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Huang HN, Li X, Peng Z, Liao YF, Li L, Nardocci AC, Ou CQ, Yang Z. Mortality risk and burden of aortic aneurysm and dissection attributable to low temperatures: A nationwide case-crossover analysis in Brazil, a predominantly tropical country. ENVIRONMENT INTERNATIONAL 2024; 190:108895. [PMID: 39059022 DOI: 10.1016/j.envint.2024.108895] [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: 03/21/2024] [Revised: 06/05/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Low temperatures are adverse contributors to cardiovascular diseases, but the associations between short-term exposure to cold and the risk of death from aortic dissection and aneurysm remain unclear, particularly in tropical regions. OBJECTIVE This study was conducted based on 123,951 records of deaths caused by aortic dissection and aneurysms extracted from the national Mortality Information System in Brazil between 2000 and 2019. METHODS Relative risks and 95 % confidence intervals (CI) for the aortic-related deaths associated with low ambient temperatures were estimated using the conditional logistic model combined with the distributed lag nonlinear model. Subgroup analyses were performed by age group, sex, race, education level, and residential region. Furthermore, this study calculated the number and fraction of aortic-related deaths attributed to temperatures below the temperature threshold to quantify the cold-related mortality burden of aortic diseases. RESULTS During the study period, aortic-related deaths and mortality rates in Brazil exhibited a steady increase, rising from 4419 (2.66/100,000) in 2000 to 8152 (3.88/100,000) in 2019. Under the identified temperature threshold (26 °C), per 1 °C decrease in daily mean temperature was associated with a 4.77 % (95 % CI: 4.35, 5.19) increase in mortality risk of aortic-related diseases over lag 0-3 days. Females, individuals aged 50 years or older, Asian and Black race, and northern residents were more susceptible to low temperatures. Low temperatures were responsible for 19.10 % (95 % CI: 17.71, 20.45) of aortic-related deaths in Brazil. CONCLUSION This study highlights that low temperatures were associated with an increased risk of aortic-related deaths, with a remarkable burden even in this predominantly tropical country.
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Affiliation(s)
- Hao-Neng Huang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xin Li
- Department of Emergency Medicine, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zhen Peng
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yi-Fu Liao
- Department of Neurology, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Adelaide C Nardocci
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China; Department of Emergency Medicine, Guangdong Provincial People's Hospital, (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Hu K, Wang S, Fei F, Song J, Chen F, Zhao Q, Shen Y, Fu J, Zhang Y, Cheng J, Zhong J, Yang X, Wu J. Modifying temperature-related cardiovascular mortality through green-blue space exposure. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2024; 20:100408. [PMID: 38560758 PMCID: PMC10979139 DOI: 10.1016/j.ese.2024.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Green-blue spaces (GBS) are pivotal in mitigating thermal discomfort. However, their management lacks guidelines rooted in epidemiological evidence for specific planning and design. Here we show how various GBS types modify the link between non-optimal temperatures and cardiovascular mortality across different thermal extremes. We merged fine-scale population density and GBS data to create novel GBS exposure index. A case time series approach was employed to analyse temperature-cardiovascular mortality association and the effect modifications of type-specific GBSs across 1085 subdistricts in south-eastern China. Our findings indicate that both green and blue spaces may significantly reduce high-temperature-related cardiovascular mortality risks (e.g., for low (5%) vs. high (95%) level of overall green spaces at 99th vs. minimum mortality temperature (MMT), Ratio of relative risk (RRR) = 1.14 (95% CI: 1.07, 1.21); for overall blue spaces, RRR = 1.20 (95% CI: 1.12, 1.29)), while specific blue space types offer protection against cold temperatures (e.g., for the rivers at 1st vs MMT, RRR = 1.17 (95% CI: 1.07, 1.28)). Notably, forests, parks, nature reserves, street greenery, and lakes are linked with lower heat-related cardiovascular mortality, whereas rivers and coasts mitigate cold-related cardiovascular mortality. Blue spaces provide greater benefits than green spaces. The severity of temperature extremes further amplifies GBS's protective effects. This study enhances our understanding of how type-specific GBS influences health risks associated with non-optimal temperatures, offering valuable insights for integrating GBS into climate adaptation strategies for maximal health benefits.
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Affiliation(s)
- Kejia Hu
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, 310058, China
| | - Shiyi Wang
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Jinglu Song
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Feng Chen
- Zhejiang Institute of Meteorological Sciences, Hangzhou, 310008, China
| | - Qi Zhao
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Yujie Shen
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Jingqiao Fu
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Jiayu Wu
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
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Zhai G, Gao Z, Zhou W. Effects of apparent temperature on cardiovascular disease admissions in rural areas of Linxia Hui Autonomous Prefecture. Sci Rep 2023; 13:14971. [PMID: 37696907 PMCID: PMC10495458 DOI: 10.1038/s41598-023-42232-9] [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: 05/27/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023] Open
Abstract
Cardiovascular disease (CVD) is a major threat to public health worldwide. The relationship between CVD and temperature has been widely reported in developed countries and regions. However, there are few studies of severe CVD in poor rural areas of developing countries. Therefore, this study aimed to explore the relationship between CVD and apparent temperature (AT) in a rural area of Linxia Hui Autonomous Prefecture, China. Daily CVD admission data and meteorological data were collected from Linxia between 2014 and 2015. The media of AT was used as the reference temperature to estimate the cumulative relative risk (RR) of CVD admission. The distributed lag non-linear models were used to examine the association between AT and cumulative RR of CVD admission at lag 0-21 days. In Linxia, high AT (20 °C) had a persistent adverse effect on cumulative RR of CVD admissions, and the RR increased with increasing lag days. Cold (- 10 °C) had a protective effect on the first and later lag days (lag 0-14 and lag 0-21). Adults (aged < 65 years) and females were more susceptible to the effects of heat than males and the elderly (aged ≥ 65 years). In Linxia, China, extremely high AT is an important risk factor for CVD hospitalizations in suburban and rural populations.
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Affiliation(s)
- Guangyu Zhai
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China
| | - Ziyao Gao
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China.
| | - Wenjuan Zhou
- Gansu Provincial Hospital, Lanzhou, 730000, Gansu, People's Republic of China
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Sun X, Tan J, Chen Y, Liu Y, Dong GH, Yang BY, Li N, Wang L, Li S, Chen G, Guo Y. The association between long-term exposure to outdoor artificial light at night and poor sleep quality among Chinese veterans: A multi-city study. Int J Hyg Environ Health 2023; 252:114218. [PMID: 37429120 DOI: 10.1016/j.ijheh.2023.114218] [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: 01/03/2023] [Revised: 06/26/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND A handful of previous studies have reported the association between exposure to outdoor artificial light at night (ALAN) and sleep problems. However, evidence for such association is limited in low- and middle-income countries. This study aimed to examine the association between outdoor ALAN exposure and sleep quality in veterans across different regions of China. METHODS Within the network of the Chinese Veteran Clinical Research Platform, we selected 7258 participants from 277 veteran communities in 18 cities across China during December 2009 and December 2011, using a multi-stage stratified cluster sampling strategy. Face-to-face interviews with the participants were conducted by trained investigators. We used the Pittsburgh Sleep Quality Index (PSQI) to assess participants' sleep quality. We defined poor sleep quality as a PSQI global score >7. The 3-year average exposure to outdoor ALAN prior to the baseline interview was calculated using satellite imagery data, according to participants' geolocation information. The association of ALAN exposure with sleep quality was examined using the mixed-effects logistic regression models with natural cubic splines. RESULTS The exposure-response curve for sleep quality associated with ALAN exposure was nonlinear, with a threshold value of 49.20 nW/cm2/sr for the 3-year average exposure to outdoor ALAN prior to the baseline interview. Higher ALAN exposure above the threshold was associated with increased risk of poor sleep quality. After adjusting for potential confounders, the odds ratios (and 95%CI, 95% confidence intervals) were 1.15 (0.97, 1.36) and 1.45 (1.17, 1.78) at the 75th and 95th percentiles of ALAN against the threshold. The association of ALAN exposure with poor sleep quality was more pronounced in veterans with depression than those without. Higher OR of poor sleep quality at the 75th percentile of ALAN against the threshold was observed in veterans with depression than those without [2.09 (1.16, 3.76) vs. 1.09 (0.92, 1.30)]. CONCLUSIONS Long-term exposure to outdoor ALAN was associated with higher risk of poor sleep quality in Chinese veterans. Effective outdoor ALAN management may help to reduce the burden of sleep disorders in Chinese veterans.
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Affiliation(s)
- Xinyi Sun
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiping Tan
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100039, China
| | - Yan Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Guang-Hui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bo-Yi Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China
| | - Luning Wang
- Geriatric Neurology Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100039, China
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Shrikhande SS, Pedder H, Röösli M, Dalvie MA, Lakshmanasamy R, Gasparrini A, Utzinger J, Cissé G. Non-optimal apparent temperature and cardiovascular mortality: the association in Puducherry, India between 2011 and 2020. BMC Public Health 2023; 23:291. [PMID: 36755271 PMCID: PMC9909923 DOI: 10.1186/s12889-023-15128-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time. METHODS Using in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (Tapp) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between Tapp and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach. RESULTS We found that the optimal temperature range for Puducherry is between 30°C and 36°C with respect to CVDs. Both cold and hot non-optimal Tapp were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that males were more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature. CONCLUSION Both heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans.
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Affiliation(s)
- Shreya S Shrikhande
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Hugo Pedder
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- School of Public Health and Family Medicine, Centre for Environmental and Occupational Health Research, University of Cape Town, Cape Town, South Africa
| | - Ravivarman Lakshmanasamy
- State Surveillance Officer, Department of Health and Family Welfare Services, Govt. of Puducherry, Puducherry, India
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre On Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Chen H, Zhang X. Influences of temperature and humidity on cardiovascular disease among adults 65 years and older in China. Front Public Health 2023; 10:1079722. [PMID: 36699927 PMCID: PMC9868618 DOI: 10.3389/fpubh.2022.1079722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Background The burden of cardiovascular disease (CVD) on the current aging society in China is substantial. Climate change, including extreme temperatures and humidity, has a detrimental influence on health. However, epidemiological studies have been unable to fully identify the association between climate change and CVD among older adults. Therefore, we investigated the associations between temperature and relative humidity and CVD among older adults in China. Methods We used cohort data from the China Longitudinal Health and Longevity Survey (CLHLS) conducted in 2002, 2005, 2008, 2011, 2014, and 2018. A total of 39,278 Chinese adults 65 years and older participated in the analyses. The average annual temperatures and relative humidity during 2001 and 2017 (before the survey year) at the city level in China were used as the exposure measures. We selected patients with hypertension, heart disease, and stroke to create a sample of CVD patients. The associations between temperature and relative humidity and CVD were analyzed using the generalized estimation equation (GEE) model. Covariates included sociodemographic factors, health status, lifestyle, and cognitive function. Results The average annual temperature was negatively correlated with the prevalence of CVD. Every 1°C increase in the average annual temperature reduced the rates of hypertension by 3% [odds ratio (OR): 0.97; 95% confidence interval (CI): 0.96-0.97], heart disease by 6% (OR: 0.94; 95% CI: 0.92-0.95), and stroke by 5% (OR: 0.95; 95% CI: 0.94-0.97). The results of the analyses stratified by sex, urban/rural residence, and educational level were robust. The average annual relative humidity was inversely associated with the likelihood of CVD among older adults. Every 1% increase in the average annual relative humidity reduced the rates of hypertension by 0.4% (OR: 0.996; 95% CI: 0.99-1.00), heart disease by 0.6% (OR: 0.994; 95% CI: 0.99-1.00), and stroke by 0.08% (OR: 0.992; 95% CI: 0.98-1.00). However, the effects were more obvious with higher humidity levels (>70). Conclusion Our findings suggest that higher temperatures and relative humidity may reduce the risk of CVD among older adults.
