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Cao R, Wang Y, Huang J, He J, Ponsawansong P, Jin J, Xu Z, Yang T, Pan X, Prapamontol T, Li G. The Mortality Effect of Apparent Temperature: A Multi-City Study in Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4675. [PMID: 33924779 PMCID: PMC8124769 DOI: 10.3390/ijerph18094675] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/22/2022]
Abstract
(1) Background: The health effect of temperature has become a rising public health topic. The objective of this study is to assess the association between apparent temperature and non-accidental deaths, and the mortality burden attributed to cold and heat temperature; (2) Methods: The daily data on temperature and deaths were collected from 10 cities in Thailand, Korea and China. We fitted a time-series regression with a distributed lag nonlinear model (DLNM) to derive the health risk of temperature for each city and then pooled them to get the overall cumulative risk by multivariate meta-analysis. Additionally, we calculated the attributable fraction of deaths for heat and cold, which was defined as temperatures above and below minimum-mortality temperature (MMT); (3) Results: There are regional heterogeneities in the minimum mortality percentiles (MMP) and attributable fractions for different countries. The MMP varied from about the 5-10th percentile in Thailand to 63-93rd percentile in China and Korea. The attributable fractions of the total deaths due to short-term exposure to temperature in Asia is 7.62%, of which the cold effect (6.44%) is much higher than the heat effect (1.18%); (4) Conclusions: Our study suggested that apparent temperature was associated with an increase in non-accidental mortality. Most of the temperature-related mortality burden was attributable to cold, except for Thailand.
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Affiliation(s)
- Ru Cao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Jie He
- Peking University School of Nursing, 38 Xueyuan Road, Haidian District, Beijing 100191, China;
| | - Pitakchon Ponsawansong
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand; (P.P.); (T.P.)
| | - Jianbo Jin
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand; (P.P.); (T.P.)
| | - Tippawan Prapamontol
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang Mai 50200, Thailand; (P.P.); (T.P.)
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (R.C.); (Y.W.); (J.H.); (J.J.); (Z.X.); (T.Y.); (X.P.)
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152
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Gu HJ, Peng L, Jiang WC, Tan YM, Zhou GJ, Kan HD, Chen RJ, Zou Y. Impact of solar ultraviolet radiation on daily outpatient visits of atopic dermatitis in Shanghai, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:18081-18088. [PMID: 33405118 DOI: 10.1007/s11356-020-11907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
The potential roles of solar ultraviolet radiation (UVR) as an environmental risk factor in inducing atopic dermatitis (AD) have not been well quantified. To determine the short-term associations between UVR and AD outpatient visits, we obtained daily outpatient visits of AD in Shanghai Skin Disease Hospital from 2013 to 2018. Data of hourly ground UVR were collected. We applied overdispersed generalized additive model to explore its associations. We found that daily exposure to UVR-A rather than UVR-B was positively associated with AD outpatient visits. The visits increased on the present day (lag 0 days) and decreased appreciably with longer lags and became insignificant at lag 4 days. For 10 w/m2 increase in daytime mean and noontime mean exposure to overall UVR and UVR-A from lag 0 to 6 days, the cumulative relative risk of AD was 1.12/1.13 and 1.08/1.08, respectively. Stronger effects of UVR exposure on AD occurred in patients aged 0-7 and > 45 years and in the cold seasons. This study contributed to the few epidemiological evidences that acute exposure to solar UVR may elevate the risks of AD.
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Affiliation(s)
- Hui-Jing Gu
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai, 200443, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, 166 Puxi Road, Xuhui District, Shanghai, 200030, China
| | - Wen-Cai Jiang
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai, 200443, China
- NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Zhangheng Road, Pudong New District, Shanghai, 201203, China
| | - Yi-Mei Tan
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai, 200443, China
- NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Zhangheng Road, Pudong New District, Shanghai, 201203, China
| | - Guo-Jiang Zhou
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai, 200443, China
- Xiangya School of Public Health, Central South University, 238 Shang Ma Yuan Ling Lane, Changsha, 410078, China
| | - Hai-Dong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Ren-Jie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai, 200032, China
| | - Ying Zou
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai, 200443, China.
- NMPA Key Laboratory for Monitoring and Evaluation of Cosmetics, Zhangheng Road, Pudong New District, Shanghai, 201203, China.
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153
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Wang Y, Li J, Wang L, Lin Y, Zhou M, Yin P, Yao S. The impact of carbon monoxide on years of life lost and modified effect by individual- and city-level characteristics: Evidence from a nationwide time-series study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 210:111884. [PMID: 33421716 DOI: 10.1016/j.ecoenv.2020.111884] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
Ambient carbon monoxide (CO) has been linked with mortality and morbidity. Little evidence is available regarding the relation between CO and years of life lost (YLL). Using data from 48 major cities in China from 2013 to 2017, we applied generalized additive models and random effects meta-analyses to explore the effects of CO on YLL from various diseases. Stratified analyses and meta-regression were performed to estimate potential effect modifications of demographic factors, regions, meteorological factors, co-pollutants, urbanization rate, economic level and health service level. Additional life gains due to avoidable YLL under certain scenario were also evaluated. Results indicated that a 1-mg/m³ increase of CO concentrations (lagged over 0-3 d), was associated with 2.08% (95% confidence interval [CI], 1.35%, 2.80%), 2.35% (95% CI: 1.39%, 3.30%), 1.47% (95% CI: -0.01%, 2.93%), 2.28% (95% CI: 1.09%, 3.47%), 2.42% (95% CI: 1.31%, 3.54%), 2.09% (95% CI: 0.47%, 3.72%) increments in daily YLL from non-accidental causes, cardiovascular diseases, respiratory diseases, coronary heart disease, stroke and chronic obstructive pulmonary disease, respectively. These associations were robust to the adjustment of co-pollutants and varied substantially by geography and demographic characteristics. Associations were stronger in the elder people (≥65 years), females, population with low education attainment, and lived in south region, than younger people, males, high educated populations and those lived in north region. Moreover, the harmful impact of increasing CO concentration could be attenuated by city-level characteristics, including the growth of urbanization rate, gross domestic product (GDP), GDP per capita, number of hospital beds, doctors and hospitals. Finally, an estimated life of 0.081 (95% CI: -0.027, 0.190) years would be gained per deceased people if CO concentration could fall to 1 mg/m3. In conclusions, this nationwide analysis showed significant associations between short-term CO exposure and cause-specific YLL. The heterogeneity of both individual- and city-level characteristics should be considered for relevant intervention. These findings may have significant public health implications for the reduction of CO-attributed disease burden in China.
