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Gestro M, Condemi V, Bardi L, Tomaino L, Roveda E, Bruschetta A, Solimene U, Esposito F. Short-term air pollution exposure is a risk factor for acute coronary syndromes in an urban area with low annual pollution rates: Results from a retrospective observational study (2011-2015). Arch Cardiovasc Dis 2020; 113:308-320. [PMID: 32359859 DOI: 10.1016/j.acvd.2020.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/13/2020] [Accepted: 03/09/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Epidemiological data suggest that air pollutants are risk factors for cardiovascular disease. Recent studies have questioned the adequacy of current legal pollutant limits, because concentrations lower than those recommended still affect cardiovascular morbidity and mortality. AIM To investigate the association between short-term exposure to air pollutants and the daily diagnosis of acute coronary syndrome (ACS) at the emergency department (ED) of S. Croce Hospital (Cuneo, Italy), between 2011 and 2015. METHODS We evaluated the effect of particulate matter (PM2.5-10), nitrogen dioxide and ozone as primary exposure, together with temperature and relative humidity as climatological control variables, on ED admissions for ACS (response variables). We studied residents aged ≥35 years, classified into three age groups (35-64, 65-74 and ≥75 years). Environmental data were analysed according to Poisson's regression, and conventional cardiovascular risk factors (CRFs; hypertension, diabetes, coronary artery disease, smoking and dyslipidaemia) were included as control variables. RESULTS ED admissions for ACS were 1625/391,689, with 298 in 2011 (0.183%), 305 in 2012 (0.188%), 347 in 2013 (0.214%), 341 in 2014 (0.21%) and 334 in 2015 (0.206%), with a general growth rate of 2.08% (from 2011 to 2015). The CRFs examined were confirmed to be highly associated with occurrence of ACS. Our study identified PM2.5 and temperature in all age groups to be additional risk factors, with PM2.5 exposure (P<0.01) being a particular risk for those aged ≥75 years. Dose-response models confirmed only PM2.5 as the main environmental risk factor in elderly patients (relative risk 1.06, 95% confidence interval 1.02-1.11; lag time 0-3 days). We also found a consistent relative risk for temperature in all age groups. CONCLUSION This study confirms the importance of PM2.5 as a risk factor for ACS, mostly in elderly patients, even in a city with low annual pollution rates.
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Affiliation(s)
- Massimo Gestro
- Department of Biomedical Science for Health, University of Milan, Via Colombo 71, 20133 Milano, Italy
| | - Vincenzo Condemi
- Department of Biomedical Science for Health, University of Milan, Via Colombo 71, 20133 Milano, Italy.
| | - Luisella Bardi
- Cuneo Department, Environmental Protection Agency of Piedmont, 10135 Turin, Italy
| | - Laura Tomaino
- Department of Clinical Science and Community Health (DISCCO), University of Milan, 20122 Milan, Italy
| | - Eliana Roveda
- Department of Biomedical Science for Health, University of Milan, Via Colombo 71, 20133 Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | | | - Umberto Solimene
- Department of Biomedical Science for Health, University of Milan, Via Colombo 71, 20133 Milano, Italy
| | - Fabio Esposito
- Department of Biomedical Science for Health, University of Milan, Via Colombo 71, 20133 Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
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Ambulance Services Associated with Extreme Temperatures and Fine Particles in a Subtropical Island. Sci Rep 2020; 10:2855. [PMID: 32071336 PMCID: PMC7029034 DOI: 10.1038/s41598-020-59294-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/20/2020] [Indexed: 11/13/2022] Open
Abstract
This study evaluated the association between the risk of events requiring ambulance services and the ambient temperature and particulate matter of 2.5 μm (PM2.5) and 10 μm (PM10) for populations living in subtropical Taiwan. We used a distributed lag nonlinear model with a quasi-Poisson function to assess the roles of ambient temperature, PM10 and PM2.5 in the use of ambulance services for respiratory distress, coma and unconsciousness, chest pain, lying down in public, headaches/dizziness/vertigo/fainting/syncope and out-of-hospital cardiac arrest (OHCA). The relative risk (RR) and 95% confidence interval (CI) of each specific event were calculated in association with the ambient conditions. In general, the events that required ambulance services had a V-shaped or J-shaped association with the temperature, where the risks were higher at extreme temperatures. The RR of each event was significant when the patients were exposed to temperatures in the 5th percentile (<15 °C); patients with OHCA had the highest adjusted RR of 1.61 (95% CI = 1.47–1.77). The risks were also significant for coma/unconsciousness, headaches/dizziness/vertigo/fainting/syncope, and OHCA but not for respiratory distress, chest pain and lying down in public, after exposure to the 99th percentile temperatures of >30 °C. The risks for use of ambulance services increased with PM exposure and were significant for events of respiratory distress, chest pain and OHCA after exposure to the 99th percentile PM2.5 after controlling for temperatures. Events requiring ambulance services were more likely to occur when the ambient temperature was low than when it was high for the population on the subtropical island of Taiwan. The association of the risk of events requiring ambulance services with PM were not as strong as the association with low temperatures.
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Tian Y, Liu H, Wu Y, Si Y, Song J, Cao Y, Li M, Wu Y, Wang X, Chen L, Wei C, Gao P, Hu Y. Association between ambient fine particulate pollution and hospital admissions for cause specific cardiovascular disease: time series study in 184 major Chinese cities. BMJ 2019; 367:l6572. [PMID: 31888884 PMCID: PMC7190041 DOI: 10.1136/bmj.l6572] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To estimate the risks of daily hospital admissions for cause specific major cardiovascular diseases associated with short term exposure to ambient fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) pollution in China. DESIGN National time series study. SETTING 184 major cities in China. POPULATION 8 834 533 hospital admissions for cardiovascular causes in 184 Chinese cities recorded by the national database of Urban Employee Basic Medical Insurance from 1 January 2014 to 31 December 2017. MAIN OUTCOME MEASURES Daily counts of city specific hospital admissions for primary diagnoses of ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and haemorrhagic stroke among different demographic groups were used to estimate the associations between PM2.5 and morbidity. An overdispersed generalised additive model was used to estimate city specific associations between PM2.5 and cardiovascular admissions, and random effects meta-analysis used to combine the city specific estimates. RESULTS Over the study period, a mean of 47 hospital admissions per day (standard deviation 74) occurred for cardiovascular disease, 26 (53) for ischaemic heart disease, one (five) for heart failure, two (four) for heart rhythm disturbances, 14 (28) for ischaemic stroke, and two (four) for haemorrhagic stroke. At the national average level, an increase of 10 μg/m3 in PM2.5 was associated with a 0.26% (95% confidence interval 0.17% to 0.35%) increase in hospital admissions on the same day for cardiovascular disease, 0.31% (0.22% to 0.40%) for ischaemic heart disease, 0.27% (0.04% to 0.51%) for heart failure, 0.29% (0.12% to 0.46%) for heart rhythm disturbances, and 0.29% (0.18% to 0.40%) for ischaemic stroke, but not with haemorrhagic stroke (-0.02% (-0.23% to 0.19%)). The national average association of PM2.5 with cardiovascular disease was slightly non-linear, with a sharp slope at PM2.5 levels below 50 μg/m3, a moderate slope at 50-250 μg/m3, and a plateau at concentrations higher than 250 μg/m3. Compared with days with PM2.5 up to 15 μg/m3, days with PM2.5 of 15-25, 25-35, 35-75, and 75 μg/m3 or more were significantly associated with increases in cardiovascular admissions of 1.1% (0 to 2.2%), 1.9% (0.6% to 3.2%), 2.6% (1.3% to 3.9%), and 3.8% (2.1% to 5.5%), respectively.According to projections, achieving the Chinese grade 2 (35 μg/m3), Chinese grade 1 (15 μg/m3), and World Health Organization (10 μg/m3) regulatory limits for annual mean PM2.5 concentrations would reduce the annual number of admissions for cardiovascular disease in China. Assuming causality, which should be done with caution, this reduction would translate into an estimated 36 448 (95% confidence interval 24 441 to 48 471), 85 270 (57 129 to 113 494), and 97 516 (65 320 to 129 820), respectively. CONCLUSIONS These data suggest that in China, short term exposure to PM2.5 is associated with increased hospital admissions for all major cardiovascular diseases except for haemorrhagic stroke, even for exposure levels not exceeding the current regulatory limits.
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Affiliation(s)
- Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
- Medical Informatics Centre, Peking University, Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Yaqin Si
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
- Beijing HealthCom Data Technology, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
| | - Libo Chen
- Beijing HealthCom Data Technology, Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
- Key Laboratory of Molecular Cardiovascular (Peking University), Ministry of Education, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, 100191 Beijing, China
- Medical Informatics Centre, Peking University, Beijing, China
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Sharpe RA, Machray KE, Fleming LE, Taylor T, Henley W, Chenore T, Hutchcroft I, Taylor J, Heaviside C, Wheeler BW. Household energy efficiency and health: Area-level analysis of hospital admissions in England. ENVIRONMENT INTERNATIONAL 2019; 133:105164. [PMID: 31518939 PMCID: PMC6853278 DOI: 10.1016/j.envint.2019.105164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Fuel poverty affects up to 35% of European homes, which represents a significant burden on society and healthcare systems. Draught proofing homes to prevent heat loss, improved glazing, insulation and heating (energy efficiency measures) can make more homes more affordable to heat. This has prompted significant investment in energy efficiency upgrades for around 40% of UK households to reduce the impact of fuel poverty. Despite some inconsistent evidence, household energy efficiency interventions can improve cardiovascular and respiratory health outcomes. However, the health benefits of these interventions have not been fully explored; this is the focus of this study. METHODS In this cross sectional ecological study, we conducted two sets of analyses at different spatial resolution to explore population data on housing energy efficiency measures and hospital admissions at the area-level (counts grouped over a 3-year period). Housing data were obtained from three data sets covering housing across England (Household Energy Efficiency Database), Energy Performance Certificate (EPC) and, in the South West of England, the Devon Home Analytics Portal. These databases provided data aggregated to Lower Area Super Output Area and postcode level (Home Analytics Portal only). These datasets provided measures of both state (e.g. EPC ratings) and intervention (e.g. number of boiler replacements), aggregated spatially and temporally to enable cross-sectional analyses with health outcome data. Hospital admissions for adult (over 18 years) asthma, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) were obtained from the Hospital Episode Statistics database for the national (1st April 2011 to 31st March 2014) and Devon, South West of England (1st April 2014 to 31st March 2017) analyses. Descriptive statistics and regression models were used to describe the associations between small area household energy efficiency measures and hospital admissions. Three main analyses were undertaken to investigate the relationships between; 1) household energy efficiency improvements (i.e. improved glazing, insulation and boiler upgrades); 2) higher levels of energy efficiency ratings (measured by Energy Performance Certificate ratings); 3) energy efficiency improvements and ratings (i.e. physical improvements and rating assessed by the Standard Assessment Procedure) and hospital admissions. RESULTS In the national analyses, household energy performance certificate ratings ranged from 37 to 83 (mean 61.98; Standard Deviation 5.24). There were a total of 312,837 emergency admissions for asthma, 587,770 for COPD and 839,416 for CVD. While analyses for individual energy efficiency metrics (i.e. boiler upgrades, draught proofing, glazing, loft and wall insulation) were mixed; a unit increase in mean energy performance rating was associated with increases of around 0.5% in asthma and CVD admissions, and 1% higher COPD admission rates. Admission rates were also influenced by the type of dwelling, tenure status (e.g. home owner versus renting), living in a rural area, and minimum winter temperature. DISCUSSION Despite a range of limitations and some mixed and contrasting findings across the national and local analyses, there was some evidence that areas with more energy efficiency improvements resulted in higher admission rates for respiratory and cardiovascular diseases. This builds on existing evidence highlighting the complex relationships between health and housing. While energy efficiency measures can improve health outcomes (especially when targeting those with chronic respiratory illness), reduced household ventilation rates can impact indoor air quality for example and increase the risk of diseases such as asthma. Alternatively, these findings could be due to the ecological study design, reverse causality, or the non-detection of more vulnerable subpopulations, as well as the targeting of areas with poor housing stock, low income households, and the lack of "whole house approaches" when retrofitting the existing housing stock. CONCLUSION To be sustainable, household energy efficiency policies and resulting interventions must account for whole house approaches (i.e. consideration of the whole house and occupant lifestyles). These must consider more alternative 'greener' and more sustainable measures, which are capable of accounting for variable lifestyles, as well as the need for adequate heating and ventilation. Larger natural experiments and more complex modelling are needed to further investigate the impact of ongoing dramatic changes in the housing stock and health. STUDY IMPLICATIONS This study supports the need for more holistic approaches to delivering healthier indoor environments, which must consider a dynamic and complex system with multiple interactions between a range of interrelated factors. These need to consider the drivers and pressures (e.g. quality of the built environment and resident behaviours) resulting in environmental exposures and adverse health outcomes.