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Affiliation(s)
- Huashuai Chen
- Department of International Trade, Business School of Xiangtan University, Xiangtan, China,*Correspondence: Huashuai Chen ✉
| | - Xuebin Zhang
- School of Urban and Regional Science, Shanghai University of Finance and Economics, Shanghai, China
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Chaseling GK, Morris NB, Ravanelli N. Extreme Heat and Adverse Cardiovascular Outcomes in Australia and New Zealand: What Do We Know? Heart Lung Circ 2023; 32:43-51. [PMID: 36424263 DOI: 10.1016/j.hlc.2022.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022]
Abstract
Extreme heat events are a leading natural hazard risk to human health. Under all future climate change models, extreme heat events will continue to increase in frequency, duration, and intensity. Evidence from previous extreme heat events across the globe demonstrates that adverse cardiovascular events are the leading cause of morbidity and mortality, particularly amongst the elderly and those with pre-existing cardiovascular disease. However, less is understood about the adverse effects of extreme heat amongst specific cardiovascular diseases (i.e., heart failure, dysrhythmias) and demographics (sex, ethnicity, age) within Australia and New Zealand. Furthermore, although Australia has implemented regional and state heat warning systems, most personal heat-health protective advice available in public health policy documents is either insufficient, not grounded in scientific evidence, and/or does not consider clinical factors such as age or co-morbidities. Dissemination of evidence-based recommendations and enhancing community resilience to extreme heat disasters within Australia and New Zealand should be an area of critical focus to reduce the burden and negative health effects associated with extreme heat. This narrative review will focus on five key areas in relation to extreme heat events within Australia and New Zealand: 1) the potential physiological mechanisms that cause adverse cardiovascular outcomes during extreme heat events; 2) how big is the problem within Australia and New Zealand?; 3) what the heat-health response plans are; 4) research knowledge and translation; and, 5) knowledge gaps and areas for future research.
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Affiliation(s)
- Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; SOLVE-CHD NHMRC Synergy Grant, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Nathan B Morris
- Department of Human Physiology & Nutrition, University of Colorado, Colorado Springs, CO, USA
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Bühler JL, Shrikhande S, Kapwata T, Cissé G, Liang Y, Pedder H, Kwiatkowski M, Kunene Z, Mathee A, Peer N, Wright CY. The Association between Apparent Temperature and Hospital Admissions for Cardiovascular Disease in Limpopo Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010116. [PMID: 36612437 PMCID: PMC9820030 DOI: 10.3390/ijerph20010116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 05/27/2023]
Abstract
Cardiovascular diseases (CVDs) have a high disease burden both globally and in South Africa. They have also been found to be temperature-sensitive globally. The association between temperature and CVD morbidity has previously been demonstrated, but little is known about it in South Africa. It is important to understand how changes in temperature in South Africa will affect CVD morbidity, especially in rural regions, to inform public health interventions and adaptation strategies. This study aimed to determine the short-term effect of apparent temperature (Tapp) on CVD hospital admissions in Mopani District, Limpopo province, South Africa. A total of 3124 CVD hospital admissions records were obtained from two hospitals from 1 June 2009 to 31 December 2016. Daily Tapp was calculated using nearby weather station measurements. The association was modelled using a distributed lag non-linear model with a negative binomial regression over a 21-day lag period. The fraction of morbidity attributable to non-optimal Tapp, i.e., cold (6-25 °C) and warm (27-32 °C) Tapp was reported. We found an increase in the proportion of admissions due to CVDs for warm and cold Tapp cumulatively over 21 days. Increasing CVD admissions due to warm Tapp appeared immediately and lasted for two to four days, whereas the lag-structure for the cold effect was inconsistent. A proportion of 8.5% (95% Confidence Interval (CI): 3.1%, 13.7%) and 1.1% (95% CI: -1.4%, 3.5%) of the total CVD admissions was attributable to cold and warm temperatures, respectively. Warm and cold Tapp may increase CVD admissions, suggesting that the healthcare system and community need to be prepared in the context of global temperature changes.
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Affiliation(s)
- Jacqueline Lisa Bühler
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Shreya Shrikhande
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
| | - Guéladio Cissé
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Hugo Pedder
- Population Health Sciences, University of Bristol, Bristol BS8 2PS, UK
| | - Marek Kwiatkowski
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Zamantimande Kunene
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa
- Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Durban 4091, South Africa
- Department of Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Caradee Y. Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0001, South Africa
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Huang Z, Chan EYY, Wong CS, Liu S, Zee BCY. Health Disparity Resulting from the Effect of Built Environment on Temperature-Related Mortality in a Subtropical Urban Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148506. [PMID: 35886357 PMCID: PMC9322054 DOI: 10.3390/ijerph19148506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022]
Abstract
Whereas previous studies have assessed the overall health impact of temperature in Hong Kong, the aim of this study was to investigate whether the health impact is modified by local temperature of small geographic units, which may be related to the diverse socioeconomic characteristics of these units. The effects of local temperature on non-accidental and cause-specific mortality were analyzed using Bayesian spatial models at a small-area level, adjusting for potential confounders, i.e., area-level air pollutants, socioeconomic status, and green space, as well as spatial dependency. We found that a 10% increase in green space density was associated with an estimated 4.80% decrease in non-accidental mortality risk and a 5.75% decrease in cardiovascular disease mortality risk in Hong Kong, whereas variation in local annual temperature did not significantly contribute to mortality. We also found that the spatial variation of mortality within this city could be explained by the geographic distribution of green space and socioeconomic factors rather than local temperature or air pollution. The findings and methodology of this study may help to further understanding and investigation of social and structural determinants of health disparities, particularly place-based built environment across class-based small geographic units in a city, taking into account the intersection of multiple factors from individual to population levels.
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Affiliation(s)
- Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (Z.H.); (C.-S.W.); (S.L.)
| | - Emily Ying-Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (Z.H.); (C.-S.W.); (S.L.)
- GX Foundation, Hong Kong SAR, China
- Correspondence:
| | - Chi-Shing Wong
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (Z.H.); (C.-S.W.); (S.L.)
| | - Sida Liu
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China; (Z.H.); (C.-S.W.); (S.L.)
- GX Foundation, Hong Kong SAR, China
| | - Benny Chung-Ying Zee
- Centre for Clinical Research and Biostatistics (CCRB), The Chinese University of Hong Kong, Hong Kong SAR, China;
- Office of Research and Knowledge Transfer Services (ORKTS), The Chinese University of Hong Kong, Hong Kong SAR, China
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10
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Miyakawa T, Michihata N, Morita K, Matsui H, Honda M, Yasunaga H. Ambient temperature and hospital admissions for acute cholecystitis: a nationwide inpatient database study in Japan. HPB (Oxford) 2022; 24:398-403. [PMID: 34284962 DOI: 10.1016/j.hpb.2021.06.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The incidence of acute cholecystitis has a seasonal peak in summer. However, the reason for such seasonality remains unclear. This retrospective cohort study was performed to examine the association between ambient temperature and acute cholecystitis. METHODS We identified admissions for acute cholecystitis from January 2011 to December 2017 from a nationwide inpatient database in Japan. We performed a Poisson regression analysis to investigate the association between ambient temperature and admission for acute cholecystitis with adjustment for relative humidity, national holidays, day of the week, and year. We accounted for clustering of the outcome within prefectures using a generalized estimating equation. RESULTS We analyzed 601 665 admissions for acute cholecystitis. With an ambient temperature of 5.0 °C-9.9 °C as a reference, Poisson regression showed that the number of admissions increased significantly with increasing temperature (highest above 30 °C; relative risk, 1.35; 95% confidence interval, 1.34-1.37). An ambient temperature of <5.0 °C was also associated with higher admission for acute cholecystitis than an ambient temperature of 5.0 °C-9.9 °C (relative risk, 1.23; 95% confidence interval, 1.21-1.25). CONCLUSION The present nationwide Japanese inpatient database study showed that high temperature (≥10.0 °C) and low temperature (<5.0 °C) were associated with increased admission for acute cholecystitis.
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Affiliation(s)
- Teppei Miyakawa
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan.
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kojiro Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Michitaka Honda
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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11
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Zhai L, Ma X, Wang J, Luan G, Zhang H. Effects of ambient temperature on cardiovascular disease: a time-series analysis of 229288 deaths during 2009-2017 in Qingdao, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:181-190. [PMID: 32196376 DOI: 10.1080/09603123.2020.1744532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/14/2020] [Indexed: 06/10/2023]
Abstract
The association between ambient temperature and cardiovascular mortality varied by regions, populations, and climates. We estimated the relative risk (RR) of cardiovascular mortality using 229,288 death cases of cardiovascular disease in Qingdao China from 1 January 2009, to 31 December 2017. A distributed lag non-linear model was used. The temperature showed a negative association with the cardiovascular mortality. The RR of cardiovascular death at -4.8 °C was 2.05 (95% CI: 1.55, 2.69). The high temperature had acute and short-term effects with the maximum risk occurring 0 day of exposure. The low temperature had the greatest effect on the 4th lag day. The cold temperature effect was stronger for males than females. The estimates of temperature-related cardiovascular mortality risk were higher in people age ≥75 years. Our study showed that the cold and hot ambient temperature had a relationship with the risk of cardiovascular mortality.
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Affiliation(s)
- Long Zhai
- Department of Occupational Health, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Department of Occupational Health, Qingdao Institute of Prevention Medicine, Qingdao, China
| | - Xiaojia Ma
- Department of Social Prevention and Control, Qingdao Mental Health Center, Qingdao, China
| | - Junhui Wang
- Department of Second Supervisory Section, Shibei District Health Supervision Institute, Qingdao, China
| | - Guijie Luan
- Department of Planned Immunization, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Hua Zhang
- Department of Chronic Noncommunicable Diseases, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Department of Chronic Noncommunicable Diseases, Qingdao Institute of Prevention Medicine, Qingdao, China
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12
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Petkova EP, Dimitrova LK, Sera F, Gasparrini A. Mortality attributable to heat and cold among the elderly in Sofia, Bulgaria. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:865-872. [PMID: 33416949 DOI: 10.1007/s00484-020-02064-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 05/21/2023]
Abstract
Although a number of epidemiological studies have examined the effects of non-optimal temperatures on mortality in Europe, evidence about the mortality risks associated with exposures to hot and cold temperatures in Bulgaria is scarce. This study provides evidence about mortality attributable to non-optimal temperatures in adults aged 65 and over in Sofia, Bulgaria, between 2000 and 2017. We quantified the relationship between the daily mean temperature and mortality in the total elderly adult population aged 65 and over, among males and females aged 65 and over, as well as individuals aged 65-84 and 85 years or older. We used a distributed lag non-linear model with a 25-day lag to fully capture the effects of both cold and hot temperatures and calculated the fractions of mortality attributable to mild and extreme hot and cold temperatures. Cold temperatures had a greater impact on mortality than hot temperatures during the studied period. Most of the temperature-attributable mortality was due to moderate cold, followed by moderate heat, extreme cold, and extreme heat. The total mortality attributable to non-optimal temperatures was greater among females compared to males and among individuals aged 85 and over compared to those aged 65 to 84. The findings of this study can serve as a foundation for future research and policy development aimed at characterizing and reducing the risks from temperature exposures among vulnerable populations in the country, climate adaptation planning and improved public health preparedness, and response to non-optimal temperatures.
