1
|
Vassalle C, Grifoni D, Gozzini B, Parlanti A, Fibbi L, Marchi F, Messeri G, Pylypiv N, Messeri A, Paradossi U, Berti S. Environmental Temperature, Other Climatic Variables, and Cardiometabolic Profile in Acute Myocardial Infarction. J Clin Med 2024; 13:2098. [PMID: 38610863 PMCID: PMC11012411 DOI: 10.3390/jcm13072098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Objectives: To evaluate CV profiles, periprocedural complications, and in-hospital mortality in acute myocardial infarction (AMI) according to climate. Methods: Data from 2478 AMI patients (1779 men; mean age 67 ∓ 13 years; Pasquinucci Hospital ICU, Massa, Italy; 2007-2018) were retrospectively analyzed according to climate (LAMMA Consortium; Firenze, Italy) by using three approaches as follows: (1) annual warm (May-October) and cold (November-April) periods; (2) warm and cold extremes of the two periods; and (3) warm and cold extremes for each month of the two periods. Results: All approaches highlighted a higher percentage of AMI hospitalization for patients with adverse CV profiles in relation to low temperatures, or higher periprocedural complications and in-hospital deaths. In warmer times of the cold periods, there were fewer admissions of dyslipidemic patients. During warm periods, progressive heat anomalies were characterized by more smoker (approaches 2 and 3) and young AMI patient (approach 3) admissions, whereas cooler times (approach 3) evidenced a reduced hospitalization of diabetic and dyslipidemic patients. No significant effects were observed for the heat index and light circulation. Conclusions: Although largely overlapping, different approaches identify patient subgroups with different CV risk factors at higher AMI admission risk and adverse short-term outcomes. These data retain potential implications regarding pathophysiological mechanisms of AMI and its prevention.
Collapse
Affiliation(s)
- Cristina Vassalle
- Department of Laboratory Medicine, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Daniele Grifoni
- Laboratory of Monitoring and Environmental Modelling for the Sustainable Development (LaMMA Consortium), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
- Institute of Bioeconomy (IBE), National Research Council (CNR), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Bernardo Gozzini
- Laboratory of Monitoring and Environmental Modelling for the Sustainable Development (LaMMA Consortium), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
- Institute of Bioeconomy (IBE), National Research Council (CNR), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Alessandra Parlanti
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, Ospedale Pasquinucci, 54100 Massa, Italy
| | - Luca Fibbi
- Laboratory of Monitoring and Environmental Modelling for the Sustainable Development (LaMMA Consortium), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
- Institute of Bioeconomy (IBE), National Research Council (CNR), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Federica Marchi
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, Ospedale Pasquinucci, 54100 Massa, Italy
| | - Gianni Messeri
- Laboratory of Monitoring and Environmental Modelling for the Sustainable Development (LaMMA Consortium), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
- Institute of Bioeconomy (IBE), National Research Council (CNR), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Nataliya Pylypiv
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, Ospedale Pasquinucci, 54100 Massa, Italy
| | - Alessandro Messeri
- Institute of Bioeconomy (IBE), National Research Council (CNR), Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Umberto Paradossi
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, Ospedale Pasquinucci, 54100 Massa, Italy
| | - Sergio Berti
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, Ospedale Pasquinucci, 54100 Massa, Italy
| |
Collapse
|
2
|
Li Z, Wan J, Peng S, Wang R, Dai Z, Liu C, Feng Y, Xiang H. Associations between cold spells of different time types and coronary heart disease severity. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123100. [PMID: 38070638 DOI: 10.1016/j.envpol.2023.123100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/15/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
Limited evidence showed the association between cold spells and the severity of coronary heart disease (CHD). This study was to investigate the association between cold spells with their different time types and CHD severity. We collected data on CHD patients admitted to the Zhongnan Hospital, Wuhan, China from 2016 to 2021. CHD severity was quantified using the SYNTAX score and transformed into a binomial variable. Daily mean, maximum and minimum temperature were collected during the study period. We first used daily mean temperature to find the optimum definition among multiple thresholds and durations. The daily maximum and minimum temperatures were used to define different types of cold spells (daytime, nighttime and compound) based on the optimum definition. Annual cold spell days were included to assess individual exposure to cold spells. Logistic regression models were performed to fit the association between cold spell days and CHD severity stratified by different tertiles of PM2.5 and NDVI. In this study, 1937 CHD patients were included. The cold spell defined as at least four consecutive days with daily mean temperature below the 5th percentile exhibited the optimum model. We found that a 4-day increase in cold spell days was associated with more severe CHD (OR = 1.170, 95% CI: 1.074, 1.282). Such an association was more pronounced under higher levels of PM2.5 by OR = 1.270 (1.086, 1.494) and lower levels of greenness by OR = 1.240 (1.044, 1.476). Compared with daytime and compound cold spells, nighttime cold spells showed the strongest association with CHD severity by OR = 1.141 (1.026, 1.269). This study showed that exposure to cold spells was positively associated with CHD severity, especially the nighttime cold spells. The association between cold spells and CHD severity was more significant in high levels of PM2.5 and low levels of greenness.
Collapse
Affiliation(s)
- Zhaoyuan Li
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Jing Wan
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Shouxin Peng
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Ruonan Wang
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Zhongli Dai
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China
| | - Cuiyi Liu
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Yujia Feng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
| | - Hao Xiang
- School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| |
Collapse
|
3
|
Jiang Y, Yi S, Gao C, Chen Y, Chen J, Fu X, Yang L, Kong X, Chen M, Kan H, Xiang D, Su X, Chen R. Cold Spells and the Onset of Acute Myocardial Infarction: A Nationwide Case-Crossover Study in 323 Chinese Cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87016. [PMID: 37610263 PMCID: PMC10445528 DOI: 10.1289/ehp11841] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Few studies have explored the relationships between cold spells and acute myocardial infarction (AMI) using the information of symptom onset. OBJECTIVES We assessed the impact of cold spells on AMI onset and the potential effect modifiers. METHODS We conducted a time-stratified case-crossover study among 456,051 eligible patients with AMI from 2,054 hospitals in 323 Chinese cities between January 2015 and June 2021 during cold seasons (November to March). Nine definitions of cold spells were used by combining three relative temperature thresholds (i.e., lower than the 7.5th, 5th, and 2.5th percentiles) and three durations of at least 2-4 consecutive d. Conditional logistic regressions with distributed lag models were applied to evaluate the cumulated effects of cold spells on AMI onset over lags 0-6 d, after adjusting for daily mean temperature. RESULTS The associations generally appeared on lag 1 d, peaked on lag 3 d, and became nonsignificant approximately on lag 5 d. Cold spells defined by more stringent thresholds of temperature were associated with higher risks of AMI onset. For cold spell days defined by a daily mean temperature of ≤ 7.5 th percentile and durations of ≥ 2 d , ≥ 3 d , and ≥ 4 d , the percentage changes in AMI risk were 4.24% [95% confidence interval (CI): 2.31%, 6.20%], 3.48% (95% CI: 1.62%, 5.38%), and 2.82% (95% CI: 0.98%, 4.70%), respectively. Significant AMI risks associated with cold spells were observed among cases from regions without centralized heating, whereas null or much weaker risks were found among those from regions with centralized heating. Patients ≥ 65 years of age were more susceptible to cold spells. DISCUSSION This national case-crossover study presents compelling evidence that cold spells could significantly increase the risk of AMI onset. https://doi.org/10.1289/EHP11841.
Collapse
Affiliation(s)
- Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shaodong Yi
- Department of Cardiology, General Hospital of Southern Theater Command of People’s Liberation Army (PLA), Guangzhou, China
| | - Chuanyu Gao
- Department of Cardiology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Yuguo Chen
- Department of Emergency and Chest Pain Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianghua Fu
- Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lixia Yang
- Department of Cardiology, 920th Hospital of Joint Logistics Support Force of the Chinese PLA, Yunnan, China
| | - Xiangqing Kong
- Department of Cardiology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Dingcheng Xiang
- Department of Cardiology, General Hospital of Southern Theater Command of People’s Liberation Army (PLA), Guangzhou, China
| | - Xi Su
- Department of Cardiology, Wuhan Asia General Hospital, Wuhan, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| |
Collapse
|
4
|
Vésier C, Urban A. Gender inequalities in heat-related mortality in the Czech Republic. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02507-2. [PMID: 37428233 PMCID: PMC10386945 DOI: 10.1007/s00484-023-02507-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/22/2023] [Accepted: 05/10/2023] [Indexed: 07/11/2023]
Abstract
It is acknowledged that climate change exacerbates social inequalities, and women have been reported as more vulnerable to heat than men in many studies in Europe, including the Czech Republic. This study aimed at investigating the associations between daily temperature and mortality in the Czech Republic in the light of a sex and gender perspective, taking into account other factors such as age and marital status. Daily mean temperature and individual mortality data recorded during the five warmest months of the year (from May to September) over the period 1995-2019 were used to fit a quasi-Poisson regression model, which included a distributed lag non-linear model (DLNM) to account for the delayed and non-linear effects of temperature on mortality. The heat-related mortality risks obtained in each population group were expressed in terms of risk at the 99th percentile of summer temperature relative to the minimum mortality temperature. Women were found generally more at risk to die because of heat than men, and the difference was larger among people over 85 years old. Risks among married people were lower than risks among single, divorced, and widowed people, while risks in divorced women were significantly higher than in divorced men. This is a novel finding which highlights the potential role of gender inequalities in heat-related mortality. Our study underlines the relevance of including a sex and gender dimension in the analysis of the impacts of heat on the population and advocates the development of gender-based adaptation policies to extreme heat.
