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Xu Z, Yi W, Bach A, Tong S, Ebi KL, Su H, Cheng J, Rutherford S. Multimorbidity and emergency hospitalisations during hot weather. EBioMedicine 2024; 104:105148. [PMID: 38705102 PMCID: PMC11087953 DOI: 10.1016/j.ebiom.2024.105148] [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: 12/14/2023] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND People with chronic diseases are a commonly listed heat-vulnerable group in heat-health action plans. While prior research identifies multiple health conditions that may increase vulnerability to ambient heat, there is minimal evidence regarding the implications of multimorbidity (two or more chronic diseases). METHODS From the statewide hospital registry of Queensland, Australia, we identified people aged ≥15 years who had emergency hospitalisation(s) between March 2004 and April 2016 and previously had 0, 1, 2, or ≥3 of five chronic diseases: cardiovascular disease, diabetes, mental disorders, asthma/COPD, and chronic kidney disease. We conducted time-stratified case-crossover analyses to estimate the odds ratio of hospitalisations associated with ambient heat exposure in people with different numbers, types, and combinations of chronic diseases. Ambient heat exposure was defined as a 5 °C increase in daily mean temperature above the median. FINDINGS There were 2,263,427 emergency hospitalisations recorded (48.7% in males and 51.3% in females). When the mean temperature increased, hospitalisation odds increased with chronic disease number, particularly in older persons (≥65 years), males, and non-indigenous people. For instance, in older persons with 0, 1, 2, or ≥3 chronic diseases, the odds ratios associated with ambient heat exposure were 1.00 (95% confidence interval: 0.96, 1.04), 1.06 (1.02, 1.09), 1.08 (1.02, 1.14), and 1.13 (1.07, 1.19), respectively. Among the chronic diseases, chronic kidney disease, and asthma/COPD, either existing alone, together, or in combination with other diseases, were associated with the highest odds of hospitalisations under ambient heat exposure. INTERPRETATION While individuals with multimorbidity are considered in heat-health action plans, this study suggests the need to consider specifically examining them as a distinct and vulnerable subgroup. FUNDING Wellcome.
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Affiliation(s)
- Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia.
| | - Weizhuo Yi
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; School of Public Health, Anhui Medical University, Hefei, China
| | - Aaron Bach
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, USA
| | - Hong Su
- School of Public Health, Anhui Medical University, Hefei, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, China
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia
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Harvey G, Bain-Donohue S, Dewi SP. The impact of extreme heat on older regional and rural Australians: A systematic review. Aust J Rural Health 2024; 32:216-226. [PMID: 38419263 DOI: 10.1111/ajr.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Extreme heat causes a major health burden, especially for older Australians. OBJECTIVE To assess the impact of extreme heat on older regional and rural Australians, including clinical presentations, social implications, and health-seeking behaviours and adaptations. DESIGN A systematic review and narrative synthesis. FINDINGS Ten articles were included in the review with research on this topic limited. Extreme heat causes an increase in mortality and ambulance dispatches for older rural Australians. Social connectedness is negatively affected by extreme heat due to cancellation of events and individuals becoming housebound. Air conditioning is the main cooling mechanism used, although cost is a major concern. Despite this, older rural populations display a depth of knowledge regarding practical behavioural responses to adapt to extreme heat. Studies show older rural Australians do not consider extreme heat to be a threat to health. DISCUSSION Further research needs to examine the role extreme heat may play in contributing to experiences of loneliness. Air conditioning cannot be the ultimate solution in responding to extreme heat due to cost and increased carbon emissions. The low-risk perception of extreme heat for older rural people may inform effective heat health warnings and effective use of primary health care in heat-health education. Listening to First Nations knowledge in dealing with heat may provide a powerful mechanism in which to protect health. CONCLUSION The extensive health effects of extreme heat highlights the necessity of further research and strengthening of services in preparation for an ageing rural population enduring climate change.
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Affiliation(s)
- Grace Harvey
- Medical School - Australian National University (ANU) School of Medicine and Psychology, ANU College of Health and Medicine, Canberra, Australian Capital Territory, Australia
- Rural Clinical School, Australian National University (ANU) School of Medicine and Psychology, ANU College of Health and Medicine, Canberra, Australian Capital Territory, Australia
| | - Suzanne Bain-Donohue
- Rural Clinical School, Australian National University (ANU) School of Medicine and Psychology, ANU College of Health and Medicine, Canberra, Australian Capital Territory, Australia
- Indigenous Health Unit, Australian National University (ANU) School of Medicine and Psychology, ANU College of Health and Medicine, Canberra, Australian Capital Territory, Australia
| | - Sari Puspa Dewi
- Rural Clinical School, Australian National University (ANU) School of Medicine and Psychology, ANU College of Health and Medicine, Canberra, Australian Capital Territory, Australia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia
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Lo Y, Vosper E, Higgins JP, Howard G. Heat impacts on human health in the Western Pacific Region: an umbrella review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100952. [PMID: 38022710 PMCID: PMC10652124 DOI: 10.1016/j.lanwpc.2023.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Background High temperatures and heatwaves are occurring more frequently and lasting longer because of climate change. A synthesis of existing evidence of heat-related health impacts in the Western Pacific Region (WPR) is lacking. This review addresses this gap. Methods The Scopus and PubMed databases were searched for reviews about heat impacts on mortality, cardiovascular morbidity, respiratory morbidity, dehydration and heat stroke, adverse birth outcomes, and sleep disturbance. The last search was conducted in February 2023 and only publications written in English were included. Primary studies and reviews that did not include specific WPR data were excluded. Data were extracted from 29 reviews. Findings There is strong evidence of heat-related mortality in the WPR, with the evidence concentrating on high-income countries and China. Associations between heat and cardiovascular or respiratory morbidity are not robust. There is evidence of heat-related dehydration and stroke, and preterm and still births in high-income countries in the WPR. Some evidence of sleep disturbance from heat is found for Australia, Japan and China. Interpretation Mortality is by far the most studied and robust health outcome of heat. Future research should focus on morbidity, and lower income countries in continental Asia and Pacific Island States, where there is little review-level evidence. Funding Funded by the World Health Organization WPR Office.
