過去已有研究證實單點的高低溫暴露會增加人體的健康危害，其中又以心血管疾病和呼吸道疾病的風險最為顯著，然而，由於人體長時間持續暴露在環境溫度下的累積效應，較能反映人體的實際暴露情形，但此類研究卻都著重在勞工族群，其結果不盡然可反映一般民眾的暴露情境和其對健康之衝擊，特別是對溫度有較高感受性的65歲以上族群。此外，現代人一天約有80%以上的時間都待在室內環境中，但有關室內溫度和人類健康關係之研究卻極為匱乏。因此本研究應用室內溫度推估模型，推算2000-2014年間和21世紀初期 (2016-2035)、中期 (2046-2065) 與末期 (2081-2100) 四個不同溫室氣體排放情境 (RCP2.6、RCP4.5、RCP6.0、RCP8.5) 下的室內溫度，並將一年分為暖季與冷季，分別探討不同季節下之室內溫度的累積效應對65歲以上族群之心血管疾病及呼吸道疾病急診次數的影響，再分層探討溫度累積效應對各次族群 (男性、女性、青老年、中老年與老老年) 之健康衝擊。
本研究蒐集2000年至2014年間的氣象因子、建築物特性和遙感觀測指標等資料，並將其代入本研究團隊過去建置的室內溫度預測模式，以估算出每小時的室內溫度，進而計算累積24小時之每一小時的溫度高於或低於某一基準溫度之溫度差總和，再連結衛生福利部衛生資料科學中心的200萬人抽樣檔之心血管疾病 (ICD-9-CM 390-459) 及呼吸道疾病 (ICD-9-CM 460-519) 急診就醫資料，以非線性遞延分配模型 (Distributed lag non-linear model, DLNM) 分析在控制空氣污染物濃度及時間趨勢等因素後，溫度累積效應對心血管疾病與呼吸道疾病急診次數之相對風險值 (Relative risk)，及在不同性別與年齡群的差異，使用的統計軟體為SAS9.4與R.3.5.3。
分析結果發現，在暖季期間，只要暴露的累積度時超過1個度時 (超過30°C) 即會增加1.3%的心血管與0.8%的呼吸道急診次數；在冷季期間，只要暴露的累積度時超過1個度時 (低於21°C) 即會增加1.1%的心血管與0.4%的呼吸道急診次數；依性別進行分層後，本研究發現無論暖季或冷季，累積度時超過1個度時即會導致心血管或呼吸道急診次數顯著增加的溫度閾值並沒有改變；但若依年齡進行分層後，在不同次族群之間，不同暴露情境下其溫度閾值會改變。在未來氣候變遷情境下，由於室內溫度略為增加，因此暖季時，年長者可調節之累積度時下降，冷季時，年長者可調節之累積度時增加，代表與高溫暴露情境下其健康效應越嚴重，與低溫暴露情境下其健康效應有些微減輕之現象。
相較於過去溫度與健康效應關係的研究，大多使用單點溫度指標，本研究使用溫度累積效應指標來探討溫度的暴露與人體健康效應之關係，其結果可貼近人體實際的暴露情形，也有助於做為未來建置溫度預警系統及擬定相關政策之參考。

Epidemiological studies have demonstrated that the cumulative effects of temperature were associated with cardiovascular and respiratory disease risks. However, these studies mostly focused on labor cohorts, not for the general population. Meanwhile, people spend over 80% of their time indoors and the elderly is often viewed as susceptible to higher temperature. The study is therefore aims to investigate the association between the cumulative effects of indoor temperature and health effects for the elders. This study predicted the indoor temperature in current and future scenarios by using an indoor temperature prediction model and explored the cumulative effects of indoor temperature exposure on the risks of emergency department visits for cardiovascular and respiratory diseases among elders and the age- and sex-stratified subgroup. Warming cumulative degree hours and cooling cumulative degree hours were linked to the counts of cardiovascular and respiratory diseases emergency department visits which was obtained from Longitudinal Health Insurance Database 2000 (LHID 2000). Data was then analyzed using a distributed lag non-linear model (DLNM). Thresholds on both cardiovascular disease and respiratory disease are 30°C for warming cumulative degree hours and 21°C for cooling cumulative degree hours in 2000-2014. Besides, thresholds on sex-stratified subgroups are unchanged, but some of them are not all the same in age-stratified subgroups. Additionally, the cumulative degree hours will decrease in the warm season and increase in the cool season under the future climate change scenarios. To clarify the threshold levels and the cumulative effect of indoor temperature for health risks will be useful for developing public health policy in the future.

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