ImportanceEnvironmental heat and cold exposure (EHCE) remains the principal preventable cause of morbidity and mortality in children and adolescents globally.ObjectiveTo report EHCE-related burden and analyze its temporal trends among children and adolescents from 1990 to 2019.Design, Setting, and ParticipantsThis repeated cross-sectional study used data from the Global Burden of Disease Study 2019, which encompassed 204 countries and territories from 1990 to 2019. Children and adolescents aged 0 to 19 years were included in the study. Data analysis occurred from December 2023 to March 2024.ExposureEHCE in children and adolescents from January 1990 to December 2019.Main Outcomes and MeasuresThe primary outcomes were cases and rates of EHCE incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Global trends in these metrics were also analyzed by sex, age, and sociodemographic index (SDI), which is a comprehensive indicator of the socioeconomic status of a country or region. A linear regression model was used to calculate AAPCs and a joinpoint regression model was used to identify the years in which trends changed significantly.ResultsFrom 1990 to 2019, EHCE-related incidence, prevalence, mortality, and DALYs showed a downward trend globally. However, an upward trend in EHCE incidence and prevalence was detected between 2010 and 2019 (incidence AAPC, 1.46; 95% CI, 1.05-1.87; prevalence AAPC, 1.25; 95% CI, 1.01-1.50). Regionally, although EHCE-related incidence showed a decreasing trend in most regions from 1990 to 2019, there were still some regions with an increasing trend (Southern sub-Saharan Africa AAPC, 0.23; 95% CI, 0.01-0.44). In 2019, the mortality and DALYs of EHCE were higher among children and adolescents in countries with low SDI levels. Additionally, the burden of EHCE among children and adolescents varied according to sex and age.Conclusions and RelevanceIn this cross-sectional study, a global increase was observed in EHCE incidence and prevalence since 2010. Furthermore, children and adolescents in low-SDI regions, which bear the brunt of the climate crisis, were disproportionately impacted. This suggests that future responses to climate change crises should emphasize health equity, which implies that vulnerable populations, such as children and adolescents, should be given priority in the allocation of resources to address climate change.

中文翻译：

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儿童和青少年环境热和冷暴露负担的时间趋势


重要性环境热和冷暴露 （EHCE） 仍然是全球儿童和青少年发病率和死亡率的主要可预防原因。目的报告 EHCE 相关负担并分析其在 1990 年至 2019.Design、环境和参与者的儿童和青少年中的时间趋势这项重复的横断面研究使用了 2019 年全球疾病负担研究的数据，该研究涵盖了 204 年至 1990 年的 2019 个国家和地区。该研究包括 0 至 19 岁的儿童和青少年。数据分析发生在 2023 年 12 月至 2024 年 3 月。暴露 1990 年 1 月至 2019 年 12 月儿童和青少年的 EHCE.主要结局和措施主要结局是 EHCE 发生率、患病率、死亡率、残疾调整生命年 （DALY） 和平均年度百分比变化 （AAPC） 的病例和比率。还通过性别、年龄和社会人口指数 （SDI） 分析了这些指标的全球趋势，SDI 是一个国家或地区社会经济地位的综合指标。线性回归模型用于计算 AAPC，连接点回归模型用于确定趋势发生显着变化的年份。结果1990—2019 年，EHCE 相关发病率、患病率、死亡率和 DALYs 在全球范围内呈下降趋势。然而，在 2010 年至 2019 年期间，检测到 EHCE 发病率和患病率呈上升趋势（发病率 AAPC，1.46;95% CI，1.05-1.87;患病率 AAPC，1.25;95% CI，1.01-1.50）。从区域来看，尽管 1990 年至 2019 年大多数地区的 EHCE 相关发病率呈下降趋势，但仍有一些地区呈上升趋势（撒哈拉以南非洲 AAPC，0.23;95% CI，0.01-0.44）。 2019 年，在 SDI 水平低的国家，儿童和青少年的 EHCE 死亡率和 DALY 较高。此外，儿童和青少年的 EHCE 负担因性别和年龄而异。结论和相关性在这项横断面研究中，自 2010 年以来，观察到 EHCE 的发病率和患病率在全球范围内增加。此外，在气候危机中首当其冲的低 SDI 地区的儿童和青少年受到了不成比例的影响。这表明，未来对气候变化危机的应对措施应强调健康公平，这意味着在分配资源以应对气候变化时，应优先考虑儿童和青少年等弱势群体。