公衆衛生85巻7号

2021年07月発行

特集 健康的な住まいが欲しい！—暮らしやすくて，寿命も延びる

住環境の温度と心血管疾患との関連

著者： 佐伯圭吾¹

所属機関： ¹奈良県立医科大学疫学・予防医学教室

ページ範囲：P.438 - P.442

【ポイント】
◆外気温低下に関連する死亡数は，年間約9.4万人と推定されることから，公衆衛生上重要な課題といえる．
◆近年の分析法の進歩により，比較的軽微な寒冷曝露によって，死亡リスクが上昇することが分かってきた．
◆室内寒冷曝露が血圧上昇と関連することから，室温の調整によって脳血管疾患を予防できる可能性がある．

参考文献

1)e-Stat(政府統計の総合窓口)：人口動態統計—死亡(確定数)，2019年．中巻 第5表〔死亡数，生年年齢(各歳)・死亡月・性別〕．https://www.e-stat.go.jp/stat-search/files?page=1＆toukei=00450011＆tstat=000001028897

2)Curwen M:Excess winter mortality:a British phenomenon? Health Trends 22:169-175, 1990-1991

3)Curriero FC, et al:Temperature and mortality in 11 cities of the eastern United States. Am J Epidemiol 155:80-87, 2002

4)Gasparrini A:Modeling exposure-lag-response associations with distributed lag non-linear models. Stat Med 33:881-899, 2014

5)Gasparrini A, et al:Mortality risk attributable to high and low ambient temperature:a multicountry observational study. Lancet 386:369-375, 2015

6)Ikeda N, et al:Adult mortality attributable to preventable risk factors for non-communicable diseases and injuries in Japan:a comparative risk assessment. PLoS Med 9:e1001160, 2012

7)Chung Y, et al:Temporal Changes in Mortality Related to Extreme Temperatures for 15 Cities in Northeast Asia:Adaptation to Heat and Maladaptation to Cold. Am J Epidemiol 185:907-913, 2017

8)The Eurowinter Group:Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe. Lancet 349:1341-1346, 1997

9)Holowatz LA, et al:Peripheral mechanisms of thermoregulatory control of skin blood flow in aged humans. J Appl Physiol(1985) 109:1538-1544, 2010

10)Wilson TE, et al:Skin-surface cooling elicits peripheral and visceral vasoconstriction in humans. J Appl Physiol(1985) 103:1257-1262, 2007

11)Saeki K, et al:Influence of room heating on ambulatory blood pressure in winter:a randomised controlled study. J Epidemiol Community Health 67:484-490, 2013

12)Saeki K, et al:Short-term effects of instruction in home heating on indoor temperature and blood pressure in elderly people:a randomized controlled trial. J Hypertens 33:2338-2343, 2015

13)Obayashi K, et al:Exposure to light at night, nocturnal urinary melatonin excretion, and obesity/dyslipidemia in the elderly:a cross-sectional analysis of the HEIJO-KYO study. J Clin Endocrinol Metab 98:337-344, 2013

14)Obayashi K, et al:Ambient Light Exposure and Changes in Obesity Parameters:A Longitudinal Study of the HEIJO-KYO Cohort. J Clin Endocrinol Metab 101:3539-3547, 2016

15)Obayashi K, et al:Bedroom Light Exposure at Night and the Incidence of Depressive Symptoms:A Longitudinal Study of the HEIJO-KYO Cohort. Am J Epidemiol 187:427-434, 2018

16)Saeki K, et al:Stronger association of indoor temperature than outdoor temperature with blood pressure in colder months. J Hypertens 32:1582-1589, 2014

17)Saeki K, et al:The relationship between indoor, outdoor and ambient temperatures and morning BP surges from inter-seasonally repeated measurements. J Hum Hypertens 28:482-488, 2014

18)Umishio W, et al:Cross-Sectional Analysis of the Relationship Between Home Blood Pressure and Indoor Temperature in Winter:A Nationwide Smart Wellness Housing Survey in Japan. Hypertension 74:756-766, 2019

19)Saeki K, et al:Platelet count and indoor cold exposure among elderly people:A cross-sectional analysis of the HEIJO-KYO study. J Epidemiol 27:562-567, 2017

20)Keatinge W R, et al:Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling:factors in mortality from coronary and cerebral thrombosis in winter. Br Med J(Clin Res Ed) 289:1405-1408, 1984

21)Ghebre M A, et al:Prospective study of seasonal patterns in hemostatic factors in older men and their relation to excess winter coronary heart disease deaths. J Thromb Haemost 10:352-358, 2012

22)Woodhouse P R, et al:Seasonal variations of plasma fibrinogen and factor Ⅶ activity in the elderly:winter infections and death from cardiovascular disease. Lancet 343:435-439, 1994