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Affiliation(s)
- Yu Wang
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jie Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yun Lin
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Shanglong Yao
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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154
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Liu T, Zhou C, Zhang H, Huang B, Xu Y, Lin L, Wang L, Hu R, Hou Z, Xiao Y, Li J, Xu X, Jin D, Qin M, Zhao Q, Gong W, Yin P, Xu Y, Hu J, Xiao J, Zeng W, Li X, Chen S, Guo L, Rong Z, Zhang Y, Huang C, Du Y, Guo Y, Rutherford S, Yu M, Zhou M, Ma W. Ambient Temperature and Years of Life Lost: A National Study in China. Innovation (N Y) 2021; 2:100072. [PMID: 34557729 PMCID: PMC8454660 DOI: 10.1016/j.xinn.2020.100072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/12/2020] [Indexed: 12/27/2022] Open
Abstract
Although numerous studies have investigated premature deaths attributable to temperature, effects of temperature on years of life lost (YLL) remain unclear. We estimated the relationship between temperatures and YLL, and quantified the YLL per death caused by temperature in China. We collected daily meteorological and mortality data, and calculated the daily YLL values for 364 locations (2013–2017 in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces, and 2006–2011 in other locations) in China. A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates (YLL/100,000 population), and a multivariate meta-analysis model was used to pool location-specific associations. Then, YLL per death caused by temperatures was calculated. The temperature and YLL rates consistently showed U-shaped associations. A mean of 1.02 (95% confidence interval: 0.67, 1.37) YLL per death was attributable to temperature. Cold temperature caused 0.98 YLL per death with most from moderate cold (0.84). The mean YLL per death was higher in those with cardiovascular diseases (1.14), males (1.15), younger age categories (1.31 in people aged 65–74 years), and in central China (1.34) than in those with respiratory diseases (0.47), females (0.87), older people (0.85 in people ≥75 years old), and northern China (0.64) or southern China (1.19). The mortality burden was modified by annual temperature and temperature variability, relative humidity, latitude, longitude, altitude, education attainment, and central heating use. Temperatures caused substantial YLL per death in China, which was modified by demographic and regional characteristics. Years of life lost (YLL) is used to estimate the effects of temperature Both low and high temperatures can increase the YLLs Average 1.02 YLL per death is attributed to temperature exposure Temperature causes larger YLLs per death in males, younger people, and central China
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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
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Haoming Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Biao Huang
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lijun Wang
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Ruying Hu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhulin Hou
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Junhua Li
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Mingfang Qin
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Qinglong Zhao
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, 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
| | - Siqi Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yaodong Du
- Guangdong Provincial Climate Center, Guangzhou, 510080, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | | | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
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155
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Yang J, Zhou M, Ren Z, Li M, Wang B, Liu DL, Ou CQ, Yin P, Sun J, Tong S, Wang H, Zhang C, Wang J, Guo Y, Liu Q. Projecting heat-related excess mortality under climate change scenarios in China. Nat Commun 2021; 12:1039. [PMID: 33589602 PMCID: PMC7884743 DOI: 10.1038/s41467-021-21305-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 01/21/2021] [Indexed: 01/31/2023] Open
Abstract
Recent studies have reported a variety of health consequences of climate change. However, the vulnerability of individuals and cities to climate change remains to be evaluated. We project the excess cause-, age-, region-, and education-specific mortality attributable to future high temperatures in 161 Chinese districts/counties using 28 global climate models (GCMs) under two representative concentration pathways (RCPs). To assess the influence of population ageing on the projection of future heat-related mortality, we further project the age-specific effect estimates under five shared socioeconomic pathways (SSPs). Heat-related excess mortality is projected to increase from 1.9% (95% eCI: 0.2-3.3%) in the 2010s to 2.4% (0.4-4.1%) in the 2030 s and 5.5% (0.5-9.9%) in the 2090 s under RCP8.5, with corresponding relative changes of 0.5% (0.0-1.2%) and 3.6% (-0.5-7.5%). The projected slopes are steeper in southern, eastern, central and northern China. People with cardiorespiratory diseases, females, the elderly and those with low educational attainment could be more affected. Population ageing amplifies future heat-related excess deaths 2.3- to 5.8-fold under different SSPs, particularly for the northeast region. Our findings can help guide public health responses to ameliorate the risk of climate change.
