| [Background]According to the intergovernmental panel on climate change reports, the trend of global warming is gradually accelerated. In the context of global warming, climate change will lead to the change of extreme weather event frequency, its intensity, its occurring time and its duration, causing heavy rain events which are prone to flooding. At present, the research of association between floods and human health in our country mainly focused on impacts of flood on infectious diseases, and the studies of impacts of floods on chronic non-communicable diseases among the population at home and abroad was relatively rare according to the reports. In recent years, several studies have shown that climate change will lead to higher morbidity and mortality of cardiovascular disease, and most of the studies suggested that high temperature and cold wave effected on cardiovascular disease. In addition, air pressure, air humidity of meteorological factors on cardiovascular and cerebrovascular disease study also had some different findings. However, there were no significant findings about the relationship between cardiovascular diseases and floods in the studies. Omama’s study found that after the east Japan earthquake and tsunami occurred, the incidence of cardiovascular disease was significantly related to the tsunami and not related to the earthquake. The study calculated the severity of the floods after the disasters, and found that the incidence of cardiovascular disease increased with the increase of the severity of the floods. Chronic disease onset time was long, complex and etiology, and exposure effect was not obvious and was easily neglected during the post-disaster emergency processing. With the rapid development of economy and the continuous improvement of people’s living standard, the effects of cardiovascular disease on the resident health were growing day by day. The cardiovascular disease did not only affect the patient’s health and lower the quality of life seriously, and its continuing medical expense for patients brought serious economic burden to individuals, families and society.[Objective]This study aimed to understand the flooding phenomenon, studying the influence of climate on human health which could attribute to a good human environment. Climate change can bring varies meteorological phenomena according to different climatic zone and season, and it was an important topic to analyze relationship between meteorological phenomena and the relevance of health. The purpose of this study was exploringthe effect of the flood events on the mortality of resident cardiovascular disease and disease burdens through hierarchical cases crossover study on the basis of Hunan province, which could provide the scientific references for health policy-making departments and allocation of health resources.The main purposes were as following:(1) According to Hunan province as study area, we found the relationship between floods and acute death due to different types of cardiovascular disease and different population characteristic.(2) Due to the possible lag time of impacts of flooding on human health, we estimated the best lag time between floods and acute death of cardiovascular disease and quantified the relative risks and confident intervals between floods and acute death due to different types of cardiovascular disease and different population characteristic.(3) We calculated the disease burdens of cardiovascular diseases during the flooded year in the study area, and calculated the attributed disease burden of different degrees of floods and different population characteristic among different populations.[Methods]Firstly, the numbers of death of cardiovascular disease were compared between flood exposure year (2010) and non-flood exposure years (2009,2011) through descriptive analysis. Then we selected the significant statistically disease through a 1:2 cases of two-way crossover study to further test. Thirdly, the analysis of cases cross mixed with stratified Cox model was applied to estimate the risk ratio (HR) and lag time of flooding to cardiovascular disease deaths, and at the same time, highest temperature, average pressure, average relative humidity were as control variables input into the model for controlling the effect of confounding. Finally, the YLDs were calculated among the different sex and age group populations in order to evaluate and compare the disease burdens of different populations.\[Results]1. Ischemic heart disease, acute cardiovascular disease deaths in rural areas, women of acute cardiovascular disease deaths in 2010 were higher than in 2009 and 2011 according to the descriptive analysis; The results of cases cross analysis showed that the HR of cardiovascular disease was the highest in the 17 lagged days with 1.584 (95％CI:1.389-1.807), and the HR of ischemic heart diseasewas the highest in the 20 lagged days with 1.409 (95% CI:1.122-1.769), followed by 1.279 (95% CI: 1.086-1.507) which was the highest in the 15 lagged days of rural population and 1.258 (95% CI:1.034-1.530) which was the highest in the 26 lagged days of female population.2. The results of disease burden were that:the DALYs was 115395 people per year in 2010 through the comparison of 2009-2010 three years, which was higher for 4108 people per year than 2009 and 26218 people per year than 2011. The DALYs per thousand people in 2010 was 29.8 years, which was larger than 2009 (28.1) and 2011 (22.1). The loss of healthy life years YLLs der to death in three years accounted for the main part, which was about 4 times larger than disability loss of healthy life years YLDs.The disease burden attributed to floods among flood-related cardiovascular diseasepopulation, ischemic heart disease population, female population and rural population, were 11 DALYs per thousand people,2.66 per thousand people,7.05 per thousand people and 3.43 per thousand people, respectively.[Conclusion]This study finds that floods may increase the risks of cardiovascular disease, ischemic heart disease, female population and rural population death through the analysis of cardiovascular disease death of 2009-2011 three years on the basis of 6 study areas in Hunan province. |
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