜0.001; d: P＜0.000 1。

Figure 2. Results of Spearman rank correlation analysis between air pollution data and meteorological factors

下载: 全尺寸图片幻灯片

图 3 2014―2018年中国某地区大气氧化性污染物每增加10 μg/m³对人群因循环系统疾病和呼吸系统疾病死亡的超额风险

A: 循环系统疾病死亡；B: 呼吸系统疾病死亡。

Figure 3. Excess risk of circulatory disease and respiratory disease mortality related with per 10 μg/m³ increase in oxidative pollutants in a region of China, 2014-2018

A: death from circulatory diseases; B: death from respiratory diseases.

下载: 全尺寸图片幻灯片

图 4 2014―2018年中国某地区气温对人群因相关疾病的死亡相对风险3D图及等高线图

A：循环系统疾病死亡；B：呼吸系统疾病死亡；C：循环系统疾病死亡；D：呼吸系统疾病死亡。

Figure 4. 3D plot and contour map of the relative risk of temperature on population mortality from related diseases in a region of China, 2014-2018

A: death from circulatory diseases; B: death from respiratory diseases; C: death from circulatory diseases; D: death from respiratory diseases.

下载: 全尺寸图片幻灯片

图 5 2014―2018年中国某地区气温对人群因相关疾病的死亡相对风险的累积效应

A：对循环系统疾病死亡1~3 d的累积效应；B：对呼吸系统疾病死亡1~3 d的累积效应。

Figure 5. Cumulative effect of the relative risk of temperature on population mortality from related diseases in a region of China, 2014-2018

A: cumulative effect on 1-3 days of death from circulatory diseases; B: cumulative effect on 1-3 days of death from respiratory diseases.

下载: 全尺寸图片幻灯片

图 6 2014―2018年中国某地区大气氧化性污染物与气温对人群因循环、呼吸系统疾病死亡的交互作用

A：循环系统疾病死亡；B：循环系统疾病死亡；C：循环系统疾病死亡；D：呼吸系统疾病死亡；E：呼吸系统疾病死亡；F：呼吸系统疾病死亡。

Figure 6. Results of the interaction between atmospheric oxidative pollutants and temperature on population mortality due to circulatory and respiratory system diseases in a region of China, 2014-2018

A: death from circulatory diseases; B: death from circulatory diseases; C: death from circulatory diseases; D: death from respiratory diseases; E: death from respiratory diseases; F: death from respiratory diseases.

下载: 全尺寸图片幻灯片

表 1 2014―2018年中国某地区每日死亡数据、每气象因素及大气污染数据描述性统计

Table 1. Descriptive statistics of daily death, daily average meteorological factors and pollutants in a region of China, from 2014 to 2018

变量Variable	人数Number of people	x±s	最小值Min	M(P₂₅, P₇₅)	最大值Max
每日死亡数据Daily death data
总体死亡Total deaths	188 039	102.98±22.08	15.00	100.00(89.00, 115.00)	185.00
病因别Etiology
呼吸系统疾病Circulatory disease	25 971	14.22±6.20	0	13.00(10.00, 17.00)	44.00
循环系统疾病Respiratory disease	56 693	31.05±9.34	4.00	30.00(25.00, 37.00)	75.00
性别Gender
女性Female	82 119	44.97±11.39	5.00	44.00(38.00, 51.00)	92.00
男性Male	105 920	58.01±12.77	6.00	57.00(50.00, 65.00)	112.00
年龄组/岁Age group/years
＜65	41 433	22.69±5.63	1.00	23.00(19.00, 26.00)	43.00
≥65	146 606	80.29±19.69	13.00	78.00(68.00, 91.00)	158.00
每日平均污染因素Daily average pollution factors/(μg·m^-3)
O_{3~8 h}		94.83±41.29	6.00	90.00(65.00, 120.75)	249.00
SO₂		12.94±7.03	4.00	11.00(8.00, 15.00)	73.00
NO₂		39.19±17.66	6.00	36.00(26.00, 51.00)	122.00
CO		834.08±240.25	400.00	800.00(700.00, 1 000.00)	2 100.00
PM₁₀		63.09±36.27	7.00	55.00(38.00, 79.00)	282.00
PM_2.5		39.74±25.13	4.00	34.00(23.00, 49.00)	219.00
O_x		75.90±26.49	17.70	71.97(57.23, 91.26)	182.32
每日平均气象因素Daily average meteorological factors
平均气温Daily average temperature/℃		17.51±8.50	-4.50	18.40(10.20, 24.40)	32.90
日最高气温Daily maximum temperature/℃		21.97±8.74	-2.30	23.15(14.70, 28.70)	39.20
日最低气温Daily minimum temperature/℃		13.82±8.82	-7.60	14.50(10.20, 24.40)	29.40
相对湿度Average relative humidity/%		79.94±11.36	23.00	81.00(73.00, 88.00)	100.00
平均气压Average air pressure/hPa		1 015.78±9.62	892.00	1 015.70(1 008.50, 1 022.88)	1 039.70
平均风速Average wind speed/(m·s^-1)		1.98±0.94	0.10	1.80(1.40, 2.40)	12.00
降水量Precipitation/mm		35.43±123.43	0	0.00(0.00, 13.00)	2 762.00
日照时数Sunshine hours/h		26.98±36.05	0	8.10(0.00, 51.00)	127.00