Collapse
Affiliation(s)
- Chloé Vésier
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamycka 129, 165 00, Prague, Czech Republic.
| | - Aleš Urban
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamycka 129, 165 00, Prague, Czech Republic
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Boční II 1401, 141 00, Prague, Czech Republic
| |
Collapse
|
5
|
Peták F, Kovács BN, Agócs S, Virág K, Nyári T, Molnár A, Südy R, Lengyel C, Babik B. Seasonal changes in proportion of cardiac surgeries associated with diabetes, smoking and elderly age. PLoS One 2022; 17:e0274105. [PMID: 36136994 PMCID: PMC9498963 DOI: 10.1371/journal.pone.0274105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
Background Seasonal variations in the ambient temperature may affect the exacerbation of cardiovascular diseases. Our primary objective was to evaluate the seasonality of the monthly proportion of cardiac surgeries associated with diabetes, smoking and/or elderly age at a tertiary-care university hospital in East-Central Europe with a temperate climate zone. As a secondary objective, we also assessed whether additional factors affecting small blood vessels (smoking, aging, obesity) modulate the seasonal variability of diabetes. Methods Medical records were analyzed for 9838 consecutive adult patients who underwent cardiac surgery in 2007–2018. Individual seasonal variations of diabetes, smoking, and elderly patients were analyzed monthly, along with the potential risk factors for cardiovascular complication. We also characterized whether pairwise coexistence of diabetes, smoking, and elderly age augments or blunts the seasonal variations. Results Seasonal variations in the monthly proportion of cardiac surgeries associated with diabetes, smoking and/or elderly age were observed. The proportion of cardiac surgeries of non-elderly and smoking patients with diabetes peaked in winter (amplitude of change as [peak-nadir]/nadir: 19.2%, p<0.02), which was associated with increases in systolic (6.1%, p<0.001) and diastolic blood pressures (4.4%, p<0.05) and serum triglyceride levels (27.1%, p<0.005). However, heart surgery in elderly patients without diabetes and smoking was most frequently required in summer (52.1%, p<0.001). Concomitant occurrence of diabetes and smoking had an additive effect on the requirement for cardiac surgery (107%, p<0.001), while the simultaneous presence of older age and diabetes or smoking eliminated seasonal variations. Conclusions Scheduling regular cardiovascular control in accordance with periodicities in diabetes, elderly, and smoking patients more than once a year may improve patient health and social consequences. Trial registration NCT03967639.
Collapse
Affiliation(s)
- Ferenc Peták
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
- * E-mail:
| | - Barbara N. Kovács
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
- Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
| | - Szilvia Agócs
- Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
- Department of Internal Medicine and Cardiology Center, Cardiac Surgery Unit, University of Szeged, Szeged, Hungary
| | - Katalin Virág
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Tibor Nyári
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Andrea Molnár
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
- Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
| | - Roberta Südy
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
- Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- Department of Internal Medicine, University of Szeged, Szeged, Hungary
| | - Barna Babik
- Department of Anesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary
- Department of Internal Medicine and Cardiology Center, Cardiac Surgery Unit, University of Szeged, Szeged, Hungary
| |
Collapse
|
6
|
Styler M, Singhal S, Halkidis K, Patel P, Ward KM, Jain M. The Impact of Winter Months on Venous Thromboembolism (VTE) Patients: A Retrospective Analysis of Hospital Outcomes in the United States. Cureus 2022; 14:e29091. [PMID: 36249631 PMCID: PMC9556336 DOI: 10.7759/cureus.29091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/09/2022] Open
Abstract
Objective: We aimed to analyze the Health Care Utilization Project’s (HCUP) Nationwide Inpatient Sample (NIS) and compare mortality rates in hospitals by month to determine if there is seasonal variability in outcomes associated with venous thromboembolism (VTE). Methods: The Nationwide Inpatient Sample database was queried from 1998 to 2011. Inclusion criteria were a diagnosis of deep vein thrombosis (DVT) (ICD-9 {International Classification of Diseases, Ninth Revision, Clinical Modification} 453.4, 453.8) and/or VTE (ICD-9 415.1) in patients aged 18 years or more. Admission data was then analyzed to compare mortality rates in teaching and non-teaching hospitals over that time and by month. Demographics, Charlson Comorbidity Index, length of stay (LOS), hospital region, and admission types (emergent/urgent versus elective admissions) were assessed. Linear and logistic models were generated for complex survey design to analyze predictors of mortality and LOS. Results: A total of 1,449,113 DVT/VTE cases were identified in the Nationwide Inpatient Sample (weighted n= 7,150,613), 54.7% female, 56.38% white, 49% in teaching hospitals. Higher mortality was found in the months of November 6.52%, December 6.9%, January 6.94%, and February 6.93% versus overall mortality of 6.4% over 12 months. Higher mortality was noted in these winter months in all regions, along with a significantly increased LOS. Mortality in the total cohort was found to be higher in January, with odds ratio (OR) 1.11 (1.08-1.15), p<0.0001; February, OR 1.11 (1.07-1.15), p<0.0001; and December, OR 1.10 (1.06-1.14), p<0.0001 compared to June. Mortality was significantly lower in the Midwest or North Central regions (OR 0.78 {0.72-0.83}, p<0.0001) and West (OR 0.80 {0.73-0.87}, p<0.0001) compared to the Northeast. Mortality was also significantly higher in teaching hospitals than in non-teaching hospitals (OR 1.16 {1.10-1.22}, p<0.0001), with mortality trending higher in teaching hospitals each month. Emergent/urgent admission, larger hospital size, female sex, age, and urban location were also significantly associated with increased mortality. Conclusions: This national study identified an increased risk of mortality associated with hospitalizations for DVT/VTE in the winter months, independent of hospital teaching status or region.
Collapse
|
7
|
Jiang Y, Hu J, Peng L, Li H, Ji JS, Fang W, Yan H, Chen J, Wang W, Xiang D, Su X, Yu B, Wang Y, Xu Y, Wang L, Li C, Chen Y, Zhao D, Kan H, Ge J, Huo Y, Chen R. Non-optimum temperature increases risk and burden of acute myocardial infarction onset: A nationwide case-crossover study at hourly level in 324 Chinese cities. EClinicalMedicine 2022; 50:101501. [PMID: 35755601 PMCID: PMC9218136 DOI: 10.1016/j.eclinm.2022.101501] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/10/2022] [Accepted: 05/20/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The associations of ambient temperature with acute myocardial infarction (AMI) have seldom been examined based on the time of symptom onset. METHODS We conducted a time-stratified case-crossover study among 1,046,773 eligible AMI patients from 2,093 hospitals in 324 Chinese cities from January 1, 2015 to June 30, 2021, after excluding those transferred from other hospitals or having not reported the time of symptom onset. Hourly exposure to ambient temperature was calculated as multiple moving 24-h averages (days) before hourly onset of AMI symptoms. Conditional logistic regression and distributed lag non-linear models with a duration of 0-21 days were used to estimate the cumulative associations of non-optimum temperature with AMI onset and the corresponding disease burden nationally. Subgroup analyses by region and period were conducted. Specifically, cities with and without centralized heating system were classified into heating and non-heating regions, respectively. The whole year in heating region was divided into heating and non-heating periods based on the duration of centralized heating in each city. FINDINGS Almost monotonically increasing risks were observed for both overall AMI and its two subtypes when ambient temperature declined. The effects of extremely low temperature occurred immediately on the concurrent day, and lasted up to almost 3 weeks. The excess risks of AMI onset associated with non-optimum ambient temperatures were observed during the whole year in the non-heating region and non-heating period in the heating region, but not during heating period. Specifically, odds ratios of AMI onset associated with extremely low temperature cumulated over 0-21 days were 1.24 (95% CI: 1.13-1.37), 1.46 (95% CI: 1.20-1.76), and 1.62 (95% CI: 1.46-1.81) in the heating region during non-heating period, in the non-heating region during winter and non-winter period, respectively. The heat effects on AMI onset were very modest and transient. Totally, 13.26% of AMI cases could be attributable to non-optimum temperatures nationally. The burden of AMI attributable to non-optimum temperature was much smaller in heating region than in non-heating region. Somewhat stronger effects were observed in females and patients aged older than 65. INTERPRETATION This nationwide study provided robust evidence that non-optimum ambient temperature may significantly trigger AMI onset, and for the first time estimated the disease burden after accounting for spatial and seasonal heterogeneity. Centralized heating might substantially mitigate AMI burden due to non-optimum temperature. FUNDING Shanghai International Science and Technology Partnership Project, National Natural Science Foundation of China, Talent Training Program of Zhongshan Hospital, Fudan University.
Collapse
Affiliation(s)
- Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John S. Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Weiyi Fang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Hongbing Yan
- Center for Coronary Artery Diseases, Chinese Academy of Medical Sciences in Shenzhen, Shenzhen, China
- Center for Coronary Artery Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Weimin Wang
- Department of Cardiology, Peking University People's Hospital, Beijing, China
| | - Dingcheng Xiang
- Department of Cardiology, General Hospital of Southern Theater Command, Guangzhou, China
| | - Xi Su
- Department of Cardiology, Wuhan ASIA General Hospital, Wuhan, China
| | - Bo Yu
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Yan Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital Xiamen University, Xiamen, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Lefeng Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chunjie Li
- Department of Emergency, Tianjin Chest Hospital, Tianjin, China
| | - Yundai Chen
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
- Corresponding author at: Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 180 Fenglin Road, Shanghai 200032, China.
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, China
- Corresponding author at: Department of Cardiology, Peking University First Hospital, No.8 Xishiku St., Xicheng District, Beijing 100034, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- Corresponding author at: Department of Environmental Health, School of Public Health, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai 200032, China.
| |
Collapse
|
8
|
Martinaitiene D, Raskauskiene N. Effects of Changes in Seasonal Weather Patterns on the Subjective Well-Being in Patients with CAD Enrolled in Cardiac Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094997. [PMID: 35564392 PMCID: PMC9099623 DOI: 10.3390/ijerph19094997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/07/2022] [Accepted: 04/16/2022] [Indexed: 02/04/2023]
Abstract
Objective: We examined whether seasonal and monthly variations exist in the subjective well-being of weather-sensitive patients with coronary artery disease (CAD) during cardiac rehabilitation. Methods: In this cross-sectional study, 865 patients (30% female, age 60 ± 9) were recruited within 2−3 weeks of treatment for acute coronary syndrome and during cardiac rehabilitation. The patients completed the Palanga self-assessment diary for weather sensitivity (PSAD-WS) daily, for an average of 15.5 days. PSAD-WS is an 11-item (general) three-factor (psychological, cardiac, and physical symptoms) questionnaire used to assess weather sensitivity in CAD patients. Weather data were recorded using the weather station “Vantage Pro2 Plus”. Continuous data were recorded eight times each day for the weather parameters and the averages of the data were linked to the respondents’ same-day diary results. Results: Weather-sensitive (WS) patients were found to be more sensitive to seasonal changes than patients who were not WS, and they were more likely to experience psychological symptoms. August (summer), December (winter), and March (spring) had the highest numbers of cardiac symptoms (all p < 0.001). In summary, peaks of symptoms appeared more frequently during the transition from one season to the next. Conclusion: This study extends the knowledge about the impact of atmospheric variables on the general well-being of weather-sensitive CAD patients during cardiac rehabilitation.