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Affiliation(s)
- Jun Yang
- grid.258164.c0000 0004 1790 3548Institute for Environmental and Climate Research, Jinan University, Guangzhou, China ,Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, China ,grid.258164.c0000 0004 1790 3548JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou, China
| | - Maigeng Zhou
- grid.508400.9National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Zhoupeng Ren
- grid.9227.e0000000119573309State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Mengmeng Li
- grid.488530.20000 0004 1803 6191State Key Laboratory of Oncology in Southern China, Department of Epidemiology, Cancer Prevention Center, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Boguang Wang
- grid.258164.c0000 0004 1790 3548Institute for Environmental and Climate Research, Jinan University, Guangzhou, China ,Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, China ,grid.258164.c0000 0004 1790 3548JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou, China
| | - De Li Liu
- grid.1680.f0000 0004 0559 5189NSW Department of Primary Industries, Wagga Wagga Agricultural Institute, Wagga Wagga, NSW Australia ,grid.1005.40000 0004 4902 0432Climate Change Research Centre, University of New South Wales, Sydney, NSW Australia
| | - Chun-Quan Ou
- grid.284723.80000 0000 8877 7471State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Peng Yin
- grid.508400.9National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Jimin Sun
- grid.198530.60000 0000 8803 2373State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shilu Tong
- grid.16821.3c0000 0004 0368 8293Shanghai Children’s Medical Center, Shanghai Jiao Tong University, Shanghai, China ,grid.186775.a0000 0000 9490 772XSchool of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China ,grid.1024.70000000089150953School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Hao Wang
- grid.258164.c0000 0004 1790 3548Institute for Environmental and Climate Research, Jinan University, Guangzhou, China ,Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, China ,grid.258164.c0000 0004 1790 3548JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou, China
| | - Chunlin Zhang
- grid.258164.c0000 0004 1790 3548Institute for Environmental and Climate Research, Jinan University, Guangzhou, China ,Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, China ,grid.258164.c0000 0004 1790 3548JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou, China
| | - Jinfeng Wang
- grid.9227.e0000000119573309State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Yuming Guo
- grid.1002.30000 0004 1936 7857Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Qiyong Liu
- grid.198530.60000 0000 8803 2373State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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156
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Li H, Yao Y, Duan Y, Liao Y, Yan S, Liu X, Zhao Z, Fu Y, Yin P, Cheng J, Jiang H. Years of life lost and mortality risk attributable to non-optimum temperature in Shenzhen: a time-series study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:187-196. [PMID: 32054993 DOI: 10.1038/s41370-020-0202-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/15/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
To assess YLL and mortality burden attributable to non-optimum ambient temperature, we collected mortality and environmental data from June 1, 2012 to December 30, 2017 in Shenzhen. We applied distributed lag nonlinear models with 21 days of lag to examine temperature-YLL and temperature-mortality associations, and calculated the attributable fractions of YLL and deaths for non-optimum temperature, including four subranges, mild cold, mild heat, extreme cold, and extreme heat. Cold and heat were distinguished by the optimum temperature, and each was separated into extreme and mild by cutoffs at 2.5th (12.2 °C) and 97.5th (30.4 °C) temperature percentile further. The optimum temperature was defined as the temperature that had minimum effect on YLL or mortality risk. The optimum temperature for non-accidental YLL was 24.5 °C, and for mortality it was 25.4 °C. Except for the population older than 65 years, the optimum temperature was generally lower in the YLL model than the mortality model. Of the total 61,576 non-accidental deaths and 1,350,835.7 YLL within the study period, 17.28% (95% empirical CI 9.42-25.14%) of YLL and 17.27% (12.70-21.34%) of mortality were attributable to non-optimum temperature. More YLL was caused by cold (10.14%, 3.94-16.36%) than by heat (7.14%, 0.47-13.88%). Mild cold (12.2-24.5 °C) was responsible for far more YLL (8.78%, 3.00-14.61%) than extreme cold (3.5-12.2 °C). As for cardiovascular deaths, only the fractions attributable to overall and cold temperature were significant, with mild cold contributing the largest fraction to YLL (16.31%, 6.85-25.82%) and mortality (16.08%, 9.77-21.22%). Most of the temperature-related YLL and mortality was attributable to mild but non-optimum weather, especially mild cold, while the YLL model implied a more prominent heat effect on premature death. Our findings can supply additional evidence from multiperspectives for health planners to define priorities and make targeted policies for mitigating the burden of adverse temperatures.
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Affiliation(s)
- Hongyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Yao Yao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Yi Liao
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Xuehan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Zhiguang Zhao
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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157
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Wang H, Yin P, Fan W, Wang Y, Dong Z, Deng Q, Zhou M. Mortality Risk Associated with Short-Term Exposure to Particulate Matter in China: Estimating Error and Implication. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:1110-1121. [PMID: 33372762 DOI: 10.1021/acs.est.0c05095] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Most previous studies used a specific size of particulate matter (PMx) for dosimetry estimation when determining particulate matter (PM)-associated risk, which precluded the impact of other sizes of PM. Here, we used a multiple-path particle dosimetry model to determine the deposition of PM in human airways and further estimated the associated mortality risk in 205 cities in China. Results showed that the fractions of PM1, PM1-2.5, and coarse PM (PM2.5-10) deposited in the tracheobronchial (TB) and pulmonary airways were estimated in ranges of 11.06-12.83, 19.9-26.37, and 5.35-9.81%, respectively. Each 10 μg/m3 increase in deposited PM was significantly associated with a nationwide increment of 1.12% (95% confidence interval, CI, 0.77-1.49%) for total nonaccidental mortality. Short-term exposure to PM during 2014-2017 resulted in a nationwide mortality of 98 826 cases/year, with contributions from PM1, PM1-2.5, coarse PM of 37.7, 43.1, and 19.2%, respectively. Our study demonstrated that the estimated mortality counts may be associated with the coefficient of variation of dosimetry estimations. In addition, we revealed the caution should be exercised when interpreting PMx-associated risk and further reinforced the importance of size distribution in relevant research.