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Affiliation(s)
- Y.T.Eunice Lo
- Cabot Institute for the Environment, University of Bristol, UK
- Elizabeth Blackwell Institute for Health Research, University of Bristol, UK
| | - Emily Vosper
- Cabot Institute for the Environment, University of Bristol, UK
- School of Geographical Sciences, University of Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Guy Howard
- Cabot Institute for the Environment, University of Bristol, UK
- School of Civil, Aerospace and Design Engineering, University of Bristol, UK
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Yang Y, Cao L, Xia Y, Li J. The effect of living environmental factors on cardiovascular diseases in Chinese adults: results from a cross-sectional and longitudinal study. Eur J Prev Cardiol 2023; 30:1063-1073. [PMID: 36537654 DOI: 10.1093/eurjpc/zwac304] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/01/2022] [Accepted: 12/16/2022] [Indexed: 08/23/2023]
Abstract
AIMS This study aimed to investigate the association between multiple living environmental factors and cardiovascular diseases (CVDs). METHODS AND RESULTS This study was conducted on the China Health and Retirement Longitudinal Study (CHARLS), with 12 489 subjects in the cross-sectional study and 7932 subjects in the 7-year follow-up. Living environmental factors included ambient fine particulate matter (PM2.5), indoor fuel use, tap water use, and residence type. Logistic regression and Cox proportional hazard regression models were applied to explore the association between living environmental risk factors and CVD events in a cross-sectional and a cohort analysis, respectively. Compared with subjects in the low-risk groups, those in the middle-risk (odd ratio [OR], 95% confidence interval [CI]: 1.203, 0.943-1.534) and high-risk groups (OR, 95% CI: 1.616, 1.259-2.074) showed increased risks of CVD prevalence when considering the combined effects of their living environment. During the follow-up, similar associations were observed (hazard ratio [HR], 1.541, 95% CI [1.142-2.080] for the high-risk group; HR 1.296, 95% CI [0.968-1.736] for the middle-risk group); P for trend = 0.003). CONCLUSION An overall poor living environmental quality is a potential risk factor for CVD. Future studies should focus more on the effects of exposure to multiple factors.
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Affiliation(s)
- Yao Yang
- Department of Cardiology, Shengjing Hospital of China Medical University, No. 36 San Hao Street, Heping District, Shenyang 110004, Liaoning Province, China
| | - Limin Cao
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36 San Hao Street, Heping District, Shenyang 110004, Liaoning Province, China
| | - Jian Li
- Department of Cardiovascular Medicine, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shengyang 110001, Liaoning Province, China
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Kai X, Hong Z, Hong Y, Wang X, Li C. Short-term impact of diurnal temperature range on cardiovascular diseases mortality in residents in northeast China. Sci Rep 2023; 13:11037. [PMID: 37419976 PMCID: PMC10328923 DOI: 10.1038/s41598-023-38129-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 07/03/2023] [Indexed: 07/09/2023] Open
Abstract
It has been reported that cardiovascular disease (CVD) has become one of the major threats to global public health and is associated with climate change. Several previous studies have shown the influence of ambient temperature on CVD, but lack some evidence for the short-term effect of diurnal temperature range (DTR) on CVD mortality in northeast China. This is the first study to assess the correlation between DTR and CVD mortality in Hulunbuir located in northeast China. Daily CVD mortality data and meteorological data were collected from 2014 to 2020. A quasi-Poisson generalized linear regression with a distributed lag non-linear model (DLNM) was applied to exploring the short-term impact of DTR on CVD mortality. Stratified analyses by gender, age, and season were conducted and the short-term impacts of extremely high DTR on CVD mortality were investigated. In this study, a total of 21,067 CVD mortality cases were recorded in Hulunbuir, China from 2014 to 2020. Compared to the reference value (11.20 [Formula: see text]C, 50[Formula: see text] percentile), a "U-shaped" non-linear relationship between DTR and CVD mortality was observed, and extremely high DTR increased the risk of CVD mortality. The short-term effect of extremely high DTR occurred immediately and lasted up to 6 days. In addition, the male and the age [Formula: see text] 65 groups were more likely to be affected by extremely high DTR compared with the female and the age < 65 groups, respectively. The results also showed that extremely high DTR in cold season had a more adverse effect on CVD mortality than warm season. This study suggests that extremely high DTR for cold season should be paid enough attention to for residents in northeast China. The male and the age [Formula: see text] 65 groups were more vulnerable to the impacts of DTR. The study results may provide some suggestions for decision-making by local public health authorities to avoid the adverse impacts of high DTR, and improve the health of residents, especially vulnerable groups in cold season.
