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Gu W, Hu Y, Li Q, Feng H, Xue Y, Xu L, Chen Y, Zhou Y, Tong S, Liu S. Association of diurnal temperature range and childhood asthma: a population-based cross-sectional study in a Tropical City, China. BMC Public Health 2025; 25:1302. [PMID: 40197324 PMCID: PMC11974045 DOI: 10.1186/s12889-025-22470-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 03/24/2025] [Indexed: 04/10/2025] Open
Abstract
BACKGROUND Climate change has significantly impacted the diurnal temperature range (DTR), particularly in tropical regions of China, where DTR fluctuations are more frequent. While previous studies have primarily focused on the link between short-term DTR exposure and childhood asthma, there is limited information on the long-term effects from large-scale studies. METHODS In 2022, a cross-sectional survey involving 9,130 children aged 2-10 years was conducted using stratified cluster random sampling in tropical Sanya, Hainan Province, China. Data on demographics, and asthma symptoms were collected using the validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Temperature, precipitation and Normalized Difference Vegetation Index (NDVI) were obtained from remote sensing satellite. A generalized linear model (GLM) was employed to analyze the association between DTR exposure and asthma, and stratified analyses were conducted based on environmental and lifestyle factors. RESULTS The prevalence of childhood asthma was 7.57%, with the annual average DTR ranging from 5.15℃ to 7.26℃. After adjusting for potential confounders, each 1℃ increase in DTR was associated with a 65.9% higher risk of asthma (95% CI: 1.058, 2.602). Stratified analyses indicated that the impact of DTR on asthma risk was stronger among children living in areas with higher temperatures, higher precipitation, lower vegetation coverage (measured by NDVI), as well as those who were not breastfed, exposed to passive smoking, or whose mothers had pets during pregnancy. CONCLUSIONS In Sanya, increased annual DTR was significantly associated with a higher odds of childhood asthma, and this effect was influenced by environmental and lifestyle factors. Therefore, public health strategies could mitigate childhood asthma risk associated with DTR through urban greening, advocating for breastfeeding, reducing secondhand smoke, and avoiding pet ownership during pregnancy.
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Affiliation(s)
- Wangyang Gu
- School of Public Health, Hainan Medical University, Haikou, China
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
| | - Yabin Hu
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Qinpeng Li
- School of Public Health, Hainan Medical University, Haikou, China
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
| | - Huike Feng
- School of Public Health, Hainan Medical University, Haikou, China
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
| | - Yihao Xue
- School of Public Health, Hainan Medical University, Haikou, China
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
| | - Linling Xu
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
- School of Basic Medicine and Life Science, Hainan Medical University, Haikou, China
| | - Yang Chen
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yushi Zhou
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
- National Institute of Environmental Health, Chinese Centers for Disease Control and Prevention, Beijing, China
| | - Shijian Liu
- School of Public Health, Hainan Medical University, Haikou, China.
- Sanya Women and Children's Hospital Affiliated to Hainan Medical University, Sanya, China.
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, China.
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
- School of Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University, 1678 Dongfang Road, Shanghai, 200127, China.