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Affiliation(s)
- R A Sharpe
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom; Public Health, Cornwall Council, 1E, New County Hall, Truro TR1 3AY, United Kingdom
| | - K E Machray
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - L E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - T Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - W Henley
- Health Statistics Research Group, Institute of Health Research, University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, United Kingdom
| | - T Chenore
- NHS NEW Devon Clinical Commissioning Group, County Hall, Exeter EX2 4QD, United Kingdom
| | - I Hutchcroft
- Regen, Bradninch Court, Castle Street, Exeter EX4 3PL and Energiesprong UK Limited, National Energy Centre, Davy Avenue, Knowlhill, Milton Keynes MK5 8NG, United Kingdom
| | - J Taylor
- UCL Institute for Environmental Design and Engineering, UCL, 14 Upper Woburn Plc, London WC1H 0NN, United Kingdom
| | - C Heaviside
- Environmental Change Institute, University of Oxford, South Parks Road, Oxford OX1 3QY, Oxford, United Kingdom
| | - B W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom.
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Silveira IH, Oliveira BFA, Cortes TR, Junger WL. The effect of ambient temperature on cardiovascular mortality in 27 Brazilian cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 691:996-1004. [PMID: 31326821 DOI: 10.1016/j.scitotenv.2019.06.493] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is limited evidence on the relationship between temperature and cardiovascular mortality in middle and low-income countries, particularly in Latin America. In this study, we investigated the total effect of temperature on cardiovascular mortality in 27 Brazilian cities, and the effect modification by geographic, socioeconomic, demographic and infrastructure characteristics within cities. METHODS In the city-specific analysis, we used time-series analyses to estimate the relationship between mean temperature and daily cardiovascular mortality using quasi-Poisson generalized linear models combined with distributed lag non-linear models. In the second stage, a meta-analysis was used to pool the effects of temperature on cardiovascular mortality for Brazil and its five regions (Central-West, North, Northeast, South, and Southeast). We used a meta-regression to examine the effect modification of city-specific geographic, socioeconomic, demographic and infrastructure-related variables. RESULTS The risks associated with temperature varied across the locations. Higher cardiovascular mortality was associated with low and high temperatures in most of the cities, Brazil and the Central-West, North, South, and Southeast regions. The overall relative risk (RR) for Brazil was 1.26 (95% confidence interval [CI]: 1.17-1.35) for the 1st percentile of temperature and 1.07 (95% CI: 1.01-1.13) for the 99th percentile of temperature versus the 79th percentile (27.7 °C), where RR was lowest. The temperature range was the variable that best explained the variation in effects among the cities, with greater effects in locations having a broader range. CONCLUSIONS The results indicate effects of low and high temperatures on the risk of cardiovascular mortality in most of Brazil's capital cities, besides a pooled effect for Brazil and the Central-West, North, South, and Southeast regions. These findings can help inform public policies addressing the health impact of temperature extremes, especially in the context of climate change.
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Affiliation(s)
- Ismael Henrique Silveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil.
| | - Beatriz Fátima Alves Oliveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Washington Leite Junger
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Tomo Ando
- Division of Interventional Cardiology, Department of Cardiology, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
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Xu R, Zhao Q, Coelho MS, Saldiva PH, Zoungas S, Huxley RR, Abramson MJ, Guo Y, Li S. Association between Heat Exposure and Hospitalization for Diabetes in Brazil during 2000-2015: A Nationwide Case-Crossover Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:117005. [PMID: 31746643 PMCID: PMC6927500 DOI: 10.1289/ehp5688] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Exposure to excessive heat, which will continue to increase with climate change, is associated with increased morbidity due to a range of noncommunicable diseases (NCDs). Whether this is true for diabetes is unknown. OBJECTIVES We aimed to quantify the relationship between heat exposure and risk of hospitalization due to diabetes in Brazil. METHODS Data on hospitalizations and weather conditions were collected from 1,814 cities during the hot seasons from 2000 to 2015. A time-stratified case-crossover design was used to quantify the association between hospitalization for diabetes and heat exposure. Region-specific odds ratios (ORs) were used to calculate the attributable fractions (AFs). RESULTS A total of 553,351 hospitalizations associated with diabetes were recorded during 2000-2015. Every 5°C increase in daily mean temperature was associated with 6% [OR=1.06; 95% confidence interval (CI): 1.04, 1.07] increase in hospitalization due to diabetes with lag 0-3 d. The association was greatest (OR=1.18; 95% CI: 1.13, 1.23) in those ≥80y of age, but did not vary by sex, and was generally consistent by region and type of diabetes. Assuming a causal association, we estimated that 7.3% (95% CI: 3.5, 10.9) of all hospitalizations due to diabetes in the hot season could be attributed to heat exposure during the study period. DISCUSSION Short-term heat exposure may increase the burden of diabetes-related hospitalization, especially among the very elderly. As global temperatures continue to rise, this burden is likely to increase. https://doi.org/10.1289/EHP5688.
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Affiliation(s)
- Rongbin Xu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Paulo H.N. Saldiva
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Sophia Zoungas
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rachel R. Huxley
- College of Science, Health and Engineering, Louisiana Trobe University, Melbourne, Victoria, Australia
| | - Michael J. Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Cheng J, Xu Z, Bambrick H, Prescott V, Wang N, Zhang Y, Su H, Tong S, Hu W. Cardiorespiratory effects of heatwaves: A systematic review and meta-analysis of global epidemiological evidence. ENVIRONMENTAL RESEARCH 2019; 177:108610. [PMID: 31376629 DOI: 10.1016/j.envres.2019.108610] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Heatwaves affect human health and global heatwave-related disease burden will continue to rise as climate change proceeds, but the effects of heatwaves on cardiovascular and respiratory diseases have not yet been investigated globally and nationally. OBJECTIVES This systematic review and meta-analysis aim to quantify heatwave effects on four major health outcomes: cardiovascular and respiratory morbidity and mortality. METHODS We searched PubMed, Scopus, Embase, and Web of Science for relevant studies from database inception to November 2018. Categories of morbidity included hospital admissions, emergency department visits, and ambulance attendances/call-outs. A random-effects meta-analysis model was used to pool previous estimates of heatwave effects on mortality and morbidity due to cardiovascular and respiratory diseases. Subgroup analyses by gender, age, and disease cause were conducted. Sensitivity analyses were performed by the categories of morbidity, heatwave definitions, study design, and using a leave-one-out cross validation approach. This study is registered with PROSPERO (number: CRD42018101964). RESULTS We identified 54 studies conducted in 20 countries. In total, there were significant associations between heatwaves and cardiovascular mortality (risk estimates (RE): 1.149, 95% confidence interval (CI): 1.090, 1.210) and respiratory mortality (RE: 1.183, 95%CI: 1.092, 1.282), but the magnitude of these associations varied across countries and studies. Heatwaves appeared to be marginally associated with cardiovascular and respiratory morbidities (RE: 0.999, 95%CI: 0.996, 1.002, p-value = 0.61 for cardiovascular morbidity; RE: 1.043, 95%CI: 0.995, 1.093; p-value = 0.08 for respiratory morbidity). For mortality, significant associations were observed for the elderly, ischemic heart disease, stroke, heart failure, and chronic obstructive pulmonary disease. Sensitivity analyses suggested that these findings were robust. CONCLUSION Mortality of cardiovascular and respiratory diseases appeared to be more vulnerable to heatwaves in comparison to morbidity. Considering high heterogeneity detected between studies and limited investigations into subpopulations, more research are required to provide a clearer picture of how heatwaves affect cardiovascular and respiratory diseases in different settings.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | | | - Ning Wang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Yuzhou Zhang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Anhui, China; School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
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Asumadu-Sakyi AB, Miller W, Barnett AG, Thai PK, Jayaratne ER, Thompson MH, Roghani R, Morawska L. Seasonal temperature patterns and durations of acceptable temperature range in houses in Brisbane, Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 683:470-479. [PMID: 31141748 DOI: 10.1016/j.scitotenv.2019.05.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/08/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
A paradigm shift to the use of indoor rather than outdoor temperature to estimate the exposure risk of low and high temperatures is vital for better prediction of temperature health effects and timely health warnings, and will also assist in understanding the influence of temperature on energy consumption and comfort. This study aimed to quantify the percentage of hours during the year that indoor temperature (living room) was in the extended comfort band (18-28 °C) of a subtropical climate, and identify the diurnal pattern of indoor temperatures in different seasons. Data used was collected in a previous study on the association between indoor and outdoor temperature. A k-shape cluster analysis resulted in two clusters of indoor temperature patterns for both weekdays and weekends. A bimodal pattern was identified during the cool season and a flat top pattern for the warm season, with many variations at weekends. These patterns can be attributed to the influence of cooling and heating processes depending on the season as well as occupancy, occupants' interference, and building materials. During the intermediate season, a sinusoidal pattern was observed for both weekdays and weekends because occupants likely relied on outdoor temperature conditions which were similar to those expected indoors without heating or cooling devices. The percentage of hours in which the indoor temperature of the houses ranged within the extended comfort band was 72-97% throughout the year, but for the coldest and hottest months it was 50-75%. These findings show that Brisbane residents are at possible risk of exposure to cold and hot temperatures due to the poor thermal performance of houses, and confirm that there is no standard indoor temperature pattern for all houses.
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Affiliation(s)
- A B Asumadu-Sakyi
- International Laboratory for Air Quality and Health, School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - W Miller
- Energy and Process Engineering, Science and Engineering Faculty, School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - A G Barnett
- School of Public Health and Social Work, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - P K Thai
- International Laboratory for Air Quality and Health, School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - E R Jayaratne
- International Laboratory for Air Quality and Health, School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - M H Thompson
- School of Mathematical Sciences, Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, Australia
| | - R Roghani
- International Laboratory for Air Quality and Health, School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - L Morawska
- International Laboratory for Air Quality and Health, School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD, Australia.
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Zhao Q, Li S, Coelho MDSZS, Saldiva PHN, Xu R, Huxley RR, Abramson MJ, Guo Y. Ambient heat and hospitalisation for COPD in Brazil: a nationwide case-crossover study. Thorax 2019; 74:1031-1036. [DOI: 10.1136/thoraxjnl-2019-213486] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/31/2019] [Accepted: 08/20/2019] [Indexed: 11/03/2022]
Abstract
BackgroundHeat exposure has been related to increased morbidity and mortality for several health outcomes. There is little evidence whether this is also true for COPD. This study quantified the relationship between ambient heat and hospitalisation for COPD in the Brazilian population.MethodsData on hospitalisations for COPD and weather conditions were collected from 1642 cities during the 2000–2015 hot seasons. A time-stratified, case-crossover design was used for city-specific analyses, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, age group and early/late hot season. Annual change in the association was examined using a random-effect meta-regression model.ResultsThe OR of hospitalisation was 1.05 (95% CI 1.04 to 1.06) for every 5℃ increase in daily mean temperature at the national level, with the effect estimate stronger in the late hot season compared with the early hot season. The effect was similar in women and in men but was greatest for those aged ≥75 years. The association was stronger in the central west and southeast regions and minimal in the northeast. Assuming a causal relationship, 7.2% of admissions were attributable to heat exposure. There was no significant temporal decline in the impact of ambient heat over the 16-year study period.ConclusionIn Brazil, exposure to ambient heat was positively associated with hospitalisation for COPD, particularly during the late hot season. These data add to the growing evidence base implicating global warming as being an important contributor to the future healthcare burden.