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Affiliation(s)
- Xuan Kai
- Department of Mathematics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China
| | - Zhimin Hong
- Department of Mathematics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China.
| | - Yang Hong
- Department of Mechanics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China
| | - Xiaolei Wang
- Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Chunyang Li
- Department of Neurology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
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Inglis SC, Ferguson C, Eddington R, McDonagh J, Aldridge CJ, Bardsley K, Candelaria D, Chen YY, Clark RA, Halcomb E, Hendriks JM, Hickman LD, Wynne R. Cardiovascular Nursing and Climate Change: A Call to Action From the CSANZ Cardiovascular Nursing Council. Heart Lung Circ 2023; 32:16-25. [PMID: 36464619 DOI: 10.1016/j.hlc.2022.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 12/03/2022]
Abstract
This Call to Action aims to provide key considerations for cardiovascular nursing, related to climate and environmental impacts. Strategies to optimise nursing preparation, immediate response and adaptation to climate emergencies are crucial to ensure those at greatest risk, including First Nations peoples, are protected from potentially avoidable harm. Professionals who manage climate consequences must also understand the impact of their care on the root cause of the problem.
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Affiliation(s)
- Sally C Inglis
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. https://twitter.com/CSANZCNC
| | - Caleb Ferguson
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia; Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia. https://twitter.com/CSANZCNC
| | - Rebecca Eddington
- Nelson Marlborough District Health Board, New Zealand. https://twitter.com/CSANZCNC
| | - Julee McDonagh
- School of Nursing and Midwifery, College of Health Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia. https://twitter.com/CSANZCNC
| | - Chris J Aldridge
- Middlemore Hospital, Auckland, New Zealand. https://twitter.com/CSANZCNC
| | - Kimberley Bardsley
- The Prince Charles Hospital, Brisbane, Qld, Australia. https://twitter.com/CSANZCNC
| | - Dion Candelaria
- Susan Wakil School of Nursing & Midwifery, Faculty of Medicine & Health, and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia. https://twitter.com/CSANZCNC
| | - Y Y Chen
- School of Nursing, Midwifery & Paramedicine, University of the Sunshine Coast, Brisbane, Qld, Australia. https://twitter.com/CSANZCNC
| | - Robyn A Clark
- Caring Futures Research Institute, College of Nursing & Health Sciences, Flinders University, Adelaide, SA, Australia. https://twitter.com/CSANZCNC
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health & Medical Research Institute, Wollongong, NSW, Australia. https://twitter.com/CSANZCNC
| | - Jeroen M Hendriks
- Caring Futures Research Institute, College of Nursing & Health Sciences, Flinders University, Adelaide, SA, Australia; Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia. https://twitter.com/CSANZCNC
| | - Louise D Hickman
- University of Wollongong, Wollongong, NSW, Australia. https://twitter.com/CSANZCNC
| | - Rochelle Wynne
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia; The Royal Melbourne Hospital, Melbourne, Vic, Australia.
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Wang B, Chai G, Sha Y, Su Y. Association between ambient temperature and cardiovascular disease hospitalisations among farmers in suburban northwest China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1317-1327. [PMID: 35381858 DOI: 10.1007/s00484-022-02278-2] [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: 04/04/2021] [Revised: 02/18/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
Cardiovascular disease (CVD) has become a severe public health and social issue in China. However, in northwest China, evidence on the association between ambient temperature and CVD hospitalisations in suburban farmers is somewhat limited. We collected CVD hospitalisations and meteorological data (2012-2015) in Zhangye suburbs and assessed the temperature-related risk and burden of admission by fitting a distributed lag nonlinear model to probe the relationship between ambient temperature and CVD hospitalisations among farmers in suburban northwest China. The results show that 23,921 cases of CVD admissions were recorded from 2012 to 2015. There was a "U-shaped" association between temperature and hospitalisations. Compared with the minimum admissions temperature (MAT) at 15.3 °C, the cumulative relative risk (RR) over lag 0-21 days was 1.369 (95% CI 0.980-1.911) for extreme cold temperature (1st percentile, -15 °C), 1.353 (95% CI 1.063-1.720) for moderate cold (5th percentile, -11 °C), 1.415 (95% CI 1.117-1.792) for extreme heat (99th percentile, 26 °C), and 1.241 (95% CI 1.053-1.464) for moderate heat (95th percentile, 24 °C). Female farmers were more susceptible to low and high temperatures than male farmers. Farmers aged ≥ 65 years old were more sensitive to low temperatures, while farmers aged < 65 years old were more sensitive to high temperatures. A total of 13.4% (3,208 cases) of the hospitalisation burden for CVD were attributed to temperature exposure, with the moderate range of temperatures accounting for the most significant proportion (12.2%). Ambient temperature, primarily moderate temperatures, might be an essential factor for cardiovascular-related hospitalisations among farmers in suburban northwest China.
