Health Risk Assessment of the Large-Scale Heat Waves — Northern China, 2023

Chen Chen¹; Runmei Ma¹; Shunshun Zhang²; Yueqiao Zhou¹; Wenfeng Fan¹, Haiqiong Lu¹, Yuanyuan Liu¹; Qing Wang¹; Tiantian Li^1,#

1. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health, China Meteorological Administration Key Laboratory of Meteorological Medicine and Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China;

2. School of Environmental Science and Engineering, Nanjing University of Information Science & Technology, Nanjing City, Jiangsu Province, China.

^# Corresponding author: Tiantian Li, litiantian@nieh.chinacdc.cn.

In the summer of 2023, the world experienced unprecedented heat waves that broke previous records. As a typical sensitive area affected by global climate change, northern China is one of the most severely impacted regions. This study used heat wave health risk assessment technology to estimate excess deaths from heat waves occurring in 420 counties in northern China in June 2023. We used 24-hour daily mean temperatures as an assessment indicator of heat wave exposure, which was derived from the National Meteorological Science Data Center. Demographic data were obtained from the seventh National Population Census of China in 2020. Population mortality data were collected from the 2020 China Death Surveillance Dataset. Parameters from a time-series study on heat wave mortality risks across 272 Chinese cities were used to calculate the exposure-response relationship. In June 2023, 420 counties of northern China experienced a total of 599 heat waves, characterized by early onset, extreme heat intensity, long duration, and widespread impact. Heat wave-attributable excess mortality risk was 6.1 per million people, with the older persons aged ≥65 (4.7 per million people) and patients with cardiovascular diseases (5.6 per million people) worse affected. The June 2023 heat wave in northern China threatened the health of residents, especially the older persons and patients with cardiovascular diseases. These findings support the use of targeted warning systems and interventions to protect vulnerable populations in similar situations.

大规模热浪健康风险评估 — 中国华北地区，2023年

陈晨¹；马润美¹；张顺顺²；周月乔¹；范文锋¹；卢海琼¹；刘园园¹；王情¹；李湉湉^1,#

1. 传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心环境与人群健康重点实验室，中国气象局气象与医疗健康重点开放实验室，环境与健康相关产品安全所，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

2. 环境科学与工程学院，南京信息工程大学，南京市，江苏省，中国。

^# 通信作者：李湉湉， litiantian@nieh.chinacdc.cn。

2023年夏季，全球遭遇了前所未有的热浪。作为受全球气候变化影响的典型敏感区域，华北地区是受影响最为严重的地区之一。该区域人口密集，当地居民健康面临严重威胁，相关问题已引发高度关注。本研究采用热浪健康风险评估技术，评估2023年6月华北地区420个区县发生的热浪所导致的超额死亡情况。研究选取24小时逐日平均气温作为热浪暴露评估指标，该数据来源于国家气象科学数据中心。人口数据取自2020年中国第七次全国人口普查，人群死亡数据收集自2020年中国死因监测数据集。同时，采用一项覆盖中国272个城市的热浪死亡风险时间序列研究中的相关参数，计算暴露-反应关系。2023年6月，华北地区420个区县共计发生599次热浪事件（本研究将县域尺度的热浪定义为：逐日平均气温超过历史基线97.5%分位数，且持续2天及以上的高温事件），此次热浪过程呈现发生时间早、高温强度大、持续时间长、影响范围广的特征。热浪归因超额死亡风险为每百万人6.1例，其中65岁及以上老年人群（每百万人4.7例）与心血管疾病患者（每百万人5.6例）所受影响更为严重。6月21日至27日的持续性热浪，造成每百万人6.2例的超额死亡。2023年6月华北地区发生的热浪事件威胁当地居民健康，老年人群与心血管疾病患者等脆弱人群受影响尤为显著。上述研究结果可为构建针对性的早期预警体系、制定干预措施提供依据，从而在类似情景下保护脆弱人群健康。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.065