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Does Particulate Matter Modify the Short-Term Association between Heat Waves and Hospital Admissions for Cardiovascular Diseases in Greater Sydney, Australia? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183270. [PMID: 31492044 PMCID: PMC6765779 DOI: 10.3390/ijerph16183270] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/25/2022]
Abstract
Little is known about the potential interactive effects of heat waves and ambient particulate matter on cardiovascular morbidity. A time-stratified case-crossover design was used to examine whether particulate matter (PM10) modifies the association between heat waves and emergency hospital admissions for six cardiovascular diseases in Greater Sydney, Australia during the warm season for 2001–2013. We estimated and compared the effect of heat waves on high- and low-level PM10 days at lag0–lag2, adjusting for dew-point temperature, ambient ozone, ambient nitrogen dioxide, and public holidays. We also investigated the susceptibility of both younger (0–64 years) and older populations (65 years and above), and tested the sensitivity of three heat wave definitions. Stronger heat wave effects were observed on high- compared to low-level PM10 days for emergency hospital admissions for cardiac arrest for all ages combined, 0–64 years and 65 years and above; conduction disorders for 0–64 years; and hypertensive diseases for all ages combined and 0–64 years. Overall, we found some evidence to suggest that PM10 may modify the association between heat waves and hospital admissions for certain cardiovascular diseases, although our findings largely differed across disease, age group, lag, and heat wave definition.
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112
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Lemery J, Sorensen C, Balbus J, Newman L, Davis C, Reno E, Salas R, Hynes EC. Science Policy Training for a New Physician Leader: Description and Framework of a Novel Climate and Health Science Policy Fellowship. AEM EDUCATION AND TRAINING 2019; 3:233-242. [PMID: 31360816 PMCID: PMC6637012 DOI: 10.1002/aet2.10323] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/26/2018] [Accepted: 01/02/2019] [Indexed: 06/10/2023]
Abstract
The accelerating health impacts of climate change are undermining global health, and the roles of the health sector in addressing the many challenges of climate change are being articulated by governments, multilateral institutions, and professional societies. Given the paucity of physician engagement on this issue to date, there now exists a clear need for health professionals to meet this new challenge with the development and cultivation of new knowledge and skill sets in public health, environmental science, policy, and communication. We describe a novel GME fellowship in climate and health science policy, designed to train a new generation of clinicians to provide the necessary perspective and skills for effective leadership in this field. This fellowship identifies available university resources and leverages external collaborations (government, medical consortiums, affiliate institutions in public health, and environmental science), which we describe as being replicatable to similar training programs of any number of medical specialties and likewise bring meaningful opportunities to their respective training programs and academic departments. The creation of this novel fellowship in climate and health policy provides a roadmap and potential path for similar programs to join us in addressing the defining health issue of this generation and many to follow.
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Affiliation(s)
- Jay Lemery
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - Cecilia Sorensen
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - John Balbus
- National Institute of Environmental Health SciencesBethesdaMD
| | - Lee Newman
- Departments of Environmental and Occupational Health and EpidemiologyColorado School of Public HealthAuroraCO
| | - Christopher Davis
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - Elaine Reno
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCO
| | - Renee Salas
- Department of Emergency Medicine at Harvard Medical SchoolBostonMA
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Luong LMT, Sly PD, Thai PK, Phung D. Impact of ambient air pollution and wheeze-associated disorders in children in Southeast Asia: a systematic review and meta-analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2019; 34:125-139. [PMID: 30753165 DOI: 10.1515/reveh-2018-0079] [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: 11/21/2018] [Accepted: 01/09/2019] [Indexed: 06/09/2023]
Abstract
Several systematic reviews have been conducted so far to examine the effect of air pollution on respiratory diseases, but there has not been a corresponding meta-analysis to estimate the effect sizes for wheeze-associated diseases/disorders, which is one of the leading causes of emergency department visits and hospitalizations for children worldwide. The aim of this review is to systematically evaluate the relationship between air pollution and risk of wheeze-associated disorders in children in Southeast Asia. We searched the relevant computerized databases (PubMed, EMBASE, Web of Science, Scopus and Cochrane library) for indexed publications up to July 2018. Finally, eight studies were qualified for performing a random-effect meta-analysis to compute the pooled effect sizes. The results show that each increase of 10 μg/m3 in concentrations of PM2.5, PM1 was associated with 1-2% increase in risk of wheeze-associated disorders. Positive associations were found for PM10, SO2, NO2, NOx but no association was found for CO and O3. We confirmed the strong effect of fine particulate matters on respiratory health and recommend an updated meta-analysis should be done when more studies are available.
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Affiliation(s)
- Ly M T Luong
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Queensland, Australia
- Faculty of Environmental Sciences, VNU University of Science, Hanoi, Vietnam
| | - Peter D Sly
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Queensland, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, Brisbane, Queensland, Australia
| | - Dung Phung
- Centre for Environment and Population Health, School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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Gao J, Yu F, Xu Z, Duan J, Cheng Q, Bai L, Zhang Y, Wei Q, Yi W, Pan R, Su H. The association between cold spells and admissions of ischemic stroke in Hefei, China: Modified by gender and age. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 669:140-147. [PMID: 30878922 DOI: 10.1016/j.scitotenv.2019.02.452] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Some studies have discovered that low ambient temperatures were associated with increased risk of the incidence of ischemic stroke. Although the frequency of extreme weather events is increasing, few studies have studied the effects of cold wave on ischemic stroke. OBJECTIVE The purpose of this study was to explore the association between cold waves and ischemic stroke onset and further to explore how this association was modified by cold spell characteristics and individual-level factors. METHODS A Poisson regression with a distributed lag nonlinear model was used to investigate the association between cold spells under 9 different definitions and daily admissions of ischemic stroke in 2013-2015 in Hefei. RESULTS By comparing the attribution risk and the results of the sensitivity analysis of different models, the local optimal cold spell was defined as the day between November to March when daily mean temperature was less than 10th for 2 or more consecutive days (backward attributable risk fraction (b-AF) = 4.19%, 95% empirical confidence intervals (eCI): 0.87%, 6.66%, backward attributable number (b-AN) = 278). On the basis of optimal model, the single-day effect of cold waves on ischemic stroke occurred on 5th day after exposure and continued until 17th day, and the maximum effect appeared on the 5th day with relative risk (RR) = 1.050 (95% confidence interval (CI) = 1.008, 1.094). The significant cumulative effect lasted from day 9 after exposure to cold spells to day 21. The maximum cumulative effect was observed on the 21st day with RR = 2.378 (95% CI = 1.304, 4.337). The female and the young and middle-aged people were susceptible to the local cold waves. CONCLUSION This study suggests that cold spell is a risk factor for ischemic stroke in Hefei, and there is a certain lag effect. Targeted measures should be taken to protect susceptible populations during cold spell days, including women and young and middle-aged people.
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Affiliation(s)
- Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Feng Yu
- Anhui Provincial Hospital, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Qiang Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Lijun Bai
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yanwu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China.
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Martínez-Solanas È, Basagaña X. Temporal changes in the effects of ambient temperatures on hospital admissions in Spain. PLoS One 2019; 14:e0218262. [PMID: 31194811 PMCID: PMC6564013 DOI: 10.1371/journal.pone.0218262] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/29/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The exposure to extreme ambient temperatures has been reported to increase mortality, although less is known about its impact on morbidity. The analysis of temporal changes in temperature-health associations has also focused on mortality with no studies on hospitalizations worldwide. Studies on temporal variations can provide insights on changes in susceptibility or on effectiveness of public health interventions. We aimed to analyse the effects of temperature on cause-specific hospital admissions in Spain and assess temporal changes using two periods, the second one characterized by the introduction of a heat health prevention plan. METHODS Daily counts of non-scheduled hospital admissions for cardiovascular, cerebrovascular and respiratory diseases and daily maximum temperature were obtained for each Spanish province for the period 1997-2013. The relationship between temperature and hospitalizations was estimated using distributed lag non-linear models. We compared the risk of hospitalization due to temperatures (cold, heat and extreme heat) in two periods (1997-2002 and 2004-2013). RESULTS Cold temperatures were associated with increased risk of cardiovascular, cerebrovascular and respiratory hospital admissions. Hot temperatures were only associated with higher hospital admissions for respiratory causes while hospitalizations for cardiovascular and cerebrovascular diseases did not increase with heat. There was a small reduction in heat-related respiratory admissions in period 2. Whereas cold-related hospitalizations for cardiovascular and cerebrovascular diseases increased in period 2, a significant reduction for respiratory hospitalizations was reported. CONCLUSIONS Our results suggested that heat had an adverse impact on hospital admissions for respiratory diseases, while cold increased the risk of the three studied cause-specific hospitalizations. Public health interventions should also focus on morbidity effects of temperature.
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Affiliation(s)
- Èrica Martínez-Solanas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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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: 34] [Impact Index Per Article: 6.8] [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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Stewart S, Moholdt TT, Burrell LM, Sliwa K, Mocumbi AO, McMurray JJ, Keates AK, Hawley JA. Winter Peaks in Heart Failure: An Inevitable or Preventable Consequence of Seasonal Vulnerability? Card Fail Rev 2019; 5:83-85. [PMID: 31179017 PMCID: PMC6546000 DOI: 10.15420/cfr.2018.40.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/12/2019] [Indexed: 01/03/2023] Open
Abstract
Climate change is a major contributor to annual winter peaks in cardiovascular events across the globe. However, given the paradoxical observation that cardiovascular seasonality is observed in relatively mild as well as cold climates, global warming may not be as positive for the syndrome of heart failure (HF) as some predict. In this article, we present our Model of Seasonal Flexibility to explain the spectrum of individual responses to climatic conditions. We have identified distinctive phenotypes of resilience and vulnerability to explain why winter peaks in HF occur. Moreover, we identify how better identification of climatic vulnerability and the use of multifaceted interventions focusing on modifiable bio-behavioural factors may improve HF outcomes.
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Affiliation(s)
- Simon Stewart
- Hatter Institute for Cardiovascular Research in Africa, University of Cape Town Cape Town, South Africa
| | - Trine T Moholdt
- Norwegian University of Science and Technology Trondheim, Norway
| | | | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, University of Cape Town Cape Town, South Africa.,Australian Catholic University Melbourne, Australia
| | - Ana O Mocumbi
- Mozambique Institute for Health Education and Research Maputo, Mozambique
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Abstract
PURPOSE OF REVIEW Low, high, extreme, and variable temperatures have been linked to multiple adverse health outcomes, particularly among the elderly and children. Recent models incorporating satellite remote sensing data have mitigated several limitations of previous studies, improving exposure assessment. This review focuses on these new temperature exposure models and their application in epidemiological studies. RECENT FINDINGS Satellite observations of land surface temperature have been used to model air temperature across large spatial areas at high spatiotemporal resolutions. These models enable exposure assessment of entire populations and have been shown to reduce error in exposure estimates, thus mitigating downward bias in health effect estimates. SUMMARY Satellite-based models improve our understanding of spatiotemporal variation in temperature and the associated health effects. Further research should focus on improving the resolution of these models, especially in urban areas, and increasing their use in epidemiological studies of direct temperature exposure and vector-borne diseases.
