Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects. We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality. We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates. Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV (0.9 °C). An IQR increase in inter-day TV (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV and inter-day TV was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type. Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.

中文翻译：

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温度变化不同组成部分对死亡率影响的比较：多国时间序列研究


温度变化（TV）与死亡风险增加相关。然而，日内或间日电视是否具有不同的效果仍不清楚。我们的目的是评估日间电视和日间电视与全因死亡率、心血管死亡率和呼吸系统死亡率的关系。我们收集了 1972 年至 2020 年间 47 个国家或地区 758 个地点的总死亡率、心血管死亡率和呼吸系统死亡率以及气象数据。我们将日间 TV 定义为整个滞后区间内日平均气温的标准差 (SD)，以及日内 TV 的标准差 (SD)。日电视作为每天最低和最高气温的平均 SD。在第一阶段，在每个位置的准泊松时间序列模型中同时对日间和日内电视进行建模。在第二阶段，使用多层次分析来汇总特定地点的估计值。总体而言，日间电视因四分位距 [IQR] 增加而导致的死亡风险高于日间电视。全因死亡率风险增加 0.59%（95% 置信区间 [CI]：0.53, 0.65），心血管死亡风险增加 0.64%（95% CI：0.56, 0.73），心血管死亡风险增加 0.65%（95% CI：0.49）。日内电视 (0.9 °C) 中每 IQR 增加的呼吸道死亡率为 0.80）。日间电视 (1.6 °C) 的 IQR 增加与全因死亡率增加 0.22% (95% CI: 0.18, 0.26)、心血管死亡率增加 0.44% (95% CI: 0.37, 0.50) 相关。呼吸道死亡率增加 0.31% (95% CI: 0.21, 0.41)。日间电视和间日电视造成的全因死亡比例分别为1.45%和0.35%。死亡风险因滞后时间、气候区域、季节和气候类型而异。 我们的研究结果表明，日间电视可以解释与电视相关的死亡风险的主要部分，并建议更多国家应提出综合评估，以帮助保护人类健康。