The Lancet regional health. Western Pacific · 2025
The temporal shift of temperature-related injury incidence risk and its driving factors in China: a nationwide case-crossover study from 2006 to 2021.
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Hu Jianxiong, Deng Xiao, Ye Shanghui, Liang Ziyi, Jin Ye, Guo Yanfang, Liu Tao, Er Yuliang, Zeng Fangfang, Ye Pengpeng, He Guanhao, Chen Sujuan, Wang Yuan, Lin Ziqiang, Jing Fengrui, Duan Leilei, Ji Cuirong, Ma Wenjun
Аннотация
BACKGROUND: Although several studies have demonstrated an association between ambient temperature and injury, the temporal trend of temperature-related injury risk remains unknown. This study aimed to examine changes in the effect of temperature on injury incidence and to explore its driving factors.
METHODS: A time-stratified case-crossover study including over 11.5 million injury cases from 243 surveillance hospitals in China was conducted, and the injury incidence risks associated with temperature during the periods 2006-2013 and 2014-2021 were compared using conditional logistic regression model combined with distributed lag nonlinear model (DLNM). The socio-economic driving factors of the temporal change from 2006-2013 to 2014-2021 were further explored based on mixed-effects linear model and random forest algorithm.
FINDINGS: The study encompassed a total of 11,512,467 injury cases from 2006 to 2021. The temperature-injury incidence relationship was linear, exhibiting a steeper slope between 2006 and 2013 compared to 2014 and 2021. The excess risk (ER) for per 1 °C increase in temperature was 1.08% (95% CI: 1.06%, 1.10%) for 2006-2013, which was significantly higher than the 0.83% (95% CI: 0.82%, 0.84%) for 2014-2021, representing a 23.31% (95% CI: 21.53%, 24.95%) decrease. Among 31 provinces, 74.19% experienced a decline in ER, predominantly in coastal regions. The primary factors influencing this temporal shift in temperature-related injury risk were identified as the child dependency ratio, air conditioners ownership per 100 rural households, and the birth rate.
INTERPRETATION: Overall, the risk of temperature-related injuries in China has decreased over the past two decades, with demographic and socioeconomic factors playing pivotal roles in this decline.
FUNDING: National Natural Science Foundation of China.
METHODS: A time-stratified case-crossover study including over 11.5 million injury cases from 243 surveillance hospitals in China was conducted, and the injury incidence risks associated with temperature during the periods 2006-2013 and 2014-2021 were compared using conditional logistic regression model combined with distributed lag nonlinear model (DLNM). The socio-economic driving factors of the temporal change from 2006-2013 to 2014-2021 were further explored based on mixed-effects linear model and random forest algorithm.
FINDINGS: The study encompassed a total of 11,512,467 injury cases from 2006 to 2021. The temperature-injury incidence relationship was linear, exhibiting a steeper slope between 2006 and 2013 compared to 2014 and 2021. The excess risk (ER) for per 1 °C increase in temperature was 1.08% (95% CI: 1.06%, 1.10%) for 2006-2013, which was significantly higher than the 0.83% (95% CI: 0.82%, 0.84%) for 2014-2021, representing a 23.31% (95% CI: 21.53%, 24.95%) decrease. Among 31 provinces, 74.19% experienced a decline in ER, predominantly in coastal regions. The primary factors influencing this temporal shift in temperature-related injury risk were identified as the child dependency ratio, air conditioners ownership per 100 rural households, and the birth rate.
INTERPRETATION: Overall, the risk of temperature-related injuries in China has decreased over the past two decades, with demographic and socioeconomic factors playing pivotal roles in this decline.
FUNDING: National Natural Science Foundation of China.