Collapse
|
9
|
Lei J, Chen R, Yin P, Meng X, Zhang L, Liu C, Qiu Y, Ji JS, Kan H, Zhou M. Association between Cold Spells and Mortality Risk and Burden: A Nationwide Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:27006. [PMID: 35157500 PMCID: PMC8843087 DOI: 10.1289/ehp9284] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Few multicity studies have evaluated the association between cold spells and mortality risk and burden. OBJECTIVES We aimed to estimate the association between cold spells and cause-specific mortality and to evaluate the mortality burden in China. METHODS We conducted a time-series analysis with a nationally representative Disease Surveillance Points System database during the cool seasons spanning from 2013 to 2015 in 272 Chinese cities. We used 12 cold-spell definitions and overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative association of cold spells over lags of 0-28 d. We controlled for the nonlinear and lagged effects of cold temperature over 0-28 d to evaluate the added effect estimates of cold spell. We also quantified the nationwide mortality burden and pooled the estimated association at national and different climatic levels with meta-regression models. RESULTS For the cold-spell definition of daily mean temperatures of ≤5th percentile of city-specific daily mean temperature and duration of ≥4 consecutive d, the relative risks (i.e., risk ratios) associated with cold spells were 1.39 [95% confidence interval (CI): 1.15, 1.69] for non-accidental mortality, 1.66 (95% CI: 1.20, 2.31) for coronary heart disease mortality, 1.49 (95% CI: 1.12, 1.97) for stroke mortality, and 1.26 (95% CI: 0.85, 1.87) for chronic obstructive pulmonary disease mortality. Cold spells showed a maximal lagged association of 28 d with the risks peaked at 10-15 d. A statistically significant attributable fraction (AF) of non-accidental mortality [2.10% (95% CI: 0.94%, 3.04%)] was estimated. The risks were higher in the temperate continental and the temperate monsoon zones than in the subtropical monsoon zone. The elderly population was especially vulnerable to cold spells. DISCUSSION Our study provides evidence for the significant relative risks of non-accidental, cardiovascular, and respiratory mortality associated with cold spells. The findings on vulnerable populations and differential risks in different climatic zones may help establish region-specific forecasting systems against the hazardous impact of cold spells. https://doi.org/10.1289/EHP9284.
Collapse
Affiliation(s)
- Jian Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence (IRDR ICoE) on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lina Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yang Qiu
- Department of Environmental Sciences and Engineering, School of Architecture and Environmental Sciences, Sichuan University, Chengdu, China
| | - John S. Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence (IRDR ICoE) on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
10
|
Meng C, Ke F, Xiao Y, Huang S, Duan Y, Liu G, Yu S, Fu Y, Peng J, Cheng J, Yin P. Effect of Cold Spells and Their Different Definitions on Mortality in Shenzhen, China. Front Public Health 2022; 9:817079. [PMID: 35141195 PMCID: PMC8818748 DOI: 10.3389/fpubh.2021.817079] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
A high premium has been put on researching the effects of cold spells because of their adverse influence on people's daily lives and health. The study aimed to find the most appropriate definition of the cold spell in Shenzhen and quantify the impact of cold spells on mortality. Based on the daily mortality data in Shenzhen from 2013 to 2017 and the meteorological and pollutant data from the same period, we quantified the effect of cold spells using eight different definitions in the framework of a distributed lag non-linear model with a quasi-Poisson distribution. In Shenzhen, low temperatures increase the risk of death more significantly than high temperatures (using the optimal temperature as the cut-off value). Comparing the quasi-Akaike information criterion value, attribution fraction (b-AF), and attribution number (b-AN) for all causes of deaths and non-accidental deaths, the optimal definition of the cold spell was defined as the threshold was 3rd percentile of the daily average temperature and duration for 3 or more consecutive days (all causes: b-AF = 2.31% [1.01–3.50%], b-AN = 650; non-accidental: b-AF = 1.92% [0.57–3.17%], b-AN = 471). For cardiovascular deaths, the best definition was the temperature threshold as the 3rd percentile of the daily average temperature with a duration of 4 consecutive days (cardiovascular: b-AF = 1.37% [0.05–2.51%], b-AN = 142). Based on the best definition in the model, mortality risk increased in cold spells, with a statistically significant lag effect occurring as early as the 4th day and the effect of a single day lasting for 6 days. The maximum cumulative effect occurred on the 14th day (all-cause: RR = 1.54 [95% CI, 1.20–1.98]; non-accidental: RR = 1.43 [95% CI, 1.11–1.84]; cardiovascular: RR = 1.58 [95% CI, 1.00–2.48]). The elderly and females were more susceptible to cold spells. Cold spells and their definitions were associated with an increased risk of death. The findings of this research provide information for establishing an early warning system, developing preventive measures, and protecting susceptible populations.
Collapse
Affiliation(s)
- Chengzhen Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Ke
- Children's Health Care Hospital, Wuhan, China
| | - Yao Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
- *Correspondence: Ji Peng
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Jinquan Cheng
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ping Yin
| |
Collapse
|
11
|
Li CY, Wu PJ, Chang CJ, Lee CH, Chung WJ, Chen TY, Tseng CH, Wu CC, Cheng CI. Weather Impact on Acute Myocardial Infarction Hospital Admissions With a New Model for Prediction: A Nationwide Study. Front Cardiovasc Med 2022; 8:725419. [PMID: 34970601 PMCID: PMC8712757 DOI: 10.3389/fcvm.2021.725419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/27/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cardiovascular disease is one of the leading causes of mortality worldwide. Acute myocardial infarction (AMI) is associated with weather change. The study aimed to investigate if weather change was among the risk factors of coronary artery disease to influence AMI occurrence in Taiwan and to generate a model to predict the probabilities of AMI in specific weather and clinical conditions. Method: This observational study utilized the National Health Insurance Research Database and daily weather reports from Taiwan Central Weather Bureau to evaluate the discharge records of patients diagnosed with AMI from various hospitals in Taiwan between January 1, 2008 and December 31, 2011. Generalized additive models (GAMs) were used to estimate the effective parameters on the trend of the AMI incidence rate with respect to the weather and health factors in the time-series data and to build a model for predicting AMI probabilities. Results: A total of 40,328 discharges were listed. The minimum temperature, maximum wind speed, and antiplatelet therapy were negatively related to the daily AMI incidence; however, a drop of 1° when the air temperature was below 15°C was associated with an increase of 1.6% of AMI incidence. By using the meaningful parameters including medical and weather factors, an estimated GAM was built. The model showed an adequate correlation in both internal and external validation. Conclusion: An increase in AMI occurrence in colder weather has been evidenced in the study, but the influence of wind speed remains uncertain. Our analysis demonstrated that the novel GAM model can predict daily onset rates of AMI in specific weather conditions.
Collapse
Affiliation(s)
- Chen-Yu Li
- Department of Finance, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Po-Jui Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chi-Jen Chang
- Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, Taiwan.,Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan.,Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Jung Chung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tien-Yu Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chien-Hao Tseng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chia-Chen Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng-I Cheng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
12
|
Sabah ZU, Alarim RAO, Alarim MAO. The Role of Cold Exposure on Ischemic Heart Disease: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/z8kswsnevd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
13
|
Regulation of free radical processes in healthy volunteers during experimental hyperthermia and in patients with coronary artery disease during summer heat waves. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.5.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. In view of the worsening forecast for global temperature rise worldwide, it seems relevant to study the effects of abnormal heat waves on systemic regulatory processes in people with chronic diseases, in particular coronary artery disease (CAD).Aims. This study aimed to investigate the effect of hyperthermia on oxidative stress parameters in patients with various severity of CAD and in healthy subjects.Materials and methods. We studied the level of malonic dialdehyde (MDA) and the activity of Cu,Zn-containing superoxide dismutase (Cu,Zn-SOD) in healthy subjects under conditions of 30-day long simulated hyperthermia and in patients with different severity of CAD after the summer heat wavesResults. We revealed signs of oxidative stress in healthy volunteers during model hyperthermia that manifested as an increase in content of MDA in blood plasma. At the same time we observed increasing activity of Cu,Zn-SOD in erythrocytes that utilizes reactive oxygen species. The increase of Cu,Zn-SOD activity started with a certain latency what also can be explained by de novo enzyme biosynthesis induction. We also studied oxidative stress parameters in patients at high and moderate cardiovascular risk according to the SCORE risk chart with uncomplicated CAD course and in patients with complicated CAD with severe coronary damage according to angiography during the summer heat waves. We observed accumulation of MDA in blood plasma and increasing activity of erythrocyte Cu,Zn-SOD in patients with uncomplicated CAD. At the same time we noted that accumulation of MDA in blood plasma was not followed by any increase in activity of red blood cell Cu,Zn-SOD in patients with severe complicated CAD. This fact indicates dysregulation of free radical processes in patients with severe course of CAD during the heat waves.Conclusions. The dysregulation of free-radical processes in patients with a severe clinical course of CAD has been revealed.
Collapse
|
14
|
Vaičiulis V, Jaakkola JJK, Radišauskas R, Tamošiūnas A, Lukšienė D, Ryti NRI. Association between winter cold spells and acute myocardial infarction in Lithuania 2000-2015. Sci Rep 2021; 11:17062. [PMID: 34426618 PMCID: PMC8382753 DOI: 10.1038/s41598-021-96366-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/04/2021] [Indexed: 11/09/2022] Open
Abstract
Acute myocardial infarction (AMI) is a major public health problem. Cold winter weather increases the risk of AMI, but factors influencing susceptibility are poorly known. We conducted an individual-level case-crossover study of the associations between winter cold spells and the risk of AMI, with special focus on survival at 28 days and effect modification by age and sex. All 16,071 adult cases of AMI among the residents of the city of Kaunas in Lithuania in 2000-2015 were included in the study. Cold weather was statistically defined using the 5th percentile of frequency distribution of daily mean temperatures over the winter months. According to conditional logistic regression controlling for time-varying and time-invariant confounders, each additional cold spell day during the week preceding AMI increased the risk of AMI by 5% (95% CI 1-9%). For nonfatal and fatal cases, the risk increase per each additional cold spell day was 5% (95% CI 1-9%) and 6% (95% CI - 2-13%), respectively. The effect estimate was greater for men (OR 1.07, 95% CI 1.02-1.12) than for women (OR 1.02, 95% CI 0.97-1.08), but there was no evidence of effect modification by age. Evidence on factors increasing susceptibility is critical for targeted cold weather planning.