下载: 导出CSV

表 2 2014―2018年中国某地区大气氧化性污染物与气温对循环及呼吸系统死亡风险的交互作用

Table 2. Interaction between atmospheric oxidative pollutants and temperature on circulatory and respiratory mortality risk in a region of China, 2014-2018

温度Temperature	污染水平Pollutant level	循环系统死亡Circulatory system mortality			呼吸系统死亡Respiratory system mortality
温度Temperature	污染水平Pollutant level	O₃	NO₂	O_x	O₃	NO₂	O_x
中温Mild	低Low	1.000	1.000	1.000	1.000	1.000	1.000
	高High	0.968(0.941~0.995) ^③	1.024(0.990~1.057)	1.001(0.977~1.024)	0.952(0.918~0.986) ^③	1.059(1.023~1.094) ^③	0.967(0.935~0.999) ^③
高温High	低Low	1.053(0.946~1.159)	1.071(1.003~1.138) ^①	1.090(1.009~1.170) ^③	1.003(0.854~1.151)	1.030(0.938~1.122)	1.030(0.919~1.142)
	高High	1.049(0.975~1.123)	1.213(1.025~1.400) ^③	1.068(0.985~1.150)	1.000(0.898~1.102)	1.194(0.937~1.451)	0.998(0.883~1.112)
	RERI^①	0.028(-0.032~0.087)	0.118(0.031~0.206) ^③	-0.023(-0.045~0.001)	0.045(-0.035~0.125)	0.105(-0.025~0.235)	0.000(-0.029~0.029)
低温Low	低Low	1.091(1.026~1.157) ^③	1.088(0.990~1.187)	1.103(1.031~1.174) ^③	1.046(0.963~1.129)	1.134(1.012~1.256) ^③	1.058(0.968~1.149)
	高High	1.045(0.932~1.159)	1.103(1.031~1.176) ^③	1.076(0.998~1.155)	1.125(0.985~1.265)	1.112(1.025~1.199) ^③	1.051(0.952~1.150)
	RERI^②	-0.014(-0.035~0.007)	-0.008(-0.051~0.068)	-0.027(-0.043~0.011)	0.127(0.104~0.150) ^③	-0.081(-0.151~0.011)	0.025(0.002~0.049) ^③
注：RERI, 交互作用相对超额危险度；中温，5%~95%分位数；低温，＜5%分位数；高温，>95%分位数；污染物低水平，≤中位数；污染物高水平，>中位数。 ①高温-高污染；②低温-高污染；③P＜0.05。 Note: RERI, relative excess risk due to interaction; Mild temperature, P₅-P₉₅; low temperature, ＜P₅; high temperature, >P₉₅; low pollutant level, ≤median; high pollutant level, >median. ① High temperature-high pollutant level; ② Low temperature-high pollutant level; ③P＜0.05.