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Affiliation(s)
- Bin Wang
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Research Center for Emergency Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Guorong Chai
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Research Center for Emergency Management, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Yongzhong Sha
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Research Center for Emergency Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Yana Su
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- College of Economics and Management, Lanzhou Institute of Technology, Lanzhou, 730050, People's Republic of China
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Rahman MM, Garcia E, Lim CC, Ghazipura M, Alam N, Palinkas LA, McConnell R, Thurston G. Temperature variability associations with cardiovascular and respiratory emergency department visits in Dhaka, Bangladesh. ENVIRONMENT INTERNATIONAL 2022; 164:107267. [PMID: 35533532 DOI: 10.1016/j.envint.2022.107267] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/30/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Greenhouse gas emissions are changing the Earth's climate, most directly by modifying temperatures and temperature variability (TV). Residents of low- and middle-income countries (LMICs) are likely more adversely affected, due to lack of air conditioning to compensate. To date, there is no local epidemiological evidence documenting the cardio-respiratory health effects of TV in Dhaka, Bangladesh, one of the most climate change vulnerable cities in the world. OBJECTIVES We assessed short-term TV associations with daily cardiovascular disease (CVD) and respiratory emergency department (ED) visits, as well as effect modification by age and season. METHODS TV was calculated from the standard deviations of the daily minimum and maximum temperatures over exposure days. Time-series regression modeling was applied to daily ED visits for respiratory and CVD from January 2014 through December 2017. TV effect sizes were estimated after controlling for long-term trends and seasonality, day-of-week, holidays, and daily mean relative humidity and ambient temperature. RESULTS A 1 °C increase in TV was associated with a 1.00% (95 %CI: 0.05%, 1.96%) increase in CVD ED visits at lag 0-1 days (TV0-1) and a 2.77% (95 %CI: 0.24%, 5.20%) increase in respiratory ED visits at lag 0-7 days (TV0-7). TV-CVD associations were larger in the monsoon and cold seasons. Respiratory ED visit associations varied by age, with older adults more affected by the TV across all seasons. A 1 °C increase in TV at lag 0-7 days (TV0-7) was associated with a 7.45% (95 %CI: 2.33%, 12.57%) increase in respiratory ED visits among patients above 50 years of age. CONCLUSION This study provided novel and important evidence that cardio-pulmonary health in Dhaka is adversely affected year-round by day-to-day increases in TV, especially among older adults. TV is a key factor that should be considered in evaluating the potential human health impacts of climate change induced temperature changes.
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Affiliation(s)
- Md Mostafijur Rahman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chris C Lim
- Department of Community, Environment, and Policy at the Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Marya Ghazipura
- New York University Langone Health, Department of Population Health, New York, NY; ZS Associates, Global Health Economics and Outcomes Research, New York, NY
| | - Nur Alam
- Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
| | - Lawrence A Palinkas
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - George Thurston
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population Health, New York University School of Medicine, New York, NY, USA
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ‘‘U’’ shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth’s climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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Lansbury Hall N, Crosby L. Climate Change Impacts on Health in Remote Indigenous Communities in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:487-502. [PMID: 32543219 DOI: 10.1080/09603123.2020.1777948] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/19/2020] [Accepted: 05/31/2020] [Indexed: 06/11/2023]
Abstract
Human-induced climate change in Australia is affecting the frequency and intensity of extreme events, including bushfires, cyclones and drought. Human health is affected by these climate impacts through direct impacts which include injuries and death from extreme events; indirect impacts through natural system changes such as impacts on water, food and air; and indirect impacts on human systems including mental health, productivity, and damage to housing and health-care facilities. Remote settlements are vulnerable to these climate impacts and associated health impacts due to isolated location, quality of the infrastructure, economic resources, limited transport, and existing health vulnerabilities that enable resilience or vulnerability. Remote Indigenous communities are particularly vulnerable. This research sought to identify vulnerabilities of human health of residents in remote Indigenous communities to human-induced climate change to contribute to adequate responses of prevention and preparation.
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Affiliation(s)
- Nina Lansbury Hall
- School of Public Health, Faculty of Medicine, The University of Queensland, Queensland, Australia
| | - Lucy Crosby
- School of Public Health, Faculty of Medicine, The University of Queensland, Queensland, Australia
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Constantinou A, Oikonomou S, Konstantinou C, Makris KC. A randomized cross-over trial investigating differences in 24-h personal air and skin temperatures using wearable sensors between two climatologically contrasting settings. Sci Rep 2021; 11:22020. [PMID: 34759278 PMCID: PMC8580978 DOI: 10.1038/s41598-021-01180-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/25/2021] [Indexed: 11/08/2022] Open
Abstract
The influence of elevated air temperatures recorded in various urban microenvironments in adversely impacting biologically relevant disease end points has not yet been extensively tackled. This study is a post hoc analysis of the TEMP pilot trial, a randomized 2 × 2 cross-over trial that examined changes in metabolic and stress hormonal profiles of healthy adults in two settings (urban vs. rural) with distinctly different climatological characteristics during the Mediterranean summer. This analysis aimed to study the association between the 24-h personal air or skin temperature sensor measurements and the diary-based location type (indoors vs. outdoors) in urban (seaside) vs. rural (higher in altitude) microenvironments. Out of 41 eligible participants, a total of 37 participants were included in this post-hoc TEMP trial analysis. Wearable sensors recorded personal air temperature, skin temperature, and activity (as a surrogate marker of physical activity) in each setting, while a time-stamped personal diary recorded the types of indoor or outdoor activities. Temperature peaks during the 24-h sampling period were detected using a peak finding algorithm. Mixed effect logistic regression models were fitted for the odds of participant location (being indoors vs. outdoors) as a function of setting (urban vs. rural) and sensor-based personal temperature data (either raw temperature values or number of temperature peaks). During the study period (July-end of September), median [interquartile range, IQR] personal air temperature in the rural (higher altitude) settings was 1.5 °C lower than that in the urban settings (27.1 °C [25.4, 29.2] vs. 28.6 °C [27.1, 30.5], p < 0.001), being consistent with the Mediterranean climate. Median [IQR] personal air temperature in indoor (micro)environments was lower than those in outdoors (28.0 °C [26.4, 30.3] vs 28.5 °C [26.8, 30.7], p < 0.001). However, median [IQR] skin temperature was higher in indoor (micro)environments vs. outdoors (34.8 °C [34.0, 35.6] and 33.9 °C [32.9, 34.8], p < 0.001) and the number of both personal air and skin temperature peaks was higher indoors compared to outdoors (median [IQR] 3.0 [2.0,4.0] vs 1.0 [1.0,1.3], p < 0.007, for the skin sensors). A significant association between the number of temperature peaks and indoor location types was observed with either the personal air sensor (OR 3.1; 95% CI 1.2-8.2; p = 0.02) or the skin sensor (OR 3.7; 95% CI 1.4-9.9; p = 0.01), suggesting higher number of indoor air temperature fluctuations. Amidst the global climate crisis, more population health studies or personalized medicine approaches that utilize continuous tracking of individual-level air/skin temperatures in both indoor/outdoor locations would be warranted, if we were to better characterize the disease phenotype in response to climate change manifestations.