Differences in Major Causes of Death and Disease Burden Among Residents of Kashin-Beck Disease Endemic and Non-Endemic Areas — Heilongjiang Province, China, 2024

Zhifeng Xing^1,2,&；Yuqian Song^3,&；Songyao Zhang¹；Zewen Wang⁴；Shichun Yan²；Ying Wei⁵；Xue Han²；Shihui Yin²；Jun Yu^1,# 

1. Institute for Kashin-Beck Disease Control and Prevention, National Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin City, Heilongjiang Province, China

2. Heilongjiang Provincial Center for Disease Control and Prevention, Harbin City, Heilongjiang Province, China

3. School of Public Health, Harbin Medical University, Harbin City, Heilongjiang Province, China

4. School of Future Technology, Harbin Institute of Technology, Harbin City, Heilongjiang Province, China

5. Heilongjiang Provincial Hospital, Harbin City, Heilongjiang Province, China

^& Joint first authors.

^# Corresponding authors: Jun Yu, 400049@hrbmu.edu.cn.

This study compared the major causes of death and disease burden in Kashin-Beck disease (KBD) endemic and non-endemic areas of Heilongjiang Province in 2024. Data were obtained from the National Disease Surveillance Point system. Age-standardized mortality rates (ASMR), rate ratio, cause-eliminated life expectancy, potential gains in life expectancy, and the rate of life lost were calculated. The ASMR for ischemic heart disease was higher in endemic areas, whereas cerebral infarction showed a lower ASMR. For ischemic heart diseases, the ASMR was significantly higher in endemic areas, particularly among male (RR=2.79, 95% CI: 1.77, 5.38), residents aged ≥65 years (RR=2.17, 95% CI: 1.52, 3.39) and residents in economically developed regions (RR=3.00, 95% CI: 1.90, 5.93). For malignant neoplasms of digestive organs, the ASMR was higher in endemic areas than in non-endemic areas, and a significant difference in ASMR between the two areas was observed in females (RR=4.14, 95% CI: 1.63, 16.30). For cerebral infarction, the ASMR was significantly lower in endemic areas than in non-endemic areas, particularly among residents in economically developed regions (RR=0.32, 95% CI: 0.20, 0.55). The rates of life lost due to ischemic heart disease, cerebral infarction, and malignant neoplasms of the digestive organs in endemic areas were 11.32%, 1.42%, and 1.84%, respectively, compared with 4.22%, 6.36%, and 1.41% in non-endemic areas, respectively. These findings provide evidence for optimizing comprehensive prevention and control strategies for endemic diseases and strengthening interventions.