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119
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Gebhard CE, Gebhard C, Maafi F, Bertrand MJ, Stähli BE, Maredziak M, Bengs S, Haider A, Zhang ZW, Smith DC, Ly HQ. Impact of summer season on pre-hospital time delays in women and men undergoing primary percutaneous coronary intervention. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 656:322-330. [PMID: 30513423 DOI: 10.1016/j.scitotenv.2018.11.363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Pre-hospital delays have been associated with poor outcomes in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). It is currently unknown how environmental variables affect treatment delays in these patients. METHODS AND RESULTS The association between environmental variables, time to treatment including transportation times and adverse in-hospital events was assessed in 1828 consecutive patients with STEMI undergoing primary PCI between 2010 and 2014 in the Montreal metropolitan area. Median[Q1;Q3] total ischemia time was significantly longer during summer season (April-September) as compared to winter season (October-March, 201[140;305] min vs 187[126;266] min, p = 0.022). This difference between seasons was due to a significant increase in median decision time to seek treatment for symptoms during summer (90[46;185] min vs 78[40;156], p = 0.004). The former peaked during July and August and was most pronounced in men. Hence, outside temperature and summer season were identified as strong predictors of prolonged decision time in patients with STEMI (p < 0.001 and p = 0.002, respectively). Transportation times slightly increased during winter season and snow fall, this difference, however, was not significant (p = 0.46). A significant increase in in-hospital adverse outcomes following primary PCI was observed during summer season as compared to winter season (7.2% vs 4.8%, p = 0.032). Accordingly, multivariate logistic regression models adjusted for baseline variables identified summer season as a strong predictor of periprocedural adverse events (OR 1.83, 95% CI 1.2-3.11, p = 0.037). CONCLUSION Contrary to our initial hypothesis, pre-hospital delays in patients with STEMI are considerably longer and associated with adverse in-hospital outcomes during summer season. Considering the consequences of global warming, it is imperative that educational efforts targeting patients' perception are implemented to counter treatment delays.
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Affiliation(s)
- Caroline E Gebhard
- Montreal Heart Institute, Montreal, Canada; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
| | - Catherine Gebhard
- Montreal Heart Institute, Montreal, Canada; Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland.
| | | | | | | | - Monika Maredziak
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland
| | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland
| | - Ahmed Haider
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; Center for Molecular Cardiology, University of Zurich, Switzerland
| | | | | | - Hung Q Ly
- Montreal Heart Institute, Montreal, Canada; Department of Medicine, Université de Montréal, Montreal, Canada
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Chen TH, Du XL, Chan W, Zhang K. Impacts of cold weather on emergency hospital admission in Texas, 2004-2013. ENVIRONMENTAL RESEARCH 2019; 169:139-146. [PMID: 30453131 DOI: 10.1016/j.envres.2018.10.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 10/25/2018] [Accepted: 10/27/2018] [Indexed: 06/09/2023]
Abstract
Cold weather has been identified as a major cause of weather-related deaths in the U.S. Although the effects of cold weather on mortality has been investigated extensively, studies on how cold weather affects hospital admissions are limited particularly in the Southern United States. This study aimed to examine impacts of cold weather on emergency hospital admissions (EHA) in 12 major Texas metropolitan statistical areas (MSAs) for the 10-year period, 2004-2013. A two-stage approach was employed to examine the associations between cold weather and EHA. First, the cold effects on each MSA were estimated using distributed lag non-linear models (DLNM). Then a random effects meta-analysis was applied to estimate pooled effects across all 12 MSAs. Percent increase in risk and corresponding 95% confidence intervals (CIs) were estimated as with a 1 °C (°C) decrease in temperature below a MSA-specific threshold for cold effects. Age-stratified and cause-specific EHA were modeled separately. The majority of the 12 Texas MSAs were associated with an increased risk in EHA ranging from 0.1% to 3.8% with a 1 ⁰C decrease below cold thresholds. The pooled effect estimate was 1.6% (95% CI: 0.9%, 2.2%) increase in all-cause EHA risk with 1 ⁰C decrease in temperature. Cold wave effects were also observed in most eastern and southern Texas MSAs. Effects of cold on all-cause EHA were highest in the very elderly (2.4%, 95% CI: 1.2%, 3.6%). Pooled estimates for cause-specific EHA association were strongest in pneumonia (3.3%, 95% CI: 2.8%, 3.9%), followed by chronic obstructive pulmonary disease (3.3%, 95% CI: 2.1%, 4.5%) and respiratory diseases (2.8%, 95% CI: 1.9%, 3.7%). Cold weather generally increases EHA risk significantly in Texas, especially in respiratory diseases, and cold effects estimates increased by elderly population (aged over 75 years). Our findings provide insight into better intervention strategy to reduce adverse health effects of cold weather among targeted vulnerable populations.
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Affiliation(s)
- Tsun-Hsuan Chen
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Xianglin L Du
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Wenyaw Chan
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Liu T, Ren Z, Zhang Y, Feng B, Lin H, Xiao J, Zeng W, Li X, Li Z, Rutherford S, Xu Y, Lin S, Nasca PC, Du Y, Wang J, Huang C, Jia P, Ma W. Modification Effects of Population Expansion, Ageing, and Adaptation on Heat-Related Mortality Risks Under Different Climate Change Scenarios in Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030376. [PMID: 30699991 PMCID: PMC6388188 DOI: 10.3390/ijerph16030376] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 12/24/2022]
Abstract
(1) Background: Although the health effects of future climate change have been examined in previous studies, few have considered additive impacts of population expansion, ageing, and adaptation. We aimed to quantify the future heat-related years of life lost (YLLs) under different Representative Concentration Pathways (RCP) scenarios and global-scale General Circulation Models (GCMs), and further to examine relative contributions of population expansion, ageing, and adaptation on these projections. (2) Methods: We used downscaled and bias-corrected projections of daily temperature from 27 GCMs under RCP2.6, 4.5, and 8.5 scenarios to quantify the potential annual heat-related YLLs in Guangzhou, China in the 2030s, 2060s, and 2090s, compared to those in the 1980s as a baseline. We also explored the modification effects of a range of population expansion, ageing, and adaptation scenarios on the heat-related YLLs. (3) Results: Global warming, particularly under the RCP8.5 scenario, would lead to a substantial increase in the heat-related YLLs in the 2030s, 2060s, and 2090s for the majority of the GCMs. For the total population, the annual heat-related YLLs under the RCP8.5 in the 2030s, 2060s, and 2090s were 2.2, 7.0, and 11.4 thousand, respectively. The heat effects would be significantly exacerbated by rapid population expansion and ageing. However, substantial heat-related YLLs could be counteracted by the increased adaptation (75% for the total population and 20% for the elderly). (4) Conclusions: The rapid population expansion and ageing coinciding with climate change may present an important health challenge in China, which, however, could be partially counteracted by the increased adaptation of individuals.
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Affiliation(s)
- Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Baixiang Feng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Hualiang Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Zhihao Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | | | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Pl, Rensselaer, NY 12148, USA.
| | - Philip C Nasca
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Pl, Rensselaer, NY 12148, USA.
| | - Yaodong Du
- Guangdong Provincial Climate Center, Guangzhou 510080, China.
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Peng Jia
- Department of Earth Observation Science, Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, 7500 Enschede, The Netherlands.
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), 7500 Enschede, The Netherlands.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
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Tian Y, Liu H, Si Y, Cao Y, Song J, Li M, Wu Y, Wang X, Xiang X, Juan J, Chen L, Wei C, Gao P, Hu Y. Association between temperature variability and daily hospital admissions for cause-specific cardiovascular disease in urban China: A national time-series study. PLoS Med 2019; 16:e1002738. [PMID: 30689640 PMCID: PMC6349307 DOI: 10.1371/journal.pmed.1002738] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/24/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Epidemiological studies have provided compelling evidence of associations between ambient temperature and cardiovascular disease. However, evidence of effects of daily temperature variability on cardiovascular disease is scarce and mixed. We aimed to examine short-term associations between temperature variability and hospital admissions for cause-specific cardiovascular disease in urban China. METHODS AND FINDINGS We conducted a national time-series analysis in 184 cities in China between 2014 and 2017. Data on daily hospital admissions for ischemic heart disease, heart failure, heart rhythm disturbances, and ischemic stroke were obtained from the database of Urban Employee Basic Medical Insurance (UEBMI) including 0.28 billion enrollees. Temperature data were acquired from the China Meteorological Data Sharing Service Center. Temperature variability was calculated from the standard deviation (SD) of daily minimum and maximum temperatures over exposure days. City-specific associations between temperature variability and cardiovascular disease were examined with overdispersed Poisson models controlling for calendar time, day of the week, public holiday, and daily mean temperature and relative humidity. Random-effects meta-analyses were performed to obtain national and regional average associations. We also plotted exposure-response relationship curve using a natural cubic spline of temperature variability. There were 8.0 million hospital admissions for cardiovascular disease during the study period. At the national-average level, a 1-°C increase in temperature variability at 0-1 days (TV0-1) was associated with a 0.44% (0.32%-0.55%), 0.31% (0.20%-0.43%), 0.48% (0.01%-0.96%), 0.34% (0.01%-0.67%), and 0.82% (0.59%-1.05%) increase in hospital admissions for cardiovascular disease, ischemic heart disease, heart failure, heart rhythm disturbances, and ischemic stroke, respectively. The estimates decreased but remained significant when controlling for ambient fine particulate matter (PM2.5), NO2, and SO2 pollution. The main limitation of the present study was the unavailability of data on individual exposure to temperature variability. CONCLUSIONS Our findings suggested that short-term temperature variability exposure could increase the risk of cardiovascular disease, which may provide new insights into the health effects of climate change.
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Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yaqin Si
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Beijing HealthCom Data Technology Co. Ltd, Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Libo Chen
- Beijing HealthCom Data Technology Co. Ltd, Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology Co. Ltd, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Key Laboratory of Molecular Cardiovascular (Peking University), Ministry of Education, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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123
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Luong LMT, Phung D, Sly PD, Dang TN, Morawska L, Thai PK. Effects of temperature on hospitalisation among pre-school children in Hanoi, Vietnam. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2603-2612. [PMID: 30474814 DOI: 10.1007/s11356-018-3737-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 11/12/2018] [Indexed: 06/09/2023]
Abstract
This study examined the effect of short-term changes in ambient temperature on hospital admissions among children aged less than 5 years old in Hanoi, Vietnam. Data on daily hospital admissions from January 2010 to June 2014 were collected from two hospitals. Daily meteorological data were obtained for the same period. We applied time series analysis to evaluate the risk of hospitalisation related to hot and cold weather by age and causes. We found that a 1 °C decrease in minimum temperature during the cold weather months was associated with 2.2% increase in hospital admission for respiratory infection among children 3-5 years old. A 1 °C increase in diurnal temperature range (DTR) in cold weather was associated with an increase of 1.9% and 1.7% in hospitalisation for all causes and respiratory infection, respectively, among children < 3 years old and an increase of 1.8% and 3.4% in hospitalisation for all causes and respiratory infection, respectively, among children of 3-5 years old. Negative associations between hot weather and hospital admissions were demonstrated. These findings suggested that low temperature and DTRs in winter are important risk factors for hospital admissions among children aged < 5 years old in Hanoi. Other factors may have modified the effect of high temperature on hospital admissions of children in Hanoi.
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Affiliation(s)
- Ly M T Luong
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
- Faculty of Environmental Sciences, VNU University of Science, Hanoi, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, Australia.
| | - Peter D Sly
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Tran Ngoc Dang
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
- The Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam
| | - Lidia Morawska
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
| | - Phong K Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia.