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Affiliation(s)
- Andria Constantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Stavros Oikonomou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
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Wang B, Chai G, Sha Y, Zha Q, Su Y, Gao Y. Impact of ambient temperature on cardiovascular disease hospital admissions in farmers in China's Western suburbs. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:143254. [PMID: 33190905 DOI: 10.1016/j.scitotenv.2020.143254] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/08/2020] [Accepted: 10/25/2020] [Indexed: 06/11/2023]
Abstract
Cardiovascular disease (CVD) has been a major threat to global public health. The association between temperature and CVD has been widely studied and reported in cities in developed countries. However, information from developing countries, especially from suburbs and countryside, is quite limited. In this study, the daily time series data on CVD hospital admissions in farmers in the suburbs of Tianshui, China, and the meteorological data from 2012 to 2015, were collected; besides, a quasi-Poisson regression with a distributed-lag non-linear model (DLNM) was used to explore the impact of local daily mean temperature on CVD hospital admissions in suburban farmers. This study found that, first, from 2011 to 2015, a total of 30,611 person-times of CVD hospital admissions in farmers were recorded; second, there was a "J-shaped" relation between temperature and CVD hospital admissions, and both low and high temperature increased the risk of hospital admission, but the impact of high temperature was greater; third, compared with the minimum hospitalization temperature (MHT) at 0.3 °C, during 0 to 21 lag days, the cumulative relative risk (RR) for extreme cold and heat (1st and 99th percentile of temperature, respectively) was 1.117 (95% CI 0.941-1.325) and 1.740 (95% CI 1.302-2.327), respectively, and that of moderate cold and heat (5st and 95th percentile of temperature, respectively) was 1.029 (95% CI 0.958-1.106) and 1.572 (95% CI 1.210-2.042), respectively; fourth, compared with male and ≥ 65 years groups, the risk for low temperature was greater for female and < 65 years groups, the risk for high temperature was just the opposite; last, about 21.04% of CVD hospital admissions burden were attributed to the ambient temperature, and most of (about 19.26%) were caused by moderate heat. In Tianshui, alongside with extreme temperature, the moderate temperature might be an important risk factor for CVD hospital admissions in suburban farmers.
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Affiliation(s)
- Bin Wang
- School of Management, Lanzhou University, Lanzhou 730000, PR China; Research Center for Emergency Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China
| | - Guorong Chai
- School of Management, Lanzhou University, Lanzhou 730000, PR China; Research Center for Emergency Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China.
| | - Yongzhong Sha
- School of Management, Lanzhou University, Lanzhou 730000, PR China; Research Center for Emergency Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China
| | - Qunwu Zha
- School of Management, Lanzhou University, Lanzhou 730000, PR China; Research Center for Emergency Management, Lanzhou University, Lanzhou 730000, PR China; Hospital Management Research Center, Lanzhou University, Lanzhou 730000, PR China
| | - Yana Su
- School of Management, Lanzhou University, Lanzhou 730000, PR China; College of Economics and Management, Lanzhou Institute of Technology, Lanzhou 730050, PR China
| | - Yanyan Gao
- School of Economics and Management, Shanxi Normal University, Linfen 041000, PR China
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13
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Zhang J, Feng L, Hou C, Gu Q. Interactive effect between temperature and fine particulate matter on chronic disease hospital admissions in the urban area of Tianjin, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:75-84. [PMID: 31190560 DOI: 10.1080/09603123.2019.1628928] [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: 04/17/2019] [Accepted: 06/04/2019] [Indexed: 06/09/2023]
Abstract
This study focuses on effects of fine particulate matter (PM2.5) on chronic disease under different levels of temperature. We obtained type 2 diabetes, cerebral stroke and coronary heart disease hospital admissions (HAs) from five hospitals in urban Tianjin as well as the concentrations of PM2.5, nitrogen dioxide (NO2) and sulphur dioxide (SO2). We used distributed lag nonlinear models to explore nonlinear and lag effects of PM2.5. In single-pollutant models, PM2.5 was positively associated with type 2 diabetes, cerebral stroke and coronary heart disease HAs, with strongest effects at lag1, lag0 and lag06, respectively. The corresponding relative risk rates (RR%) were 1.836%, 2.083% and 6.428%. In co-pollutant models, the correlation between PM2.5 and HAs on high-temperature days was generally stronger than that on low-temperature days. This study indicated that PM2.5 can increase HA rates for these chronic diseases, and effects of PM2.5 on high-temperature days were stronger than that on low-temperature days.