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Affiliation(s)
- Hao Wang
- School of Space and Environment, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Wenhong Fan
- School of Space and Environment, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
| | - Ying Wang
- School of Space and Environment, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
| | - Zhaomin Dong
- School of Space and Environment, Beihang University, Beijing 100191, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
- Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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158
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Zhu G, Zhu Y, Wang Z, Meng W, Wang X, Feng J, Li J, Xiao Y, Shi F, Wang S. The association between ambient temperature and mortality of the coronavirus disease 2019 (COVID-19) in Wuhan, China: a time-series analysis. BMC Public Health 2021; 21:117. [PMID: 33430851 PMCID: PMC7797893 DOI: 10.1186/s12889-020-10131-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/25/2020] [Indexed: 01/08/2023] Open
Abstract
Background The COVID-19 has caused a sizeable global outbreak and has been declared as a public health emergency of international concern. Sufficient evidence shows that temperature has an essential link with respiratory infectious diseases. The objectives of this study were to describe the exposure-response relationship between ambient temperature, including extreme temperatures, and mortality of COVID-19. Methods The Poisson distributed lag non-linear model (DLNM) was constructed to evaluate the non-linear delayed effects of ambient temperature on death, by using the daily new death of COVID-19 and ambient temperature data from January 10 to March 31, 2020, in Wuhan, China. Results During the period mentioned above, the average daily number of COVID-19 deaths was approximately 45.2. Poisson distributed lag non-linear model showed that there was a non-linear relationship (U-shape) between the effect of ambient temperature and mortality. With confounding factors controlled, the daily cumulative relative death risk decreased by 12.3% (95% CI [3.4, 20.4%]) for every 1.0 °C increase in temperature. Moreover, the delayed effects of the low temperature are acute and short-term, with the most considerable risk occurring in 5–7 days of exposure. The delayed effects of the high temperature appeared quickly, then decrease rapidly, and increased sharply 15 days of exposure, mainly manifested as acute and long-term effects. Sensitivity analysis results demonstrated that the results were robust. Conclusions The relationship between ambient temperature and COVID-19 mortality was non-linear. There was a negative correlation between the cumulative relative risk of death and temperature. Additionally, exposure to high and low temperatures had divergent impacts on mortality.
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Affiliation(s)
- Gaopei Zhu
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Yuhang Zhu
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China.,Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W 29, 20246, Hamburg, Germany
| | - Zhongli Wang
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People's Republic of China
| | - Weijing Meng
- School of Life Sciences and Technology, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Xiaoxuan Wang
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Jianing Feng
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Juan Li
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Yufei Xiao
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China
| | - Fuyan Shi
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China.
| | - Suzhen Wang
- Department of Health Statistics, School of Public Health, Weifang Medical University, No. 7166 Baotong West Street, Weifang, 261053, People's Republic of China.
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159
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Ruan Z, Qi J, Yin P, Qian Z(M, Liu J, Liu Y, Yang Y, Li H, Zhang S, Howard SW, Lin H, Wang L. Prolonged Life Expectancy for Those Dying of Stroke by Achieving the Daily PM 2.5 Targets. GLOBAL CHALLENGES (HOBOKEN, NJ) 2020; 4:2000048. [PMID: 33304609 PMCID: PMC7713556 DOI: 10.1002/gch2.202000048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Indexed: 05/11/2023]
Abstract
This time-series study collects data on stroke-related mortality, years of life lost (YLL), air pollution, and meteorological conditions in 96 Chinese cities from 2013 to 2016 and proposes a three-stage strategy to generate the national and regional estimations of avoidable YLL, gains in life expectancy and stroke-related population attributable fraction by postulating that the daily fine particulate matter (PM2.5) has been kept under certain standards. A total of 1 318 911 stroke deaths are analyzed. Each 10 µg m-3 increment in PM2.5 at lag03 is associated with a city-mean increase of 0.31 (95% CI: 0.19, 0.44) years of life lost from stroke. A number of 914.11 (95% CI: 538.28, 1288.94) years of city-mean life lost from stoke could be avoided by attaining the WHO's Air Quality Guidelines (AQG) (25 µg m-3). Moreover, by applying the AQG standard, 0.11 (0.08, 0.15) years of life lost might be prevented for each death, and about 0.91% (95% CI: 0.62%, 1.19%) of the total years of life lost from stroke might be explained by the daily excess PM2.5 exposure. This study indicates that stroke patients can have a longer life expectancy if stricter PM2.5 standards are put in place, especially ischemic stroke patients.
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Affiliation(s)
- Zengliang Ruan
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Zhengmin (Min) Qian
- Department of Epidemiology and BiostatisticsCollege for Public Health & Social JusticeSaint Louis UniversitySaint LouisMO63104USA
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
| | - Yin Yang
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Huan Li
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Shiyu Zhang
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Steven W. Howard
- Department of Health Management & PolicyCollege for Public Health & Social JusticeSaint Louis UniversitySaint LouisMO63104USA
| | - Hualiang Lin
- Department of EpidemiologySchool of Public HealthSun Yat‐Sen UniversityGuangzhou510080China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijing100050China
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160
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Qiu H, Wang L, Zhou L, Pan J. Coarse particles (PM 2.5-10) and cause-specific hospitalizations in southwestern China: Association, attributable risk and economic costs. ENVIRONMENTAL RESEARCH 2020; 190:110004. [PMID: 32745536 DOI: 10.1016/j.envres.2020.110004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
The short-term morbidity effects of the coarse particle (diameter in 2.5-10 μm, PM2.5-10), as well as the corresponding morbidity burden and economic costs, remain understudied, especially in developing countries. This study aimed to examine the associations of PM2.5-10 with cause-specific hospitalizations in a multi-city setting in southwestern China and assess the attributable risk and economic costs. City-specific associations were firstly estimated using generalized additive models with quasi-poisson distribution to handle over-dispersion, and then combined to obtain the regional average association. City-specific and pooled concentration-response (C-R) associations of PM2.5-10 with cause-specific hospitalizations were also modeled. Subgroup analyses were performed by age, sex, season and region. The health and economic burden of hospitalizations for multiple outcomes due to PM2.5-10 were further evaluated. A total of 4,407,601 non-accidental hospitalizations were collected from 678 hospitals. The estimates of percentage change in hospitalizations per 10 μg/m³ increase in PM2.5-10 at lag01 was 0.68% (95%CI: 0.33%-1.03%) for non-accidental causes, 0.86% (95% CI: 0.36%-1.37%) for circulatory diseases, 1.52% (95% CI: 1.00%-2.05%) for respiratory diseases, 1.08% (95% CI: 0.47%-1.69%) for endocrine diseases, 0.66% (95% CI: 0.12%-1.21%) for nervous system diseases, and 0.84% (95% CI: 0.42%-1.25%) for genitourinary diseases, respectively. The C-R associations of PM2.5-10 with cause-specific hospitalizations suggested some evidence of nonlinearity, except for endocrine diseases. Meanwhile, the adverse effects were modified by age and season. Overall, about 0.70% (95% CI: 0.35%-1.06%) of non-accidental hospitalizations and 0.78% (95% CI: 0.38%-1.17%) of total hospitalization expenses could be attributed to PM2.5-10. The largest morbidity burden and economic costs were observed in respiratory diseases. Our findings indicate that PM2.5-10 exposure may increase the risk of hospitalizations for multiple outcomes, and account for considerable morbidity and economic burden.