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124
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Xu Z, FitzGerald G, Guo Y, Jalaludin B, Tong S. Assessing heatwave impacts on cause-specific emergency department visits in urban and rural communities of Queensland, Australia. ENVIRONMENTAL RESEARCH 2019; 168:414-419. [PMID: 30388498 DOI: 10.1016/j.envres.2018.10.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Heatwave impact on morbidity of people in rural areas has rarely been assessed in prior studies, and recently published literature has documented heatwave impact on a wide spectrum of diseases, for example, ear and eye diseases. OBJECTIVES To examine the associations between heatwaves and cause-specific emergency department visits (EDVs) across eight communities in both urban and rural regions throughout Queensland, Australia. METHODS Daily data on EDVs, air pollution and climatic conditions during the 1st January 2013 to the 31st December 2015 were obtained from relevant government agencies. Heatwave was defined as ≥ 95th percentile of the mean temperature for three or more consecutive days in each community. A quasi-Poisson generalized additive model with a distributed lag non-linear model was used to assess the heatwave impacts on EDVs. Random effect meta-analysis was performed to investigate the effects of heatwaves on cause-specific EDVs across the urban and rural regions as well as the whole Queensland. The causes of EDVs investigated in this study were infectious and parasitic diseases (ICD code: A00-B99), endocrine, nutritional and metabolic diseases (E00-E90), mental and behavioural disorders (F00-F99), diseases of the nervous system (G00-G99), diseases of the ear and mastoid process (H60-H95), diseases of the circulatory system (I00-I99), diseases of the respiratory system (J00-J99), diseases of the skin and subcutaneous tissue (L00-L99), diseases of the musculoskeletal system and connective tissue (M00-M99), diseases of the genitourinary system (N00-N99), and injury, poisoning and certain other consequences of external causes (S00-T98). RESULTS The meta-analysis results showed that there were significant effects of heatwaves on total EDVs and a wide-spectrum of cause-specific EDVs. For example, EDVs for endocrine, nutritional and metabolic diseases (RR: 1.18, 95% CI: 1.04-1.34), diseases of the nervous system (RR: 1.09, 95% CI: 1.02-1.17), and diseases of the genitourinary system (RR: 1.05, 95% CI: 1.00-1.09) increased substantially during heatwave days. The effect of heatwaves on total EDVs was similar for rural (RR: 1.04, 95% CI: 1.01-1.07) and urban regions (RR: 1.04, 95% CI: 1.00-1.07). CONCLUSIONS A wide range of diseases were sensitive to heatwave impacts. Residents in urban and rural areas were all vulnerable to heatwave impacts, calling for heat adaptation measures to be undertaken in Queensland, Australia.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.
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125
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Yitshak-Sade M, Bobb JF, Schwartz JD, Kloog I, Zanobetti A. The association between short and long-term exposure to PM 2.5 and temperature and hospital admissions in New England and the synergistic effect of the short-term exposures. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 639:868-875. [PMID: 29929325 PMCID: PMC6051434 DOI: 10.1016/j.scitotenv.2018.05.181] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/25/2018] [Accepted: 05/15/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Particulate matter < 2.5 μm in diameter (PM2.5) and heat are strong predictors of morbidity, yet few studies have examined the effects of long-term exposures on non-fatal events, or assessed the short and long-term effect on health simultaneously. OBJECTIVE We jointly investigated the association of short and long-term exposures to PM2.5 and temperature with hospital admissions, and explored the modification of the associations with the short-term exposures by one another and by temperature variability. METHODS Daily ZIP code counts of respiratory, cardiac and stroke admissions of adults ≥65 (N = 2,015,660) were constructed across New-England (2001-2011). Daily PM2.5 and temperature exposure estimates were obtained from satellite-based spatio-temporally resolved models. For each admission cause, a Poisson regression was fit on short and long-term exposures, with a random intercept for ZIP code. Modifications of the short-term effects were tested by adding interaction terms with temperature, PM2.5 and temperature variability. RESULTS Associations between short and long-term exposures were observed for all of the outcomes, with stronger effects of long-term exposures to PM2.5. For respiratory admissions, the short-term PM2.5 effect (percent increase per IQR) was larger on warmer days (1.12% versus -0.53%) and in months of higher temperature variability (1.63% versus -0.45%). The short-term temperature effect was higher in months of higher temperature variability as well. For cardiac admissions, the PM2.5 effect was larger on colder days (0.56% versus -0.30%) and in months of higher temperature variability (0.99% versus -0.56%). CONCLUSIONS We observed synergistic effects of short-term exposures to PM2.5, temperature and temperature variability. Long-term exposures to PM2.5 were associated with larger effects compared to short-term exposures.
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Affiliation(s)
- Maayan Yitshak-Sade
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer F Bobb
- Biostatistics Unit, Kaiser Permanent Washington Health Research Institute, Seattle, WA, USA
| | - Joel D Schwartz
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Antonella Zanobetti
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Sun Z, Chen C, Xu D, Li T. Effects of ambient temperature on myocardial infarction: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 241:1106-1114. [PMID: 30029319 DOI: 10.1016/j.envpol.2018.06.045] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 05/03/2023]
Abstract
Previous studies have suggested that ambient temperature is associated with the mortality and morbidity of myocardial infarction (MI) although consistency among these investigations is lacking. We performed a meta-analysis to investigate the relationship between ambient temperature and MI. The PubMed, Web of Science, and China National Knowledge Infrastructure databases were searched back to August 31, 2017. The pooled estimates for different temperature exposures were calculated using a random-effects model. The Cochran's Q test and coefficient of inconsistency (I2) were used to evaluate heterogeneity, and the Egger's test was used to assess publication bias. The exposure-response relationship of temperature-MI mortality or hospitalization was modeled using random-effects meta-regression. A total of 30 papers were included in the review, and 23 studies were included in the meta-analysis. The pooled estimates for the relationship between temperature and the relative risk of MI hospitalization was 1.016 (95% confidence interval [CI]: 1.004-1.028) for a 1 °C increase and 1.014 (95% CI: 1.004-1.024) for a 1 °C decrease. The pooled estimate of MI mortality was 1.639 (95% CI: 1.087-2.470) for a heat wave. The heterogeneity was significant for heat exposure, cold exposure, and heat wave exposure. The Egger's test revealed potential publication bias for cold exposure and heat exposure, whereas there was no publication bias for heat wave exposure. An increase in latitude was associated with a decreased risk of MI hospitalization due to cold exposure. The association of heat exposure and heat wave were immediate, and the association of cold exposure were delayed. Consequently, cold exposure, heat exposure, and exposure to heat waves were associated with an increased risk of MI. Further research studies are required to understand the relationship between temperature and MI in different climate areas and extreme weather conditions.
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Affiliation(s)
- Zhiying Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China
| | - Chen Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China
| | - Dandan Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China.
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Short-Term Effects of Ambient Air Pollution on Hospitalization for Respiratory Disease in Taiyuan, China: A Time-Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102160. [PMID: 30275384 PMCID: PMC6210308 DOI: 10.3390/ijerph15102160] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/29/2018] [Accepted: 09/30/2018] [Indexed: 12/15/2022]
Abstract
In this study, we estimated the short-term effects of ambient air pollution on respiratory disease hospitalization in Taiyuan, China. Daily data of respiratory disease hospitalization, daily concentration of ambient air pollutants and meteorological factors from 1 October 2014 to 30 September 2017 in Taiyuan were included in our study. We conducted a time-series study design and applied a generalized additive model to evaluate the association between every 10-μg/m³ increment of air pollutants and percent increase of respiratory disease hospitalization. A total of 127,565 respiratory disease hospitalization cases were included in this study during the present period. In single-pollutant models, the effect values in multi-day lags were greater than those in single-day lags. PM2.5 at lag02 days, SO₂ at lag03 days, PM10 and NO₂ at lag05 days were observed to be strongly and significantly associated with respiratory disease hospitalization. No significant association was found between O₃ and respiratory disease hospitalization. SO₂ and NO₂ were still significantly associated with hospitalization after adjusting for PM2.5 or PM10 into two-pollutant models. Females and younger population for respiratory disease were more vulnerable to air pollution than males and older groups. Therefore, some effective measures should be taken to strengthen the management of the ambient air pollutants, especially SO₂ and NO₂, and to enhance the protection of the high-risk population from air pollutants, thereby reducing the burden of respiratory disease caused by ambient air pollution.
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128
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Heatwave and health impact research: A global review. Health Place 2018; 53:210-218. [DOI: 10.1016/j.healthplace.2018.08.017] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/07/2018] [Accepted: 08/22/2018] [Indexed: 11/17/2022]
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Wang N, Mengersen K, Kimlin M, Zhou M, Tong S, Fang L, Wang B, Hu W. Lung cancer and particulate pollution: A critical review of spatial and temporal analysis evidence. ENVIRONMENTAL RESEARCH 2018; 164:585-596. [PMID: 29626820 DOI: 10.1016/j.envres.2018.03.034] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/14/2018] [Accepted: 03/21/2018] [Indexed: 05/02/2023]
Abstract
BACKGROUND Particulate matter (PM) has been recognized as one of the key risk factors of lung cancer. However, spatial and temporal patterns of this association remain unclear. Spatiotemporal analyses incorporate the spatial and temporal structure of the data within random effects models, generating more accurate evaluations of PM-lung cancer associations at a scale that can better inform lung cancer prevention programs. METHODS We conducted a critical review of spatial and temporal analyses of PM and lung cancer. The databases of PubMed, Web of Science and Scopus were searched for potential articles published until September 30, 2017. We included studies that applied spatial and temporal analyses to evaluate the associations of PM2.5 (inhalable particles with diameters that are 2.5 µm and smaller) and PM10 (inhalable particles with diameters that are 10 µm and smaller) with lung cancer. RESULTS We identified 17 articles eligible for the review. Of these, 11 focused on PM2.5, five on PM10, and one on both. These studies suggested a significant positive association between PM2.5 exposure and the risk of lung cancer. Relative risks of lung cancer mortality ranged from 1.08 (95% confidence interval (CI): 1.07-1.09) to 1.60 (95%CI: 1.09-2.33) for 10 µg/m3 increase in PM2.5 exposure. The association between PM10 and lung cancer had been less well researched and the results were not consistent. In terms of the analysis methods, 16 papers undertook spatial analysis and one paper employed temporal analysis. No paper included spatial and temporal analyses simultaneously and considered spatiotemporal uncertainty into model predictions. Among the 16 papers with spatial analyses, thirteen studies presented maps, while only five and 11 studies utilized spatial exploration and modeling methods, respectively. CONCLUSIONS Advanced spatial and temporal epidemiological methods were seldom applied to PM-lung cancer associations. Further research is urgently needed to develop and employ robust and comprehensive spatiotemporal analysis methods for the evaluation of PM-lung cancer associations and the support of lung cancer prevention strategies.
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Affiliation(s)
- Ning Wang
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael Kimlin
- Health Research Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia; Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Maigeng Zhou
- National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shilu Tong
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, 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
| | - Liwen Fang
- National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baohua Wang
- National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
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Dominianni C, Lane K, Johnson S, Ito K, Matte T. Health Impacts of Citywide and Localized Power Outages in New York City. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:067003. [PMID: 29894117 PMCID: PMC6084843 DOI: 10.1289/ehp2154] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 05/02/2023]
Abstract
BACKGROUND Previous studies investigated potential health effects of large-scale power outages, including the massive power failure that affected the northeastern United States and Ontario, Canada, in August 2003, and outages associated with major storms. However, information on localized outages is limited. OBJECTIVE The study sought to examine potential health impacts of citywide and localized outages in New York City (NYC). METHODS Along with the citywide 2003 outage, localized outages in July 1999 and July 2006 were identified. We additionally investigated localized, warm- and cold-weather outages that occurred in any of 66 NYC electric-grid networks during 2002–2014 using New York State Public Service Commission data. Mortality and hospitalizations were geocoded and linked to the networks. Associations were estimated using Poisson time-series regression, including examining distributed lags and adjusting for temperature and temporal trends. Network-specific estimates were pooled by season. RESULTS Respiratory disease hospitalizations were associated with the 2006 localized outage [cumulative relative risk [CRR] over 0–1 lag day, lag01=2.26 (95% confidence interval [CI]: 1.08, 4.74)] and the 2003 citywide outage, but not with other localized, warm-weather outages. Renal disease hospitalizations were associated with the 2003 citywide outage, and with localized, warm-weather outages, pooled across networks [RR at lag3=1.16 (95% CI: 1.00, 1.34)], but not the 2006 localized outage. All-cause mortality was positively associated with the 1999, 2003, and 2006 outages (significant for the 2003 outage only), but not with other localized, warm-weather outages. Localized, cold-weather outages were associated with all-cause mortality [lag01 CRR=1.06 (95% CI: 1.01, 1.12)] and cardiovascular disease hospitalizations [lag01 CRR=1.14 (95% CI: 1.03, 1.26)], and fewer respiratory disease hospitalizations [lag03 CRR=0.77 (95% CI: 0.61, 0.97)]. CONCLUSIONS Localized outages may affect health. This information can inform preparedness efforts and underscores the public health importance of ensuring electric grid resiliency to climate change. https://doi.org/10.1289/EHP2154.