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Affiliation(s)
- Elisaveta P Petkova
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA.
| | - Lyudmila K Dimitrova
- Department of Computer and Information Technology, Prof. Asen Zlatarov University, Burgas, Bulgaria
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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Rowland ST, Parks RM, Boehme AK, Goldsmith J, Rush J, Just AC, Kioumourtzoglou MA. The association between ambient temperature variability and myocardial infarction in a New York-State-based case-crossover study: An examination of different variability metrics. ENVIRONMENTAL RESEARCH 2021; 197:111207. [PMID: 33932478 PMCID: PMC8609500 DOI: 10.1016/j.envres.2021.111207] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Short-term temperature variability has been consistently associated with mortality, with limited evidence for cardiovascular outcomes. Previous studies have used multiple metrics to measure temperature variability; however, those metrics do not capture hour-to-hour changes in temperature. OBJECTIVES We assessed the correlation between sub-daily temperature-change-over-time metrics and previously-used metrics, and estimated associations with myocardial infarction (MI) hospitalizations. METHODS Hour-to-hour change-over-time was measured via three metrics: 24-hr mean absolute hourly first difference, 24-hr maximum absolute hourly first difference, and 24-hr mean hourly first difference. We first assessed the Spearman correlations between these metrics and four previously-used metrics (24-hr standard deviation of hourly temperature, 24-hr diurnal temperature range, 48-hr standard deviation of daily minimal and maximal temperatures, and 48-hr difference of daily mean temperature), using hourly data from the North America Land Data Assimilation System-2 Model. Subsequently, we estimated the association between these metrics and primary MI hospitalization in adult residents of New York State for 2000-2015 using a time-stratified case-crossover design. RESULTS The hour-to-hour change-over-time metrics were correlated, but not synonymous, with previously-used metrics. We observed 809,259 MI, 45% of which were among females and the mean (standard deviation) age was 70 (15). An increase from mean to 90th percentile in mean absolute first difference of temperature was associated with a 2.04% (95% Confidence Interval [CI]: 1.30-2.78%) increase in MI rate. An increase from mean to 90th percentile in mean first difference also yielded a positive association (1.86%; 95%CI: 1.09-2.64%). We observed smaller- or similar-in-magnitude positive associations for previously-used metrics. DISCUSSION First, short-term hour-to-hour temperature change was positively associated with MI risk. Second, all other variability metrics yielded positive associations with MI, with varying magnitude. In future research on temperature variability, researchers should define their research question, including which aspects of variability they intend to measure, and apply the appropriate metric. ALTERNATIVE All metrics of temperature variability, including short-term hour-to-hour temperature changes, were positively associated with MI risk, though the magnitude of effect estimates varied by metric.
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Affiliation(s)
- Sebastian T Rowland
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Robbie M Parks
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Amelia K Boehme
- Departments of Neurology, Columbia University Medical School and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Jeff Goldsmith
- Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Johnathan Rush
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Ji XY, Huang LY, Song J, Fei CN, Liu J, Liu H. Short-term effects of meteorological factors, air pollution, and sunspot on childhood hand, foot, and mouth disease in Tianjin, China: a new time series regression, 2014-2018. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:37022-37035. [PMID: 32577970 PMCID: PMC7311115 DOI: 10.1007/s11356-020-09794-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
This study is aimed at defining the relationship between a set of environmental factors and childhood HFMD and then at estimating the related effect. The 16 environmental factors included meteorological, air pollution, and sunspot. A traditional TSR modified by using susceptible-infectious-recovery models and distribution lag nonlinear model was applied to estimate the short-term effects of daily environmental factors on children HFMD occurrence in 2014-2018 with adjustment of potential confounding factors. A total of 70,027 children aged 0-15 years with HFMD were enrolled. No significant effect was observed for daily sunspot numbers and average visibility. We found positive effects of the ambient average temperature, with an approximately m-shaped curve of the overall cumulative relationship, peaking at 25.6 °C with a relative risk (RR) of 1.45 (95% confidence intervals 1.21-1.73). The largest RR value of hot effect was achieved on the current day and then decreased by 2 days (total group, male group, and scatter group) or 1 day (female group and nursery group), and the effect lasted about 6 to 8 days from the lag 4 or lag 6 day. A greater association of temperature with HFMD for the female group and the scattered group was observed. This study suggests that ambient average temperature might be a risk factor for children HFMD in Tianjin. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Xue-Yue Ji
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China.
| | - Li-Yuan Huang
- Editorial Department of China Journal Environment and Health, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jia Song
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - Chun-Nan Fei
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - Jun Liu
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - He Liu
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
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Phosri A, Sihabut T, Jaikanlaya C. Short-term effects of diurnal temperature range on hospital admission in Bangkok, Thailand. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 717:137202. [PMID: 32062282 DOI: 10.1016/j.scitotenv.2020.137202] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/28/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Diurnal temperature range (DTR) is a key indicator reflecting climate stability. Many previous studies have examined the effects of ambient temperature, both hot and cold, on human morbidity and mortality, but few studies have evaluated health effects of DTR, especially those in developing countries. This study aimed to investigate the association between short-term exposure to DTR and hospital admissions for cardiovascular and respiratory diseases in Bangkok, Thailand. We obtained daily meteorological variables from the Thai Meteorological Department from January 2006 through December 2014 and daily hospital admissions from the National Health Security Office during the same period. Quasi-Poisson generalized linear regression model combined with distributed lag non-linear model was used to examine the association between DTR and cardiovascular and respiratory hospital admissions controlling for daily average temperature, relative humidity, day of the week, public holiday, and seasonal and long-term trend. A J-shape relationship between DTR and hospital admissions was observed. With 7.8 °C DTR as a reference value, the relative risks for cardiovascular and respiratory hospital admission associated with extremely high DTR (11.6 °C) at cumulative lag 0-21 (21-day cumulative effects) were 1.206 (95% CI: 1.002-1.452) and 1.021 (95% CI: 0.856-1.218), respectively. The effects of extremely high DTR relative to a reference value did not significantly differ between males and females, as well as between young people (<65 years) and the elderly (≥65 years) for both cardiovascular and respiratory admission. When stratifying the effects by season, the effect of extremely high DTR in winter was greater than that in summer and rainy season. This study showed that short-term exposure to extremely high DTR was significantly associated with increased risk of hospital admissions for cardiovascular disease in Bangkok, especially during winter. Results from this study could provide important scientific evidence for policy decision making to protect populations from adverse health effects of DTR.
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Affiliation(s)
- Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
| | - Tanasri Sihabut
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Chate Jaikanlaya
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
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16
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Lin W, Dai J, Liu R, Zhai Y, Yue D, Hu Q. Integrated assessment of health risk and climate effects of black carbon in the Pearl River Delta region, China. ENVIRONMENTAL RESEARCH 2019; 176:108522. [PMID: 31202046 DOI: 10.1016/j.envres.2019.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 05/27/2019] [Accepted: 06/03/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Black carbon (BC) caused by incomplete combustion of fossil and bio-fuel has a dual effect on health and climate. There is a need for systematic approaches to evaluation of health outcomes and climate impacts relevant to BC exposure. OBJECTIVES We propose and illustrate for the first time, to our knowledge, an integrated analysis of a region-specific health model with climate change valuation module to quantify the health and climate consequences of BC exposure. METHODS Based on the data from regional air pollution monitoring stations from 2013 to 2014 in the Pearl River Delta region (PRD), China, we analyzed the carcinogenic and non-carcinogenic effects and the relative risk of cause-specific mortality due to BC exposure in three typical cities of the PRD (i.e. Guangzhou, Jiangmen and Huizhou). The radiative forcing (RF) and heating rate (HR) were calculated by the Fu-Liou-Gu (FLG) plane-parallel radiation model and the conversion of empirical formula. We further connected the health and climate impacts by calculating the excess mortalities attributed to climate warming due to BC. RESULTS Between 2013 and 2014, carcinogenic risks of adults and children due to BC exposure in the PRD were higher than the recommended limits (1 × 10-6 to 1 × 10-4), resulting in an excess of 4.82 cancer cases per 10,000 adults (4.82 × 10-4) and an excess of 1.97 cancer cases per 10,000 children (1.97 × 10-4). Non-carcinogenic risk caused by BC was not found. The relative risks of BC exposure on mortality were higher in winter and dry season. The atmospheric RFs of BC were 26.31 W m-2, 26.41 W m-2, and 22.45 W m-2 for Guangzhou, Jiangmen and Huizhou, leading to a warming of the atmosphere in the PRD. The estimated annual excess mortalities of climate warming due to BC were 5052 (95% CI: 1983, 8139), 5121 (95% CI: 2010, 8249) and 4363 (95% CI: 1712, 7032) for Guangzhou, Jiangmen and Huizhou, respectively. CONCLUSION Our estimates suggest that current levels of BC exposure in the PRD region posed a considerable risk to human health and the climate. Reduction of BC emission could lead to substantial health and climate co-benefits.
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Affiliation(s)
- Weiwei Lin
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Jiajia Dai
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Run Liu
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
| | - Yuhong Zhai
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou 510308, China
| | - Dingli Yue
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou 510308, China.
| | - Qiansheng Hu
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
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Rodrigues M, Santana P, Rocha A. Effects of extreme temperatures on cerebrovascular mortality in Lisbon: a distributed lag non-linear model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:549-559. [PMID: 30798365 DOI: 10.1007/s00484-019-01685-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 12/31/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
Cerebrovascular diseases are the leading cause of mortality in Portugal, especially when related with extreme temperatures. This study highlights the impacts of the exposure-response relationship or lagged effect of low and high temperatures on cerebrovascular mortality, which can be important to reduce the health burden from cerebrovascular diseases. The purpose of this study was to assess the effects of weather on cerebrovascular mortality, measured by ambient temperature in the District of Lisbon, Portugal. A quasi-Poisson generalized additive model combined with a distributed lag non-linear model was applied to estimate the delayed effects of temperature on cerebrovascular mortality up to 30 days. With reference to minimum mortality temperature threshold of 22 °C, there was a severe risk (RR = 2.09, 95% CI 1.74, 2.51) of mortality for a 30-day-cumulative exposure to extreme cold temperatures of 7.3 °C (1st percentile). Similarly, the cumulative effect of a 30-day exposure to an extreme hot temperature of 30 °C (99th percentile) was 52% (RR = 1.65, 95% CI 1.37, 1.98) higher than same-day exposure. Over the 13 years of study, non-linear effects of temperature on mortality were identified, and the probability of dying from cerebrovascular disease in Lisbon was 7% higher in the winter than in the summer. The findings of this study provide a baseline for future public health prevention programs on weather-related mortality.