Collapse
Affiliation(s)
- Vidmantas Vaičiulis
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181, Kaunas, Lithuania.,Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181, Kaunas, Lithuania
| | - Jouni J K Jaakkola
- Faculty of Medicine, Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Finnish Meteorological Institute, Helsinki, Finland
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181, Kaunas, Lithuania.,Laboratory of Population Studies, Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, 50103, Kaunas, Lithuania
| | - Abdonas Tamošiūnas
- Laboratory of Population Studies, Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, 50103, Kaunas, Lithuania.,Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181, Kaunas, Lithuania
| | - Dalia Lukšienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181, Kaunas, Lithuania.,Laboratory of Population Studies, Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, 50103, Kaunas, Lithuania
| | - Niilo R I Ryti
- Faculty of Medicine, Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland. .,Biocenter Oulu, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Osyaeva MK, Tikhaze AK, Konovalova GG, Heimets GI, Martynyuk TV, Lankin VZ. Impact of summer heat waves on key parameters of oxidative stress in patients with coronary artery disease. TERAPEVT ARKH 2021; 93:421-426. [DOI: 10.26442/00403660.2021.04.200684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 11/22/2022]
Abstract
Aim. To assess the impact of summer heat waves on key parameters of oxidative stress in patients with coronary heart disease.
Materials and methods. We included 30 male patients aged 5213 years with stable angina pectoris of IIIII functional class with at least one coronary artery stenosis proved by angiography (ischemic group) in comparison with 10 male patients aged 487 years with no angiographic sings of significant coronary stenosis and without angina manifestation (non-ischemic group). The following parameters were studied: activity of superoxide dismutase (Cu,Zn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), the level of malondialdehyde (MDA) and MDA-modified low-density lipoproteins (MDA-LDL). The analysis of indicators was performed at normal average daily temperature (daytime temperature not higher than 20С) and after a heat wave (daytime temperature above 27C for more than 2 consecutive days).
Results. Our study revealed the decrease of CAT and GSH-Px activities with increased activity of Cu,Zn-SOD in both groups after the heat wave. At the same time we observed accumulation of MDA and increased MDA-LDL level in both groups. Initially ischemic patients showed significantly increased level of CAT and GSH-Px activity compared to the non-ischemic group, while it was no difference in activity of Cu,Zn-SOD and MDA and MDA-LDL level. We observed significant reduce of Cu,Zn-SOD activity in ischemic patients compared to non-ischemic group with no significant differences in all other studied parameters of oxidative stress after heat wave.
Conclusion. Changes in the key parameters of oxidative stress in patients with ischemic heart disease during summer heat waves are comparable to those in patients without ischemia, however significantly greater inhibition of GSH-Px activity and significantly lower increase in Cu,Zn-SOD activity was noted. These results may indicate misregulation of free radical processes in patients with ischemic heart decease
Collapse
|
17
|
Liu X, He Y, Tang C, Wei Q, Xu Z, Yi W, Pan R, Gao J, Duan J, Su H. Association between cold spells and childhood asthma in Hefei, an analysis based on different definitions and characteristics. ENVIRONMENTAL RESEARCH 2021; 195:110738. [PMID: 33485910 DOI: 10.1016/j.envres.2021.110738] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
As the global climate continues to warm, there is an increased focus on heat, but the role of low temperatures on health has been overlooked, especially for developing countries. Methods We collected the admission data of childhood asthma in 2013-2016 from Anhui Provincial Children's Hospital, as well as meteorological data from the Meteorological Bureau for the study period and collected data of pollutants from 10 monitoring stations around Hefei city. Poisson's generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was used to estimate the short-term effects of cold spell on childhood asthma in cold seasons (November to March). 16 definitions of cold spells were clearly compared, which combining 4 temperature indexes (daily minimum and mean temperature; daily minimum and mean apparent temperature), 2 temperature thresholds (2.5th and 5th) and 3 durations of at least 2-4 days. We then have an analysis of the modifying effect of characteristics of cold spells and individuals(gender and age), with a view to discovering the susceptible population to cold spell. Results There was significant association between cold spells and admission risk for childhood asthma. And the definition, in which daily minimum apparent temperature falls below 5th percentile for at least 3 consecutive days, produced the optimum model fit performance. Based on this optimal fit we found that, for the total population, the effect of cold spell lasted approximately five days (lag1-lag5), with the largest effect occurring in lag 3 (RR = 1.110; 95% CI: 1.052-1.170). In subgroup analysis, the cumulative effect of lag0-7 was higher in males and school-age children than in females and other age groups, respectively. In addition, we found that the effect of is higher as the duration increases. Conclusion This study suggests an association between cold spell and childhood asthma, and minimum AT may be a better indicator to define the cold spells. Boys and school-age children are more vulnerable to cold spell. And one of our very interesting findings is that if a cold spell lasts for several days, the impact of the cold spell on those later days is likely to be greater than that of the previous days. In conclusion, we should pay more attention to the protection of boys and school-aged children in our future public health protection and give more attention to those cold spells that last longer. Therefore, we recommend that schools and health authorities need to take targeted measures to reduce the risk of asthma in children during the cold spell.
Collapse
Affiliation(s)
- Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
| |
Collapse
|
18
|
Bruno RR, Wernly B, Masyuk M, Muessig JM, Schiffner R, Bäz L, Schulze C, Franz M, Kelm M, Jung C. No impact of weather conditions on the outcome of intensive care unit patients. Wien Med Wochenschr 2021; 172:40-51. [PMID: 33738633 PMCID: PMC8837525 DOI: 10.1007/s10354-021-00830-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/10/2021] [Indexed: 11/30/2022]
Abstract
Global warming leads to increased exposure of humankind to meteorological variation, including short-term weather changes. Weather conditions involve changes in temperature, heat and cold, in air pressure and in air humidity. Every single condition influences the incidence and mortality of different diseases such as myocardial infarction and stroke. This study investigated the impact of weather conditions on short- and long-term mortality of 4321 critically ill patients (66 ± 14 years, 2638 men) admitted to an intensive care unit (ICU) over a period of 5 years. Meteorological information (air temperature, air pressure and humidity) for the same period was retrieved. The influence of absolute weather parameters, different seasons, sudden weather changes including "warm" and "cold" spells on ICU and long-term mortality was analyzed. After correction for Simplified Acute Physiology Score (SAPS-2), no impact of meteorological conditions on mortality was found. Different seasons, sudden weather changes, "warm spells" or "cold spells" did not affect the outcome of critically ill patients.
Collapse
Affiliation(s)
- Raphael Romano Bruno
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Bernhard Wernly
- Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.,Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Maryna Masyuk
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Johanna M Muessig
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Rene Schiffner
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Orthopedic Department, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Laura Bäz
- Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology, and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| | - Christian Schulze
- Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology, and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| | - Marcus Franz
- Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology, and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.,Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany
| | - Christian Jung
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| |
Collapse
|
19
|
López-Bueno JA, Linares C, Sánchez-Guevara C, Martinez GS, Mirón IJ, Núñez-Peiró M, Valero I, Díaz J. The effect of cold waves on daily mortality in districts in Madrid considering sociodemographic variables. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:142364. [PMID: 33370923 DOI: 10.1016/j.scitotenv.2020.142364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/24/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
Abstract
While there is much research that focuses on the association between cold waves and their impacts on daily mortality at the city level, few analyze the impact related to social context and demographic variables at levels lower than the municipal. The objective of this study was to determine the role of the percentage of people over age 65, income level and percentage of homes without heating in the analysis of the impact of cold waves on daily mortality between January 1, 2010 and December 31, 2013 in different districts of the municipality of Madrid. We calculated Relative Risks (RR) and Attributable Risks (RA) for each of 17 districts to determine correlations between the effect of cold waves and daily mortality due to natural causes (CIEX: A00-R99) using Generalized Linear Models (GLM) of the Poisson family (link log). The pattern of risks obtained by district was analyzed using binomial family models (link logit), considering socioeconomic and demographic variables. In terms of results, an impact of cold on mortality was detected in 9 of the 17 districts analyzed. The analysis of risk patterns revealed that the probability of detecting an impact in a district increases in a statistically significant way (p-value <0.05) with a higher percentage of homes without heating systems and a higher percentage of population over age 65. The results obtained identify the factors that should be considered in public health policies that target the district level to reduce the impact of cold waves.
Collapse
Affiliation(s)
- J A López-Bueno
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain
| | - C Linares
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain
| | - C Sánchez-Guevara
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | | | - I J Mirón
- Consejería de Sanidad, Junta de Comunidades de Castilla- La Mancha, Spain
| | - M Núñez-Peiró
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | - I Valero
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | - J Díaz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain.
| |
Collapse
|
20
|
Plavcová E, Urban A. Intensified impacts on mortality due to compound winter extremes in the Czech Republic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 746:141033. [PMID: 32750577 DOI: 10.1016/j.scitotenv.2020.141033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/01/2020] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
Although impacts of extremely cold temperatures on human health have been widely studied, adverse effects of other extreme weather phenomena have so far received much less attention. We employed a high-quality long-term mortality time series (1982-2017) to evaluate impacts of extreme winter weather in the Czech Republic. We aimed to clarify whether compound events of extreme weather cause larger impacts on mortality than do each type of extreme if evaluated individually. Using daily data from the E-OBS and ERA5 datasets, we analyzed 9 types of extreme events: extreme wind gust, precipitation, snowfall, and sudden temperature and pressure changes. Relative mortality deviations from the adjusted baseline were used to estimate the immediate effect of the selected extreme events on excess mortality. The impact was adjusted for the effect of extreme cold. Extreme events associated with sudden rise of minimum temperature and pressure drops had generally significant impact on excess mortality (3.7% and 1.4% increase). The impacts were even more pronounced if these events occurred simultaneously or were compounded with other types of extremes, such as heavy precipitation, snowfall, maximum temperature rise, and their combinations (increase as great as 14.4%). Effects of some compound events were significant even for combinations of extremes having no significant impact on mortality when evaluated separately. On the other hand, a "protective" effect of pressure increases reduced the risk for its compound events. Meteorological patterns during extreme events linked to excess mortality indicate passage of a low-pressure system northerly from the study domain. We identified extreme winter weather events other than cold temperatures with significant impact on excess mortality. Our results suggest that occurrence of compound extreme events strengthen the impacts on mortality and therefore analysis of multiple meteorological parameters is a useful approach in defining adverse weather conditions.