下载: 导出CSV

表 3 2014―2018年中国某地区大气氧化性污染物每增加10 μg/m³引起相关疾病超额风险改变的敏感性分析结果

Table 3. Sensitivity analysis of changes in excess risk of diseases associated with each 10 μg/m³ increase in atmospheric oxidative pollutants in a region of China, 2014-2018

不同模型参数Model parameter	循环系统死亡Circulatory system mortality			呼吸系统死亡Respiratory system mortality
不同模型参数Model parameter	O₃	NO₂	O_x	O₃	NO₂	O_x
v=7	0.82(0.30~1.34)	1.46(0.26~2.69)	1.11(0.51~1.72)	0.40(-0.29~1.10)	2.66(1.07~4.27)	1.12(0.31~1.94)
v=5	0.96(0.15~1.47)	1.75(0.57~2.94)	1.32(0.73~1.91)	0.82(0.13~1.52)	2.86(1.32~4.41)	1.52(0.72~2.32)
v=6	1.00(0.49~1.51)	1.87(0.69~3.06)	1.38(0.79~1.97)	0.78(0.08~1.47)	3.07(1.54~4.61)	1.53(0.73~2.32)
v=8	0.82(0.30~1.34)	1.07(-0.15~2.29)	1.01(0.40~1.61)	0.38(-0.32~1.07)	2.33(0.75~3.92)	1.00(0.19~1.81)
v=9	0.81(0.30~1.32)	0.89(-0.35~2.13)	0.95(0.35~1.54)	0.46(-0.23~1.15)	2.15(0.53~3.77)	0.99(0.18~1.80)

下载: 导出CSV

表 4 2014―2018年中国某地区大气氧化性污染物每增加10 μg/m³引起相关疾病超额风险改变的双污染物模型

Table 4. Results of a two-pollutant model of excess risk change for diseases associated with each 10 μg/m³ increase in atmospheric oxidative pollutants in a region of China, 2014-2018

污染物Pollutant	循环系统死亡Circulatory system mortality			呼吸系统死亡Respiratory system mortality
污染物Pollutant	O₃	NO₂	O_x	O₃	NO₂	O_x
单污染物模型One-pollutant	0.82(0.30~1.34)	1.47(0.26~2.69)	1.11(0.51~1.72)	0.40(-0.30~1.10)	2.66(1.07~4.27)	1.12(0.31~1.94)
+PM₁₀	0.82(0.30~1.34)	1.47(0.26~2.69)	1.11(0.51~1.72)	0.40(-0.30~1.10)	2.66(1.07~4.27)	1.12(0.31~1.94)
+PM_2.5	0.82(0.30~1.34)	1.47(0.26~2.69)	1.11(0.51~1.72)	0.31(-0.40~1.02)	2.77(1.08~4.49)	1.12(0.31~1.94)
+SO₂	0.81(0.29~1.34)	1.47(0.26~2.69)	1.11(0.51~1.72)	0.43(-0.28~1.15)	2.66(1.07~4.27)	1.08(0.25~1.91)
+CO	0.83(0.31~1.35)	1.48(0.27~2.70)	1.13(0.52~1.73)	0.39(-0.31~1.09)	2.66(1.07~4.27)	1.11(0.30~1.93)

下载: 导出CSV

参考文献(31)