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Yu J, Zhu A, Liu M, Dong J, Tian T, Liu T, Zhang K, Zhang X, Ruan Y. The correlation between daily temperature, diurnal temperature range, and asthma hospital admissions in Lanzhou city, 2013-2020. BMC Public Health 2024; 24:2454. [PMID: 39251927 PMCID: PMC11386359 DOI: 10.1186/s12889-024-19737-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 08/08/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND With the backdrop of global climate change, the impact of climate change on respiratory diseases like asthma is receiving increasing attention. However, the effects of temperature and diurnal temperature range (DTR) on asthma are complex, and understanding these effects across different seasons, age groups, and sex is of utmost importance. METHODS This study utilized asthma hospitalization data from Lanzhou, China, and implemented a distributed lag nonlinear model (DLNM) to investigate the relationship between temperature and DTR and asthma hospitalizations. It considered differences in the effects across various seasons and population subgroups. RESULTS The study revealed that low temperatures immediately increase the risk of asthma hospitalization (RR = 1.2010, 95% CI: 1.1464, 1.2580), and this risk persists for a period of time. Meanwhile, both high and low DTR were associated with an increased risk of asthma hospitalization. Lower temperatures (RR = 2.9798, 95% CI: 1.1154, 7.9606) were associated with higher asthma risk in the warm season, while in the cold season, the risk significantly rose for the general population (RR = 3.6867, 95% CI: 1.7494, 7.7696), females (RR = 7.2417, 95% CI: 2.7171, 19.3003), and older individuals (RR = 18.5425, 95% CI: 5.1436, 66.8458). In the warm season, low DTR conditions exhibited a significant association with asthma hospitalization risk in males (RR = 7.2547, 95% CI: 1.2612, 41.7295) and adults aged 15-64 (RR = 9.9494, 95% CI: 2.2723, 43.5643). Children also exhibited noticeable risk within specific DTR ranges. In the cold season, lower DTR increases the risk of asthma hospitalization for the general population (RR = 3.1257, 95% CI: 1.4004, 6.9767). High DTR significantly increases the risk of asthma hospitalization in adults (RR = 5.2563, 95% CI: 2.4131, 11.4498). CONCLUSION This study provides crucial insights into the complex relationship between temperature, DTR, and asthma hospitalization, highlighting the variations in asthma risk across different seasons and population subgroups.
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Affiliation(s)
- Jingze Yu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Anning Zhu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Miaoxin Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Tian Tian
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Tong Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Ke Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Xiaowen Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China
| | - Ye Ruan
- School of Public Health, Lanzhou University, Lanzhou, 730000, PR China.
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Jiang F, Wang R, Yang Y, Jia X, Ma L, Yuan M, Liu K, Bao J. Effects of intra- and inter-day temperature change on acute upper respiratory infections among college students, assessments of three temperature change indicators. Front Public Health 2024; 12:1406415. [PMID: 39247226 PMCID: PMC11377250 DOI: 10.3389/fpubh.2024.1406415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/31/2024] [Indexed: 09/10/2024] Open
Abstract
Background Acute upper respiratory infection (AURI) is a significant disease affecting all age groups worldwide. The differences in the impacts of different temperature change indicators, such as diurnal temperature range (DTR), temperature variation (TV), and temperature change between neighboring days (TCN), on AURI morbidity, are not clear. Methods We collected data on 87,186 AURI patients during 2014-2019 in Zhengzhou. Distributed lag non-linear model was adopted to examine the effects of different temperature change indicators on AURI. We calculated and compared the attributable fractions (AF) of AURI morbidity caused by various indicators. We used stratified analysis to investigate the modification effects of season and gender. Results With the increase in DTR and TV, the risk of AURI tended to increase; the corresponding AF values (95% eCI) higher than the references (5% position of the DTR or TV distribution) were 24.26% (15.46%, 32.05%), 23.10% (15.59%, 29.20%), and 19.24% (13.90%, 24.63%) for DTR, TV0 - 1, and TV0 - 7, respectively. The harmful effects of TCN on AURI mainly occurred when the temperature dropped (TCN < 0), and the AF value of TCN below the reference (0°C) was 3.42% (1.60%, 5.14%). The harm of DTR and TV were statistically significant in spring, autumn and winter, but not in summer, while the harm of TCN mainly occurred in winter. Three indicators have statistically significant effects on both males and females. Conclusions High DTR and TV may induce AURI morbidity, while the harm of TCN occurs when the temperature drops. The impacts of DTR and TV on AURI are higher than that of TCN, and the impact of few-day TV is higher than that of multi-day TV. The adverse effects of DTR and TV are significant except in summer, while the hazards of TCN mainly occur in winter.