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Affiliation(s)
- Hang Qiu
- School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China; Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China.
| | - Liya Wang
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Zhou
- Health Information Center of Sichuan Province, Chengdu, China
| | - Jingping Pan
- Health Information Center of Sichuan Province, Chengdu, China
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161
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Zhan ZY, Tian Q, Chen TT, Ye Y, Lin Q, Han D, Ou CQ. Temperature Variability and Hospital Admissions for Chronic Obstructive Pulmonary Disease: Analysis of Attributable Disease Burden and Vulnerable Subpopulation. Int J Chron Obstruct Pulmon Dis 2020; 15:2225-2235. [PMID: 33061340 PMCID: PMC7519840 DOI: 10.2147/copd.s260988] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is a major cause of chronic diseases causing considerable social and economic burden globally. Despite substantial evidence on temperature-COPD association, few studies have investigated the acute effect of temperature variability (TV), a potential trigger of exacerbation of COPD disease, and it remains unknown what fraction of the disease burden of COPD is attributable to TV. Patients and Methods Based on 71,070 COPD hospitalizations during 2013–2015 in Guangzhou, China, we conducted a time-series analysis using quasi-Poisson regression to assess the association between TV and hospital admission for COPD after adjusting for daily mean temperature. Short-term TV was captured by the standard deviation of hourly or daily temperatures across various exposure days. We also provided the fraction (total number) of COPD attributable to TV. Stratified analyses by admission route, sex, age, occupation, marital status and season were performed to identify vulnerable subpopulations. Results We found a linear relationship between TV and COPD hospitalization, with a 1°C increase in hourly TV and daily TV associated with 4.3% (95%CI: 2.2–6.4) and 4.0% (2.3–5.8) increases in COPD, respectively. The greater relative risks of TV identified males, people aged 0–64 years, blue collar, and divorced/widowed people as vulnerable population. There were 12.0% (8500 cases) of COPD hospitalization attributable to hourly TV during the study period. Daily TV produced similar estimates of relative effects (relative risk) but grater estimates of absolute effects (attributable fraction) than hourly TV. Conclusion We concluded that TV was an independent risk factor of COPD morbidity, especially among the susceptible subgroups. These findings would be helpful to guide the development of targeted public intervention.
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Affiliation(s)
- Zhi-Ying Zhan
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China.,Department of Health Care Management and Social Medicine, School of Public Health, Fujian Medical University, Fuzhou, People's Republic of China
| | - Qi Tian
- Department of Information Resources, Guangzhou Health Information Center, Guangzhou, People's Republic of China
| | - Ting-Ting Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Yunshao Ye
- Department of Information Resources, Guangzhou Health Information Center, Guangzhou, People's Republic of China
| | - Qiaoxuan Lin
- Department of Information Resources, Guangzhou Health Information Center, Guangzhou, People's Republic of China
| | - Dong Han
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
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162
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Chen S, Xiao Y, Zhou M, Zhou C, Yu M, Huang B, Xu Y, Liu T, Hu J, Xu X, Lin L, Hu R, Hou Z, Li J, Jin D, Qin M, Zhao Q, Gong W, Yin P, Xu Y, Xiao J, Zeng W, Li X, Guo L, Zhang Y, Huang C, Ma W. Comparison of life loss per death attributable to ambient temperature among various development regions: a nationwide study in 364 locations in China. Environ Health 2020; 19:98. [PMID: 32933549 PMCID: PMC7491140 DOI: 10.1186/s12940-020-00653-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/08/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Several studies have investigated the associations between ambient temperature and years of life lost (YLLs), but few focused on the difference of life loss attributable to temperature among different socioeconomic development levels. OBJECTIVES We investigated the disparity in temperature-YLL rate relationships and life loss per death attributable to nonoptimal temperature in regions with various development levels. METHODS Three hundred sixty-four Chinese counties or districts were classified into 92 high-development regions (HDRs) and 272 low-development regions (LDRs) according to socioeconomic factors of each location using K-means clustering approach. We used distributed lag non-linear models (DLNM) and multivariate meta-analysis to estimate the temperature-YLL rate relationships. We calculated attributable fraction (AF) of YLL and temperature-related average life loss per death to compare mortality burden of temperature between HDRs and LDRs. Stratified analyses were conducted by region, age, sex and cause of death. RESULTS We found that non-optimal temperatures increased YLL rates in both HDRs and LDRs, but all subgroups in LDRs were more vulnerable. The disparity of cold effects between HDRs and LDRs was significant, while the difference in heat effect was insignificant. The overall AF of non-optimal temperature in LDRs [AF = 12.2, 95% empirical confidence interval (eCI):11.0-13.5%] was higher than that in HDRs (AF = 8.9, 95% eCI: 8.3-9.5%). Subgroups analyses found that most groups in LDRs had greater AFs than that in HDRs. The average life loss per death due to non-optimal temperature in LDRs (1.91 years, 95% eCI: 1.72-2.10) was also higher than that in HDRs (1.32 years, 95% eCI: 1.23-1.41). Most of AFs and life loss per death were caused by moderate cold in both HDRs and LDRs. CONCLUSIONS Mortality burden caused by temperature was more significant in LDRs than that in HDRs, which means that more attention should be paid to vulnerable populations in LDRs in planning adaptive strategies.