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Affiliation(s)
- Jingwei Zhang
- Department of Environment and Health, Tianjin Centers for Disease Control and Prevention , Tianjin, China
| | - Lihong Feng
- Department of Environment and Health, Tianjin Centers for Disease Control and Prevention , Tianjin, China
| | - Changchun Hou
- Department of Environment and Health, Tianjin Centers for Disease Control and Prevention , Tianjin, China
| | - Qing Gu
- Department of Environment and Health, Tianjin Centers for Disease Control and Prevention , Tianjin, China
- School of Public Health, Tianjin Medical University , Tianjin, China
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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.
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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
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Carroll SJ, Dale MJ, Bailie R, Daniel M. Climatic and community sociodemographic factors associated with remote Indigenous Australian smoking rates: an ecological study of health audit data. BMJ Open 2019; 9:e032173. [PMID: 31292187 PMCID: PMC6624038 DOI: 10.1136/bmjopen-2019-032173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED Australian Indigenous smoking rates are highest in remote communities but likely vary between communities; few studies have assessed community features in relation to Indigenous smoking rates. DESIGN AND OBJECTIVE This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large sample of remote Indigenous communities. SETTING AND SAMPLE Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. METHODS Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. RESULTS Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35-10.01)), income (2.86 (11.07-7.67)) and heat (2.86 (1.07-7.67)). CONCLUSIONS Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.
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Affiliation(s)
- Suzanne Jane Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Michael J Dale
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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16
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Cui L, Geng X, Ding T, Tang J, Xu J, Zhai J. Impact of ambient temperature on hospital admissions for cardiovascular disease in Hefei City, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:723-734. [PMID: 30852664 DOI: 10.1007/s00484-019-01687-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 05/21/2023]
Abstract
Many studies have quantified the hospitalization risk for cardiovascular disease (CVD) caused by temperature, but the results of most studies are not consistent. In this study, we evaluate the effect of temperature on CVD hospitalizations. We use a quasi-Poisson regression with a distributed-lag nonlinear model (DLNM) to evaluate the effect of temperature on CVD hospitalizations between July 1, 2015, and October 31, 2017, in Hefei City, China. We found that the cold effect and heat effect of temperature can impact CVD hospital admissions. Compared with the 25th percentile of temperature (10.3 °C), the cumulative relative risk (RR) of extremely low temperature (first percentile of temperature, 0.075 °C) over lags 0-27 days was 0.616 (95% CI 0.423-0.891), and the cumulative RR of moderate low temperature (10th percentile of temperature, 5.16 °C) was 1.081 (95% CI 1.019-1.147) over lags 0-7 days. Compared with the 75th percentile of temperature (25.6 °C), the cumulative RR of extremely high temperature (99th percentile of temperature, 33.7 °C) was 1.078 (95% CI 0.752-1.547) over lags 0-27 days, and the cumulative RR of moderate-high temperature (90th percentile of temperature, 29.0 °C) was 1.015 (95% CI 0.988-1.043) over lag 0 day. In the subgroup, the < 65-year group and male were more susceptible to low temperature; however, the ≥ 65-year group and female were more vulnerable to high temperature. The high temperature's impact on CVD hospital admissions was found to be more obvious in female and the ≥ 65-year group compared to male and the < 65-year group. However, the < 65-year group and men are more sensitive to low temperature.
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Affiliation(s)
- Longjiang Cui
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xiya Geng
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Tao Ding
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jing Tang
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jixiang Xu
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jinxia Zhai
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
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de Sousa TCM, Amancio F, Hacon SDS, Barcellos C. [Climate-sensitive diseases in Brazil and the world: systematic reviewEnfermedades sensibles al clima en Brasil y el mundo: revisión sistemática]. Rev Panam Salud Publica 2018; 42:e85. [PMID: 31093113 PMCID: PMC6385874 DOI: 10.26633/rpsp.2018.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/12/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To survey the literature regarding climate-sensitive diseases (CSD) and the impacts of climate changes on health. METHOD This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The Lilacs, SciELO, Scopus, and PubMed databases were searched in July 2017 without temporal restrictions for articles published in in Portuguese, English and Spanish. The following search strategy was used in all databases: (climate) AND (disease) AND (sensitive). RESULTS The systematic review included 106 articles, most of which focused on dengue, malaria, and respiratory and cardiovascular diseases. The most commonly studied climate variables were temperature and precipitation. The studies revealed a relationship between the incidence of certain diseases, especially cardiovascular and respiratory diseases, dengue, malaria, and arboviral diseases, and climate conditions in different regions of the world. This relationship was analyzed considering both past data on the incidence of diseases and climate variables and projections regarding the future incidence of diseases according to expected climate variations. A greater number of studies was performed by authors originating from developed countries. The world regions most often studied were China, the United States, Australia, and Brazil. CONCLUSIONS Despite the increase in the number of published articles on this theme, a greater number of climate and environmental variables must be studied, with expansion of studies to additional regions in the world.