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Affiliation(s)
- Feng Jiang
- Department of Disease Prevention and Control, Zhengzhou University Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Rensong Wang
- Department of Emergency, Shanghai Fengxian District Medical Emergency Center, Shanghai, China
| | - Yongli Yang
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaocan Jia
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Leying Ma
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Mengyang Yuan
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Kangkang Liu
- Department of Research Center for Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Junzhe Bao
- Department of Biostatistics and Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Hu Y, Yang G, Wang D, Gu W, Xie D, Huang T, Xue P, Tang J, Wei H, Li S, Tong S, Liu S. Associations of Insecticide Exposure with Childhood Asthma and Wheezing: A Population-Based Cross-Sectional Study in Sanya, China. TOXICS 2024; 12:392. [PMID: 38922071 PMCID: PMC11209441 DOI: 10.3390/toxics12060392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024]
Abstract
Insecticide exposure may affect childhood asthma/wheezing, but evidence is scarce in low- and middle-income countries. We conducted a population-based cross-sectional study in Sanya, China. Generalized linear models were adopted to assess the associations of insecticide exposure with childhood asthma/wheezing, reported as odds ratios (ORs) and 95% confidence intervals (CIs). A subgroup analysis was performed to explore the possible effects of sociodemographic and environmental factors on these associations. The median age of the 9754 children was 6.7 years, and 5345 (54.8%) were boys. The prevalences of ever asthma (EA), ever wheezing (EW), and current wheezing (CW) were 7.4%, 5.3%, and 2.9%, respectively. We found a greater prevalence of childhood EA with insecticide exposure (OR = 1.18, 95% CI: 1.00, 1.38). Outdoor insecticide exposure was associated with elevated ORs for EA (1.24, 95% CI: 1.03, 1.50), EW (1.27, 95% CI: 1.03, 1.57), and CW (1.38, 95% CI: 1.04, 1.81). The p for the trend in insecticide exposure frequency was significant for EA (p = 0.001) and CW (p = 0.034). These adverse impacts were pronounced in girls who were exposed to low temperatures. Our findings suggest adverse effects of insecticide use, especially outdoors, on childhood asthma/wheezing. Further studies are warranted to verify this association and develop tailored prevention measures.
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Affiliation(s)
- Yabin Hu
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (P.X.); (J.T.)
| | - Guiyan Yang
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
| | - Dan Wang
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
| | - Wangyang Gu
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
| | - Dan Xie
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
| | - Tingyue Huang
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
| | - Peng Xue
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (P.X.); (J.T.)
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China;
| | - Jingyi Tang
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (P.X.); (J.T.)
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China;
| | - Hui Wei
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China;
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Centers for Disease Control and Prevention, Beijing 102206, China;
- School of Public Health and Social Work, Queensland University of Technology, Brisbane 4001, Australia
| | - Shijian Liu
- Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; (Y.H.); (W.G.); (T.H.); (H.W.)
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (P.X.); (J.T.)
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China;
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Zhai C, Bai L, Xu Y, Liu Y, Sun H, Gong X, Yu G, Zong Q, Hu W, Wang F, Cheng J, Zou Y. Temperature variability associated with respiratory disease hospitalisations, hospital stays and hospital expenses the warm temperate sub-humid monsoon climate. Public Health 2023; 225:206-217. [PMID: 37939462 DOI: 10.1016/j.puhe.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/25/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES The abrupt change of climate has led to an increasing trend of hospitalised patients in recent years. This study aimed to analyse the temperature variability (TV) associated with respiratory disease (RD) hospitalisations, hospital stays and hospital expenses. STUDY DESIGN The generalized linear model combined with distributed lag non-linear model was used to investigate the association between TV and RD hospitalisations. METHODS TV was determined by measuring the standard deviation of maximum and minimum temperatures for the current day and the previous 7 days. RD hospitalisations data were obtained from three major tertiary hospitals in Huaibei City, namely, the Huaibei People's Hospital, the Huaibei Hospital Of Traditional Chinese Medicine and the Huaibei Maternal and Child Health Care Hospital. First, using a time series decomposition model, the seasonality and long-term trend of hospitalisations, hospital stays and hospital expenses for RD were explored in this warm temperate sub-humid monsoon climate. Second, robust models were used to analyse the association between TV and RD hospitalisations, hospital stays and hospital expenses. In addition, this study stratified results by sex, age and season. Third, using the attributable fraction (AF) and attributable number (AN), hospitalisations, hospital stays and hospital expenses for RD attributed to TV were quantified. RESULTS Overall, 0.013% of hospitalisations were attributed to TV0-1 (i.e. TV at the current day and previous 1 day), corresponding to 220 cases, 1603 days of hospital stays and 1,308,000 RMB of hospital expenses. Females were more susceptible to TV than males, and the risk increased with longer exposure (the highest risk was seen at TV0-7 [i.e. TV at the current day and previous 7 days] exposure). Higher AF and AN were observed at ages 0-5 years and ≥65 years. In addition, it was also found that TV was more strongly linked to RD in the cool season. The hot season was positively associated with hospital stays and hospital expenses at TV0-3 to TV0-7 exposure. CONCLUSIONS Exposure to TV increased the risk of hospitalisations, longer hospital stays and higher hospital expenses for RD. The findings suggested that more attention should be paid to unstable weather conditions in the future to protect the health of vulnerable populations.