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Affiliation(s)
- Siqi Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022 China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050 China
| | - Chunliang Zhou
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Ruying Hu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Junhua Li
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Donghui Jin
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Mingfang Qin
- Yunnan Center for Disease Control and Prevention, Kunming, 650022 China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050 China
| | - Yiqing Xu
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
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163
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Affiliation(s)
- Raymond B Huey
- Department of Biology, University of Washington, Seattle, WA, USA.
| | - Michael R Kearney
- School of BioSciences, University of Melbourne, Melbourne, Victoria 3010, Australia
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164
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Zhang Y, Wang S, Zhang X, Hu Q, Zheng C. Association between moderately cold temperature and mortality in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:26211-26220. [PMID: 32361971 DOI: 10.1007/s11356-020-08960-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
Ambient air temperature is a key factor affecting human health. Adverse effects of extreme weather on mortality have been well explored and expounded in numerous epidemiological studies. The relationship between moderate temperature and mortality is, however, underexplored. This study quantitatively investigated the temperature-dependent mortality burden in China. Data on daily average temperature and mortality in 15 Chinese cities during 2010-2016 were collected for this study. The association between temperature and city-specific mortality was investigated with a quasi-Poisson regression combined with a distributed lag nonlinear model across lag 0-21 days. The results were then included in a multivariate meta-analysis to derive the pooled estimates of the effect of temperature on mortality at the multi-city level. Mortality fractions attributable to cold and heat (i.e., at temperatures below and above the minimum mortality temperature (MMT)) were calculated. Additionally, temperature ranges were further divided into 1 °C intervals of ambient temperature, and the attributable fractions were calculated for each range. The MMT varied from the 71th to 93th percentiles of temperature in the 15 Chinese cities, centering at the 78th percentile at the multi-city level. In total, 12.65% of non-accidental mortality was attributable to non-optimum temperature, of which cold and hot temperatures corresponded to attributable fractions of 11.38% and 1.27%, respectively. The results of temperature stratifications suggested that moderately cold temperatures provided the highest contribution to mortality caused by temperature. Specifically, the highest attributable fractions were at 7 °C, 7 °C, 8 °C, 8 °C, 4 °C, 4 °C, 5 °C, 7 °C, 7 °C, 4 °C, 5 °C, 5 °C, 6 °C, 11 °C, and 12 °C, for Harbin, Changchun, Shenyang, Urumqi, Beijing, Tianjin, Shijiazhuang, Xining, Lanzhou, Nanjing, Shanghai, Hefei, Chengdu, Kunming, and Guangzhou, respectively. Cold temperature was responsible for a higher proportion of deaths than heat. Moderate cold temperature contributed to most of the total health burden. Finally, the cumulative total counts of deaths caused by moderate cold were the largest. Although moderate cold conferred a slightly lower relative risk than extreme cold, it was more common than extreme cold. Taken together, our results show that the effects of moderate cold temperature on health should receive more attention. Furthermore, our findings could help improve the prediction of climate change effects on human health and support the development of response strategies for the changing climate.
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Affiliation(s)
- Ying Zhang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610000, Sichuan, China.
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610000, Sichuan, China
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Xiaoling Zhang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610000, Sichuan, China
- Institute of Urban Meteorology, CMA, Beijing, 100089, China
| | - Qin Hu
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610000, Sichuan, China
| | - CanJun Zheng
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155, Changbai Road, Changping, Beijing, 102206, China
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165
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Chen K, Vicedo-Cabrera AM, Dubrow R. Projections of Ambient Temperature- and Air Pollution-Related Mortality Burden Under Combined Climate Change and Population Aging Scenarios: a Review. Curr Environ Health Rep 2020; 7:243-255. [PMID: 32542573 DOI: 10.1007/s40572-020-00281-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Climate change will affect mortality associated with both ambient temperature and air pollution. Because older adults have elevated vulnerability to both non-optimal ambient temperature (heat and cold) and air pollution, population aging can amplify future population vulnerability to these stressors through increasing the number of vulnerable older adults. We aimed to review recent evidence on projections of temperature- or air pollution-related mortality burden (i.e., number of deaths) under combined climate change and population aging scenarios, with a focus on evaluating the role of population aging in assessing these health impacts of climate change. We included studies published between 2014 and 2019 with age-specific population projections. RECENT FINDINGS We reviewed 16 temperature projection studies and 15 air pollution projection studies. Nine of the temperature studies and four of the air pollution studies took population aging into account by performing age-stratified analyses that utilized age-specific relationships between temperature or air pollution exposures and mortality (i.e., age-specific exposure-response functions (ERFs)). Population aging amplifies the projected mortality burden of temperature and air pollution under a warming climate. Compared with a constant population scenario, population aging scenarios lead to less reduction or even increases in cold-related mortality burden, resulting in substantial net increases in future overall (heat and cold) temperature-related mortality burden. There is strong evidence suggesting that to accurately assess the future temperature- and air pollution-related mortality burden of climate change, investigators need to account for the amplifying effect of population aging. Thus, all future studies should incorporate age-specific population size projections and age-specific ERFs into their analyses. These studies would benefit from refinement of age-specific ERF estimates.