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Affiliation(s)
- Mónica Rodrigues
- Centre of Studies on Geography and Spatial Planning, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal.
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Alfredo Rocha
- Centre for Environmental and Marine Studies, Department of Physics, University of Aveiro, Aveiro, Portugal
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Rodrigues M, Santana P, Rocha A. Bootstrap approach to validate the performance of models for predicting mortality risk temperature in Portuguese Metropolitan Areas. Environ Health 2019; 18:25. [PMID: 30922390 PMCID: PMC6440075 DOI: 10.1186/s12940-019-0462-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/04/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND There has been increasing interest in assessing the impacts of extreme temperatures on mortality due to diseases of the circulatory system. This is further relevant for future climate scenarios where marked changes in climate are expected. This paper presents a solid method do identify the relationship between extreme temperatures and mortality risk by using as predictors simulated temperature data for cold and hot conditions in two urban areas in Portugal. METHODS Based on the mortality and meteorological data from Porto Metropolitan Area (PMA) and Lisbon Metropolitan Area (LMA), a distributed lag nonlinear model (DLNM) was implemented to estimate the temperature effects on mortality due to diseases of the circulatory system. The performance of the models was validated via bootstrapping approaching by creating resamples with replacement from the validating data. Bootstrapping was also used to identify the best candidate model and to evaluate the sensitivity of the spline functions to the exposure-lag-response relationship. RESULTS It is found that the model is able to reproduce the temperature-related mortality risk for two metropolitan areas. Temperature previously simulated by climate models is useful and even better than observed temperature. Although, the biases in predictions in both metropolitan areas are low, mortality risk predictions in PMA are more accurate than in LMA. Using parametric bootstrapping, we found that the overall cumulative association estimated under different bi-dimensional exposure-lag-response relationship are relatively stable, especially for the model selected by Quasi-Akaike Information Criteria (QAIC). Exposure to summer temperature conditions is best related to mortality risk. The association between winter temperature and mortality risk is somewhat less strong. CONCLUSIONS The use of QAIC to choose from several candidate models provides valid predictions and reduced the uncertainty in the estimated relative risk for circulatory disease mortality. Our findings can be applied to better understand the characteristics and facilitate the prevention of circulatory disease mortality in Porto and Lisbon Metropolitan Areas, namely if we consider the actual context of climate change.
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Affiliation(s)
- Mónica Rodrigues
- Centre of Studies on Geography and Spatial Planning, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal.
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Alfredo Rocha
- Centre for Environmental and Marine Studies, Department of Physics, University of Aveiro, Aveiro, Portugal
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Kouis P, Kakkoura M, Ziogas K, Paschalidou AΚ, Papatheodorou SI. The effect of ambient air temperature on cardiovascular and respiratory mortality in Thessaloniki, Greece. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 647:1351-1358. [PMID: 30180342 DOI: 10.1016/j.scitotenv.2018.08.106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES There is a growing body of evidence linking ambient air temperature and adverse health effects, in the form of hospitalization or even increased mortality mainly due to respiratory and cardio/cerebro-vascular illnesses. In the present study, we examine the association between high ambient air temperature and cardiovascular as well as respiratory mortality for the population of the greater area of Thessaloniki, Greece, taking into account the role of particulate pollution as a potential confounder. METHODS A mixed Poisson regression model, using a quasi-likelihood function to account for potential over-dispersion in the outcome distribution given covariates, was combined with distributed lag non-linear models, to estimate the non-linear and lag patterns in the association between mortality and daily mean temperature from 1999 to 2012. RESULTS A direct heat effect was found, as the mortality risk increased sharply above the temperature threshold of 33 °C, suggesting a significant effect of high temperatures on mortality on the same and next day of the heat events (lags 0-1) which was retained for a week, whereas a harvesting effect was noticed for the following days. Cardiovascular and respiratory mortality risk increased by 4.4% (95% CI 2.7%-6.1%) and 5.9% (95% CI 1.8%-10.3%) respectively on the same and following day of a heat event, whereas the risk dropped steeply in the following days. Particulate matter did not confound the association between high temperature and mortality in this population. CONCLUSION There is a significant association between mortality and hot temperatures in Thessaloniki, Greece. Reduction in exposure to increased temperatures, as part of prevention measures and strategies, should be considered for vulnerable subpopulations.
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Affiliation(s)
- Panayiotis Kouis
- Medical School, University of Cyprus, Nicosia, Cyprus; Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus.
| | | | - Konstantinos Ziogas
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece.
| | - Anastasia Κ Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece.
| | - Stefania I Papatheodorou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus.
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Ma Y, Zhou J, Yang S, Yu Z, Wang F, Zhou J. Effects of extreme temperatures on hospital emergency room visits for respiratory diseases in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:3055-3064. [PMID: 30506386 DOI: 10.1007/s11356-018-3855-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
Extreme temperature is closely associated with human health, but limited evidence is available for the effects of extreme temperatures on respiratory diseases in China. The goal of this study is to evaluate the effects of extreme temperatures on hospital emergency room (ER) visits for respiratory diseases in Beijing, China. We used a distributed lag non-linear model (DLNM) coupled with a generalized additive model (GAM) to estimate the association between extreme temperatures and hospital ER visits for different age and gender subgroups in Beijing from 2009 to 2012. The results showed that the exposure-response curve between temperature and hospital ER visits was almost W-shaped, with increasing relative risks (RRs) at extremely low temperature. In the whole year period, strong acute hot effects were observed, especially for the elders (age > 65 years). The highest RR associated with the extremely high temperature was 1.36 (95% CI, 0.96-1.92) at lag 0-27. The longer-lasting cold effects were found the strongest at lag 0-27 for children (age ≤ 15 years) and the relative risk was 1.96 (95% CI, 1.70-2.26). We also found that females were more susceptible to extreme temperatures than males.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Jianding Zhou
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Sixu Yang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fei Wang
- Tacheng Meteorology Bureau, Xinjiang, 834700, China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
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21
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Ge Y, Liu C, Niu Y, Chen C, Wang W, Lin Z, Chen R, Cai J, Kan H. Associations between ambient temperature and daily hospital admissions for rheumatic heart disease in Shanghai, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:2189-2195. [PMID: 30368679 DOI: 10.1007/s00484-018-1621-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/13/2018] [Accepted: 09/20/2018] [Indexed: 05/21/2023]
Abstract
Rheumatic heart disease (RHD) remains a serious public health burden in developing countries. We conducted a time-series study to explore the association between ambient temperature and daily hospital admissions for RHD in Shanghai, China. We collected data on daily hospital admissions for RHD from 2013 to 2015 from the database of Shanghai Health Insurance System. We applied the generalized additive models together with the distributed lag nonlinear model to estimate the association between temperature and RHD hospital admissions after controlling for relative humidity, time trend, day of the week, and holidays. Stratification analyses by age and gender were performed to evaluate their potential effect modification. A total of 4178 cases of RHD hospitalizations were identified over the study period. There were almost linear, positive, and significant associations between daily mean temperature and RHD hospital admissions with higher risks at hotter days. Compared to reference temperature (0 °C), the cumulative risks of moderate heat (the 90th percentile of temperature, 28.0 °C) and extreme heat (the 99th percentile of temperature, 33.5 °C) over lags 0-5 days were 2.55 (95% confidence interval 1.14, 5.73) and 3.22 (95% confidence interval 1.36, 7.61), respectively. These associations were significantly stronger in older people than in younger people. This study indicated larger risks of RHD hospital admissions associated with higher temperature, especially in older people. Our findings provided first-hand epidemiological evidence regarding the effects of ambient temperature on RHD incidence.
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Affiliation(s)
- Yihui Ge
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Yue Niu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Chen Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Weibing Wang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Zhijing Lin
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China.
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
| | - Jing Cai
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China.
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
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22
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Spatial and temporal characteristics of temperature effects on cardiovascular disease in Southern China using the Empirical Mode Decomposition method. Sci Rep 2018; 8:14775. [PMID: 30283072 PMCID: PMC6170419 DOI: 10.1038/s41598-018-33184-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/04/2018] [Indexed: 11/08/2022] Open
Abstract
Until now, few studies have analyzed the effects of temperature on cardiovascular disease (CVD) death at different time points. In this study, we chose 9 different cities in the subtropical and tropical areas of China and analyzed the correlation between temperature at different time points and CVD mortality. We completed this study in two steps. First, we analyzed different time trend decomposition data related to CVD mortality in different populations within the 9 selected cities using empirical mode decomposition (EMD). Second, we created a regression fitting analysis of CVD mortality and temperatures at different time periods. The results showed that the CVD mortality of subtropical and tropical areas in southern Chinese cities represented spatial heterogeneity. The CVD mortality rates in Beihai, Hefei and Nanning showed rising trends, whereas the CVD mortality rates in Haikou, Guilin and Changde appeared to be decreasing. At the daily, seasonal and year time scales, low temperatures were negatively correlated with CVD mortality. Other than at the daily time scale, high temperatures did not significantly influence CVD mortality. This article will help to develop appropriate measures to reduce temperature-related mortality risk in different populations within the subtropical and tropical regions of China.
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He Y, Zhang X, Ren M, Bao J, Huang C, Hajat S, Barnett AG. Assessing Effect Modification of Excess Winter Death by Causes of Death and Individual Characteristics in Zhejiang Province, China: A Multi-Community Case-Only Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1663. [PMID: 30082621 PMCID: PMC6121352 DOI: 10.3390/ijerph15081663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/18/2022]
Abstract
Mortality in many parts of the world has a seasonal pattern, with a marked excess of deaths during winter. To date, however, there is very little published evidence on the nature of this wintertime excess in low- and middle-income countries. In this study, we aimed to quantify the extent of the death peak in winter and to assess effect modification on excess winter death (EWD) by individual characteristics and cause of deaths in China. We used a Cosinor model to examine seasonal patterns for specific causes of deaths and a case-only analysis of deaths in winter compared with other seasons to assess effect modification by individual characteristics. A total of 398,529 deaths were investigated between January 2010 and December 2013 in Zhejiang Province, China. Deaths peaked in winter, and overall mortality was around 30% higher in winter than in summer. Although diseases of the respiratory and circulatory systems were highly seasonal, surprisingly we observed that deaths from mental and behavioral disorders exhibited greater fluctuation. Males, the elderly and illiterate individuals suffered high EWD. EWDs were also particularly common in emergency rooms, at home, on the way to hospitals, and in nursing homes/family wards. This study highlighted the high EWD in some previously unreported groups, indicating new information to facilitate the targeting of necessary preventive measures to those at greatest risk in order to mitigate wintertime death burdens.
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Affiliation(s)
- Yiling He
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 31004, China.
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Shakoor Hajat
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland 4059, Australia.