Collapse
Affiliation(s)
- Eva Plavcová
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Aleš Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
| |
Collapse
|
21
|
Davis RE, Markle ES, Windoloski S, Houck ME, Enfield KB, Kang H, Balling RC, Kuehl DR, Burton JH, Farthing W, Rubio ER, Novicoff WM. A comparison of the effect of weather and climate on emergency department visitation in Roanoke and Charlottesville, Virginia. ENVIRONMENTAL RESEARCH 2020; 191:110065. [PMID: 32827524 PMCID: PMC7658034 DOI: 10.1016/j.envres.2020.110065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
Compared with mortality, the impact of weather and climate on human morbidity is less well understood, especially in the cold season. We examined the relationships between weather and emergency department (ED) visitation at hospitals in Roanoke and Charlottesville, Virginia, two locations with similar climates and population demographic profiles. Using patient-level data obtained from electronic medical records, each patient who visited the ED was linked to that day's weather from one of 8 weather stations in the region based on each patient's ZIP code of residence. The resulting 2010-2017 daily ED visit time series were examined using a distributed lag non-linear model to account for the concurrent and lagged effects of weather. Total ED visits were modeled separately for each location along with subsets based on gender, race, and age. The relationship between the relative risk of ED visitation and temperature or apparent temperature over lags of one week was positive and approximately linear at both locations. The relative risk increased about 5% on warm, humid days in both cities (lag 0 or lag 1). Cold conditions had a protective effect, with up to a 15% decline on cold days, but ED visits increased by 4% from 2 to 5 days after the cold event. The effect of thermal extremes tended to be larger for non-whites and the elderly, and there was some evidence of a greater lagged response for non-whites in Roanoke. Females in Roanoke were more impacted by winter cold conditions than males, who were more likely to show a lagged response at high temperatures. In Charlottesville, males sought ED attention at lower temperatures than did females. The similarities in the ED response patterns between these two hospitals suggest that certain aspects of the response may be generalizable to other locations that have similar climates and demographic profiles.
Collapse
Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Erin S Markle
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Sara Windoloski
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Margaret E Houck
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, USA.
| | - Kyle B Enfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois, Champaign-Urbana, IL, USA.
| | - Robert C Balling
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA.
| | - Damon R Kuehl
- Department of Emergency Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - John H Burton
- Department of Emergency Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Wilson Farthing
- Department of Emergency Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Edmundo R Rubio
- Section of Pulmonology, Critical Care, Sleep and Environmental Medicine, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Wendy M Novicoff
- Departments of Public Health Sciences and Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
| |
Collapse
|
22
|
Ma Y, Jiao H, Zhang Y, Feng F, Cheng B, Ma B, Yu Z. Short-term effect of extreme air temperature on hospital emergency room visits for cardiovascular diseases from 2009 to 2012 in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:38029-38037. [PMID: 32621192 DOI: 10.1007/s11356-020-09814-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
Extreme air temperature directly affected human health. However, the short-term effect of extreme air temperature on the incidence of cardiovascular diseases has rarely been reported in China. In this study, we focused on Beijing, China, and assessed the effects of cold/warm days and nights on the number of hospital emergency room (ER) visits for cardiovascular diseases from 2009 to 2012. We used a generalized additive model (GAM) to estimate the association between extreme air temperature and the number of hospital ER visits for cardiovascular diseases. We divided the entire study group into two gender subgroups and three age subgroups. The results showed that the short-term effect of extreme air temperature on hospital ER visits for cardiovascular diseases was more profound in females and the elderly (aged ≥ 75 years). Among all the study subgroups, the highest relative risk (RR) of cardiovascular diseases associated with extremely cold days, warm days, cold nights, and warm nights was 3.0% (95% CI, 1.6%-4.4%), 0.8% (95% CI, - 0.9%-2.6%), 2.8% (95% CI, 1.6%-4.2%), and 1.8% (95% CI, 0.6%-4.3%), respectively. Overall, the effect of extremely low air temperature (during both days and nights) on the incidence of cardiovascular diseases was stronger and more acute than that of extremely high air temperature.
Collapse
Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bingji Ma
- 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
| |
Collapse
|
23
|
Wen Y, Leng J, Shen X, Han G, Sun L, Yu F. Environmental and Health Effects of Ventilation in Subway Stations: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031084. [PMID: 32046319 PMCID: PMC7037944 DOI: 10.3390/ijerph17031084] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 12/30/2022]
Abstract
Environmental health in subway stations, a typical type of urban underground space, is becoming increasingly important. Ventilation is the principal measure for optimizing the complex physical environment in a subway station. This paper narratively reviews the environmental and health effects of subway ventilation and discusses the relevant engineering, environmental, and medical aspects in combination. Ventilation exerts a notable dual effect on environmental health in a subway station. On the one hand, ventilation controls temperature, humidity, and indoor air quality to ensure human comfort and health. On the other hand, ventilation also carries the potential risks of spreading air pollutants or fire smoke through the complex wind environment as well as produces continuous noise. Assessment and management of health risks associated with subway ventilation is essential to attain a healthy subway environment. This, however, requires exposure, threshold data, and thereby necessitates more research into long-term effects, and toxicity as well as epidemiological studies. Additionally, more research is needed to further examine the design and maintenance of ventilation systems. An understanding of the pathogenic mechanisms and aerodynamic characteristics of various pollutants can help formulate ventilation strategies to reduce pollutant concentrations. Moreover, current comprehensive underground space development affords a possibility for creating flexible spaces that optimize ventilation efficiency, acoustic comfort, and space perception.
Collapse
Affiliation(s)
- Yueming Wen
- School of Architecture, Future Underground Space Institute, Southeast University, Nanjing 210019, Jiangsu, China; (Y.W.); (G.H.); (L.S.); (F.Y.)
| | - Jiawei Leng
- School of Architecture, Future Underground Space Institute, Southeast University, Nanjing 210019, Jiangsu, China; (Y.W.); (G.H.); (L.S.); (F.Y.)
- Correspondence: ; Tel.: +86-025-83790760
| | - Xiaobing Shen
- School of Public Health, Station and Train Health Institute, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing 210019, Jiangsu, China;
| | - Gang Han
- School of Architecture, Future Underground Space Institute, Southeast University, Nanjing 210019, Jiangsu, China; (Y.W.); (G.H.); (L.S.); (F.Y.)
| | - Lijun Sun
- School of Architecture, Future Underground Space Institute, Southeast University, Nanjing 210019, Jiangsu, China; (Y.W.); (G.H.); (L.S.); (F.Y.)
| | - Fei Yu
- School of Architecture, Future Underground Space Institute, Southeast University, Nanjing 210019, Jiangsu, China; (Y.W.); (G.H.); (L.S.); (F.Y.)
| |
Collapse
|
24
|
Díaz J, López-Bueno JA, Sáez M, Mirón IJ, Luna MY, Sánchez-Martínez G, Carmona R, Barceló MA, Linares C. Will there be cold-related mortality in Spain over the 2021-2050 and 2051-2100 time horizons despite the increase in temperatures as a consequence of climate change? ENVIRONMENTAL RESEARCH 2019; 176:108557. [PMID: 31265969 DOI: 10.1016/j.envres.2019.108557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/20/2019] [Accepted: 06/24/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Global warming is resulting in an increase in temperatures which is set to become more marked by the end of the century and depends on the accelerating pace of greenhouse gas emissions into the atmosphere. Yet even in this scenario, so-called "cold waves" will continue to be generated and have an impact on health. OBJECTIVES This study sought to analyse the impact of cold waves on daily mortality at a provincial level in Spain over the 2021-2050 and 2051-2100 time horizons under RCP4.5 and RCP 8.5 emission scenarios, on the basis of two hypotheses: (1) that the cold-wave definition temperature (T threshold) would not vary over time; and, (2) that there would be a variation in T threshold. MATERIAL AND METHODS The results of a retrospective study undertaken for Spain as a whole across the period 2000-2009 enabled us to ascertain the cold-wave definition temperature at a provincial level and its impact on health, measured by reference to population attributable risk (PAR). The minimum daily temperatures projected for each provincial capital considering the above time horizons and emission scenarios were provided by the State Meteorological Agency. On the basis of the T threshold definition values and minimum daily temperatures projected for each province, we calculated the expected impact of low temperatures on mortality under the above two hypotheses. Keeping the PAR values constant, it was assumed that the mortality rate would vary in accordance with the available data. RESULTS If T threshold remained constant over the above time horizons under both emission scenarios, there would be no cold-related mortality. If T threshold were assumed to vary over time, however, then cold-related mortality would not disappear: it would instead remain practically constant over time and give rise to an estimated overall figure of around 250 deaths per year, equivalent to close on a quarter of Spain's current annual cold-related mortality and entailing a cost of approximately €1000 million per year. CONCLUSION Given that cold waves are not going to disappear and that their impact on mortality is far from negligible and is likely to remain so, public health prevention measures must be implemented to minimise these effects as far as possible.
Collapse
Affiliation(s)
- J Díaz
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
| | - J A López-Bueno
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - M Sáez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Calle de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos, 5, Pabellón 11, Planta Baja, 28029, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health Authority (Consejería de Sanidad, Torrijos (Toledo), Spain
| | - M Y Luna
- State Meteorological Agency (Agencia Estatal de Meteorología/AEMET), Madrid, Spain
| | | | - R Carmona
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - M A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Calle de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos, 5, Pabellón 11, Planta Baja, 28029, Madrid, Spain
| | - C Linares
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| |
Collapse
|
25
|
Thu Dang TA, Wraith D, Bambrick H, Dung N, Truc TT, Tong S, Naish S, Dunne MP. Short - term effects of temperature on hospital admissions for acute myocardial infarction: A comparison between two neighboring climate zones in Vietnam. ENVIRONMENTAL RESEARCH 2019; 175:167-177. [PMID: 31128426 DOI: 10.1016/j.envres.2019.04.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/22/2019] [Accepted: 04/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Vietnam is one of the countries most affected by climate change, but few studies have focused on the population health effects of climate variation. Extreme heatwaves and cold spells might exacerbate underlying chronic conditions and precipitate hospitalization or early death. This study examined the short-term effects of ambient temperature extremes on hospital admissions (HAs) due to acute myocardial infarction (AMI) between different climate zones in the Central Coast region of Vietnam. METHODS Information from medical records of all 3328 cases of AMI HAs (with hospital records cross-checked by clinicians) was collected from three hospitals in the South-Central Coast region (tropical savanna climate) and North-Central Coast region (tropical monsoon climate) for the period 2008-2015. Meteorological data were obtained from the National Hydro-Meteorological and Environment Network Centre. We used distributed lag non-linear models to assess the association between daily average temperature and AMI HAs, accounting for long-term trend and other meteorological variables. RESULTS We found a negative and significant association between AMI HAs and temperature in the North-Central Coast region while conversely there was a positive and significant association in the South-Central Coast region. In the North-Central Coast region, the risk of AMI HAs increased by 11% (Relative risk (RR): 1.11, 95% CI: 0.91-1.35, p > 0.05) at moderately low temperatures (10th percentile of temperature range - 18.5 °C) and increased by 25% (RR: 1.25, 95% CI: 1.02-1.55, p < 0.05) at extremely low temperatures (5th percentile of temperature range - 16.8 °C). In the South-Central Coast region, the risk of AMI HAs increased by 18% (RR: 1.18, 95% CI: 0.95-1.47, p > 0.05) and 36% (RR: 1.36, 95% CI: 1.06-1.73, p < 0.05) at moderately high temperatures (90th percentile of temperature range -29.5 °C) and extreme high temperatures (95th percentile of temperature range - 29.9 °C), respectively. CONCLUSIONS Risk of AMI is associated with extremely high and extremely low temperature in Vietnam and the risk varies in relation to the local regional climate. Public health preparedness and multi-level interventions should attempt to reduce people's exposure in periods of disadvantageous temperatures.