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Affiliation(s)
- Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA. .,Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, 43 Mittelstrasse, 3012, Bern, Switzerland.,Oeschger Center for Climate Change Research, University of Bern, 4 Hochschulstrasse, 3012, Bern, Switzerland
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.,Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
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166
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Association between ambient temperature and hypertensive disorders in pregnancy in China. Nat Commun 2020; 11:2925. [PMID: 32522990 PMCID: PMC7286884 DOI: 10.1038/s41467-020-16775-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
Hypertensive disorders in pregnancy (HDPs) are leading perinatal diseases. Using a national cohort of 2,043,182 pregnant women in China, we evaluated the association between ambient temperatures and HDP subgroups, including preeclampsia or eclampsia, gestational hypertension, and superimposed preeclampsia. Under extreme temperatures, very cold exposure during preconception (12 weeks) increases odds of preeclampsia or eclampsia and gestational hypertension. Compared to preconception, in the first half of pregnancy, the impact of temperature on preeclampsia or eclampsia and gestational hypertension is opposite. Cold exposure decreases the odds, whereas hot exposure increases the odds. Under average temperatures, a temperature increase during preconception decreases the risk of preeclampsia or eclampsia and gestational hypertension. However, in the first half of pregnancy, temperature is positively associated with a higher risk. No significant association is observed between temperature and superimposed preeclampsia. Here we report a close relationship exists between ambient temperature and preeclampsia or eclampsia and gestational hypertension. Hypertensive disorders in pregnancy are prevalent perinatal diseases. Here the authors report an association between ambient temperature before or after conception and risk of preeclampsia or eclampsia and gestational hypertension.
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167
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Qiu H, Xia X, Man CL, Ko FWS, Yim SHL, Kwok TCY, Ho KF. Real-Time Monitoring of the Effects of Personal Temperature Exposure on the Blood Oxygen Saturation Level in Elderly People with and without Chronic Obstructive Pulmonary Disease: A Panel Study in Hong Kong. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:6869-6877. [PMID: 32363866 DOI: 10.1021/acs.est.0c01799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Few studies have investigated the short-term effect of personal temperature exposure on blood oxygen saturation (SpO2). We conducted this longitudinal panel study with real-time monitoring of SpO2 and environmental exposure for 3 continuous days for 20 patients with chronic obstructive pulmonary disease (COPD) and 20 healthy volunteers in Hong Kong, to explore the time course (from minutes to hours) of change in SpO2 in response to temperature in elderly people. We employed a generalized additive mixed model to evaluate the acute effects of personal temperature exposure on changes in SpO2 and risk of oxygen desaturation while adjusting for seasonality, environmental co-exposures, and personal characteristics. We observed a concurrent decline in SpO2 by 0.27% (95% confidence interval [CI]: 0.22-0.32%) and an increase in the risk of oxygen desaturation by an OR of 1.14 (95% CI, 1.10-1.18) associated with a 1 °C increase in personal temperature, and the association lasted over several hours. Results showed that the decline in SpO2 in elderly people was associated with an increase in personal temperature exposure within minutes to hours, particularly in women and male patients with COPD. Temperature-induced oxygen desaturation may play a pivotal role in COPD exacerbation.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
| | - Xi Xia
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Chung Ling Man
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Fanny W S Ko
- Division of Respiratory Medicine, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Steve H L Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, HKSAR, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
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168
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Zhang Y, Wang S, Zhang X, Ni C, Zhang J, Zheng C. Temperature modulation of the adverse consequences on human mortality due to exposure to fine particulates: A study of multiple cities in China. ENVIRONMENTAL RESEARCH 2020; 185:109353. [PMID: 32222628 DOI: 10.1016/j.envres.2020.109353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/25/2020] [Accepted: 03/04/2020] [Indexed: 05/26/2023]
Abstract
Exposure to particulate matter of smaller than 2.5 μm in diameter (PM2.5) is linked to increased human mortality, and could be further complicated by concurrent ambient air temperatures. Published reports indicate that the association between ambient temperatures and mortality due to PM2.5 exposure is dissimilar across different geographic areas. Thus, it is unclear how ambient temperatures at different geographic locations can together modulate the influence of PM2.5 on mortality. In this paper, we examined how temperature modulated the association between mortality and PM2.5 exposure in 15 Chinese cities during 2014-2016. For analysis, First, Poisson generalized additive models under different temperature stratifications (<10th, 10-90th, and >90th temperature percentiles) was used to estimate PM2.5 associations to mortality, which were specific to different cities. Second, we used a meta-analysis to combine the effects at each temperature stratum and region (southern and northern China). Results revealed that high temperatures (daily mean temperature >90th percentile) robustly amplified observed associations of mortality and PM2.5 exposure, and the modifications were heterogeneous geographically. In the northern regions, a 10 μg/m3 increment in PM2.5 was associated with 0.18%, 0.28%, and 1.54% increase in non-accidental mortalities and 0.33%, 0.39%, and 1.32% increase in cardiovascular mortalities at low, moderate, and high temperature levels, respectively. In the southern regions, a 10 μg/m3 increment in PM2.5 was associated with 0.52%, 0.62%, and 1.90% increase in non-accidental mortalities and 0.55%, 0.98%, and 2.25% increase in cardiovascular mortalities at low, moderate, and high temperature levels, respectively. It is concluded that temperature altered PM2.5-mortality associations in southern and northern China synergistically, but the effect was more pronounced in the south. Therefore, geography and temperature need to be considered when studying how PM2.5 affects health.