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Affiliation(s)
- Christine Dominianni
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, New York, USA
| | - Kathryn Lane
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, New York, USA
| | - Sarah Johnson
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, New York, USA
| | - Kazuhiko Ito
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, New York, USA
| | - Thomas Matte
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, New York, USA
- Vital Strategies, New York, New York, USA
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Zhang Y, Yu C, Peng M, Zhang L. The burden of ambient temperature on years of life lost: A multi-community analysis in Hubei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 621:1491-1498. [PMID: 29054637 DOI: 10.1016/j.scitotenv.2017.10.079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/07/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Compared with death rates, years of life lost (YLL) has been widely used as a more informative indicator to quantify the burden of premature death. In the context of global climate change, existing evidence linking ambient temperatures and YLL was very scarce across the globe. METHODS Daily mortality and meteorological data during 2009-2012 were obtained from 12 communities across Hubei Province in central China. A two-stage approach was used for statistical analysis. At the first stage, a generalized linear regression combined with distributed lag non-linear model was applied to estimate community-specific temperature-YLL associations. A second-stage multivariable meta-analysis was then conducted to pool the community-specific estimates of temperature-related effects on YLL. RESULTS A pooled J- or U-shaped association was observed between ambient temperature and YLL due to different mortality categories. Heat effects occurred immediately and only persisted for several days, whereas cold effects were delayed and much longer-lasting. At the provincial level, heat effect (per 1°C increase from 75th to 99th percentile of temperature) at lag 0-2days and cold effect (per 1°C decrease from 25th to 1st percentile of temperature) at lag 0-21days was associated with an increase of 1.91% (95% CI: 0.83, 3.00) and 5.09% (2.79, 7.40) in YLL due to non-accidental deaths, respectively. Much greater effect estimates of cold than heat were also observed for other mortality-specific YLLs (except for respiratory mortality). Heat effects on YLL were higher for males and the youth, while cold effects were greater for females and the elderly. Additionally, relatively stronger associations between heat, cold and YLL were consistently observed in low-educated persons. CONCLUSIONS This multi-community study strengthened the evidence that both cold and hot temperatures were associated with increased years of life lost. Our findings may have important implications for better understanding the burden of premature death related to temperature extremes.
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Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road,Wuchang District, Wuhan 430071, China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road,Wuchang District, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuchang District, Wuhan 430072, China.
| | - Minjin Peng
- Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Lan Zhang
- Office of Chronic Disease, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan Road, Wuhan 430079, China
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Weather and risk of ST-elevation myocardial infarction revisited: Impact on young women. PLoS One 2018; 13:e0195602. [PMID: 29630673 PMCID: PMC5891074 DOI: 10.1371/journal.pone.0195602] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 03/26/2018] [Indexed: 12/22/2022] Open
Abstract
Background During the last decade, the incidence and mortality rates of ST-elevation myocardial infarction (STEMI) has been steadily increasing in young women but not in men. Environmental variables that contribute to cardiovascular events in women remain ill-defined. Methods and results A total of 2199 consecutive patients presenting with acute ST-elevation myocardial infarction (STEMI, 25.8% women, mean age 62.6±12.4 years) were admitted at the Montreal Heart Institute between June 2010 and December 2014. Snow fall exceeding 2cm/day was identified as a positive predictor for STEMI admission rates in the overall population (RR 1.28, 95% CI 1.07–1.48, p = 0.005), with a significant effect being seen in men (RR 1.30, 95% CI 1.06–1.53, p = 0.01) but not in women (p = NS). An age-specific analysis revealed a significant increase in hospital admission rates for STEMI in younger women ≤55 years, (n = 104) during days with higher outside temperature (p = 0.004 vs men ≤55 years) and longer daylight hours (p = 0.0009 vs men ≤55 years). Accordingly, summer season, increased outside temperature and sunshine hours were identified as strong positive predictors for STEMI occurrence in women ≤55 years (RR 1.66, 95% CI 1.1–2.5, p = 0.012, RR 1.70, 95% CI 1.2–2.5, p = 0.007, and RR 1.67, 95% CI 1.2–2.5, p = 0.011, respectively), while an opposite trend was observed in men ≤55 years (RR for outside temperature 0.8, 95% CI 0.73–0.95, p = 0.01). Conclusion The impact of environmental variables on STEMI is age- and sex-dependent. Higher temperature may play an important role in triggering such acute events in young women.
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Li T, Horton RM, Bader DA, Liu F, Sun Q, Kinney PL. Long-term projections of temperature-related mortality risks for ischemic stroke, hemorrhagic stroke, and acute ischemic heart disease under changing climate in Beijing, China. ENVIRONMENT INTERNATIONAL 2018; 112:1-9. [PMID: 29241068 DOI: 10.1016/j.envint.2017.12.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 11/15/2017] [Accepted: 12/04/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Changing climates have been causing variations in the number of global ischemic heart disease and stroke incidences, and will continue to affect disease occurrence in the future. OBJECTIVES To project temperature-related mortality for acute ischemic heart disease, and ischemic and hemorrhagic stroke with concomitant climate warming. METHODS We estimated the exposure-response relationship between daily cause-specific mortality and daily mean temperature in Beijing. We utilized outputs from 31 downscaled climate models and two representative concentration pathways (RCPs) for the 2020s, 2050s, and 2080s. This strategy was used to estimate future net temperature along with heat- and cold-related deaths. The results for predicted temperature-related deaths were subsequently contrasted with the baseline period. RESULTS In the 2080s, using the RCP8.5 and no population variation scenarios, the net total number of annual temperature-related deaths exhibited a median value of 637 (with a range across models of 434-874) for ischemic stroke; this is an increase of approximately 100% compared with the 1980s. The median number of projected annual temperature-related deaths was 660 (with a range across models of 580-745) for hemorrhagic stroke (virtually no change compared with the 1980s), and 1683 (with a range across models of 1351-2002) for acute ischemic heart disease (a slight increase of approximately 20% compared with the 1980s). In the 2080s, the monthly death projection for hemorrhagic stroke and acute ischemic heart disease showed that the largest absolute changes occurred in summer and winter while the largest absolute changes for ischemic stroke occurred in summer. CONCLUSIONS We projected that the temperature-related mortality associated with ischemic stroke will increase dramatically due to climate warming. However, projected temperature-related mortality pertaining to acute ischemic heart disease and hemorrhagic stroke should remain relatively stable over time.
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Affiliation(s)
- Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Radley M Horton
- Center for Climate Systems Research, Columbia University, New York, USA
| | - Daniel A Bader
- Center for Climate Systems Research, Columbia University, New York, USA
| | - Fangchao Liu
- Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College,China
| | - Qinghua Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
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Exploring Heat Stress Relief Measures among the Australian Labour Force. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030401. [PMID: 29495396 PMCID: PMC5876946 DOI: 10.3390/ijerph15030401] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/15/2018] [Accepted: 02/23/2018] [Indexed: 11/17/2022]
Abstract
Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%), 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected temperature increases.
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135
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Zhao Q, Zhao Y, Li S, Zhang Y, Wang Q, Zhang H, Qiao H, Li W, Huxley R, Williams G, Zhang Y, Guo Y. Impact of ambient temperature on clinical visits for cardio-respiratory diseases in rural villages in northwest China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 612:379-385. [PMID: 28858748 DOI: 10.1016/j.scitotenv.2017.08.244] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/14/2017] [Accepted: 08/23/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND The association between temperature and cardio-respiratory disease in urban areas has been widely reported but there is limited information from populations living in rural areas that may be disproportionately affected by climate change. OBJECTIVES To quantify the associations between daily temperature and clinical visits due to cardiovascular and/or respiratory disease in rural villages in the Ningxia Hui Autonomous Region, China over 2012-2015. METHODS Daily data on clinical visits and weather conditions were collated from 203 villages. A quasi-Poisson regression with distributed lag non-linear model was used to examine the associations between daily temperature and clinical visits up to 28days, after controlling for potential confounders. RESULTS Over three years, 158,733 and 1,272,212 clinical visits were recorded for cardiovascular and respiratory diseases, respectively. Both low and high temperatures were associated with an increased risk of clinical visits for cardiovascular-related conditions, whereas only low temperatures were associated with increased clinical visits related to respiratory illness. The cold effect on cardiovascular visits appeared at the lag 6th day and persisted until the 22nd day, resulting in a cumulative relative risk (RR) 1.55 (95% CI: 1.26-1.92), compared with the minimum-clinical visit temperature. The cold effect on respiratory visits appeared immediately and lasted over the lag 0-28days, with a cumulative RR 2.96 (2.74-3.21). Suboptimal temperature accounted for approximately 13% and 26% of clinic visits due to cardiovascular and respiratory disorders, respectively, with the majority of cases attributable to moderate - rather than extreme - cold temperature. CONCLUSIONS In rural settings, sub-optimal temperatures explained nearly one quarter of all clinical visits due to cardiovascular and respiratory diseases. Although extreme cold temperature had a stronger, more immediate, prolonged effect on respiratory disease than for cardiovascular disease, moderately cold temperatures accounted for most of the overall burden of clinical visits.
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Affiliation(s)
- Qi Zhao
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, 4006, Queensland, Australia
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - Yajuan Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Qingan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Huiling Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Hui Qiao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Wuping Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Rachel Huxley
- School of Public Health, Curtin University, Kent Street, Perth, 6102, Western Australia, Australia
| | - Gail Williams
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, 4006, Queensland, Australia
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia.
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van Loenhout JAF, Delbiso TD, Kiriliouk A, Rodriguez-Llanes JM, Segers J, Guha-Sapir D. Heat and emergency room admissions in the Netherlands. BMC Public Health 2018; 18:108. [PMID: 29304777 PMCID: PMC5756417 DOI: 10.1186/s12889-017-5021-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 12/25/2017] [Indexed: 01/03/2023] Open
Abstract
Background Due to a global warming-related increase in heatwaves, it is important to obtain detailed understanding of the relationship between heat and health. We assessed the relationship between heat and urgent emergency room admissions in the Netherlands. Methods We collected daily maximum temperature and relative humidity data over the period 2002–2007. Daily urgent emergency room admissions were divided by sex, age group and disease category. We used distributed lag non-linear Poisson models, estimating temperature-admission associations. We estimated the relative risk (RR) for urgent hospital admissions for a range of temperatures compared to a baseline temperature of 21 °C. In addition, we compared the impact of three different temperature scenarios on admissions using the RR. Results There is a positive relationship between increasing temperatures above 21 °C and the RR for urgent emergency room admissions for the disease categories ‘Potential heat-related diseases’ and ‘Respiratory diseases’. This relationship is strongest in the 85+ group. The RRs are strongest for lag 0. For admissions for ‘circulatory diseases’, there is only a small significant increase of RRs within the 85+ age group for moderate heat, but not for extreme heat. The RRs for a one-day event with extreme heat are comparable to the RRs for multiple-day events with moderate heat. Conclusions Hospitals should adjust the capacity of their emergency departments on warm days, and the days immediately thereafter. The elderly in particular should be targeted through prevention programmes to reduce harmful effects of heat. The fact that this increase in admissions already occurs in temperatures above 21 °C is different from previous findings in warmer countries. Given the similar impact of three consecutive days of moderate heat and one day of extreme heat on admissions, criteria for activation of national heatwave plans need adjustments based on different temperature scenarios. Electronic supplementary material The online version of this article (10.1186/s12889-017-5021-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joris Adriaan Frank van Loenhout
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200, Woluwé-Saint-Lambert, Brussels, Belgium.