大骨节病病区与非病区居民主要死因及疾病负担的差异 — 黑龙江省，中国，2024年

邢智锋^1,2,&；宋雨倩^3,&；张松瑶¹；王泽文⁴；闫世春²；魏影⁵；韩雪²；尹世辉²；于钧^1,#

1. 大骨节病防治研究所, 中国疾病预防控制中心地方病控制中心，哈尔滨医科大学，哈尔滨市，黑龙江省，中国；

2. 黑龙江省疾病预防控制中心，哈尔滨市，黑龙江省，中国；

3. 公共卫生学院，哈尔滨医科大学，哈尔滨市，黑龙江省，中国；

4. 未来技术学院，哈尔滨工业大学，哈尔滨市，黑龙江省，中国 ；

5. 黑龙江省医院，哈尔滨市，黑龙江省，中国。

^& 共同第一作者。

^# 通信作者：于钧，400049@hrbmu.edu.cn。

本研究比较了2024年黑龙江省大骨节病病区与非病区的主要死因及疾病负担情况。数据来源于全国疾病监测点（DSP）系统。本研究计算了年龄标化死亡率（ASMR）、率比（RR）、去死因期望寿命（CELE）、预期寿命潜在增益（PGLE）及寿命损失率。大骨节病病区缺血性心脏病的年龄标化死亡率显著高于非病区，而脑梗死年龄标化死亡率低于非病区。缺血性心脏病方面，病区年龄标化死亡率显著高于非病区，其中男性（RR=2.79，95% CI：1.77, 5.38）、≥65岁人群（RR=2.17，95% CI：1.52, 3.39）及经济发达地区居民（RR=3.00，95% CI：1.90, 5.93）差异尤为显著。消化器官恶性肿瘤方面，病区年龄标化死亡率高于非病区，女性组间差异具有统计学意义（RR=4.14，95% CI：1.63, 16.30）。脑梗死方面，病区年龄标化死亡率显著低于非病区，尤以经济发达地区居民最为明显（RR=0.32，95% CI：0.20, 0.55）。病区缺血性心脏病、脑梗死、消化器官恶性肿瘤的寿命损失率分别为11.32%、1.42%、1.84%，非病区则分别为4.22%、6.36%、1.41%。本研究结果可为优化地方病综合防控策略、强化重点疾病干预措施提供科学依据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.066

Machine Learning-Based Assessment of Heat Vulnerability at County-Level — China, 2020

Yirong Liu¹; Yuanyuan Liu¹; Runmei Ma¹; Qing Wang¹; Tiantian Li^1,#

1. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease and Prevention, Beijing & Chinese Academy of Preventive Medicine, Beijing, China.

^# Corresponding authors: Tiantian Li, litiantian@nieh.chinacdc.cn.

Extreme heat poses an increasing threat to public health. Heat-vulnerability assessment, which integrates population sensitivity and adaptive capacity, is a vital approach for identifying vulnerable areas and providing targeted interventions. This study evaluates the county-level heat vulnerability across China in 2020. A comprehensive county-level assessment of heat vulnerability was conducted across China using the 2020 data encompassing socioeconomic, demographic, environmental, and infrastructure-related indicators. The Boruta machine-learning algorithm was applied to objectively identify indicators associated with the proportion of non-accidental deaths on extreme-heat days. A heat-vulnerability index (HVI) was constructed using principal component analysis and validated using linear regression against the proportion of non-accidental deaths on extreme-heat days. Ten key indicators were integrated into a county-level HVI representing national heat-vulnerability patterns in 2020. The HVI demonstrated a significant positive correlation with the proportion of non-accidental deaths on extreme-heat days (P<0.05). Spatial analysis revealed that high-vulnerability counties were primarily concentrated in Southwestern China, whereas low-vulnerability areas were mainly located in South China and the eastern coastal regions. Heat vulnerability exhibits significant spatial heterogeneity across China. Counties in Southwestern China show significantly higher vulnerability than the southern and eastern coastal areas and should be prioritized in heat-related prevention and adaptation planning. This study delivers an accurate and up-to-date representation of current vulnerability patterns by providing an updated and refined county-level assessment for 2020, supporting evidence-based public-health planning, efficient resource allocation, and climate-adaptation strategies to mitigate the impact of extreme heat.

基于机器学习的中国区县热脆弱性评估 — 中国，2020年

刘依荣¹；刘园园¹；马润美¹；王情¹；李湉湉^1,#

1. 传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心环境与人群健康重点实验室，环境与健康相关产品安全所，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者：李湉湉，litiantian@nieh.chinacdc.cn。

极端高温正日益成为公共健康的重要威胁。热脆弱性评估通过综合考虑人群敏感性和适应能力，是识别脆弱地区并制定针对性干预措施的重要手段。本研究旨在评估2020年中国区县尺度的热脆弱性水平。基于2020年数据，从社会经济、人口学、环境及基础设施等多个维度，对中国区县热脆弱性进行了综合评估。采用Boruta机器学习算法，客观筛选与极端高温日非意外死亡比例相关的指标；随后利用主成分分析（PCA）构建热脆弱性指数（HVI），并通过线性回归方法，以极端高温日非意外死亡比例对HVI进行验证。研究最终纳入10项关键指标，这些指标被整合用于构建2020年全国区县热脆弱性指数，刻画全国热脆弱性的空间格局。结果表明，HVI与极端高温日非意外死亡比例呈显著正相关（P < 0.05）。空间分析显示，高脆弱性区县主要集中在中国西南地区，而低脆弱性地区主要分布于中国南方及东部沿海地区。中国热脆弱性在空间上表现出显著异质性。西南地区区县的热脆弱性明显高于南方和东部沿海地区，应在高温相关的预防和适应规划中予以优先关注。通过提供2020年更新且精细化的区县评估结果，本研究准确地反映了当前热脆弱性的空间格局，为循证公共卫生决策、资源高效配置以及气候变化适应策略的制定提供了科学依据，以减轻极端高温对健康的不利影响。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.067