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Affiliation(s)
| | - Flavia Amancio
- Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro (RJ), Brasil
| | - Sandra de Sousa Hacon
- Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro (RJ), Brasil
| | - Christovam Barcellos
- Fundação Oswaldo Cruz (Fiocruz), Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Rio de Janeiro (RJ), Brasil
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Goldie J, Alexander L, Lewis SC, Sherwood SC, Bambrick H. Changes in relative fit of human heat stress indices to cardiovascular, respiratory, and renal hospitalizations across five Australian urban populations. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:423-432. [PMID: 28965155 DOI: 10.1007/s00484-017-1451-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/30/2017] [Accepted: 09/20/2017] [Indexed: 05/22/2023]
Abstract
Various human heat stress indices have been developed to relate atmospheric measures of extreme heat to human health impacts, but the usefulness of different indices across various health impacts and in different populations is poorly understood. This paper determines which heat stress indices best fit hospital admissions for sets of cardiovascular, respiratory, and renal diseases across five Australian cities. We hypothesized that the best indices would be largely dependent on location. We fit parent models to these counts in the summers (November-March) between 2001 and 2013 using negative binomial regression. We then added 15 heat stress indices to these models, ranking their goodness of fit using the Akaike information criterion. Admissions for each health outcome were nearly always higher in hot or humid conditions. Contrary to our hypothesis that location would determine the best-fitting heat stress index, we found that the best indices were related largely by health outcome of interest, rather than location as hypothesized. In particular, heatwave and temperature indices had the best fit to cardiovascular admissions, humidity indices had the best fit to respiratory admissions, and combined heat-humidity indices had the best fit to renal admissions. With a few exceptions, the results were similar across all five cities. The best-fitting heat stress indices appear to be useful across several Australian cities with differing climates, but they may have varying usefulness depending on the outcome of interest. These findings suggest that future research on heat and health impacts, and in particular hospital demand modeling, could better reflect reality if it avoided "all-cause" health outcomes and used heat stress indices appropriate to specific diseases and disease groups.
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Affiliation(s)
- James Goldie
- Climate Change Research Centre, UNSW Australia, Sydney, NSW, Australia.
- ARC Centre of Excellence for Climate System Science, UNSW Australia, Sydney, NSW, Australia.
- Fenner School of Environment & Society, Australian National University, Acton, ACT, Australia.
| | - Lisa Alexander
- Climate Change Research Centre, UNSW Australia, Sydney, NSW, Australia
- ARC Centre of Excellence for Climate System Science, UNSW Australia, Sydney, NSW, Australia
| | - Sophie C Lewis
- ARC Centre of Excellence for Climate System Science, UNSW Australia, Sydney, NSW, Australia
- Fenner School of Environment & Society, Australian National University, Acton, ACT, Australia
| | - Steven C Sherwood
- Climate Change Research Centre, UNSW Australia, Sydney, NSW, Australia
- ARC Centre of Excellence for Climate System Science, UNSW Australia, Sydney, NSW, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Goldie J, Alexander L, Lewis SC, Sherwood S. Comparative evaluation of human heat stress indices on selected hospital admissions in Sydney, Australia. Aust N Z J Public Health 2017; 41:381-387. [DOI: 10.1111/1753-6405.12692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 01/01/2017] [Accepted: 04/01/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- James Goldie
- Climate Change Research Centre; University of New South Wales
- ARC Centre of Excellence for Climate System Science; University of New South Wales
| | - Lisa Alexander
- Climate Change Research Centre; University of New South Wales
- ARC Centre of Excellence for Climate System Science; University of New South Wales
| | - Sophie C. Lewis
- ARC Centre of Excellence for Climate System Science; University of New South Wales
- Fenner School of Environment & Society; Australian National University, Australian Capital Territory
| | - Steven Sherwood
- Climate Change Research Centre; University of New South Wales
- ARC Centre of Excellence for Climate System Science; University of New South Wales
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20
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Song X, Wang S, Hu Y, Yue M, Zhang T, Liu Y, Tian J, Shang K. Impact of ambient temperature on morbidity and mortality: An overview of reviews. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 586:241-254. [PMID: 28187945 DOI: 10.1016/j.scitotenv.2017.01.212] [Citation(s) in RCA: 175] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/02/2017] [Accepted: 01/30/2017] [Indexed: 05/18/2023]
Abstract
The objectives were (i) to conduct an overview of systematic reviews to summarize evidence from and evaluate the methodological quality of systematic reviews assessing the impact of ambient temperature on morbidity and mortality; and (ii) to reanalyse meta-analyses of cold-induced cardiovascular morbidity in different age groups. The registration number is PROSPERO-CRD42016047179. PubMed, Embase, the Cochrane Library, Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Global Health were systematically searched to identify systematic reviews. Two reviewers independently selected studies for inclusion, extracted data, and assessed quality. The Assessment of Multiple Systematic Reviews (AMSTAR) checklist was used to assess the methodological quality of included systematic reviews. Estimates of morbidity and mortality risk in association with heat exposure, cold exposure, heatwaves, cold spells and diurnal temperature ranges (DTRs) were the primary outcomes. Twenty-eight systematic reviews were included in the overview of systematic reviews. (i) The median (interquartile range) AMSTAR scores were 7 (1.75) for quantitative reviews and 3.5 (1.75) for qualitative reviews. (ii) Heat exposure was identified to be associated with increased risk of cardiovascular, cerebrovascular and respiratory mortality, but was not found to have an impact on cardiovascular or cerebrovascular morbidity. (iii) Reanalysis of the meta-analyses indicated that cold-induced cardiovascular morbidity increased in youth and middle-age (RR=1.009, 95% CI: 1.004-1.015) as well as the elderly (RR=1.013, 95% CI: 1.007-1.018). (iv) The definitions of temperature exposure adopted by different studies included various temperature indicators and thresholds. In conclusion, heat exposure seemed to have an adverse effect on mortality and cold-induced cardiovascular morbidity increased in the elderly. Developing definitions of temperature exposure at the regional level may contribute to more accurate evaluations of the health effects of temperature.