[1]	Goshua A, Akdis CA, Nadeau KC. World Health Organization global air quality guideline recommendations: executive summary[J]. Allergy, 2022, 77(7): 1955-1960. DOI: 10.1111/all.15224.
[2]	World Health Organization. Ambient (outdoor) air pollution[EB/OL]. (2022-12-19)[2023-01-19]. https://www.who.int/en/news-room/factsheets/detail/ambient-(outdoor)-air-quality-and-health.
[3]	Liu C, Chen R, Sera F, et al. Ambient particulate air pollution and daily mortality in 652 cities[J]. N Engl J Med, 2019, 381(8): 705-715. DOI: 10.1056/NEJMoa1817364.
[4]	Xu JX, Geng WF, Geng XY, et al. Study on the association between ambient air pollution and daily cardiovascular death in Hefei, China[J]. Environ Sci Pollut Res Int, 2020, 27(1): 547-561. DOI: 10.1007/s11356-019-06867-4.
[5]	Samadi MT, Shakerkhatibi M, Poorolajal J, et al. Association of long term exposure to outdoor volatile organic compounds (BTXS) with pro-inflammatory biomarkers and hematologic parameters in urban adults: a cross-sectional study in Tabriz, Iran[J]. Ecotoxicol Environ Saf, 2019, 180: 152-159. DOI: 10.1016/j.ecoenv.2019.05.008.
[6]	中华人民共和国生态环境部. 2021中国生态环境状况公报[R]. 北京: 中华人民共和国生态环境部, 2022: 9. Ministry of Ecology and Environment of the People's Republic of China. 2021 China ecological and environmental status bulletin[R]. Beijing: Ministry of Ecology and Environment of the People's Republic of China, 2022: 9.
[7]	中华人民共和国生态环境部. 2019中国生态环境状况公报[R]. 北京: 中华人民共和国生态环境部, 2020: 9. Ministry of Ecology and Environment of the People's Republic of China. 2019 China ecological and environmental status bulletin[R]. Beijing: Ministry of Ecology and Environment of the People's Republic of China, 2020: 9.
[8]	Chen RJ, Yin P, Wang LJ, et al. Association between ambient temperature and mortality risk and burden: time series study in 272 main Chinese cities[J]. BMJ, 2018, 363: k4306. DOI: 10.1136/bmj.k4306.
[9]	Silveira IH, Oliveira BFA, Cortes TR, et al. The effect of ambient temperature on cardiovascular mortality in 27 Brazilian cities[J]. Sci Total Environ, 2019, 691: 996-1004. DOI: 10.1016/j.scitotenv.2019.06.493.
[10]	Yang CY, Li HC, Chen RJ, et al. Combined atmospheric oxidant capacity and increased levels of exhaled nitric oxide[J]. Environ Res Lett, 2016, 11(7): 074014. DOI: 10.1088/1748-9326/11/7/074014.
[11]	Williams ML, Atkinson RW, Anderson HR, et al. Associations between daily mortality in London and combined oxidant capacity, ozone and nitrogen dioxide[J]. Air Qual Atmos Health, 2014, 7(4): 407-414. DOI: 10.1007/s11869-014-0249-8.
[12]	Reid EC, Snowden MJ, Kontgis C, et al. Atmospheric ozone epidemiological studies the role of heat related mortality[J]. J Environ Occup Med, 2013, 30(4): 316-319. DOI: 10.13213/j.cnki.jeom.2013.04.021.
[13]	叶伟鹏, 刘苗苗, 毕军. 中国臭氧短期暴露与人群死亡之间关系的Meta分析研究[J]. 环境科学学报, 2020, 40(7): 2644-2651. DOI: 10.13671/j.hjkxxb.2020.0146. Ye WP, Liu MM, Bi J. Meta-analysis of the associations between short-term ozone exposure and human mortality in China[J]. Acta Sci Circumstantiae, 2020, 40(7): 2644-2651. DOI: 10.13671/j.hjkxxb.2020.0146.
[14]	谢昀霏, 宋晓明, 方嘉堃, 等. 广州市氧化性污染物与气温对居民心脑血管疾病死亡风险的交互作用[J]. 环境与职业医学, 2021, 38(11): 1199-1206. DOI: 10.13213/j.cnki.jeom.2021.21188. Xie YF, Song XM, Fang JK, et al. Interaction between oxidant pollutants and ambient temperature on cardio-cerebrovascular mortality risks in Guangzhou, China[J]. J Environ Occup Med, 2021, 38(11): 1199-1206. DOI: 10.13213/j.cnki.jeom.2021.21188.
[15]	中国疾控中心环境与健康相关产品安全所. 共享杯版-我国某地区2014-2018年死因及环境监测数据[EB/OL]. (2021-07-06)[2022-09-03]. https://doi.org/10.12213/11.A0006.202109.581.V1.0.
[16]	Paul LA, Burnett RT, Kwong JC, et al. The impact of air pollution on the incidence of diabetes and survival among prevalent diabetes cases[J]. Environ Int, 2020, 134: 105333. DOI: 10.1016/j.envint.2019.105333.