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Tang J, Xiao CC, Li YR, Zhang JQ, Zhai HY, Geng XY, Ding R, Zhai JX. Effects of diurnal temperature range on mortality in Hefei city, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:851-860. [PMID: 29224119 DOI: 10.1007/s00484-017-1486-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/23/2017] [Accepted: 11/29/2017] [Indexed: 06/07/2023]
Abstract
Although several studies indicated an association between diurnal temperature range (DTR) and mortality, the results about modifiers are inconsistent, and few studies were conducted in developing inland country. This study aims to evaluate the effects of DTR on cause-specific mortality and whether season, gender, or age might modify any association in Hefei city, China, during 2007-2016. Quasi-Poisson generalized linear regression models combined with a distributed lag non-linear model (DLNM) were applied to evaluate the relationships between DTR and non-accidental, cardiovascular, and respiratory mortality. We observed a J-shaped relationship between DTR and cause-specific mortality. With a DTR of 8.3 °C as the reference, the cumulative effects of extremely high DTR were significantly higher for all types of mortality than effects of lower or moderate DTR in full year. When stratified by season, extremely high DTR in spring had a greater impact on all cause-specific mortality than other three seasons. Male and the elderly (≥ 65 years) were consistently more susceptible to extremely high DTR effect than female and the youth (< 65 years) for non-accidental and cardiovascular mortality. To the contrary, female and the youth were more susceptible to extremely high DTR effect than male and the elderly for respiratory morality. The study suggests that extremely high DTR is a potential trigger for non-accidental mortality in Hefei city, China. Our findings also highlight the importance of protecting susceptible groups from extremely high DTR especially in the spring.
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Affiliation(s)
- Jing Tang
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Chang-Chun Xiao
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, Anhui Province, 230032, China
| | - Yu-Rong Li
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Hangzhou, Zhejiang Province, 310021, China
| | - Jun-Qing Zhang
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, Anhui Province, 230032, China
| | - Hao-Yuan Zhai
- School of Clinical Medicine, Wannan Medical College, 22 Wenchang West Road, Wuhu, Anhui Province, 241000, China
| | - Xi-Ya Geng
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Rui Ding
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Jin-Xia Zhai
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
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25
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Mohammadi R, Soori H, Alipour A, Bitaraf E, Khodakarim S. The impact of ambient temperature on acute myocardial infarction admissions in Tehran, Iran. J Therm Biol 2018; 73:24-31. [DOI: 10.1016/j.jtherbio.2018.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/06/2018] [Accepted: 02/11/2018] [Indexed: 12/27/2022]
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26
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Zhao Q, Zhao Y, Li S, Zhang Y, Wang Q, Zhang H, Qiao H, Li W, Huxley R, Williams G, Zhang Y, Guo Y. Impact of ambient temperature on clinical visits for cardio-respiratory diseases in rural villages in northwest China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 612:379-385. [PMID: 28858748 DOI: 10.1016/j.scitotenv.2017.08.244] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/14/2017] [Accepted: 08/23/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND The association between temperature and cardio-respiratory disease in urban areas has been widely reported but there is limited information from populations living in rural areas that may be disproportionately affected by climate change. OBJECTIVES To quantify the associations between daily temperature and clinical visits due to cardiovascular and/or respiratory disease in rural villages in the Ningxia Hui Autonomous Region, China over 2012-2015. METHODS Daily data on clinical visits and weather conditions were collated from 203 villages. A quasi-Poisson regression with distributed lag non-linear model was used to examine the associations between daily temperature and clinical visits up to 28days, after controlling for potential confounders. RESULTS Over three years, 158,733 and 1,272,212 clinical visits were recorded for cardiovascular and respiratory diseases, respectively. Both low and high temperatures were associated with an increased risk of clinical visits for cardiovascular-related conditions, whereas only low temperatures were associated with increased clinical visits related to respiratory illness. The cold effect on cardiovascular visits appeared at the lag 6th day and persisted until the 22nd day, resulting in a cumulative relative risk (RR) 1.55 (95% CI: 1.26-1.92), compared with the minimum-clinical visit temperature. The cold effect on respiratory visits appeared immediately and lasted over the lag 0-28days, with a cumulative RR 2.96 (2.74-3.21). Suboptimal temperature accounted for approximately 13% and 26% of clinic visits due to cardiovascular and respiratory disorders, respectively, with the majority of cases attributable to moderate - rather than extreme - cold temperature. CONCLUSIONS In rural settings, sub-optimal temperatures explained nearly one quarter of all clinical visits due to cardiovascular and respiratory diseases. Although extreme cold temperature had a stronger, more immediate, prolonged effect on respiratory disease than for cardiovascular disease, moderately cold temperatures accounted for most of the overall burden of clinical visits.
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Affiliation(s)
- Qi Zhao
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, 4006, Queensland, Australia
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - Yajuan Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Qingan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Huiling Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Hui Qiao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Wuping Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Rachel Huxley
- School of Public Health, Curtin University, Kent Street, Perth, 6102, Western Australia, Australia
| | - Gail Williams
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, 4006, Queensland, Australia
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia.
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Vanasse A, Talbot D, Chebana F, Bélanger D, Blais C, Gamache P, Giroux JX, Dault R, Gosselin P. Effects of climate and fine particulate matter on hospitalizations and deaths for heart failure in elderly: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2017; 106:257-266. [PMID: 28709636 DOI: 10.1016/j.envint.2017.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 05/30/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND There are limited data on the effects of climate and air pollutant exposure on heart failure (HF) within taking into account individual and contextual variables. OBJECTIVES We measured the lag effects of temperature, relative humidity, atmospheric pressure and fine particulate matter (PM2.5) on hospitalizations and deaths for HF in elderly diagnosed with this disease on a 10-year period in the province of Quebec, Canada. METHODS Our population-based cohort study included 112,793 elderly diagnosed with HF between 2001 and 2011. Time dependent Cox regression models approximated with pooled logistic regressions were used to evaluate the 3- and 7-day lag effects of daily temperature, relative humidity, atmospheric pressure and PM2.5 exposure on HF morbidity and mortality controlling for several individual and contextual covariates. RESULTS Overall, 18,309 elderly were hospitalized and 4297 died for the main cause of HF. We observed an increased risk of hospitalizations and deaths for HF with a decrease in the average temperature of the 3 and 7days before the event. An increase in atmospheric pressure in the previous 7days was also associated with a higher risk of having a HF negative outcome, but no effect was observed in the 3-day lag model. No association was found with relative humidity and with PM2.5 regardless of the lag period. CONCLUSIONS Lag effects of temperature and other meteorological parameters on HF events were limited but present. Nonetheless, preventive measures should be issued for elderly diagnosed with HF considering the burden and the expensive costs associated with the management of this disease.
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Affiliation(s)
- Alain Vanasse
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada; Research Center of the Centre hospitalier universitaire de Sherbrooke - Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada.
| | - Denis Talbot
- Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada.
| | - Fateh Chebana
- The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada.
| | - Diane Bélanger
- Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada.
| | - Claudia Blais
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada; Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada.
| | - Philippe Gamache
- Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada.
| | - Jean-Xavier Giroux
- The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada.
| | - Roxanne Dault
- Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada.
| | - Pierre Gosselin
- Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada; The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada; Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada; Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada.
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28
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Keshtkar A, Naddafi K, Yekaninejad MS. Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis. PeerJ 2017; 5:e3574. [PMID: 28791197 PMCID: PMC5546177 DOI: 10.7717/peerj.3574] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. RESULT After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]). CONCLUSION Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Harvard Humanitarian Initiative, Harvard University, Cambridge, United States of America
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Wichmann J. Heat effects of ambient apparent temperature on all-cause mortality in Cape Town, Durban and Johannesburg, South Africa: 2006-2010. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 587-588:266-272. [PMID: 28242220 DOI: 10.1016/j.scitotenv.2017.02.135] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 06/06/2023]
Abstract
Due to climate change, an increase of 3-4°C in ambient temperature is projected along the South African coast and 6-7°C inland during the next 80years. The objective of this study was to investigate the association between daily ambient apparent temperature (Tapp) and daily all-cause non-accidental mortality (hereafter mortality) in Cape Town, Durban and Johannesburg during a 5-year study period (2006-2010). Susceptibility by sex and age groups (<15years, 15-64years and ≥65years) was also investigated. The associations were investigated with the time-stratified case-crossover epidemiological design. Models were controlled for PM10, public holidays and influenza epidemics. City-specific Tapp thresholds were determined using quasi-Poisson generalised additive models. The pooled estimates by sex and age groups were determined in meta-analyses. The city-specific Tapp thresholds were 18.6°C, 24.8°C and 18.7°C, respectively for Cape Town, Durban and Johannesburg. A 3.3%, 2.6% and 2.8% increase in mortality per IQR increase in Tapp (lag0-1) was observed in Cape Town, Durban and Johannesburg, respectively above the city-specific thresholds. The elderly were more at risk in Cape Town and Johannesburg. No difference in risk was observed for males and females in the three cities. In the meta-analysis an overall significant increase of 0.9% in mortality per 1°C increase in Tapp (lag0-1) was observed for all age groups combined in the three cities. For the ≥65year group a significant increase of 2.1% in mortality was observed. In conclusion, the risks for all age groups combined and the elderly are similar to those reported in studies from developed and developing countries. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased Tapp in the country due to climate change. Future research should investigate the association between Tapp and cause-specific mortality and also morbidity.
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Affiliation(s)
- Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
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Ponjoan A, Blanch J, Alves-Cabratosa L, Martí-Lluch R, Comas-Cufí M, Parramon D, del Mar Garcia-Gil M, Ramos R, Petersen I. Effects of extreme temperatures on cardiovascular emergency hospitalizations in a Mediterranean region: a self-controlled case series study. Environ Health 2017; 16:32. [PMID: 28376798 PMCID: PMC5379535 DOI: 10.1186/s12940-017-0238-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/20/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Cold spells and heatwaves increase mortality. However little is known about the effect of heatwaves or cold spells on cardiovascular morbidity. This study aims to assess the effect of cold spells and heatwaves on cardiovascular diseases in a Mediterranean region (Catalonia, Southern Europe). METHODS We conducted a population-based retrospective study. Data were obtained from the System for the Development of Research in Primary Care and from the Catalan Meteorological Service. The outcome was first emergency hospitalizations due to coronary heart disease, stroke, or heart failure. Exposures were: cold spells; cold spells and 3 or 7 subsequent days; and heatwaves. Incidence rate ratios (IRR) and 95% confidence intervals were calculated using the self-controlled case series method. We accounted for age, time trends, and air pollutants; results were shown by age groups, gender or cardiovascular event type. RESULTS There were 22,611 cardiovascular hospitalizations in winter and 17,017 in summer between 2006 and 2013. The overall incidence of cardiovascular hospitalizations significantly increased during cold spells (IRR = 1.120; CI 95%: 1.10-1.30) and the effect was even stronger in the 7 days subsequent to the cold spell (IRR = 1.29; CI 95%: 1.22-1.36). Conversely, cardiovascular hospitalizations did not increase during heatwaves, neither in the overall nor in the stratified analysis. CONCLUSIONS Cold spells but not heatwaves, increased the incidence of emergency cardiovascular hospitalizations in Catalonia. The effect of cold spells was greater when including the 7 subsequent days. Such knowledge might be useful to develop strategies to reduce the impact of extreme temperature episodes on human health.
