【摘要】 [背景]非适宜温度显著威胁公众健康，分析温度暴露与急性酒精中毒急救量的关联，可以为优化急救资源配置和应急响应提供依据。[目的]通过分析非适宜温度对无锡市急性酒精中毒120急救量的总体影响及滞后效应，评估归因风险，为气候适应性公共卫生策略的制定提供实证依据。[方法]收集2014年1月1日—2020年12月31日无锡市120急性酒精中毒急救记录、同期空气污染物及气象数据（含日均温度等）。采用分布滞后非线性模型进行时间序列分析，通过交叉基函数捕捉温度与急救量的非线性关系及滞后效应，控制长期趋势、湿度、污染物[最终纳入臭氧（O₃）和细颗粒物(PM_2.5)]、星期及节假日等混杂因素，设定最大滞后天数14 d。分析极端温度的单日滞后及累积滞后效应，经敏感性分析验证，以相对风险值（RR）及95%置信区间（95%CI）量化效应，并计算不同温度范围的归因分数和归因人数。[结果]研究期间共纳入急性酒精中毒急救病例10 705例，男性占比89.5%,18～50岁人群占83.4%。日均气温与急救量呈非线性“U”型关联，最适温度为13.3℃。极端低温（1.88℃）的效应在暴露后lag1～lag3有统计学意义（P<0.05），在lag1达最大效应（RR=1.063,95%CI:1.002～1.129）；极端高温（32.3℃）则呈现即时效应，在lag0达最大效应（RR=1.374,95%CI:1.248～1.512）。累积效应分析显示，高温在lag0～3的风险最高（RR=2.000,95%CI:1.667～2.399），低温在lag0～14风险最大（RR=1.462,95%CI:1.042～2.051）。归因分析结果显示，轻度炎热（> 24.7～30.8℃）和炎热（> 30.8～33.5℃）造成的归因人数最多，分别为591例（95%CI:56～1 032）和190例（95%CI:51～309），对应的归因分数分别为5.81%（95%CI:0.80%～9.94%）和1.87%（95%CI:0.49%～2.96%）。[结论]极端高、低温均显著增加无锡市急性酒精中毒急救量，高温表现为急性效应，低温则具有延迟性特征。轻度炎热对急救负担的影响更为显著。建议急救部门结合气候特征优化资源配置，极端天气期间强化应急响应，以降低酒精相关健康负担。更多还原

【Abstract】 [Background] Non-optimal temperatures pose significant threats to public health. Analyzing the association between temperature exposure and the number of emergency cases of acute alcohol intoxication can provide evidence for optimizing emergency resource allocation and response strategies.[Objective] To analyze the overall impact and lag effects of non-optimal temperatures on the number of 120 emergency calls for acute alcohol intoxication in Wuxi, and to assess the attributable risk, in order to provide empirical evidence for formulating climate-adaptive public health strategies.[Methods] Call records of acute alcohol intoxication from Wuxi’s 120 emergency service, concurrent air pollutant data, and meteorological data（including daily mean temperature） were collected from January 1, 2014 to December 31, 2020. Distributed lag nonlinear modeling was used for time-series analysis, with cross-basis functions to capture the nonlinear relationship and lag effects between temperature and emergency volume. Confounding factors such as long-term trends, humidity, pollutants [ultimately including ozone（O₃） and fine particulate matter(PM_2.5)], day of the week, and holidays were controlled. The maximum lag period was set to 14 days. Single-day lag and cumulative lag effects of extreme temperatures were analyzed, followed by sensitivity analysis. Effects were quantified using relative risk（RR） and 95% confidence intervals（95%CI）, and attributable fractions and numbers for different temperature ranges were calculated.[Results] A total of 10 705 emergency cases of acute alcohol intoxication were included during the study period, with males accounting for 89.5% and individuals aged 18–50 years accounting for 83.4%. A non-linear "U-shaped" association was observed between daily mean temperature and the number of emergency calls, with an optimal temperature of 13.3 ℃. The effect of the extreme low temperature（1.88 ℃） was statistically significant from lag1 to lag3 after exposure（P < 0.05）, with the maximum effect at lag1（RR=1.063, 95%CI:1.002, 1.129）. The extreme high temperature（32.3 ℃） showed an immediate effect, with maximum effect at lag0（RR=1.374, 95%CI:1.248, 1.512）. The cumulative effect analysis showed that the risk associated with high temperature was the highest at lag0–3（RR=2.000,95%CI: 1.667, 2.399）, while the risk associated with low temperature was the highest at lag0–14（RR=1.462, 95%CI: 1.042, 2.051）. The attribution analysis indicated that the mild heat（ > 24.7–30.8 ℃） and heat（ > 30.8–33.5 ℃） contributed the largest numbers of attributable cases, with 591 cases（95%CI: 56, 1 032） and 190 cases（95%CI: 51, 309）, respectively. The corresponding attributable fractions were5.81%（95%CI: 0.80%, 9.94%） and 1.87%（95%CI: 0.49%, 2.96%）, respectively.[Conclusion] Both extreme high and low temperatures significantly increase the number of 120 emergency calls for acute alcohol intoxication in Wuxi. High temperature exhibit an acute effect, while low temperature show a delayed effect. Mild heat have a significant impact on the emergency burden. It is recommended that emergency departments optimize resource allocation according to climatic characteristics and strengthen emergency responses during extreme weather to reduce alcohol-related health burden.更多还原