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Affiliation(s)
- Chunxia Zhai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Liangliang Bai
- School of Biomedical Engineering, Anhui Medical University, Hefei, Anhui, China
| | - Ying Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yuqi Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hongyu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - XingYu Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Guanghui Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qiqun Zong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Wanqin Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Fang Wang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yanfeng Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
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He L, Evans S, Norris C, Barkjohn K, Cui X, Li Z, Zhou X, Li F, Zhang Y, Black M, Bergin MH, Zhang J(J. Associations between personal apparent temperature exposures and asthma symptoms in children with asthma. PLoS One 2023; 18:e0293603. [PMID: 37956155 PMCID: PMC10642815 DOI: 10.1371/journal.pone.0293603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
Ambient temperature and relative humidity can affect asthma symptoms. Apparent temperature is a measure of temperature perceived by humans that takes into account the effect of humidity. However, the potential link between personal exposures to apparent temperature and asthma symptoms has not been investigated. We conducted a panel study of 37 asthmatic children, aged 5-11 years, during an early spring season (average daily ambient temperature: 14°C, range: 7-18°C). Asthma symptoms were measured 4 times for each participant with a 2-week interval between consecutive measurements using the Childhood Asthma-Control Test (C-ACT). Average, minimum, and maximum personal apparent temperature exposures, apparent temperature exposure variability (TV), and average ambient temperature were calculated for the 12 hours, 24 hours, week, and 2 weeks prior to each visit. We found that a 10°C lower in 1-week and 2-week average & minimum personal apparent temperature exposures, TV, and average ambient temperature exposures were significantly associated with lower total C-ACT scores by up to 2.2, 1.4, 3.3, and 1.4 points, respectively, indicating worsened asthma symptoms. Our results support that personal apparent temperature exposure is potentially a stronger driver than ambient temperature exposures for the variability in asthma symptom scores. Maintaining a proper personal apparent temperature exposure could be an effective strategy for personalized asthma management.
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Affiliation(s)
- Linchen He
- Department of Community and Population Health, College of Health, Lehigh University, Bethlehem, Pennsylvania, United States of America
| | - Shoshana Evans
- Department of Community and Population Health, College of Health, Lehigh University, Bethlehem, Pennsylvania, United States of America
| | - Christina Norris
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Karoline Barkjohn
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina, United States of America
- Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, United States of America
| | - Xiaoxing Cui
- Nicholas School of the Environment, Duke University, Durham, North Carolina, United States of America
| | - Zhen Li
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaojian Zhou
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Li
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing, China
| | - Marilyn Black
- Underwriters Laboratories, Inc, Marietta, Georgia, United States of America
| | - Michael H. Bergin
- Department of Civil and Environmental Engineering, Duke University, Durham, North Carolina, United States of America
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment, Duke University, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Duke Kunshan University, Kunshan, Jiangsu Province, China
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Wen B, Wu Y, Guo Y, Li S. A new method to separate the impacts of interday and intraday temperature variability on mortality. BMC Med Res Methodol 2023; 23:92. [PMID: 37061686 PMCID: PMC10105159 DOI: 10.1186/s12874-023-01914-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/04/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Temperature variability (TV) is associated with increased mortality risks. However, the independent impacts of interday and intraday are still unknown. METHODS We proposed a new method to decompose TV into interday TV and intraday TV through algebra derivation. Intraday TV was defined as the weighted average standard deviation (SD) of minimum temperature and maximum temperature on each day. Interday TV was defined as the weighted SD of daily mean temperatures during the exposure period. We