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Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Girona Biomedical Research Institute (IDIBGi), c/ del Dr. Castany, s/n, Salt, Girona, 17190 Catalonia Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra Spain
| | - Jordi Blanch
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Girona Biomedical Research Institute (IDIBGi), c/ del Dr. Castany, s/n, Salt, Girona, 17190 Catalonia Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra Spain
| | - Marc Comas-Cufí
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Dídac Parramon
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Centre d’Atenció Primària Santa Clara, Gerència d’Àmbit d’Atenció Primària Girona, Institut Català de la Salut, Girona, Spain
| | - María del Mar Garcia-Gil
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Rafel Ramos
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, University of Girona, Girona, Spain
| | - Irene Petersen
- Department of Primary Care and Population Health, University College of London, London, UK
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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Temperature and Cardiovascular Mortality Associations in Four Southern Chinese Cities: A Time-Series Study Using a Distributed Lag Non-Linear Model. SUSTAINABILITY 2017. [DOI: 10.3390/su9030321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wang Q, Li C, Guo Y, Barnett AG, Tong S, Phung D, Chu C, Dear K, Wang X, Huang C. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 575:276-286. [PMID: 27750133 DOI: 10.1016/j.scitotenv.2016.10.019] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research. METHODS We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1°C reduction in temperature were pooled using a random-effects meta-analysis. RESULTS Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1°C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26mmHg (95% CI: 0.18-0.33) and 0.13 (95% CI: 0.11-0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1°C decrease in indoor temperature was associated with 0.38mmHg (0.18-0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved. CONCLUSIONS Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted.
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Affiliation(s)
- Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Yanfang Guo
- Department of Chronic Disease Prevention, Bao'an Hospital for Chronic Disease Prevention and Treatment, 99 Wenwei Road, Shenzhen 518101, China
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Dung Phung
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Cordia Chu
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Keith Dear
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu 215316, China
| | - Xuemei Wang
- School of Atmospheric Sciences, Sun Yat-sen University, 135 Xingang Xi Road, Guangzhou 510275, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia.
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The Role of Influenza in the Delay between Low Temperature and Ischemic Heart Disease: Evidence from Simulation and Mortality Data from Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050454. [PMID: 27136571 PMCID: PMC4881079 DOI: 10.3390/ijerph13050454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/22/2016] [Accepted: 04/21/2016] [Indexed: 11/22/2022]
Abstract
Many studies have found that cardiovascular deaths mostly occur within a few days of exposure to heat, whereas cold-related deaths can occur up to 30 days after exposure. We investigated whether influenza infection could explain the delayed cold effects on ischemic heart diseases (IHD) as they can trigger IHD. We hypothesized two pathways between cold exposure and IHD: a direct pathway and an indirect pathway through influenza infection. We created a multi-state model of the pathways and simulated incidence data to examine the observed delayed patterns in cases. We conducted cross-correlation and time series analysis with Japanese daily pneumonia and influenza (P&I) mortality data to help validate our model. Simulations showed the IHD incidence through the direct pathway occurred mostly within 10 days, while IHD through influenza infection peaked at 4–6 days, followed by delayed incidences of up to 20–30 days. In the mortality data from Japan, P&I lagged IHD in cross-correlations. Time series analysis showed strong delayed cold effects in the older population. There was also a strong delay on intense days of influenza which was more noticeable in the older population. Influenza can therefore be a plausible explanation for the delayed association between cold exposure and cardiovascular mortality.
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Wang X, Li G, Liu L, Westerdahl D, Jin X, Pan X. Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:16136-56. [PMID: 26703637 PMCID: PMC4690978 DOI: 10.3390/ijerph121215042] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/12/2015] [Accepted: 12/14/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. METHODS We collected data from Beijing and Shanghai, China, during 2007-2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. RESULTS For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0-27, while the hot effects reached the strongest at lag 0-14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. CONCLUSION People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.
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Affiliation(s)
- Xuying Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Liqun Liu
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Dane Westerdahl
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14850, USA.
| | - Xiaobin Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
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Yang C, Meng X, Chen R, Cai J, Zhao Z, Wan Y, Kan H. Long-term variations in the association between ambient temperature and daily cardiovascular mortality in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 538:524-30. [PMID: 26318688 DOI: 10.1016/j.scitotenv.2015.08.097] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/22/2015] [Accepted: 08/17/2015] [Indexed: 05/24/2023]
Abstract
OBJECTIVE The objective of this study was to explore the long-term variation in the association between ambient temperature and daily cardiovascular (CVD) mortality in Shanghai, China. MATERIALS AND METHODS We collected daily data on ambient temperature and CVD mortality from a central urban district in Shanghai, China, during the period from 1981 to 2012. We used overdispersed generalized additive Poisson regression together with a distributed lag nonlinear model to estimate potentially lagged and nonlinear effects of temperature on CVD mortality after controlling for the seasonality, relative humidity, day of the week, holidays and population size. To allow for the evaluation of long-term variations in the effects, we divided the entire study period into six sub-periods (1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2012) and analyzed the effect estimates in each sub-period separately. RESULTS The association between temperature and daily CVD mortality was J-shaped with both low and high temperatures increasing the risk of CVD deaths. The effects of extremely low temperatures were delayed and persisted for two weeks, while extreme hot effects were limited to the first five days followed by a significant mortality displacement (9days). The relative risks (RRs) of extremely low, moderately low, moderately high, and extremely high temperatures comparing the 1st, 10th, 90th, and 99th percentile with the reference temperature (26°C) over the cumulative lags of 0-14days were 1.95 [95% confidence interval (CI): 1.84,2.07], 1.61 (95% CI: 1.57,1.66), 1.03 (95% CI: 1.01,1.05), and 1.14 (95% CI: 1.07,1.21). The RRs for extremely low and moderately low temperature attenuated substantially from 9.78 and 5.52 in 1981-1985 to 1.42 and 1.18 in 2006-2012, respectively, but the RRs remained almost stable for extremely high and moderately high temperatures. CONCLUSIONS This time-series study suggested that there might have been some human adaptation to low ambient temperature in Shanghai, China, over the last 3 decades.
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Affiliation(s)
- Changyuan Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Yue Wan
- Division of Environment and Health Management, Department of Science, Technology and Standards, Ministry of Environmental Protection, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
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Ingole V, Rocklöv J, Juvekar S, Schumann B. Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS--A Rural Setting in Western India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15298-308. [PMID: 26633452 PMCID: PMC4690916 DOI: 10.3390/ijerph121214980] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/12/2015] [Accepted: 11/18/2015] [Indexed: 01/17/2023]
Abstract
Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0-4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.
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Affiliation(s)
- Vijendra Ingole
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune 411011, India.
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden.
- INDEPTH Network, Accra KD 213, Ghana.
| | - Joacim Rocklöv
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden.
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune 411011, India.
- INDEPTH Network, Accra KD 213, Ghana.
| | - Barbara Schumann
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden.
- Centre for Demographic and Ageing Research, Umeå University, Umeå 901 87, Sweden.
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Yang J, Yin P, Zhou M, Ou CQ, Guo Y, Gasparrini A, Liu Y, Yue Y, Gu S, Sang S, Luan G, Sun Q, Liu Q. Cardiovascular mortality risk attributable to ambient temperature in China. Heart 2015; 101:1966-72. [PMID: 26567233 DOI: 10.1136/heartjnl-2015-308062] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 10/03/2015] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To examine cardiovascular disease (CVD) mortality burden attributable to ambient temperature; to estimate effect modification of this burden by gender, age and education level. METHODS We obtained daily data on temperature and CVD mortality from 15 Chinese megacities during 2007-2013, including 1,936,116 CVD deaths. A quasi-Poisson regression combined with a distributed lag non-linear model was used to estimate the temperature-mortality association for each city. Then, a multivariate meta-analysis was used to derive the overall effect estimates of temperature at the national level. Attributable fraction of deaths were calculated for cold and heat (ie, temperature below and above minimum-mortality temperatures, MMTs), respectively. The MMT was defined as the specific temperature associated to the lowest mortality risk. RESULTS The MMT varied from the 70th percentile to the 99th percentile of temperature in 15 cities, centring at 78 at the national level. In total, 17.1% (95% empirical CI 14.4% to 19.1%) of CVD mortality (330,352 deaths) was attributable to ambient temperature, with substantial differences among cities, from 10.1% in Shanghai to 23.7% in Guangzhou. Most of the attributable deaths were due to cold, with a fraction of 15.8% (13.1% to 17.9%) corresponding to 305,902 deaths, compared with 1.3% (1.0% to 1.6%) and 24,450 deaths for heat. CONCLUSIONS This study emphasises how cold weather is responsible for most part of the temperature-related CVD death burden. Our results may have important implications for the development of policies to reduce CVD mortality from extreme temperatures.
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Affiliation(s)
- Jun Yang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Yunning Liu
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Yujuan Yue
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shaohua Gu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shaowei Sang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guijie Luan
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Qinghua Sun
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Ohio, USA
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Liu C, Yavar Z, Sun Q. Cardiovascular response to thermoregulatory challenges. Am J Physiol Heart Circ Physiol 2015; 309:H1793-812. [PMID: 26432837 DOI: 10.1152/ajpheart.00199.2015] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/28/2015] [Indexed: 01/05/2023]
Abstract
A growing number of extreme climate events are occurring in the setting of ongoing climate change, with an increase in both the intensity and frequency. It has been shown that ambient temperature challenges have a direct and highly varied impact on cardiovascular health. With a rapidly growing amount of literature on this issue, we aim to review the recent publications regarding the impact of cold and heat on human populations with regard to cardiovascular disease (CVD) mortality/morbidity while also examining lag effects, vulnerable subgroups, and relevant mechanisms. Although the relative risk of morbidity/mortality associated with extreme temperature varied greatly across different studies, both cold and hot temperatures were associated with a positive mean excess of cardiovascular deaths or hospital admissions. Cause-specific study of CVD morbidity/mortality indicated that the sensitivity to temperature was disease-specific, with different patterns for acute and chronic ischemic heart disease. Vulnerability to temperature-related mortality was associated with some characteristics of the populations, including sex, age, location, socioeconomic condition, and comorbidities such as cardiac diseases, kidney diseases, diabetes, and hypertension. Temperature-induced damage is thought to be related to enhanced sympathetic reactivity followed by activation of the sympathetic nervous system, renin-angiotensin system, as well as dehydration and a systemic inflammatory response. Future research should focus on multidisciplinary adaptation strategies that incorporate epidemiology, climatology, indoor/building environments, energy usage, labor legislative perfection, and human thermal comfort models. Studies on the underlying mechanism by which temperature challenge induces pathophysiological response and CVD await profound and lasting investigation.
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Affiliation(s)
- Cuiqing Liu
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, China; and
| | - Zubin Yavar
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Qinghua Sun
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
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Huang Z, Lin H, Liu Y, Zhou M, Liu T, Xiao J, Zeng W, Li X, Zhang Y, Ebi KL, Tong S, Ma W, Wang L. Individual-level and community-level effect modifiers of the temperature-mortality relationship in 66 Chinese communities. BMJ Open 2015; 5:e009172. [PMID: 26369803 PMCID: PMC4577931 DOI: 10.1136/bmjopen-2015-009172] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/11/2015] [Accepted: 08/25/2015] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To examine the modification of temperature-mortality association by factors at the individual and community levels. DESIGN AND METHODS This study investigated this issue using a national database comprising daily data of 66 Chinese communities for 2006-2011. A 'threshold-natural cubic spline' distributed lag non-linear model was utilised to estimate the mortality effects of daily mean temperature, and then examined the modification of the relationship by individual factors (age, sex, education level, place of death and cause of death) using a meta-analysis approach and community-level factors (annual temperature, population density, sex ratio, percentage of older population, health access, household income and latitude) using a meta-regression method. RESULTS We found significant effects of high and low temperatures on mortality in China. The pooled excess mortality risk was 1.04% (95% CI 0.90% to 1.18%) for a 1°C temperature decrease below the minimum mortality temperature (MMT), and 3.44% (95% CI 3.00% to 3.88%) for a 1°C temperature increase above MMT. At the individual level, age and place of death were found to be significant modifiers of cold effect, while age, sex, place of death, cause of death and education level were effect modifiers of heat effect. At the community level, communities with lower socioeconomic status and higher annual temperature were generally more vulnerable to the mortality effects of high and low temperatures. CONCLUSIONS This study identifies susceptibility based on both individual-level and community-level effect modifiers; more attention should be given to these vulnerable individuals and communities to reduce adverse health effects of extreme temperatures.