Collapse
Affiliation(s)
- Thi Anh Thu Dang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
| | - Darren Wraith
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nguyen Dung
- People's Committee of Thua Thien Hue Province, Hue City, Thua Thien Hue, Viet Nam
| | - Thai Thanh Truc
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Department of Training and Scientific Research, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia; Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Anhui Medical University, Hefei, China
| | - Sue Naish
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael P Dunne
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
26
|
Chen J, Yang J, Zhou M, Yin P, Wang B, Liu J, Chen Z, Song X, Ou CQ, Liu Q. Cold spell and mortality in 31 Chinese capital cities: Definitions, vulnerability and implications. ENVIRONMENT INTERNATIONAL 2019; 128:271-278. [PMID: 31071590 DOI: 10.1016/j.envint.2019.04.049] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 03/26/2019] [Accepted: 04/20/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND In the context of global warming, most researches have been conducted on health influences of heat waves, with limited understanding of health impacts of cold spells, especially for developing countries. METHODS We collected daily mortality and meteorological data for 31 capital cities across China during the maximum period of 2007-2013. A quasi-Poisson regression model combined with a distributed lag non-linear model was used to estimate the short-term effects of cold spells on mortality in cold seasons (November to March). 19 definitions of cold spell were clearly compared, including three definitions from the China Meteorological Administration (CMA) and 16 definitions by combining two temperature indicators (daily minimum and mean temperature), two temperature thresholds (3rd and 5th percentile) and four durations of at least 2-5 days. Then, a random effect meta-analysis was applied to pool the effect estimates at national level. Furthermore, a stratified analysis was constructed to identify the vulnerable subpopulations to cold spells. RESULTS The definition, in which daily mean temperature falls below 5th percentile for at least two consecutive days, produced the optimum model fit performance. Generally, the mortality risk increased to the maximum after 3-6 days' exposure to cold spell and then leveled off in the next 3 weeks. The pooled relative risks (RR) of non-accidental mortality for cold spells were 1.03 (95% CI: 1.01-1.05), 1.27 (1.19-1.35) and 1.55 (1.40-1.70) at lag 0, lag 0-14 and lag 0-27 days, respectively. The greatest effect estimates of cold spells were found among total respiratory diseases and COPD, with RR of 1.88 (1.65-2.11) and 1.88 (1.58-2.19), respectively. The elderly, less-educated individuals and residents in southern China were more vulnerable to cold spells. CONCLUSION There are remarkable mortality effects of cold spells, with effect estimates varying with the definition of cold spell and subpopulations. Using the official definition of cold spells may fail to capture the mortality risk associated with cold spells. These findings may facilitate the development of cold alert warning system and preventive actions to the vulnerable populations.
Collapse
Affiliation(s)
- Jinjian Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China; Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Zhaoyue Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xiuping Song
- 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 102206, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China.
| | - 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 102206, China.
| |
Collapse
|
27
|
Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101696. [PMID: 31091805 PMCID: PMC6573000 DOI: 10.3390/ijerph16101696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/03/2019] [Accepted: 05/10/2019] [Indexed: 01/13/2023]
Abstract
Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.
Collapse
|
28
|
Budhathoki NK, Zander KK. Socio-Economic Impact of and Adaptation to Extreme Heat and Cold of Farmers in the Food Bowl of Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1578. [PMID: 31064089 PMCID: PMC6539874 DOI: 10.3390/ijerph16091578] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/16/2022]
Abstract
Farmers worldwide have to deal with increasing climate variability and weather extremes. Most of the previous research has focused on impacts on agricultural production, but little is known about the related social and economic impacts on farmers. In this study, we investigated the social and economic impact of extreme weather events (EWE) on farmers in Nepal, and explored how they coped with and adapted to heat waves and cold spells between 2012 and 2017. To address these aims, we conducted a survey of 350 farms randomly selected from the Bardiya and Banke districts of the Terai lowlands of Nepal. They were specifically asked to rate the impacts of extreme temperatures, as well as their effect on labour productivity and collective farmer health, and the detailed preventative measures they had implemented. About 84% of the farmers self-reported moderate or severe heat stress during the last five years, and about 85%, moderate or severe cold stress. Likewise, the majority of respondents reported that both farmer health and labour productivity had been compromised by EWEs. Productivity loss had a strong association with the perceived levels of heat and cold stress, which, in turn, were more likely to be reported by farmers with previous EWE experience. Potentially due to the increased care required during EWEs, those farmers with livestock reported increased heat and cold stress, as, surprisingly, did those who had implemented adaptation measures. Farmers seemed to be less prepared for potential threats of cold spells than heat waves, and therefore less likely to adopt coping strategies, since these are a recent phenomenon. This study identified some limitations. The cross sectional and self-reported data, as a common source of information to estimate health impact, level of heat/cold stress and labour productivity loss. Community-based education/community engagement programs could be developed to facilitate proactive adaptation.
Collapse
Affiliation(s)
- Nanda Kaji Budhathoki
- Northern Institute, Charles Darwin University, Ellengowan Drive, Brinkin 0909, Darwin NT, Australia.
| | - Kerstin K Zander
- Northern Institute, Charles Darwin University, Ellengowan Drive, Brinkin 0909, Darwin NT, Australia.
- German Development Institute, 53113 Bonn, Germany.
| |
Collapse
|
29
|
Urban A, Hondula DM, Hanzlíková H, Kyselý J. The predictability of heat-related mortality in Prague, Czech Republic, during summer 2015-a comparison of selected thermal indices. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:535-548. [PMID: 30739159 DOI: 10.1007/s00484-019-01684-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices-Universal Thermal Climate Index and Excess Heat Factor (EHF)-were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May-September) during 1994-2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system.
Collapse
Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, P.O. Box 875302, Tempe, AZ, 85287-5302, USA
| | - Hana Hanzlíková
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 165 21, Prague 6, Czech Republic
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 603 00, Brno, Czech Republic
| |
Collapse
|
30
|
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.
Collapse
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.
| |
Collapse
|
31
|
Li S, Wang J, Xu Z, Wang X, Xu G, Zhang J, Shen X, Tong S. Exploring associations of maternal exposure to ambient temperature with duration of gestation and birth weight: a prospective study. BMC Pregnancy Childbirth 2018; 18:513. [PMID: 30594173 PMCID: PMC6311008 DOI: 10.1186/s12884-018-2100-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 11/19/2018] [Indexed: 12/22/2022] Open
Abstract
Background Evidence suggests the possible impact of ambient high temperature on fetal growth and birth outcomes. However, little is known about the relative impact of exposure to heat and cold and the possible vulnerable window during pregnancy. Methods Data on a total of 237,585 pregnant women from January 1st, 2001 to December 31st, 2010 were acquired from the Queensland Health, Australia. Daily data on meteorological factors, including ambient temperature, relative humidity, barometric pressure, and air pollutants, such as PM10, SO2, NO2, and O3, were obtained from relevant government agencies. This study was to examine the associations of maternal exposure to ambient temperature (high and low temperatures, in early vs. late pregnancy) with the duration of gestation and birth weight. Results A J-shaped association between minimum temperature at conception and duration of gestation was observed after adjusting for seasonality and other confounders. Compared to women who were exposed to the minimum temperature of 15–20 °C in the first gestational week, exposure to the minimum temperature of > 20 °C significantly increased the duration of gestation by 0.029 weeks (95% CI: 0.008, 0.049). A cumulative effect was found when exposure across the first four weeks was examined. There was an inverted U-shaped relationship between minimum temperature at delivery and the duration of gestation. Compared to women exposed to 15–20 °C, exposure to minimum temperature of > 20 °C and ≤ 10 °C was associated with a shortened gestation by 0.030 weeks (95% CI: -0.052, − 0.008) and 0.018 weeks (95% CI: -0.057, − 0.004), respectively. By contrast, an inverse relationship between maximum temperature and birth weight was observed. Compared to exposure to the maximum temperature of > 30 °C in the last week of pregnancy, maternal exposure to 20–25 °C and < 20 °C significantly increased birth weight by 0.011 kg (95% CI: 0.008, 0.018) and 0.018 kg (95% CI: 0.010, 0.031), respectively. Similarly, a mild cumulative effect was observed when maximum temperature exposure across the four weeks before delivery was evaluated. Conclusions The finding emphasized the importance of keeping an optimal temperature range during pregnancy for reducing the risk of preterm birth and low birthweight. Electronic supplementary material The online version of this article (10.1186/s12884-018-2100-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shenghui Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China. .,MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Jiajia Wang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| | - Xiaoyu Wang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.,MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoming Shen
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.,MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shilu Tong
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
32
|
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.
Collapse
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
| |
Collapse
|
33
|
Martinez GS, Diaz J, Hooyberghs H, Lauwaet D, De Ridder K, Linares C, Carmona R, Ortiz C, Kendrovski V, Adamonyte D. Cold-related mortality vs heat-related mortality in a changing climate: A case study in Vilnius (Lithuania). ENVIRONMENTAL RESEARCH 2018; 166:384-393. [PMID: 29936286 DOI: 10.1016/j.envres.2018.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/23/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Direct health effects of extreme temperatures are a significant environmental health problem in Lithuania, and could worsen further under climate change. This paper attempts to describe the change in environmental temperature conditions that the urban population of Vilnius could experience under climate change, and the effects such change could have on excess heat-related and cold-related mortality in two future periods within the 21st century. METHODS We modelled the urban climate of Vilnius for the summer and winter seasons during a sample period (2009-2015) and projected summertime and wintertime daily temperatures for two prospective periods, one in the near (2030-2045) and one in the far future (2085-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the historical relationship between temperature and mortality for the period 2009-2015, and estimated the projected mortality in the near future and far future periods under a changing climate and population, assuming alternatively no acclimatisation and acclimatisation to heat and cold based on a constant-percentile threshold temperature. RESULTS During the sample period 2009-2015 in summertime we observed an increase in daily mortality from a maximum daily temperature of 30 °C (the 96th percentile of the series), with an average of around 7 deaths per year. Under a no acclimatisation scenario, annual average heat-related mortality would rise to 24 deaths/year (95% CI: 8.4-38.4) in the near future and to 46 deaths/year (95% CI: 16.4-74.4) in the far future. Under a heat acclimatisation scenario, mortality would not increase significantly in the near or in the far future. Regarding wintertime cold-related mortality in the sample period 2009-2015, we observed increased mortality on days on which the minimum daily temperature fell below - 12 °C (the 7th percentile of the series), with an average of around 10 deaths a year. Keeping the threshold temperature constant, annual average cold-related mortality would decrease markedly in the near future, to 5 deaths/year (95% CI: 0.8-7.9) and even more in the far future, down to 0.44 deaths/year (95% C: 0.1-0.8). Assuming a "middle ground" between the acclimatisation and non-acclimatisation scenarios, the decrease in cold-related mortality will not compensate the increase in heat-related mortality. CONCLUSION Thermal extremes, both heat and cold, constitute a serious public health threat in Vilnius, and in a changing climate the decrease in mortality attributable to cold will not compensate for the increase in mortality attributable to heat. Study results reinforce the notion that public health prevention against thermal extremes should be designed as a dynamic, adaptive process from the inception.