Analysis of Indoor Radon Concentrations in Urban and Rural Areas in 20 Cities — China, 2023–2025

Bowei Ding¹, Yunyun Wu^1,#, Xianliang Wang^2,#, Yanchao Song¹, Hang Du², Haoran Sun¹, Jialu Li¹, Changsong Hou¹

1. Key Laboratory of Radiological Protection and Nuclear Emergency, National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China

2. Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China

^# Corresponding author: Yunyun Wu, wuyunyun@nirp.chinacdc.cn; Xianliang Wang, wangxianliang@nieh.chinacdc.cn.

As public concern over indoor environmental quality and healthy living conditions continues to grow, understanding indoor radon levels, their determinants, and urban-rural disparities in residential buildings has become increasingly important. This study measured indoor radon concentrations in 1,139 dwellings across 20 cities from 2023 to 2025 using the solid-state nuclear track detector (SSNTD) technique over a 6-month cumulative sampling period. The median indoor radon concentration was 67 Bq/m³, corresponding to an annual effective dose of 2.03 mSv/year. Urban areas had a median concentration of 65 Bq/m³ (dose: 1.97 mSv/year), while rural areas reached 72 Bq/m³ (dose: 2.18 mSv/year). Comparison with previous data revealed an increasing trend in indoor radon concentrations nationwide, with rural areas exhibiting significantly higher levels than urban areas. To mitigate indoor radon pollution, a comprehensive strategy is recommended, including controlling radon exhalation from building materials at the source, ensuring adequate ventilation, and inspecting and sealing structural cracks.

20个城市城乡室内氡浓度水平 — 中国，2023-2025年

丁博威¹； 武云云^1.#；王先良^2,#；宋延超¹；杜航²；孙浩然¹；李佳璐¹；侯长松¹

1. 中国疾病预防控制中心辐射防护与核应急重点实验室，辐射防护与核安全医学所，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

2. 中国疾病预防控制中心环境与人群健康重点实验室，环境与健康相关产品安全所，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者: 武云云，wuyunyun@nirp.chinacdc.cn；王先良，wangxianliang@nieh.chinacdc.cn。

随着人们对室内环境质量和健康居住条件关注度的不断提升，研究城乡居住建筑室内氡水平的分布规律以及影响因素对于制定科学合理的室内氡防控策略、保障城乡居民的居住健康具有重要的现实意义。本研究在全国范围内选取20个典型城市，每个城市布设约40个城镇点位和20个农村点位，采用固体核径迹法开展为期6个月的室内氡浓度累积测量。共获得1,139个有效数据，室内氡浓度中位数为67 Bq/m³，氡致居民年有效剂量为2.03 mSv。其中，城镇地区共810个数据，氡浓度中位数为65 Bq/m³（年有效剂量1.97 mSv）；农村地区共329个数据，氡浓度中位数为72 Bq/m³（年有效剂量2.18 mSv）。跟以往我国室内氡浓度调查相比，我国室内氡浓度呈现升高趋势。农村室内氡浓度高于城市室内氡浓度。为应对室内氡污染问题，建议采用综合策略。首先应从源头进行控制，严格按照国家标准选择建筑材料。其次，建议居民定期开窗通风，减少氡在室内的累积。此外，还应注意检查房间墙面和地面缝隙，并及时封堵，以减少土壤和建筑材料的氡析出量，从而降低室内氡对人体健康的危害。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.064