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Affiliation(s)
- Zhengjing Huang
- National Center of Non-Communicable Chronic Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hualiang Lin
- Division of Environmental Health, Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yunning Liu
- National Center of Non-Communicable Chronic Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center of Non-Communicable Chronic Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Liu
- Division of Environmental Health, Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianpeng Xiao
- Division of Environmental Health, Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weilin Zeng
- Division of Environmental Health, Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Li
- Division of Environmental Health, Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Kristie L Ebi
- Departments of Global Health and Occupational and Environmental Health Sciences, University of Washington, Washington, USA
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Wenjun Ma
- Division of Environmental Health, Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Lijun Wang
- National Center of Non-Communicable Chronic Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Scalley BD, Spicer T, Jian L, Xiao J, Nairn J, Robertson A, Weeramanthri T. Responding to heatwave intensity: Excess Heat Factor is a superior predictor of health service utilisation and a trigger for heatwave plans. Aust N Z J Public Health 2015; 39:582-7. [PMID: 26260877 DOI: 10.1111/1753-6405.12421] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/01/2014] [Accepted: 03/01/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine which measures of heatwave have the greatest predictive power for increases in health service utilisation in Perth, Western Australia. METHODS Three heatwave formulas were compared, using Poisson or zero-inflated Poisson regression, against the number of presentations to emergency departments from all causes, and the number of inpatient admissions from heat-related causes. The period from July 2006 to June 2013 was included. A series of standardised thresholds were calculated to allow comparison between formulas, in the absence of a gold standard definition of heatwaves. RESULTS Of the three heatwave formulas, Excess Heat Factor (EHF) produced the most clear dose-response relationship with Emergency Department presentations. The EHF generally predicted periods that resulted in a similar or higher rate of health service utilisation, as compared to the two other formulas, for the thresholds examined. CONCLUSIONS The EHF formula, which considers a period of acclimatisation as well as the maximum and minimum temperature, best predicted periods of greatest health service demand. The strength of the dose-response relationship reinforces the validity of the measure as a predictor of hazardous heatwave intensity. IMPLICATIONS The findings suggest that the EHF formula is well suited for use as a means of activating heatwave plans and identifies the required level of response to extreme heatwave events as well as moderate heatwave events that produce excess health service demand.
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Affiliation(s)
- Benjamin D Scalley
- Public Health Division, Department of Health, Government of Western Australia.,Western Australian Centre for Rural Health, University of Western Australia
| | - Tony Spicer
- Public Health Division, Department of Health, Government of Western Australia
| | - Le Jian
- Public Health Division, Department of Health, Government of Western Australia.,School of Public Health, Curtin University, Western Australia
| | - Jianguo Xiao
- Public Health Division, Department of Health, Government of Western Australia
| | - John Nairn
- Australian Bureau of Meteorology, South Australia
| | - Andrew Robertson
- Public Health Division, Department of Health, Government of Western Australia
| | - Tarun Weeramanthri
- Public Health Division, Department of Health, Government of Western Australia
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Qiao Z, Guo Y, Yu W, Tong S. Assessment of Short- and Long-Term Mortality Displacement in Heat-Related Deaths in Brisbane, Australia, 1996-2004. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:766-72. [PMID: 25794410 PMCID: PMC4529002 DOI: 10.1289/ehp.1307606] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 03/17/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Mortality displacement (or "harvesting") has been identified as a key issue in the assessment of the temperature-mortality relationship. However, only a few studies have addressed the "harvesting" issue and findings have not been consistent. OBJECTIVES We examined the potential impact of both short- and long-term harvesting effects on heat-related deaths in Brisbane, Australia. METHODS We collected data on daily counts of deaths (nonaccidental, cardiovascular, and respiratory), weather, and air pollution in Brisbane from 1 January 1996 to 30 November 2004. We estimated heat-related deaths, identified potential short-term mortality displacement, and assessed how and to what extent the impact of summer temperature on mortality was modified by mortality in the previous winter using a Poisson time-series regression combined with distributed lag nonlinear model (DLNM). RESULTS There were significant associations between temperature and each mortality outcome in summer. We found evidence of short-term mortality displacement for respiratory mortality, and evidence of longer-term mortality displacement for nonaccidental and cardiovascular mortality when the preceding winter's mortality was low. The estimated heat effect on mortality was generally stronger when the preceding winter mortality level was low. For example, we estimated a 22% increase in nonaccidental mortality (95% CI: 14, 30) with a 1°C increase in mean temperature above a 28°C threshold in summers that followed a winter with low mortality, compared with 12% (95% CI: 7, 17) following a winter with high mortality. The short- and long-term mortality displacement appeared to jointly influence the assessment of heat-related deaths. CONCLUSIONS We found evidence of both short- and long-term harvesting effects on heat-related mortality in Brisbane, Australia. Our finding may clarify temperature-related health risks and inform effective public health interventions to manage the health impacts of climate change.
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Affiliation(s)
- Zhen Qiao
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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42
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Cardiovascular mortality associated with low and high temperatures: determinants of inter-region vulnerability in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5918-33. [PMID: 26024362 PMCID: PMC4483679 DOI: 10.3390/ijerph120605918] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/11/2015] [Indexed: 11/17/2022]
Abstract
The objectives of this study were to estimate the effects of temperature on cardiovascular mortality in 26 regions in the south and west of China from 2008 to 2011, and to identify socioeconomic and demographic factors contributing to such inter-region variation in the temperature effect. A separate Poisson generalized additive model (GAM) was fitted to estimate percent changes in cardiovascular mortality at low and high temperatures on a daily basis for each region. The model used the smooth functions to model the nonlinear effects of temperature and humidity and to control for the seasonal factor using the calendar time variable. Given variation in the magnitude of the temperature effect on cardiovascular mortality, we employed a Bayesian network (BN) to identify potential region-specific socioeconomic and demographic factors that may explain the variation. In most regions, an increasing trend in high or low temperature was associated with an increase in cardiovascular mortality, with variation in the magnitude of the temperature effects across regions. Three factors, including per capita years of education (as an indicator of economic status), percentage of the population over 65 years of age and percentage of women had direct impact on cold-related cardiovascular mortality. Number of hospital beds (as an indicator of the availability of medical resources), percentage of population engaged in industrial occupations, and percentage of women showed direct impact on heat-related cardiovascular mortality. Due to the socioeconomic and demographic inequalities between regions, the development of customized prevention and adaptation programs to address the low/high temperatures in vulnerable regions should be prioritized.
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43
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Ding Z, Guo P, Xie F, Chu H, Li K, Pu J, Pang S, Dong H, Liu Y, Pi F, Zhang Q. Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 526:358-65. [PMID: 25962628 DOI: 10.1016/j.scitotenv.2015.05.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/28/2015] [Accepted: 05/05/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007-2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China. METHODS Poisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for daily mean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends. RESULTS The cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 °C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0-21 days was 1.03 (95% confidence interval: 0.95-1.11) and 1.33 (0.94-1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age <75 years than females and age ≥75 years. CONCLUSIONS The effect of DTR on mortality was non-linear, with high DTR associated with increased mortality. A DTR of 16 °C may be a cut-off point for mortality prognosis and has implications for developing intervention strategies to address high DTR exposure.
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Affiliation(s)
- Zan Ding
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong 515041, PR China
| | - Pi Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Fang Xie
- Hongta District Center for Disease Control and Prevention, Yuxi, Yunnan 653100, PR China
| | - Huifang Chu
- Tonghai Center for Disease Control and Prevention, Yuxi, Yunnan 652700, PR China
| | - Kun Li
- Hongta District Center for Disease Control and Prevention, Yuxi, Yunnan 653100, PR China
| | - Jingbo Pu
- Tonghai Center for Disease Control and Prevention, Yuxi, Yunnan 652700, PR China
| | - Shaojie Pang
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong 515041, PR China
| | - Hongli Dong
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong 515041, PR China
| | - Yahui Liu
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong 515041, PR China
| | - Fuhua Pi
- Department of Sports, Shantou University Medical College, Shantou, Guangdong 515041, PR China
| | - Qingying Zhang
- Department of Preventive Medicine, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong 515041, PR China.
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Kim H, Heo J, Kim H, Lee JT. Has the impact of temperature on mortality really decreased over time? THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 512-513:74-81. [PMID: 25613771 DOI: 10.1016/j.scitotenv.2015.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/31/2014] [Accepted: 01/07/2015] [Indexed: 06/04/2023]
Abstract
Many studies have reported that the temperature effect on mortality has decreased over time. However, most of those studies did not consider lag times longer than 10 days, which is frequently used to explore its effect net out compensatory effect (harvesting) and lag effects. We sought to examine the temporal variation of the temperature effect on mortality, considering both a lag effect and mortality displacement. Time-series analysis was conducted with lag of temperature up to 21 days on all-cause, cardiovascular, cerebrovascular, and respiratory deaths. We applied a series of time-windows, 8 years long, with which we compared the oldest to more recent intervals and took consecutive annual variation, excluding an interannual harvesting effect. At the 99th percentile (29°C), relative to the 90th percentile (25°C), we found a decreasing trend of heat effect on concurrent days whereas the risk of cardiovascular deaths increased over time. Cumulative risks of deaths increased recently except for respiratory disease. At the 10th percentile (-1°C) relative to the 25th percentile (4°C), cumulative cold effects on cardiovascular and respiratory mortality have emerged recently. Our study showed differences in the temporal variation in the temperature effect on mortality at concurrent day and in cumulative term. It is suggested that the time-varying nature of the temperature-mortality relationship depends not only on suggested factors, such as improvements in technology and infrastructure, and human physiological acclimatization, but also mortality displacement and lagged effects. Further studies on its complex nature are needed to provide relevant evidence for public health policy making.
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Affiliation(s)
- Honghyok Kim
- Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Jina Heo
- Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Hyomi Kim
- Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Jong-Tae Lee
- Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea.