| | - Tefera Darge Delbiso
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200, Woluwé-Saint-Lambert, Brussels, Belgium
| | - Anna Kiriliouk
- Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA), Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | | | - Johan Segers
- Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA), Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200, Woluwé-Saint-Lambert, Brussels, Belgium
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Luo Y, Li H, Huang F, Van Halm-Lutterodt N, Wang A, Guo J, Tao L, Li X, Liu M, Zheng D, Chen S, Zhang F, Yang X, Tan P, Wang W, Xie X, Guo X. The cold effect of ambient temperature on ischemic and hemorrhagic stroke hospital admissions: A large database study in Beijing, China between years 2013 and 2014-Utilizing a distributed lag non-linear analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 232:90-96. [PMID: 28941717 DOI: 10.1016/j.envpol.2017.09.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/02/2017] [Accepted: 09/07/2017] [Indexed: 05/03/2023]
Abstract
The effects of ambient temperature on stroke death in China have been well addressed. However, few studies are focused on the attributable burden for the incident of different types of stroke due to ambient temperature, especially in Beijing, China. We purpose to assess the influence of ambient temperature on hospital stroke admissions in Beijing, China. Data on daily temperature, air pollution, and relative humidity measurements and stroke admissions in Beijing were obtained between 2013 and 2014. Distributed lag non-linear model was employed to determine the association between daily ambient temperature and stroke admissions. Relative risk (RR) with 95% confidence interval (CI) and Attribution fraction (AF) with 95% CI were calculated based on stroke subtype, gender and age group. A total number of 147, 624 stroke admitted cases (including hemorrhagic and ischemic types of stroke) were documented. A non-linear acute effect of cold temperature on ischemic and hemorrhagic stroke hospital admissions was evaluated. Compared with the 25th percentile of temperature (1.2 °C), the cumulative RR of extreme cold temperature (first percentile of temperature, -9.6 °C) was 1.51 (95% CI: 1.08-2.10) over lag 0-14 days for ischemic type and 1.28 (95% CI: 1.03-1.59) for hemorrhagic stroke over lag 0-3 days. Overall, 1.57% (95% CI: 0.06%-2.88%) of ischemic stroke and 1.90% (95% CI: 0.40%-3.41%) of hemorrhagic stroke was attributed to the extreme cold temperature over lag 0-7 days and lag 0-3 days, respectively. The cold temperature's impact on stroke admissions was found to be more obvious in male gender and the youth compared to female gender and the elderly. Exposure to extreme cold temperature is associated with increasing both ischemic and hemorrhagic stroke admissions in Beijing, China.
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Affiliation(s)
- Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Fangfang Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Medical School, Henan University of Science and Technology, China
| | | | - Anxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Jin Guo
- Greenwood Medical Company, Australia
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Australia
| | - Mengyang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Sipeng Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Feng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Peng Tan
- Beijing Public Health Information Center, Beijing, China
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Joondalup WA6027, Australia
| | - Xueqin Xie
- Beijing Public Health Information Center, Beijing, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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Sherbakov T, Malig B, Guirguis K, Gershunov A, Basu R. Ambient temperature and added heat wave effects on hospitalizations in California from 1999 to 2009. ENVIRONMENTAL RESEARCH 2018; 160:83-90. [PMID: 28964966 DOI: 10.1016/j.envres.2017.08.052] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/24/2017] [Accepted: 08/28/2017] [Indexed: 05/24/2023]
Abstract
Investigators have examined how heat waves or incremental changes in temperature affect health outcomes, but few have examined both simultaneously. We utilized distributed lag nonlinear models (DLNM) to explore temperature associations and evaluate possible added heat wave effects on hospitalizations in 16 climate zones throughout California from May through October 1999-2009. We define heat waves as a period when daily mean temperatures were above the zone- and month-specific 95th percentile for at least two consecutive days. DLNMs were used to estimate climate zone-specific non-linear temperature and heat wave effects, which were then combined using random effects meta-analysis to produce an overall estimate for each. With higher temperatures, admissions for acute renal failure, appendicitis, dehydration, ischemic stroke, mental health, non-infectious enteritis, and primary diabetes were significantly increased, with added effects from heat waves observed for acute renal failure and dehydration. Higher temperatures also predicted statistically significant decreases in hypertension admissions, respiratory admissions, and respiratory diseases with secondary diagnoses of diabetes, though heat waves independently predicted an added increase in risk for both respiratory types. Our findings provide evidence that both heat wave and temperature exposures can exert effects independently.
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Affiliation(s)
- Toki Sherbakov
- University of California, Berkeley, School of Public Health, Division of Biostatistics, Berkeley, CA, United States; California Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, Oakland, CA, United States
| | - Brian Malig
- California Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, Oakland, CA, United States.
| | - Kristen Guirguis
- University of California, San Diego, Scripps Institution of Oceanography, La Jolla, CA, United States
| | - Alexander Gershunov
- University of California, San Diego, Scripps Institution of Oceanography, La Jolla, CA, United States
| | - Rupa Basu
- California Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, Oakland, CA, United States
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Ravljen M, Hovelja T, Vavpotič D. Immediate, lag and time window effects of meteorological factors on ST-elevation myocardial infarction incidence. Chronobiol Int 2017; 35:63-71. [DOI: 10.1080/07420528.2017.1381847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Mirjam Ravljen
- Nursing Department, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Tomaž Hovelja
- Information Systems Laboratory, Faculty of Computer and Information, University of Ljubljana, Ljubljana, Slovenia
| | - Damjan Vavpotič
- Information Systems Laboratory, Faculty of Computer and Information, University of Ljubljana, Ljubljana, Slovenia
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Ha S, Nguyen K, Liu D, Männistö T, Nobles C, Sherman S, Mendola P. Ambient temperature and risk of cardiovascular events at labor and delivery: A case-crossover study. ENVIRONMENTAL RESEARCH 2017; 159:622-628. [PMID: 28926807 PMCID: PMC5624535 DOI: 10.1016/j.envres.2017.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/06/2017] [Accepted: 09/09/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Extreme ambient temperatures are linked to cardiac events in the general population, but this relationship is unclear among pregnant women. We estimated the associations and attributable risk between ambient temperature and the risk of cardiovascular event at labor/delivery, and investigated whether these associations vary by maternal race/ethnicity. METHODS We identified 680 women with singleton deliveries affected by cardiovascular events across 12 US sites (2002-2008). Average daily temperature during the week before, delivery day, and each of the seven days before delivery was estimated for each woman. In a case-crossover analysis, exposures during these hazard periods were compared to two control periods before and after delivery using conditional logistic regression adjusted for other environmental factors. RESULTS During the cold season (October-April), 1°C lower during the week prior to delivery was associated with a 4% (95% CI: 1-7%) increased risk of having a labor/delivery affected by cardiovascular events including cardiac arrest and stroke. During the warm season (May-September), 1°C higher during the week prior was associated with a 7% (95% CI: 3-12%) increased risk. These risks translated to 13.4 and 23.9 excess events per 100,000 singleton deliveries during the cold and warm season, respectively. During the warm season, the risks were more pronounced on days closer to delivery and Black women appeared to be more susceptible to the same temperature increase. CONCLUSION Small changes in temperature appear to affect the risk of having cardiovascular events at labor/delivery. Black women had a differentially higher warm season risk. These findings merit further investigation.
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Affiliation(s)
- Sandie Ha
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA; School of Social Sciences, Humanties and Arts, University of California, Merced, CA, USA
| | - Kelly Nguyen
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA; San Diego State University, San Diego, CA, USA; Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Danping Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, NICHD, Rockville, MD, USA
| | - Tuija Männistö
- Northern Finland Laboratory Centre NordLab, Oulu, Finland; Department of Clinical Chemistry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; National Institute for Health and Welfare, Oulu, Finland
| | - Carrie Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA
| | | | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA.
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141
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Lin Y, Hu W, Xu J, Luo Z, Ye X, Yan C, Liu Z, Tong S. Association between temperature and maternal stress during pregnancy. ENVIRONMENTAL RESEARCH 2017; 158:421-430. [PMID: 28689033 DOI: 10.1016/j.envres.2017.06.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 06/09/2017] [Accepted: 06/27/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Maternal psychological stress during pregnancy has essentially been conceptualized as a teratogen. However, little is known about the effect of temperature on maternal stress during pregnancy. The aim of this study is to investigate the relationship between temperature and maternal stress during pregnancy. METHODS In 2010, a total of 1931 eligible pregnant women were enrolled across Shanghai from four prenatal-care clinics during their mid-to-late pregnancy. Maternal life-event stress and emotional stress levels during pregnancy were assessed by the "Life Event Scale for Pregnant Women" (LESPW) and "Symptom Checklist-90-Revised Scale" (SCL-90-R), respectively. Exposure to ambient temperature was evaluated based on daily regional average in different moving average and lag days. The generalized estimating equations were used to evaluate the relationship between daily average temperature/temperature difference and maternal stress. RESULTS After adjusting for relevant confounders, an U-shaped relationship was observed between daily average temperature and maternal Global-Severity-Index (GSI) of the SCL-90-R. Cumulative exposures to extremely low temperatures (< P5, 1.4-10.5℃, lag 0-1 days, 0-2 days and 0-5 days) and extremely high temperatures (≥ P95, 31.2-34.1℃, lag 0-1 days and 0-2 days), and acute exposures to extremely low (lag day 0, 1, 2 and 3) and high (lag day 0, 1) temperatures, all induced higher risks of high GSI (the highest tertile), compared to the risk induced by exposed to an optimal temperature range (20-25℃) (P< 0.05). Increased temperature difference was associated with high maternal GSI (P< 0.05). However, non-significant associations were observed between daily average temperatures/temperature differences and maternal log-transferred LESPW scores. CONCLUSIONS Cumulative and acute exposures to extremely low/high temperatures may both induce emotional stress during pregnancy.
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Affiliation(s)
- Yanfen Lin
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Wenjing Hu
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jian Xu
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Zhongcheng Luo
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Xiaofang Ye
- Shanghai Key Laboratory of Meteorology and Health, Shanghai 200135, China
| | - Chonghuai Yan
- Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zhiwei Liu
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia
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142
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Cong X, Xu X, Zhang Y, Wang Q, Xu L, Huo X. Temperature drop and the risk of asthma: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:22535-22546. [PMID: 28804860 DOI: 10.1007/s11356-017-9914-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/03/2017] [Indexed: 02/05/2023]
Abstract
The relationship between asthma and temperature changes remains controversial. The aim of this study was to investigate the association between temperature changes and the risk of asthma. A total of 26 studies (combined total number of subjects N > 26 million), covering 13 countries and Costa Rica, were identified by using a series of keywords in different combinations and searching the papers in PubMed, EMBSEA, Web of Science, MEDLINE, AIM, LILACS, and WPRIM before February 2016. Most of the papers were published in English. Random-effects meta-analyses were performed to evaluate the effect of temperature drop on risk of asthma. Several secondary analyses were also calculated based on stratification for different age, season, latitude, and region on risk of asthma. The odds ratio (OR) estimate between temperature drop and asthma was 1.05 (95% CI 1.02, 1.08) in the meta-analysis. For children, the overall OR was 1.09 (95% CI 1.03, 1.15). Dose-effect analyses showed stronger associations in asthma risk for each 1°1 °C decrement in short-term temperature (OR 1.055, 95% CI 1.00, 1.11). Further stratifications showed that winter (OR 1.03, 95% CI 1.01, 105) and low latitude (OR 1.72, 95% CI 1.23, 2.41) have a statistically significant association with the increased risk of asthma. Exposure of people to short-term temperature drop (per 1 °C decrement) was significantly associated with the risk of lower respiratory tract infections (LRTI) with asthma (OR 1.02, 95% CI 1.00, 1.04). Results suggest an adverse effect of temperature drop on asthma risk, especially in children and low-latitude areas. It may be opportune to consider the preventive actions against temperature drop, including simple face masks, to decrease the risk of asthma.