[17]	Wu RS, Song XM, Chen DH, et al. Health benefit of air quality improvement in Guangzhou, China: results from a long time-series analysis (2006-2016)[J]. Environ Int, 2019, 126: 552-559. DOI: 10.1016/j.envint.2019.02.064.
[18]	Qin RX, Xiao CC, Zhu YB, et al. The interactive effects between high temperature and air pollution on mortality: a time-series analysis in Hefei, China[J]. Sci Total Environ, 2017, 575: 1530-1537. DOI: 10.1016/j.scitotenv.2016.10.033.
[19]	Lee W, Choi HM, Kim D, et al. Synergic effect between high temperature and air pollution on mortality in Northeast Asia[J]. Environ Res, 2019, 178: 108735. DOI: 10.1016/j.envres.2019.108735.
[20]	晋乐飞, 冯斐斐, 段丽菊, 等. 臭氧对呼吸系统影响研究进展[J]. 中国公共卫生, 2015, 31(5): 685-689. DOI: 10.11847/zgggws2015-31-05-43. Jin LF, Feng FF, Duan LJ, et al. Effects of ambient ozone on human respiratory system[J]. Chin J Public Health, 2015, 31(5): 685-689. DOI: 10.11847/zgggws2015-31-05-43.
[21]	杨虎, 袭著革, 刘晓华, 等. 臭氧对心血管系统影响的研究进展[J]. 解放军预防医学杂志, 2018, 36(2): 271-274. DOI: 10.13704/j.cnki.jyyx.2018.02.034. Yang H, Xi ZG, Liu XH, et al. Research progress of ozone effect on cardiovascular system[J]. J Prev Med Chin PLA, 2018, 36(2): 271-274. DOI: 10.13704/j.cnki.jyyx.2018.02.034.
[22]	Duan YR, Liao Y, Li HY, et al. Effect of changes in season and temperature on cardiovascular mortality associated with nitrogen dioxide air pollution in Shenzhen, China[J]. Sci Total Environ, 2019, 697: 134051. DOI: 10.1016/j.scitotenv.2019.134051.
[23]	Lavigne E, Burnett RT, Weichenthal S. Association of short-term exposure to fine particulate air pollution and mortality: effect modification by oxidant gases[J]. Sci Rep, 2018, 8(1): 16097. DOI: 10.1038/s41598-018-34599-x.
[24]	胡建雄, 何冠豪, 马文军. 高温热浪增加人群死亡风险的脆弱性理论框架[J]. 环境与职业医学, 2022, 39(3): 240-246. DOI: 10.11836/JEOM21454. Hu JX, He GH, Ma WJ. A theoretical framework for vulnerability of heatwave-related mortality[J]. Journal of Environmental and Occupational Medicine, 2022, 39(3): 240-246. DOI: 10.11836/JEOM21454.
[25]	Tang YM, Wang DG, Li J, et al. Relationships between micronutrient losses in sweat and blood pressure among heat-exposed steelworkers[J]. Ind Health, 2016, 54(3): 215-223. DOI: 10.2486/indhealth.2014-0225.
[26]	Astrand PO, Rodahl K, Dahl HA, et al. Textbook of work physiology: physiological bases of exercise[M]. Champaign: Human Kinetics, 2003: 5.
[27]	刘昊辰. 热浪对心血管疾病影响的机理研究[D]. 南京: 南京信息工程大学, 2015. Liu HC. Study on the mechanism of the influence of heat wave on cardiovascular diseases[D]. Nanjing: Nanjing University of Information Science & Technology, 2015.
[28]	杨军, 欧春泉, 丁研, 等. 广州市逐日死亡人数与气温关系的时间序列研究[J]. 环境与健康杂志, 2012, 29(2): 136-138. DOI: 10.16241/j.cnki.1001-5914.2012.02.015. Yang J, Ou CQ, Ding Y, et al. Association between daily temperature and mortality in Guangzhou: a time-series study[J]. J Environ Health, 2012, 29(2): 136-138. DOI: 10.16241/j.cnki.1001-5914.2012.02.015.
[29]	Wang CZ, Zhang Z, Zhou MG, et al. Nonlinear relationship between extreme temperature and mortality in different temperature zones: a systematic study of 122 communities across the mainland of China[J]. Sci Total Environ, 2017, 586: 96-106. DOI: 10.1016/j.scitotenv.2017.01.218.
[30]	张宇静, 赵天良, 殷翀之, 等. 徐州市大气PM_2.5与O₃作用关系的季节变化[J]. 中国环境科学, 2019, 39(6): 2267-2272. DOI: 10.19674/j.cnki.issn1000-6923.2019.0269. Zhang YJ, Zhao TL, Yin CZ, et al. Seasonal variation of the relationship between surface PM_2.5 and O₃ concentrations in Xuzhou[J]. China Environmental Science, 2019, 39(6): 2267-2272. DOI: 10.19674/j.cnki.issn1000-6923.2019.0269.
[31]	宋全全. 高温热浪与臭氧对冠心病的交互作用影响及机制研究[D]. 兰州: 兰州大学, 2019. Song QQ. Study on the interaction between high temperature heat wave and ozone on coronary heart disease and its mechanism[D]. Lanzhou: Lanzhou University, 2019.