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45
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Xuan LTT, Egondi T, Ngoan LT, Toan DTT, Huong LT. Seasonality in mortality and its relationship to temperature among the older population in Hanoi, Vietnam. Glob Health Action 2014; 7:23115. [PMID: 25511883 PMCID: PMC4265647 DOI: 10.3402/gha.v7.23115] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 03/02/2014] [Accepted: 03/11/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Several studies have established a relationship between temperature and mortality. In particular, older populations have been shown to be vulnerable to temperature effects. However, little information exists on the temperature-mortality relationship in Vietnam. OBJECTIVES This article aims to examine the monthly temperature-mortality relationship among older people in Hanoi, Vietnam, over the period between 2005 and 2010, and estimate seasonal patterns in mortality. METHODS We employed Generalized Additive Models, including smooth functions, to model the temperature-mortality relationships. A quasi-Poisson distribution was used to model overdispersion of death counts. Temporal trends, seasonality, and population size were adjusted for while estimating changes in monthly mortality over the study period. A cold month was defined as a month with a mean temperature below 19°C. RESULTS This study found that the high peak of mortality coincided with low temperatures in the month of February 2008, during which the mean temperature was the lowest in the whole study period. There was a significant relationship between mean monthly temperature and mortality among the older people (p<0.01). Overall, there was a significant decrease in the number of deaths in the year 2009 during the study period. There was a 21% increase in the number of deaths during the cold season compared to the warm season. The increase in mortality during the cold period was higher among females compared to males (female: IRR [incidence relative risk] =1.23; male: IRR=1.18). CONCLUSIONS Cold temperatures substantially increased mortality among the older population in Hanoi, Vietnam, and there were gender differences. Necessary preventive measures are required to mitigate temperature effects with greater attention to vulnerable groups.
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Affiliation(s)
- Le Thi Thanh Xuan
- Department of Environmental Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam;
| | - Thaddaeus Egondi
- African Population and Health Research Center, Nairobi, Kenya; Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Le Tran Ngoan
- Department of Occupational Health, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Do Thi Thanh Toan
- Department of Biostatistics and Medical Informatics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Le Thi Huong
- Department of Nutrition and Food Safety, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
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46
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Schuch G, Serrao-Neumann S, Choy DL. Managing health impacts of heat in South East Queensland, Australia. DISASTER HEALTH 2014; 2:82-91. [PMID: 28229002 DOI: 10.4161/2167549x.2014.960717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/21/2014] [Accepted: 08/28/2014] [Indexed: 11/19/2022]
Abstract
Heatwaves kill more people than any other natural hazard in Australia. Current literature on managing health risks of heatwaves highlights the importance of implementing urban planning measures, and engaging with vulnerable groups on a local level to better understand perceptions of risk and tailor health protection measures. This paper reviews arrangements to reduce heatwave health risks in South East Queensland in response to these themes. A literature search and document analysis, stakeholder interviews, and multi-stakeholder cross-sectoral workshops revealed that although heatwave management is not always considered by local government and disaster management stakeholders, many urban planning measures to minimize urban heat have been pursued. However, greater information from vulnerable groups is still needed to better inform heatwave management measures.
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Affiliation(s)
- Gemma Schuch
- Urban Research Program; Nathan Campus; Griffith University ; Nathan; Queensland, Australia
| | - Silvia Serrao-Neumann
- Urban Research Program; Nathan Campus; Griffith University ; Nathan; Queensland, Australia
| | - Darryl Low Choy
- Urban Research Program; Nathan Campus; Griffith University ; Nathan; Queensland, Australia
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47
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Li Y, Lan L, Wang Y, Yang C, Tang W, Cui G, Luo S, Cheng Y, Liu Y, Liu J, Jin Y. Extremely cold and hot temperatures increase the risk of diabetes mortality in metropolitan areas of two Chinese cities. ENVIRONMENTAL RESEARCH 2014; 134:91-7. [PMID: 25086705 DOI: 10.1016/j.envres.2014.06.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/30/2014] [Accepted: 06/22/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Numerous studies have reported the association between ambient temperature and mortality. However, few studies have focused on the effects of extreme temperatures on diabetes mortality, particularly in China. The objective of the present study was to assess the effects of extremely cold and hot temperatures on diabetes mortality in urban areas of Harbin and Chongqing in China to provide scientific evidence for public health policy implementation to respond to challenges in diabetes mortality because of extreme temperature events. METHODS A double threshold B-spline distributed lag non-linear model (DLNM) was used to investigate the effects of extremely cold and hot temperatures on diabetes mortality from lag 0 to 30 days, after controlling for potential confounders including air pollutants. The unit risk, which is the elevated cumulative risk of diabetes mortality caused by each 1 °C change in extremely cold and hot temperatures during certain lag days, was estimated for extreme cold and heat using simple regression analysis. RESULTS Significant associations between both extreme hot and cold temperatures and diabetes mortality were observed in Harbin and Chongqing for different lag lengths. In Harbin, the extreme cold effects on diabetes mortality were delayed by three days and lasted for six days (lag 3-8), with the highest risk (RR 95% CI: 1.223,1.054-1.418 for -23 °C) at lag 5. The hot effects were delayed one day and lasted for three days (lag 1-3), with the peak RR (1.343: 1.080-1.670 for 37 °C) at lag 2. In Chongqing, the cold effects on diabetes mortality were delayed by seven days and lasted for four days (lag 7-10), with the highest risk (1.201: 1.006-1.434 for 4 °C) at lag 7. The hot effects peaked (1.811: 1.083-3.027 for 41 °C) at lag 0 and lasted for 2 days (lag 0-1). The unit risk for cold and hot effects was 12.9% (95% CI: 2.5-33.7%) and 16.5% (95% CI: 3.8-39.1%) in Harbin and 12.5% (95% CI: -4.7 to 47.5%) and 19.7% (95% CI: 3.9-48.5%) in Chongqing, respectively. CONCLUSIONS The results indicate that both extremely cold and hot temperatures increase diabetes mortality in different manners in Harbin and Chongqing. Diabetes education programs should include information on either managing or combating the effects of extreme hot and cold weather.
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Affiliation(s)
- Yonghong Li
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Beijing 100021, China
| | - Li Lan
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Yulin Wang
- Chongqing Center for Disease Control and Prevention, Chongqing 404000, China
| | - Chao Yang
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Wenge Tang
- Chongqing Center for Disease Control and Prevention, Chongqing 404000, China
| | - Guoquan Cui
- Harbin Center for Disease Control and Prevention, Harbin 150056, China
| | - Shuquan Luo
- Chongqing Center for Disease Control and Prevention, Chongqing 404000, China
| | - Yibin Cheng
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Beijing 100021, China
| | - Yingchun Liu
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Beijing 100021, China
| | - Jingyi Liu
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Beijing 100021, China
| | - Yinlong Jin
- Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, 29 Nanwei Road, Beijing 100021, China.
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Hondula DM, Barnett AG. Heat-related morbidity in brisbane, australia: spatial variation and area-level predictors. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:831-6. [PMID: 24787277 PMCID: PMC4123028 DOI: 10.1289/ehp.1307496] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 03/20/2014] [Indexed: 05/07/2023]
Abstract
BACKGROUND Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable communities. OBJECTIVES We sought to quantify spatial variability in heat-related morbidity in Brisbane, Australia, to highlight regions of the city with the greatest risk. We also aimed to find area-level social and environmental determinants of high risk within Brisbane. METHODS We used a series of hierarchical Bayesian models to examine city-wide and intracity associations between temperature and morbidity using a 2007-2011 time series of geographically referenced hospital admissions data. The models accounted for long-term time trends, seasonality, and day of week and holiday effects. RESULTS On average, a 10°C increase in daily maximum temperature during the summer was associated with a 7.2% increase in hospital admissions (95% CI: 4.7, 9.8%) on the following day. Positive statistically significant relationships between admissions and temperature were found for 16 of the city's 158 areas; negative relationships were found for 5 areas. High-risk areas were associated with a lack of high income earners and higher population density. CONCLUSIONS Geographically targeted public health strategies for extreme heat may be effective in Brisbane, because morbidity risk was found to be spatially variable. Emergency responders, health officials, and city planners could focus on short- and long-term intervention measures that reach communities in the city with lower incomes and higher population densities, including reduction of urban heat island effects.
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Affiliation(s)
- David M Hondula
- Center for Policy Informatics, Arizona State University, Phoenix, Arizona, USA
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Huang J, Wang J, Yu W. The lag effects and vulnerabilities of temperature effects on cardiovascular disease mortality in a subtropical climate zone in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:3982-94. [PMID: 24733034 PMCID: PMC4025023 DOI: 10.3390/ijerph110403982] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/19/2014] [Accepted: 03/28/2014] [Indexed: 11/16/2022]
Abstract
This research quantifies the lag effects and vulnerabilities of temperature effects on cardiovascular disease in Changsha—a subtropical climate zone of China. A Poisson regression model within a distributed lag nonlinear models framework was used to examine the lag effects of cold- and heat-related CVD mortality. The lag effect for heat-related CVD mortality was just 0–3 days. In contrast, we observed a statistically significant association with 10–25 lag days for cold-related CVD mortality. Low temperatures with 0–2 lag days increased the mortality risk for those ≥65 years and females. For all ages, the cumulative effects of cold-related CVD mortality was 6.6% (95% CI: 5.2%–8.2%) for 30 lag days while that of heat-related CVD mortality was 4.9% (95% CI: 2.0%–7.9%) for 3 lag days. We found that in Changsha city, the lag effect of hot temperatures is short while the lag effect of cold temperatures is long. Females and older people were more sensitive to extreme hot and cold temperatures than males and younger people.
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Affiliation(s)
- Jixia Huang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Weiwei Yu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane 4059, Australia.
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50
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Zhang Y, Li S, Pan X, Tong S, Jaakkola JJK, Gasparrini A, Guo Y, Wang S. The effects of ambient temperature on cerebrovascular mortality: an epidemiologic study in four climatic zones in China. Environ Health 2014; 13:24. [PMID: 24690204 PMCID: PMC4021080 DOI: 10.1186/1476-069x-13-24] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/26/2014] [Indexed: 05/27/2023]
Abstract
BACKGROUND Little evidence is available about the association between temperature and cerebrovascular mortality in China. This study aims to examine the effects of ambient temperature on cerebrovascular mortality in different climatic zones in China. METHOD We obtained daily data on weather conditions, air pollution and cerebrovascular deaths from five cities (Beijing, Tianjin, Shanghai, Wuhan, and Guangzhou) in China during 2004-2008. We examined city-specific associations between ambient temperature and the cerebrovascular mortality, while adjusting for season, long-term trends, day of the week, relative humidity and air pollution. We examined cold effects using a 1°C decrease in temperature below a city-specific threshold, and hot effects using a 1°C increase in temperature above a city-specific threshold. We used a meta-analysis to summarize the cold and hot effects across the five cities. RESULTS Beijing and Tianjin (with low mean temperature) had lower thresholds than Shanghai, Wuhan and Guangzhou (with high mean temperature). In Beijing, Tianjin, Wuhan and Guangzhou cold effects were delayed, while in Shanghai there was no or short induction. Hot effects were acute in all five cities. The cold effects lasted longer than hot effects. The hot effects were followed by mortality displacement. The pooled relative risk associated with a 1°C decrease in temperature below thresholds (cold effect) was 1.037 (95% confidence interval (CI): 1.020, 1.053). The pooled relative risk associated with a 1°C increase in temperature above thresholds (hot effect) was 1.014 (95% CI: 0.979, 1.050). CONCLUSION Cold temperatures are significantly associated with cerebrovascular mortality in China, while hot effect is not significant. People in colder climate cities were sensitive to hot temperatures, while people in warmer climate cities were vulnerable to cold temperature.
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Affiliation(s)
- Yanshen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China
| | - Shanshan Li
- Department of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Brisbane, QLD 4006, Australia
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Jouni JK Jaakkola
- Center for Environmental and Respiratory Health Research, Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Antonio Gasparrini
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Brisbane, QLD 4006, Australia
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Sheng Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China
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