Collapse
Affiliation(s)
| | - Julio Diaz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Hans Hooyberghs
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Dirk Lauwaet
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Koen De Ridder
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Rocio Carmona
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Cristina Ortiz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Vladimir Kendrovski
- WHO European Centre for Environment and Health (World Health Organization Regional Office for Europe), Germany.
| | - Dovile Adamonyte
- Centre for Health Education and Diseases Prevention (SMLPC), Lithuania.
| |
Collapse
|
34
|
Gumabay EMS, Ramirez RC, Dimaya JMM, Beltran MM. Adversity of prolonged extreme cold exposure among adult clients diagnosed with coronary artery diseases: a primer for recommending community health nursing intervention. Nurs Open 2018; 5:62-69. [PMID: 29344396 PMCID: PMC5762701 DOI: 10.1002/nop2.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/15/2017] [Indexed: 01/31/2023] Open
Abstract
Aim This research study explored the lived experiences of adults diagnosed with Coronary Artery Disease (CAD) when exposed to a prolonged period of extreme cold. Design This research study utilized descriptive qualitative research design. Methods Face-to-face interview sessions with audio recording were conducted. There were 30 informants who participated in the study. Descriptive phenomenology with Colaizzi's method of data analysis was used. Results Results revealed three themes, namely: (i) elucidating cold exposure; (ii) challenges of cold exposure; and (iii) translating adverse exposure to self-management. The results further revealed the significance of nursing health care especially to health promotion, disease prevention and health restoration especially in community setting. Conclusion In conclusion, manifestations of CAD are triggered when exposed to a prolonged period of extremely low environmental temperature.
Collapse
Affiliation(s)
- Eladio Martin S. Gumabay
- Center for Health Research and DevelopmentUniversity of Saint LouisTuguegarao CityCagayan ValleyPhilippines
| | | | | | - Mae M. Beltran
- University of Saint LouisTuguegarao CityCagayan ValleyPhilippines
| |
Collapse
|
35
|
Urban A, Kyselý J. Application of spatial synoptic classification in evaluating links between heat stress and cardiovascular mortality and morbidity in Prague, Czech Republic. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:85-96. [PMID: 26337727 DOI: 10.1007/s00484-015-1055-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 07/20/2015] [Accepted: 08/23/2015] [Indexed: 06/05/2023]
Abstract
Spatial synoptic classification (SSC) is here first employed in assessing heat-related mortality and morbidity in Central Europe. It is applied for examining links between weather patterns and cardiovascular (CVD) mortality and morbidity in an extended summer season (16 May-15 September) during 1994-2009. As in previous studies, two SSC air masses (AMs)-dry tropical (DT) and moist tropical (MT)-are associated with significant excess CVD mortality in Prague, while effects on CVD hospital admissions are small and insignificant. Excess mortality for ischaemic heart diseases is more strongly associated with DT, while MT has adverse effect especially on cerebrovascular mortality. Links between the oppressive AMs and excess mortality relate also to conditions on previous days, as DT and MT occur in typical sequences. The highest CVD mortality deviations are found 1 day after a hot spell's onset, when temperature as well as frequency of the oppressive AMs are highest. Following this peak is typically DT- to MT-like weather transition, characterized by decrease in temperature and increase in humidity. The transition between upward (DT) and downward (MT) phases is associated with the largest excess CVD mortality, and the change contributes to the increased and more lagged effects on cerebrovascular mortality. The study highlights the importance of critically evaluating SSC's applicability and benefits within warning systems relative to other synoptic and epidemiological approaches. Only a subset of days with the oppressive AMs is associated with excess mortality, and regression models accounting for possible meteorological and other factors explain little of the mortality variance.
Collapse
Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic.
- Faculty of Science, Charles University, Albertov 6, 128 43, Prague 2, Czech Republic.
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| |
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
Carmona R, Díaz J, Mirón IJ, Ortiz C, Luna MY, Linares C. Mortality attributable to extreme temperatures in Spain: A comparative analysis by city. ENVIRONMENT INTERNATIONAL 2016; 91:22-8. [PMID: 26900891 DOI: 10.1016/j.envint.2016.02.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/10/2016] [Accepted: 02/12/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND The Low Temperature Days (LTD) have attracted far less attention than that of High Temperature Days (HTD), though its impact on mortality is at least comparable. This lower degree of attention may perhaps be due to the fact that its influence on mortality is less pronounced and longer-term, and that there are other concomitant infectious winters factors. In a climate-change scenario, the studies undertaken to date report differing results. The aim of this study was to analyse mortality attributable to both thermal extremes in Spain's 52 provinces across the period 2000-2009, and estimate the related economic cost to show the benefit or "profitability" of implementing prevention plans against LTD. METHODS Previous studies enabled us: to obtain the maximum daily temperature above which HTD occurred and the minimum daily temperature below which LTD occurred in the 52 provincial capitals analysed across the same study period; and to calculate the relative and attributable risks (%) associated with daily mortality in each capital. These measures of association were then used to make different calculations to obtain the daily mean mortality attributable to both thermal extremes. To this end, we obtained a summary of the number of degrees whereby the temperature exceeded (excess °C) or fell short (deficit °C) of the threshold temperature for each capital, and calculated the respective number of extreme temperatures days. The economic estimates rated the prevention plans as being 68% effective. RESULTS Over the period considered, the number of HTD (4373) was higher than the number of LTD (3006) for Spain as a whole. Notwithstanding this, in every provincial capital the mean daily mortality attributable to heat was lower (3deaths/day) than that attributable to cold (3.48deaths/day). In terms of the economic impact of the activation of prevention plans against LTD, these could be assumed to avoid 2.37 deaths on each LTD, which translated as a saving of €0.29M. Similarly, in the case of heat, 2.04 deaths could be assumed to be avoided each day on which the prevention plan against HTD was activated, amounting to a saving of €0.25M. While the economic cost of cold-related mortality across the ten-year period 2000-2009 was €871.7M, that attributable to heat could be put at €1093.2M. CONCLUSION The effect of extreme temperatures on daily mortality was similar across the study period for Spain overall. The lower number of days with LTD meant, however, that daily cold-related mortality was higher than daily heat-related mortality, thereby making prevention plans against LTD more "profitable" prevention plans against HTD in terms of avoidable mortality.
Collapse
Affiliation(s)
- R Carmona
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - J Díaz
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority (Consejería de Sanidad y Asuntos Sociales de Castilla-La Mancha), Torrijos, Toledo, Spain
| | - C Ortiz
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - M Y Luna
- State Meteorological Agency, (AEMET), Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| |
Collapse
|
38
|
Urban A, Burkart K, Kyselý J, Schuster C, Plavcová E, Hanzlíková H, Štěpánek P, Lakes T. Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030284. [PMID: 26959044 PMCID: PMC4808947 DOI: 10.3390/ijerph13030284] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/31/2016] [Accepted: 02/23/2016] [Indexed: 01/28/2023]
Abstract
The study examines spatial patterns of effects of high temperature extremes on cardiovascular mortality in the Czech Republic at a district level during 1994–2009. Daily baseline mortality for each district was determined using a single location-stratified generalized additive model. Mean relative deviations of mortality from the baseline were calculated on days exceeding the 90th percentile of mean daily temperature in summer, and they were correlated with selected demographic, socioeconomic, and physical-environmental variables for the districts. Groups of districts with similar characteristics were identified according to socioeconomic status and urbanization level in order to provide a more general picture than possible on the district level. We evaluated lagged patterns of excess mortality after hot spell occurrences in: (i) urban areas vs. predominantly rural areas; and (ii) regions with different overall socioeconomic level. Our findings suggest that climatic conditions, altitude, and urbanization generally affect the spatial distribution of districts with the highest excess cardiovascular mortality, while socioeconomic status did not show a significant effect in the analysis across the Czech Republic as a whole. Only within deprived populations, socioeconomic status played a relevant role as well. After taking into account lagged effects of temperature on excess mortality, we found that the effect of hot spells was significant in highly urbanized regions, while most excess deaths in rural districts may be attributed to harvesting effects.
Collapse
Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
- Faculty of Science, Charles University, Albertov 6, 12843 Prague 2, Czech Republic.
| | - Katrin Burkart
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY 10032, USA.
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 16521 Prague 6, Czech Republic.
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 60300 Brno, Czech Republic.
| | - Christian Schuster
- Department of Geography, Geoinformation Science Lab, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| | - Eva Plavcová
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
| | - Hana Hanzlíková
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
- Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
| | - Petr Štěpánek
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 60300 Brno, Czech Republic.