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Affiliation(s)
- Xiaowei Cong
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China.
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, China.
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Qihua Wang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Long Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xia Huo
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong, 510632, China.
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143
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Phung D, Mueller J, Lai FY, O'Brien J, Dang N, Morawska L, Thai PK. Can wastewater-based epidemiology be used to evaluate the health impact of temperature? - An exploratory study in an Australian population. ENVIRONMENTAL RESEARCH 2017; 156:113-119. [PMID: 28342346 DOI: 10.1016/j.envres.2017.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/12/2017] [Accepted: 03/13/2017] [Indexed: 06/06/2023]
Abstract
Ambient temperature is known to have impact on population health but assessing its impact by the traditional cohort approach is resource intensive. Wastewater-based epidemiology (WBE) could be an alternative for the traditional approach. This study was to provide the first evaluation to see if WBE can be used to assess the impact of temperature exposure to a population in South East Queensland, Australia using selected pharmaceuticals and personal care products (PPCPs) as biomarkers. Daily loads of eight PPCPs in wastewater collected from a wastewater treatment plant were measured from February 2011 to June 2012. Corresponding daily weather data were obtained from the closest weather station. Missing data of PPCPs were handled using the multiple imputation (MI) method, then we used a one-way between-groups analysis of variance to examine the seasonal effect on daily variation of PPCPs by seasons. Finally, an MI estimate was performed to evaluate the continuous relationship between daily average temperature and each multiply-imputed PPCP using time-series regression analysis. The results indicated that an increase of 1°C in average temperature associated with decrease at 1.3g/d (95% CI: -2.2 to (-0.4), p<0.05) for atenolol, increase at 36.5g/d (95% CI: 25.2-47.8, p<0.01) for acesulfame, and increase at 0.8g/d (95% CI: 0.02-1.55, p=0.05) for naproxen. No significant association was observed between temperature and the remaining PPCPs, comprising: caffeine, carbamazepine, codeine, hydrochlorothiazide, and salicylic acid. The findings suggested that consumption of sweetened drinks, risk of worsening cardiovascular conditions and pains are associated with variation in ambient temperature. WBE can thus be used as a complementary method to traditional cohort studies in epidemiological evaluation of the association between environmental factors and health outcomes provided that specific biomarkers of such health outcomes can be identified.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, QLD, Australia
| | - Jochen Mueller
- Queensland Alliance for Environmental Health Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Foon Yin Lai
- Queensland Alliance for Environmental Health Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Jake O'Brien
- Queensland Alliance for Environmental Health Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Nhung Dang
- Dermatology Research Centre, University of Queensland, Brisbane, QLD, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Phong K Thai
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia.
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144
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Wichmann J. Heat effects of ambient apparent temperature on all-cause mortality in Cape Town, Durban and Johannesburg, South Africa: 2006-2010. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 587-588:266-272. [PMID: 28242220 DOI: 10.1016/j.scitotenv.2017.02.135] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 06/06/2023]
Abstract
Due to climate change, an increase of 3-4°C in ambient temperature is projected along the South African coast and 6-7°C inland during the next 80years. The objective of this study was to investigate the association between daily ambient apparent temperature (Tapp) and daily all-cause non-accidental mortality (hereafter mortality) in Cape Town, Durban and Johannesburg during a 5-year study period (2006-2010). Susceptibility by sex and age groups (<15years, 15-64years and ≥65years) was also investigated. The associations were investigated with the time-stratified case-crossover epidemiological design. Models were controlled for PM10, public holidays and influenza epidemics. City-specific Tapp thresholds were determined using quasi-Poisson generalised additive models. The pooled estimates by sex and age groups were determined in meta-analyses. The city-specific Tapp thresholds were 18.6°C, 24.8°C and 18.7°C, respectively for Cape Town, Durban and Johannesburg. A 3.3%, 2.6% and 2.8% increase in mortality per IQR increase in Tapp (lag0-1) was observed in Cape Town, Durban and Johannesburg, respectively above the city-specific thresholds. The elderly were more at risk in Cape Town and Johannesburg. No difference in risk was observed for males and females in the three cities. In the meta-analysis an overall significant increase of 0.9% in mortality per 1°C increase in Tapp (lag0-1) was observed for all age groups combined in the three cities. For the ≥65year group a significant increase of 2.1% in mortality was observed. In conclusion, the risks for all age groups combined and the elderly are similar to those reported in studies from developed and developing countries. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased Tapp in the country due to climate change. Future research should investigate the association between Tapp and cause-specific mortality and also morbidity.
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Affiliation(s)
- Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa.
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145
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146
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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: 181] [Impact Index Per Article: 25.9] [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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147
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Ogbomo AS, Gronlund CJ, O'Neill MS, Konen T, Cameron L, Wahl R. Vulnerability to extreme-heat-associated hospitalization in three counties in Michigan, USA, 2000-2009. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:833-843. [PMID: 27796569 PMCID: PMC5410403 DOI: 10.1007/s00484-016-1261-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 05/27/2023]
Abstract
With climate change, extreme heat (EH) events are increasing, so it is important to understand who is vulnerable to heat-associated morbidity. We determined the association between EH and hospitalizations for all natural causes; cardiovascular, respiratory, and renal diseases; diabetes mellitus; and acute myocardial infarction in Michigan, USA, at different intensities and durations. We assessed confounding by ozone and how individual characteristics and health insurance payer (a proxy for income) modified these associations. We obtained Michigan Inpatient Database, National Climatic Data Center, and US Environmental Protection Agency ozone data for May-September, 2000-2009 for three Michigan counties. We employed a case-crossover design and modeled EH as an indicator for temperature above the 95th, 97th, or 99th percentile thresholds for 1, 2, 3, or 4 days. We examined effect modification by patient age, race, sex, and health insurance payer and pooled the county results. Among non-whites, the pooled odds ratio for hospitalization on EH (97th percentile threshold) vs. non-EH days for renal diseases was 1.37 (95 % CI = 1.13-1.66), which increased with increasing EH intensity, but was null among whites (OR = 1.00, 95 % CI = 0.81, 1.25). We observed a null association between EH and cardiovascular hospitalization. EH (99th percentile threshold) was associated with myocardial infarction hospitalizations. Confounding by ozone was minimal. EH was associated with hospitalizations for renal disease among non-whites. This information on vulnerability to heat-associated morbidity helps characterize the public health burden of EH and target interventions including patient education.
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Affiliation(s)
- Adesuwa S Ogbomo
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Carina J Gronlund
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109,, USA.
| | - Marie S O'Neill
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109,, USA
| | - Tess Konen
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Lorraine Cameron
- Division of Environmental Health, Michigan Department of Health and Human Services, 333 South Grand Ave, Lansing, MI, 48913, USA
| | - Robert Wahl
- Lifecourse Epidemiology and Genomics Division, Michigan Department of Health and Human Services, 333 South Grand Ave, Lansing, MI, 48913, USA
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148
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Ponjoan A, Blanch J, Alves-Cabratosa L, Martí-Lluch R, Comas-Cufí M, Parramon D, del Mar Garcia-Gil M, Ramos R, Petersen I. Effects of extreme temperatures on cardiovascular emergency hospitalizations in a Mediterranean region: a self-controlled case series study. Environ Health 2017; 16:32. [PMID: 28376798 PMCID: PMC5379535 DOI: 10.1186/s12940-017-0238-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/20/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Cold spells and heatwaves increase mortality. However little is known about the effect of heatwaves or cold spells on cardiovascular morbidity. This study aims to assess the effect of cold spells and heatwaves on cardiovascular diseases in a Mediterranean region (Catalonia, Southern Europe). METHODS We conducted a population-based retrospective study. Data were obtained from the System for the Development of Research in Primary Care and from the Catalan Meteorological Service. The outcome was first emergency hospitalizations due to coronary heart disease, stroke, or heart failure. Exposures were: cold spells; cold spells and 3 or 7 subsequent days; and heatwaves. Incidence rate ratios (IRR) and 95% confidence intervals were calculated using the self-controlled case series method. We accounted for age, time trends, and air pollutants; results were shown by age groups, gender or cardiovascular event type. RESULTS There were 22,611 cardiovascular hospitalizations in winter and 17,017 in summer between 2006 and 2013. The overall incidence of cardiovascular hospitalizations significantly increased during cold spells (IRR = 1.120; CI 95%: 1.10-1.30) and the effect was even stronger in the 7 days subsequent to the cold spell (IRR = 1.29; CI 95%: 1.22-1.36). Conversely, cardiovascular hospitalizations did not increase during heatwaves, neither in the overall nor in the stratified analysis. CONCLUSIONS Cold spells but not heatwaves, increased the incidence of emergency cardiovascular hospitalizations in Catalonia. The effect of cold spells was greater when including the 7 subsequent days. Such knowledge might be useful to develop strategies to reduce the impact of extreme temperature episodes on human health.
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Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Girona Biomedical Research Institute (IDIBGi), c/ del Dr. Castany, s/n, Salt, Girona, 17190 Catalonia Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra Spain
| | - Jordi Blanch
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Girona Biomedical Research Institute (IDIBGi), c/ del Dr. Castany, s/n, Salt, Girona, 17190 Catalonia Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra Spain
| | - Marc Comas-Cufí
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Dídac Parramon
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Centre d’Atenció Primària Santa Clara, Gerència d’Àmbit d’Atenció Primària Girona, Institut Català de la Salut, Girona, Spain
| | - María del Mar Garcia-Gil
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Rafel Ramos
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, University of Girona, Girona, Spain
| | - Irene Petersen
- Department of Primary Care and Population Health, University College of London, London, UK
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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149
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Vermund SH. The Vital Case for Global Health Investments by the US Government. Clin Infect Dis 2017; 64:707-710. [PMID: 28158519 PMCID: PMC10941300 DOI: 10.1093/cid/cix048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Sten H Vermund
- Vanderbilt Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
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150
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Kim J, Kim H. Influence of ambient temperature and diurnal temperature range on incidence of cardiac arrhythmias. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:407-416. [PMID: 27568189 DOI: 10.1007/s00484-016-1221-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
We investigated the association between ambient temperature and diurnal temperature range (DTR) and the exacerbation of arrhythmia symptoms, using data from 31,629 arrhythmia-related emergency department (ED) visits in Seoul, Korea. Linear regression analyses with allowances for over-dispersion were applied to temperature variables and ED visits, adjusted for various environmental factors. The effects were expressed as percentage changes in the risk of arrhythmia-related ED visits up to 5 days later, with 95 % confidence intervals (CI), per 1 °C increase in DTR and 1 °C decrease in mean temperature. The overall risk of ED visits increased by 1.06 % (95 % CI 0.39 %, 1.73 %) for temperature and by 1.84 % (0.34, 3.37 %) for DTR. A season-specific effect was detected for temperature during both fall (1.18 % [0.01, 2.37 %]) and winter (0.87 % [0.07, 1.67 %]), and for DTR during spring (3.76 % [0.34, 7.29 %]). Females were more vulnerable, with 1.57 % [0.56, 2.59 %] and 3.84 % [1.53, 6.20 %] for the changes in temperature and DTR, respectively. An age-specific effect was detected for DTR, with 3.13 % [0.95, 5.36 %] for age ≥ 65 years, while a greater increased risk with temperature decrease was observed among those aged <65 (1.08 % [0.17, 2.00 %]) than among those aged ≥65 (1.02 % [0.06, 1.99 %]). Cardiac arrest was inversely related with temperature (1.61 % [0.46, 2.79 %]), while other cardiac arrhythmias depended more on the change in DTR (4.72 % [0.37, 9.26 %]). These findings provide evidence that low-temperature and elevated DTR influence the occurrence of arrhythmia exacerbations or symptoms, suggesting a possible strategy for reducing risk by encouraging vulnerable populations to minimize exposure.
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Affiliation(s)
- Jayeun Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea.
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak_Gu, Seoul, 151-752, South Korea.
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