then performed an illustrative analysis using data on daily mortality and temperature in France in 2019-2021. RESULTS The novel interday and intraday TV indices were good proxies for existing indicators, inlcluding diurnal temperature range (DTR) and temperature change between neighbouring days (TCN). In the illustrative analyses, interday and intraday TVs showed differentiated mortality risks. Mortality burden related to TV was mainly explained by the intraday component, accounting for an attributable fraction (AF) of 1.81% (95% CI: 0.64%, 2.97%) of total mortality, more than twice the AF of interday TV (0.86%, 95% CI: 0.47%, 1.24%). CONCLUSIONS This study proposed a novel method for identifying and isolating the different components of temperature variability and offered a comprehensive way to investigate their health impacts.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
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Zheng J, Yue L, Wang B, Li Y, Zhang L, Xue B, Tian X, Lei R, Luo B. Seasonal characteristics of ambient temperature variation (DTR, TCN, and TV 0-t) and air pollutants on childhood asthma attack in a dry and cold city in China. ENVIRONMENTAL RESEARCH 2023; 217:114872. [PMID: 36435499 DOI: 10.1016/j.envres.2022.114872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 06/16/2023]
Abstract
Very few researches have concentrated on a variety of time scales to evaluate the association between temperature variation (TV) and childhood asthma (CA), and the evidence for the interaction of air pollutants on this association is lacking. In this study, we aim to estimate the relative risks (RRs) of CA due to TV by following metrics: diurnal temperature range (DTR), temperature changes between neighboring days (TCN), and temperature variability (TV0-t); to quantify the seasonal attributable fraction (AF) and number (AN) of CA due to TV; to examine the interactive effects of the TV and air pollutants on CA in different seasons. We mainly applied distributed lagged nonlinear model (DLNM) and conditional Poisson models to evaluate the associations between TV and outpatient visits for CA during 2014-2019 in Lanzhou, China. Additionally, the bivariate response surface model was used to examine the interplay effect of air pollutants. We found that in warm season, the risks of DTR maximum at lag5 (RR = 1.073, 95% CI: 1.017-1.133); TCN showed protective effect. In cold season, the risks of DTR peaked at lag8 (RR = 1.063, 95% CI: 1.027-1.100); the risks of TCN maximum at lag0 (RR = 1.058 95% CI: 1.009-1.109); the estimation of total cases maximized at TV0-4 in cold season (RR = 1.039 at TV0-3, 95% CI: 1.001, 1.077) and was the lowest at TV0-1 in warm season (RR = 0.999, 95% CI: 0.969, 1.030). In addition, the response surface model graphically pictured ambient air pollutants enhanced the DTR/TV0-4-CA effect for girls. In conclusion, the RRs of CA are markedly increased by TV exposure, particularly during the colder months. A combined evaluation of DTR, TCN, TV0-5∼TV0-6, NO2, SO2, and PM2.5 should be used to identify the adverse effects of TV on CA.
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Affiliation(s)
- Jie Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Li Yue
- Department of Child Healthcare of Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730030, PR China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Yanlin Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, PR China.
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Diurnal temperature range impacts on outpatients department visits for allergic rhinitis in Lanzhou, China. Int Arch Occup Environ Health 2023; 96:587-595. [PMID: 36624239 DOI: 10.1007/s00420-023-01951-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aims to investigate the association between the diurnal temperature range (DTR) and allergic rhinitis (AR) outpatient visits in Lanzhou, China, utilizing more than 7 years of participant surveys. METHODS Our study used the distributed lag non-linear model (DLNM) aimed to evaluate the association between DTR and AR outpatient visits. We also performed subgroup analyses in order to find susceptible populations by gender and age groups. RESULTS In 2013-2019, DTR in Lanzhou demonstrates a non-linear correlation with outpatient visits for AR, which is S-shaped. In addition, when DTR was located in the 0.9-5.3 °C and 12-20 °C compared with 12 °C, the risk of outpatient visits for AR increased. Moreover, males appeared to be more vulnerable to the DTR effect than females, the risk of children visits exceeded both the adult and the elderly groups at the higher DTR. CONCLUSION Our study adds to the evidence that DTR is a possible risk factor for outpatient visits for AR; therefore, the public health sector and medical staff should take DTR into account when it comes to preventing AR onset.
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