- Czech Hydrometeorological Institute, Regional Office Brno, Kroftova 2578, 61667 Brno, Czech Republic.
| | - Tobia Lakes
- Department of Geography, Geoinformation Science Lab, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| |
Collapse
|
39
|
Carmona R, Díaz J, Mirón IJ, Ortíz C, León I, Linares C. Geographical variation in relative risks associated with cold waves in Spain: The need for a cold wave prevention plan. ENVIRONMENT INTERNATIONAL 2016; 88:103-111. [PMID: 26735348 DOI: 10.1016/j.envint.2015.12.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/17/2015] [Accepted: 12/19/2015] [Indexed: 05/18/2023]
Abstract
In general, there are few studies that analyse the impact of low temperatures on mortality and fewer still that use cold-wave-definition thresholds based on epidemiological and non-climatological criteria. Such a threshold definition, which took into account population features such as socio-economic and demographic characteristics, made it possible for a specific threshold temperature to be obtained for each of Spain's 52 provincial capitals in this study. Using generalised linear models with the Poisson regression link, and controlling for trend, autocorrelations and seasonalities of the series, and influenza epidemics, we obtained the impact of low temperatures on mortality in each provincial capital by calculating the relative risks (RRs) and attributable risks (ARs) for natural as well as circulatory and respiratory causes. The study showed higher minimum temperature thresholds in coastal areas, and an overall impact of cold on mortality in Spain due to natural causes RR=1.13 (95% CI: 1.11-1.16), circulatory causes RR=1.18 (95% CI: 1.15-1.22) and respiratory causes RR=1.24 (95% CI: 1.20-1.29) slightly greater than that obtained to date for heat. From a public health standpoint, there is a need for specific cold wave prevention plans at a regional level which would enable mortality attributable to low temperatures to be reduced. These plans have shown themselves to be effective in decreasing heat-related mortality, and we feel that they are essential for reducing cold-related effects on morbidity and mortality.
Collapse
Affiliation(s)
- R Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
| | - J Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority (Consejería de Sanidad y Asuntos Sociales de Castilla-La Mancha), Torrijos, Toledo, Spain
| | - C Ortíz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - I León
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| |
Collapse
|
40
|
Smith S, Elliot AJ, Hajat S, Bone A, Bates C, Smith GE, Kovats S. The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010132. [PMID: 26784214 PMCID: PMC4730523 DOI: 10.3390/ijerph13010132] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/23/2015] [Accepted: 01/09/2016] [Indexed: 11/18/2022]
Abstract
We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH), out of hours (GPOOH) and emergency department (ED) syndromic surveillance systems. Data were stratified by age group and compared between a heatwave year (2013) and non-heatwave years (2012, 2014). Incidence rate ratios were calculated to estimate the differential impact of heatwave compared to non-heatwave summers: there were no apparent differences for the morbidities tested between the 2013 heatwave and non-heatwave years. A subset of GPIH data were used to study individuals at higher risk from heatwaves based on their pre-existing disease. Higher risk patients were not more likely to present at GPs or ED than other individuals. Comparing GPIH consultations and ED attendances for myocardial infarction/ischaemia (MI), there was evidence of a fall in the presentation of MI during the heatwave, which was particularly noted in the 65–74 years age group (and over 75 years in ED attendances). These results indicate the difficulty in identifying individuals at risk from non-fatal health effects of heatwaves and hot weather.
Collapse
Affiliation(s)
- Sue Smith
- Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK.
| | - Alex J Elliot
- Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK.
| | - Shakoor Hajat
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
| | - Angie Bone
- Extreme Events and Health Protection, Public Health England, London SE1 8UG, UK.
| | - Chris Bates
- ResearchOne, The Phoenix Partnership, Leeds LS18 5TN, UK.
| | - Gillian E Smith
- Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK.
| | - Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK.
| |
Collapse
|
41
|
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.
Collapse
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.
| |
Collapse
|
42
|
Kozlovskaya IL, Bulkina OS, Lopukhova VV, Chernova NA, Ivanova OV, Kolmakova TE, Karpov YA. [Heat and cardiovascular diseases: A review of epidemiological surveys]. TERAPEVT ARKH 2015; 87:84-90. [PMID: 26591558 DOI: 10.17116/terarkh201587984-90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The review summarizes epidemiologic data on the effects of heat on cardiovascular morbidity and mortality. Patients with heart failure and cardiac arrhythmias are most susceptible to negative heat exposure. At the same time, measures aimed at preserving the health of the population lead to a considerable reduction in losses associated with an abnormal rise in air temperature.
Collapse
Affiliation(s)
- I L Kozlovskaya
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - O S Bulkina
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - V V Lopukhova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - N A Chernova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - O V Ivanova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - T E Kolmakova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - Yu A Karpov
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| |
Collapse
|
43
|
Hanzlíková H, Plavcová E, Kynčl J, Kříž B, Kyselý J. Contrasting patterns of hot spell effects on morbidity and mortality for cardiovascular diseases in the Czech Republic, 1994-2009. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1673-1684. [PMID: 25744153 DOI: 10.1007/s00484-015-0974-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 02/11/2015] [Accepted: 02/11/2015] [Indexed: 06/04/2023]
Abstract
The study examines effects of hot spells on cardiovascular disease (CVD) morbidity and mortality in the population of the Czech Republic, with emphasis on differences between ischaemic heart disease (IHD) and cerebrovascular disease (CD) and between morbidity and mortality. Daily data on CVD morbidity (hospital admissions) and mortality over 1994-2009 were obtained from national hospitalization and mortality registers and standardized to account for long-term changes as well as seasonal and weekly cycles. Hot spells were defined as periods of at least two consecutive days with average daily air temperature anomalies above the 95% quantile during June to August. Relative deviations of mortality and morbidity from the baseline were evaluated. Hot spells were associated with excess mortality for all examined cardiovascular causes (CVD, IHD and CD). The increases were more pronounced for CD than IHD mortality in most population groups, mainly in males. In the younger population (0-64 years), however, significant excess mortality was observed for IHD while there was no excess mortality for CD. A short-term displacement effect was found to be much larger for mortality due to CD than IHD. Excess CVD mortality was not accompanied by increases in hospital admissions and below-expected-levels of morbidity prevailed during hot spells, particularly for IHD in the elderly. This suggests that out-of-hospital deaths represent a major part of excess CVD mortality during heat and that for in-hospital excess deaths CVD is a masked comorbid condition rather than the primary diagnosis responsible for hospitalization.
Collapse
Affiliation(s)
- Hana Hanzlíková
- Institute of Atmospheric Physics, The Czech Academy of Sciences, Boční II 1401, 141 31, Prague, Czech Republic.
- Faculty of Science, Charles University, Prague, Czech Republic.
- Institute of Geophysics, The Czech Academy of Sciences, Prague, Czech Republic.
| | - Eva Plavcová
- Institute of Atmospheric Physics, The Czech Academy of Sciences, Boční II 1401, 141 31, Prague, Czech Republic
| | - Jan Kynčl
- Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Bohumír Kříž
- Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, The Czech Academy of Sciences, Boční II 1401, 141 31, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| |
Collapse
|
44
|
Díaz J, Carmona R, Mirón IJ, Ortiz C, Linares C. Comparison of the effects of extreme temperatures on daily mortality in Madrid (Spain), by age group: The need for a cold wave prevention plan. ENVIRONMENTAL RESEARCH 2015; 143:186-91. [PMID: 26496852 DOI: 10.1016/j.envres.2015.10.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/30/2015] [Accepted: 10/15/2015] [Indexed: 05/16/2023]
Abstract
A number of studies have shown that there is a time trend towards a reduction in the effects of heat on mortality. In the case of cold, however, there is practically no research of this type and so there is no clearly defined time trend of the impact of cold on mortality. Furthermore, no other specific studies have yet analysed the time trend of the impact of both thermal extremes by age group. We analysed data on daily mortality due to natural causes (ICD-10: A00-R99) in the city of Madrid across the period 2001-2009 and calculated the impact of extreme temperatures on mortality using Poisson regression models for specific age groups. The groups of age selected coinciding with the pre-existing age-groups analyzed in previous papers. For heat waves the groups of age used were: <10 years, 10-17 years, 18-44 years, 45-64 years, 65-74 years and over-75 years. For cold waves the groups of age used were: <1 year; 1-5 years, 6-17 years, 18-44 years, 45-64 years, 65-74 years and over-75 years. <1, 1-17, 18-44, 45-66, 65-74 and over-75 years. We controlled for confounding variables, such as air pollution, noise, influenza, pollen, pressure and relative humidity, trend of the series, as well as seasonalities and autoregressive components of the series. The results of these models were compared to those obtained for the same city during the period 1986-1997 and published in different studies. Our results show a lightly reduction in the effects of heat, especially in the over-45-year age group. In the case of cold, the behaviour pattern was the opposite, with an increase in its effect. Heat adaptation and socio-economic and public-health prevention and action measures may be behind this amelioration in the effects of heat, whereas the absence of such actions in respect of low temperatures may account for the increase in the effects of cold on mortality. From a public health point of view, the implementation of cold wave prevention plans covering all age groups is thus called for.
Collapse
Affiliation(s)
- J Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
| | - R Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority (Consejería de Sanidad y Asuntos Sociales de Castilla-La Mancha), Torrijos, Toledo, Spain
| | - C Ortiz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| |
Collapse
|
45
|
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.
Collapse
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
| |
Collapse
|
46
|
Kozlovskaia IL, Bulkina OS, Lopukhova VV, Kolmakova TE, Karpov IA, Starostin IV, Baratashvili VL, Rubinshtein KG, Emelina SV, Borovikov VP. [Trends in hospitalizations of patients with acute coronary syndrome and indicators of the atmospheric state in Moscow in 2009-2012]. TERAPEVT ARKH 2014; 86:20-6. [PMID: 25804035 DOI: 10.17116/terarkh2014861220-26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To identify the meteorological factors or their combinations, which are most significant for the development of acute coronary syndrome (ACS) in different seasons. SUBJECTS AND METHODS A Statistica package was used to make an exploration analysis of the data of the A.S. Puchkov Central Emergency Medical Care Station on 63,412 admissions of patients diagnosed with acute myocardial infarction (AMI) to Moscow hospitals in 2009-2012 and those of the Hydrometeorology Center of Russia on weather conditions in the period under study. RESULTS Among the 63,412 patients, there were more men than women (p < 0.000005). Two long frost periods and three long abnormal heat periods were recorded in 2009-2012. In summer, the number of patients with a prehospital diagnosis of AMI was an average 19-22% less than in the other seasons. There was no peak in the number of hospitalizations during the abnormally hot summer of 2010. Air temperature proved to be a factor that was most strongly associated with the trend in AMI hospitalizations in men (MS = 1011.52, MSor = 27.27; p < 0.00005) and women (MS = 895.36, MSor = 25.37; p < 0.00005). The number of hospitalizations was negatively associated with daily average temperature in its positive range. In summer, the interdaily temperature difference turned out to be statistically significant; the highest number of hospitalizations was noted when it grew 6 °C colder. On days off, the number of admitted patients was 25% less than that on weekdays. CONCLUSION The trend in hospitalizations for a referral diagnosis of AMI has a significant seasonal component. Their number was minimal in summer, including in the abnormally hot summer of 2010. Air temperature is the most important factor. Positive temperature was found to be strongly negatively correlated with diagnosed AMI hospitalizations.
Collapse
|