The Vector-Proofing Gap in Sponge City Design: Implications for Arboviral Risk Under Climate Adaptation — Guangdong Province, China, 2025

Yu Wang¹, Xinghai Wu², Bin Xu³, Xingui Sun⁴, Zhongjun Guan^5,#

1. School of Public Health, Peking University, Beijing, China;

2. Chuiyangliu Hospital Affiliated with Tsinghua University, Beijing, China;

3. Beijing Tiantan Hospital, Capital Medical University, Beijing, China;

4. Beijing Center for Disease Prevention and Control, Beijing, China;

5. Xuanwu Hospital, Capital Medical University, Beijing, China.

^# Corresponding authors: Zhongjun Guan, guanzhj@ccmu.edu.cn.

This Perspective examines the July 2025 chikungunya fever outbreak in Guangdong Province as a sentinel event exposing a practical gap in climate-resilient urban design. As of July 26, 2025, Guangdong had reported 4,824 confirmed cases, 98.5% in Foshan City and most concentrated in Shunde District. Although sponge-city green stormwater infrastructure (GSI) strengthens urban flood resilience, its detention and retention features can also generate cryptic, hard-to-inspect water habitats that sustain Aedes mosquito production under hot, humid conditions when post-storm dry-down and maintenance fall short. This Perspective synthesizes outbreak context, China's sponge-city evaluation metrics, and vector-ecology thresholds to define a vector-proofing gap: prevailing sponge-city guidance excels at hydrological performance but typically lacks explicit, measurable constraints on water residence time and inspectability tied directly to vector risk. An operational vector-proofing framework is proposed that 1) translates entomological risk into engineering indicators (e.g., post-storm dry-down within 48–72 hours where feasible, access/inspectability, and trigger-based maintenance), 2) embeds vector impact assessment across the project lifecycle, and 3) clarifies cross-sector responsibilities among housing/urban–rural development, water resources, and health agencies. Aligning hydrological and entomological objectives can reduce the likelihood that climate adaptation investments inadvertently shift risk from flooding to arboviral transmission.

“海绵城市”设计中的防媒缺口：对气候适应背景下虫媒病毒风险的启示 — 中国广东省，2025年

王宇¹，吴兴海²，徐玢³，孙鑫贵⁴，管仲军^5,#

1. 北京大学公共卫生学院，北京，中国；

2. 清华大学附属垂杨柳医院，北京，中国；

3. 首都医科大学附属北京天坛医院，北京，中国；

4. 北京市疾病预防控制中心，北京，中国；

5. 首都医科大学宣武医院，北京，中国。

^# 通信作者：管仲军，guanzhj@ccmu.edu.cn。

本观点文章以2025年7月广东省基孔肯雅热疫情作为一个哨点事件，揭示气候适应型城市设计中的一个现实缺口。截至2025年7月26日，广东全省累计报告确诊病例4,824例，其中98.5%发生在佛山市，且主要集中于顺德区。海绵城市绿色雨洪基础设施（GSI）虽然能够提升城市防洪韧性，但其滞蓄设施在高温高湿环境下，如暴雨后排干不及时、维护不足，也可能形成隐蔽且难以检查的积水生境，从而支持伊蚊孳生。本文综合了疫情背景、中国海绵城市评价指标以及媒介生态学阈值，提出了“防媒缺口”这一概念：现行海绵城市导则在水文绩效方面较为完善，但通常缺乏与媒介风险直接相关的、关于积水滞留时间和可检查性的明确且可测量约束。基于此，本文提出一套操作性的“防媒化”框架：一是将昆虫媒介风险转化为工程指标（如在可行情况下暴雨后48–72小时内完成排干、保障可进入/可检查性以及建立触发式维护机制）；二是在项目全生命周期嵌入媒介影响评估；三是明确住房城乡建设、水资源及卫生健康等部门之间的跨部门职责分工。将水文目标与媒介控制目标相协调，有助于降低气候适应投资在无意中将风险从洪涝转移为虫媒病毒传播风险的可能性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.068