【摘要】 目的 了解寒潮与我国3省和1自治区的道路交通伤害死亡风险的关系，为制定有效的防控措施提供科学依据。方法 基于2013—2018年冷季（11月至次年2月）广东省、湖南省、吉林省和西藏自治区的道路交通伤害死亡数据，整合同时期的气象数据和空气污染数据，采用时间分层的病例交叉设计方法构建条件logistic回归模型。模型分析了寒潮对道路交通伤害死亡风险的单日滞后效应（用相对危险度RR表示）和累积滞后效应(用累积相对危险度RR_cum表示)，并计算归因分值（AF）评估寒潮造成的道路交通伤害死亡负担，并按照性别、年龄、伤害类别、地理分区及有无日降水进一步实施分层分析。结果 本研究共纳入道路交通伤害死亡人数35 776例。与非寒潮日相比，寒潮可增加道路交通伤害死亡风险(RR_cum=1.10,95%CI:1.01～1.19)，造成的死亡负担为8.74%（95%CI:1.26%～15.67%）。分层结果表明，45～64岁人群在寒潮期间发生道路交通伤害死亡的累积风险为1.19（95%CI:1.04～1.35）,AF为15.62%（95%CI:4.21%～25.67%）；引起的非机动车事故风险较高(RR_cum=1.12,95%CI:1.02～1.22),AF为10.34%（95%CI:2.24%～17.76%）；降水可增加道路交通伤害死亡风险(RR_cum=1.12,95%CI:1.01～1.24)，其AF为10.49%（95%CI:1.05%～19.04%）。结论 寒潮可增加人群道路交通伤害死亡风险，其中在有降水的天气中影响较大，中老年群体因道路交通伤害致死和非机动车事故受寒潮影响较为明显。更多还原

【Abstract】 Objective To investigate relationships between cold spells and mortality risk of road traffic injury（RTI） in three provinces and one autonomous region of China, and to provide scientific information for developing effective prevention and control measures. Methods Based on road traffic mortality data from Guangdong, Hunan, Jilin, and Xizang during the cold seasons（from November to February） in the years from 2013 to 2018, the study analyzed the meteorological data and air pollutant data in the same periods. With a time-stratified case-crossover design, the study established a conditional logistic regression model to explore the lag effects（RR） and the cumulative lag effects(RR_cum) of cold spells on RTI mortality, and then calculate the attributable fraction（AF） of mortality to estimate the burden caused by cold spells. The stratified analyses were further conducted by gender, age, RTI mechanism, region, and daily total precipitation. Results A total of 35 776 road traffic injury deaths were included in this study. Compared to non-cold spells, the mortality risk of RTI increased during cold spells(RR_cum= 1.10, 95% CI: 1.01-1.19), with the mortality burden of 8.74%（95% CI: 1.26%-15.67%）. The stratified analyses showed that the RR_cumamong people aged 45-64 during cold spells was 1.19（95% CI: 1.04-1.35）, with the AF of 15.62%（95%CI: 4.21%-25.67%）. The mortality risk of RTI for non-motor vehicle accidents(RR_cum= 1.12, 95% CI: 1.02-1.22) during cold spells was higher and the AF was 10.34%（95% CI: 2.24%-17.76%）. Precipitation(RR_cum= 1.12, 95% CI: 1.01-1.24) increased the mortality risk of RTI, with an AF of 10.49%（95% CI: 1.05%-19.04%）. Conclusion Exposure to cold spells was observed to increase the mortality risk of RTI among the population, with powerful impacts on the days with precipitation. The mortality risks of RTI among middle-aged and elderly people and non-motor vehicle accidents were greatly affected by cold spells.更多还原