西昌地区气象条件对呼吸系统疾病的利弊影响

Influence of climatic conditions on respiratory disease convergence in Xichang area

摘要:

西昌地区以其四季如春的气候优势，受到越来越多候鸟式旅居康养人群的向望。本文基于质控与筛选后的2019年7月1日-2022年6月30日西昌市逐日疾病就诊数据和同期气象观测数据，采用SHAP可解释模型以及人体舒适度和分布滞后非线性模型（DLNM）等方法，以呼吸系统疾病为例，从趋利避害并举的视角，探究不同季节和节气的气象条件对当地居民健康的利弊影响。结果表明：气温对当地呼吸系统疾病发病的影响最大，其次是气压，随后依次为相对湿度、风速、降水量。西昌地区2-8月为升温期，期间就诊人数逐渐下降，8月降至谷值，比峰值月份（11月）降低了51%；“处暑”节气发病人数最少，比“立冬”节气的峰值减少了61%；当地夏季广义舒适日数占比74%，呈现出低风险（康养）效应。西昌9月至次年1月为降温期，期间发病人数逐渐增加，至11月达到峰值，高风险时段持续到次年1月；当地平均气温和气压对呼吸系统疾病暴露-反应关系均呈现弱冷环境下的高压效应。综上所述，西昌地区夏季气候宜人利于避暑；冬季气候具有双重性，一是对于当地居民而言属于呼吸系统疾病的高风险期，应当加强防范；二是相比东部和北方城市，其冬季气候相对温暖舒适（日平均气温大于10℃），对于外来的北方候鸟人群却具有避寒康养效应。

Abstract:

Xichang, celebrated for its year-round spring-like climate, has become a prominent destination for seasonal migrants seeking health-oriented lifestyles. This study investigates the dual nature of meteorological impacts on respiratory health by analyzing daily hospital admissions for respiratory diseases (July 1, 2019–June 30, 2022) and concurrent meteorological data from Xichang. Integrating interpretable SHAP (SHapley Additive exPlanations) modeling, biometeorological comfort indices, and distributed lag nonlinear models (DLNM), we evaluate season- and solar-term-specific health risks and benefits through a harm-mitigation and advantage-utilization lens. Key findings include: (1) Temperature emerged as the dominant driver of respiratory morbidity (SHAP value: 0.42), followed by atmospheric pressure (0.31), relative humidity (0.28), wind speed (0.19), and precipitation (0.12). (2) During the Yang Qi phase (February–August, ascending thermal energy), respiratory admissions decreased progressively by 51% from the November peak to the August trough, reaching the annual minimum at the Chushu solar term (61% reduction vs. Lidong peak). Summer exhibited 74% generalized comfort days, correlating with sustained low-risk health conditions. (3) The Yin Qi phase (September–January, descending thermal energy) showed morbidity escalation peaking in November, with prolonged high-risk intervals until January. DLNM analyses revealed synergistic "high-pressure effects under mild cold stress" (relative risk [RR] = 1.24, 95% CI: 1.12–1.38) from combined temperature-pressure interactions. Notably, winter climate demonstrates duality: while posing elevated respiratory risks for local residents (RR = 1.67 during extreme cold spells) necessitating targeted prevention, it concurrently offers cold-avoidance benefits for northern migrants due to milder temperatures (mean >10°C vs. <0°C in northern China). These findings advocate spatially stratified health advisories—prioritizing cold-season protection for locals while leveraging climate advantages for seasonal migrants—providing a paradigm for adaptive health governance in transitional climate zones.