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Affiliation(s)
- Xuping Song
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Shigong Wang
- Mountain Environment and Meteorology Key Laboratory of Education Bureau of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China; Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Yuling Hu
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Man Yue
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Tingting Zhang
- School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
| | - Yu Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Jinhui Tian
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Kezheng Shang
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
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Phung D, Thai PK, Guo Y, Morawska L, Rutherford S, Chu C. Ambient temperature and risk of cardiovascular hospitalization: An updated systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 550:1084-1102. [PMID: 26871555 DOI: 10.1016/j.scitotenv.2016.01.154] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 12/22/2015] [Accepted: 01/23/2016] [Indexed: 05/18/2023]
Abstract
The association between temperatures and risk of cardiovascular mortality has been recognized but the association drawn from previous meta-analysis was weak due to the lack of sufficient studies. This paper presented a review with updated reports in the literature about the risk of cardiovascular hospitalization in relation to different temperature exposures and examined the dose-response relationship of temperature-cardiovascular hospitalization by change in units of temperature, latitudes, and lag days. The pooled effect sizes were calculated for cold, heat, heatwave, and diurnal variation using random-effects meta-analysis, and the dose-response relationship of temperature-cardiovascular admission was modelled using random-effect meta-regression. The Cochrane Q-test and index of heterogeneity (I(2)) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Sixty-four studies were included in meta-analysis. The pooled results suggest that for a change in temperature condition, the risk of cardiovascular hospitalization increased 2.8% (RR, 1.028; 95% CI, 1.021-1.035) for cold exposure, 2.2% (RR, 1.022; 95% CI, 1.006-1.039) for heatwave exposure, and 0.7% (RR, 1.007; 95% CI, 1.002-1.012) for an increase in diurnal temperature. However no association was observed for heat exposure. The significant dose-response relationship of temperature - cardiovascular admission was found with cold exposure and diurnal temperature. Increase in one-day lag caused a marginal reduction in risk of cardiovascular hospitalizations for cold exposure and diurnal variation, and increase in latitude was associated with a decrease in risk of cardiovascular hospitalizations for diurnal temperature only. There is a significant short-term effect of cold exposure, heatwave and diurnal variation on cardiovascular hospitalizations. Further research is needed to understand the temperature-cardiovascular relationship for different climate areas.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Griffith University, Australia.
| | - Phong K Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Australia.
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality & Health, Queensland University of Technology, Australia
| | - Shannon Rutherford
- Centre for Environment and Population Health, Griffith University, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Australia
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Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15352-65. [PMID: 26633456 PMCID: PMC4690924 DOI: 10.3390/ijerph121214988] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/16/2015] [Accepted: 12/01/2015] [Indexed: 01/18/2023]
Abstract
The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.
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Goldie J, Sherwood SC, Green D, Alexander L. Temperature and Humidity Effects on Hospital Morbidity in Darwin, Australia. Ann Glob Health 2015; 81:333-41. [DOI: 10.1016/j.aogh.2015.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Liu C, Yavar Z, Sun Q. Cardiovascular response to thermoregulatory challenges. Am J Physiol Heart Circ Physiol 2015; 309:H1793-812. [PMID: 26432837 DOI: 10.1152/ajpheart.00199.2015] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/28/2015] [Indexed: 01/05/2023]
Abstract
A growing number of extreme climate events are occurring in the setting of ongoing climate change, with an increase in both the intensity and frequency. It has been shown that ambient temperature challenges have a direct and highly varied impact on cardiovascular health. With a rapidly growing amount of literature on this issue, we aim to review the recent publications regarding the impact of cold and heat on human populations with regard to cardiovascular disease (CVD) mortality/morbidity while also examining lag effects, vulnerable subgroups, and relevant mechanisms. Although the relative risk of morbidity/mortality associated with extreme temperature varied greatly across different studies, both cold and hot temperatures were associated with a positive mean excess of cardiovascular deaths or hospital admissions. Cause-specific study of CVD morbidity/mortality indicated that the sensitivity to temperature was disease-specific, with different patterns for acute and chronic ischemic heart disease. Vulnerability to temperature-related mortality was associated with some characteristics of the populations, including sex, age, location, socioeconomic condition, and comorbidities such as cardiac diseases, kidney diseases, diabetes, and hypertension. Temperature-induced damage is thought to be related to enhanced sympathetic reactivity followed by activation of the sympathetic nervous system, renin-angiotensin system, as well as dehydration and a systemic inflammatory response. Future research should focus on multidisciplinary adaptation strategies that incorporate epidemiology, climatology, indoor/building environments, energy usage, labor legislative perfection, and human thermal comfort models. Studies on the underlying mechanism by which temperature challenge induces pathophysiological response and CVD await profound and lasting investigation.
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Affiliation(s)
- Cuiqing Liu
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, China; and
| | - Zubin Yavar
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Qinghua Sun
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
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Climate change and human health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7347-53. [PMID: 25046633 PMCID: PMC4113880 DOI: 10.3390/ijerph110707347] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/09/2014] [Indexed: 12/05/2022]
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