| BackgroundGuangdong is an economically advanced province in China. With the rapid growth of economy, it is faced with the population, environment and many other problems at the same time. With the transformation of life style, a lot of unfavorable behaviors have affected people’s health and lead to diseases. The detriment of chronic non-communicable disease to human health is becoming more and more serious. Therefore, it is very urgent and important to investigate the residents’ causes of death and population distribution, to probe the main cause of population death, to discuss their epidemiological characteristics and changing patterns, and to find out the main disease types which do harm to human health. All above contribute to have a comprehensive recognition to the health level of residents in Guangdong province and will provide the reference for the planning for health care policy and the resource allocation by the health sector.Tropical cyclone, as a kind of extreme weather event, seriously endangers the national economic construction, people’s life and property safety. It not only cause damage, destroys medical infrastructures and makes public health services vulnerable, but also increase the possibility of infectious disease epidemic and the risk of suffering from chronic diseases. There were studies found that the mortality of residents, the incidence and fatality rate of some diseases also increased after the tropical cyclone. In recent years, along with the climate change becoming an international consensus, studies of meteorological factors and the residents’ death also increase gradually, but the effect of tropical cyclone is still in yearly stage, in China, and relevant research is also relatively scarce.Guangdong province, the study region of this research, is affected by tropical cyclones most frequently in China. By analyzing data from the disease surveillance points from 2008 to 2011, this study investigates the age distribution and the main causes of the deaths among residents in Guangdong. We mainly analyze several main types of diseases, carry out quantitative analysis of tropical cyclones’ effect on residents’ death, and calculate the excess mortality in order to estimate the losses brought to local residents by tropical cyclones, so as to provide scientific basis for other researches.Objective1. To investigate the constituents of death, rank of death cause, the age trend on death, the constituents of death and rank of death cause among different ages groups.2. To comprehensively analyze the main causes of death and find out sensitive people and age trend on main death cause.3. To quantify the effect of tropical cyclone on death.4. To calculate excess death and excess mortality caused by cyclones, and to estimate the health losses caused by cyclones.MethodDeath data were extracted from disease surveillance points (DSPs) in Guangdong province from 2008 to 2011 and analysis were based on the classification of ICD-10.A descriptive study about the mortality, constituents of death, rank of death cause, age trend on death using all death data as well as main causes of death was conducted. Daily data were then sorted and a generalized additive model was used to analyze the effect of tropical cyclone on death after controlling the secular trend, the season trend and adjusting for meteorological factors. The effect of tropical cyclone on death was estimated based on the model and the relative risk as well as excess mortality was calculated. Data sorting was conducted by Microsoft Excel and data analysis was conducted using SAS9.4.Result1. There were 20 tropical cyclones affecting Guangdong province from 2008 to 2011 in total, including 7 tropical storm,5 severe tropical storm,6 typhoon and 2 severe typhoon.2. The mortality in DSPs in Guangdong province from 2008 to 2011 was 582.71/105in total,663.20/105 in males, and 501.23/105 in females. The main cause of death were circulatory system diseases (223.96/105), malignancy (147.37/105), respiratory system diseases (105.42/105) and injuries and poisoning (35.12/105). The main cause of death was injuries and poisoning among people aged 0 to 29, malignancy among people aged 30 to 59, circulatory system diseases among people aged above 60.3. Main circulatory system diseases that caused death were cerebrovascular disease and ischemic heart disease. Main malignancy that caused death were lung cancer and liver cancer. Main respiratory system disease that caused death were COPD and pneumonia. Main injuries and poisoning that caused death were transportation accident.4. The effect of tropical cyclone on death within 20 days among all population, male population were 1.023(95％CI:1.004-1.043) and 1.033(95％CI:1.008-1.059) respectively. No statistically significant effect was observed among female population. The effect was statistically significant among people aged 18 to 59(RR=1.058,95％CI: 1.015-1.103) and the effect were not statistically significant among other age groups. The effect among people died from harm was 1.118(95％CI:1.001-1.248). The effect of tropical cyclone among people died from malignancy could last for 40 days at longest, but the impact is 1.080(95％CI:1.042-1.120) which is the highest for 20 days.5. The excess death because of tropical cyclone in DSPs of Guangdong province from 2008 to 2011 was 448 and the excess mortality is 29.4/106 at the same time.ConclusionThe mortality of residents in Guangdong province from 2008 to 2011 was consistent with the national average. Chronic non-communicable diseases were still the most important reason that resulted in the deaths of residents, mainly including circulatory system disease, malignancy, respiratory system disease, injuries and poisoning. Circulatory system diseases led to the deaths of residents mainly because of cerebrovascular diseases and ischemic heart diseases. Malignancy led to the deaths of residents mainly because of lung cancer and liver cancer. The respiratory system disease led to the deaths of residents mainly because of chronic obstructive pulmonary disease and pneumonia. Injuries and poisoning led to the deaths of residents mainly because of the traffic accident.Tropical cyclones could influence the 20-day mortality. In this period, deaths in all population, male population, people aged from 18 to 59 could rise. Risk of dying from malignancy and harm could increase. Therefore, we should pay attention to the sensitive people, protect them from exposed to the tropical cyclone. The medical and health institutions should take care of people suffered from the specific diseases. At the same time, tropical cyclones would lead to excess mortality which is more serious than temperature leads. |
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