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Affiliation(s)
- Ying Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China; State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China.
| | - Shigong Wang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Xiaoling Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China; Institute of Urban Meteorology, China Meteorological Administration, Beijing, 100089, China
| | - Changjian Ni
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Jie Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Canjun Zheng
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
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169
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Lian T, Fu Y, Sun M, Yin M, Zhang Y, Huang L, Huang J, Xu Z, Mao C, Ni J, Liu G. Effect of temperature on accidental human mortality: A time-series analysis in Shenzhen, Guangdong Province in China. Sci Rep 2020; 10:8410. [PMID: 32439880 PMCID: PMC7242478 DOI: 10.1038/s41598-020-65344-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 05/01/2020] [Indexed: 12/16/2022] Open
Abstract
Health-risk assessments of temperature are central to determine total non-accidental human mortality; however, few studies have investigated the effect of temperature on accidental human mortality. We performed a time-series study combined with a distributed lag non-linear model (DLNM) to quantify the non-linear and delayed effects of daily mean temperature on accidental human mortality between 2013 and 2017 in Shenzhen, China. The threshold for effects of temperature on accidental human mortality occurred between 5.6 °C and 18.5 °C. Cold exposures, but not hot exposures, were significantly associated with accidental human mortality. All of the observed groups were susceptible to cold effects, with the strongest effects presented in females (relative risk [RR]: 3.14, 95% confidence interval (CI) [1.44-6.84]), followed by poorly educated people (RR: 2.63, 95% CI [1.59-4.36]), males (RR: 1.79, 95% CI [1.10-2.92]), and well-educated people (RR: 1.20, 95% CI [0.58-2.51]). Pooled estimates for cold effects at a lag of 0-21 days (d) were also stronger than hot effects at a lag of 0-2 d. Our results indicate that low temperatures increased the risk of accidental human mortality. Females and poorly educated people were more susceptible to the low temperatures. These findings imply that interventions which target vulnerable populations during cold days should be developed to reduce accidental human mortality risk.
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Affiliation(s)
- Tingyu Lian
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Longzhu Avenue Nanshan District, Shenzhen, 518000, Guangdong, China
| | - Mingwei Sun
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Mingjuan Yin
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Yan Zhang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Lingfeng Huang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Jingxiao Huang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Ziqian Xu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Longzhu Avenue Nanshan District, Shenzhen, 518000, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China.
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Longzhu Avenue Nanshan District, Shenzhen, 518000, Guangdong, China.
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170
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The Impact of Non-optimum Ambient Temperature on Years of Life Lost: A Multi-county Observational Study in Hunan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082699. [PMID: 32295256 PMCID: PMC7215980 DOI: 10.3390/ijerph17082699] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 12/27/2022]
Abstract
The ambient temperature–health relationship is of growing interest as the climate changes. Previous studies have examined the association between ambient temperature and mortality or morbidity, however, there is little literature available on the ambient temperature effects on year of life lost (YLL). Thus, we aimed to quantify the YLL attributable to non-optimum ambient temperature. We obtained data from 1 January 2013 to 31 December 2017 of 70 counties in Hunan, China. In order to combine the effects of each county, we used YLL rate as a health outcome indicator. The YLL rate was equal to the total YLL divided by the population of each county, and multiplied by 100,000. We estimated the associations between ambient temperature and YLL with a distributed lag non-linear model (DNLM) in a single county, and then pooled them in a multivariate meta-regression. The daily mean YLL rates were 22.62 y/(p·100,000), 10.14 y/(p·100,000) and 2.33 y/(p·100,000) within the study period for non-accidental, cardiovascular, and respiratory disease death. Ambient temperature was responsible for advancing a substantial fraction of YLL, with attributable fractions of 10.73% (4.36–17.09%) and 16.44% (9.09–23.79%) for non-accidental and cardiovascular disease death, respectively. However, the ambient temperature effect was not significantly for respiratory disease death, corresponding to 5.47% (−2.65–13.60%). Most of the YLL burden was caused by a cold temperature than the optimum temperature, with an overall estimate of 10.27% (4.52–16.03%) and 15.94% (8.82–23.05%) for non-accidental and cardiovascular disease death, respectively. Cold and heat temperature-related YLLs were higher in the elderly and females than the young and males. Extreme cold temperature had an effect on all age groups in different kinds of disease-caused death. This study highlights that general preventative measures could be important for moderate temperatures, whereas quick and effective measures should be provided for extreme temperatures.
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171
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Zhou G, Peng L, Gao W, Zou Y, Tan Y, Ding Y, Li S, Sun H, Chen R. The acute effects of ultraviolet radiation exposure on solar dermatitis in Shanghai, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:585-591. [PMID: 31872267 DOI: 10.1007/s00484-019-01845-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/27/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
Ultraviolet radiation (UVR) has long been considered associated with solar dermatitis, but the associations have not been well quantified. To depict the full-range exposure-response association between daily UVR exposures and daily outpatient visits of solar dermatitis. We collected the daily number of outpatient visits of solar dermatitis and monitored hourly ground data of UVR (the sum of A- and B-band) from 1 January 2013 to 31 December 2017 in Shanghai, China. The data were analyzed using the time-series approach, in which overdispersed generalized additive model was used and time trends and weather conditions were controlled for. During the study period, we recorded a total of 15,051 outpatient visits of solar dermatitis. There was a consistently increasing risk of solar dermatitis associated with stronger UVR without a discernible threshold. The effects occurred on the present day, increased to the largest at lag 1 or 2 days, and attenuated to the null at lag 5 days or more. A unit (w/m2) increase in daily maximum-hour UVR was associated with 1.70% (95%CI: 1.19%, 2.20%) increase of outpatient visits of solar dermatitis. Stronger effects occurred among the young people, females, and in the warm season. The risks of solar dermatitis due to UVR exposure would be overestimated if ambient temperature was not adjusted. This study provides quantitative epidemiological estimates for the positive associations between short-term exposure to UVR and increased risks of solar dermatitis. The associations were more prominent among young people, females, and in warm seasons.
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Affiliation(s)
- Guojiang Zhou
- Xiangya School of Public Health, Central South University, Changsha, China.
- Shanghai Skin Disease Hospital, Shanghai, China.
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Wei Gao
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Ying Zou
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Yimei Tan
- Shanghai Skin Disease Hospital, Shanghai, China
| | | | - Shanqun Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hong Sun
- Xiangya Hospital, Central South University, Changsha, China.
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
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172
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Probability Risk of Heat- and Cold-Related Mortality to Temperature, Gender, and Age Using GAM Regression Analysis. CLIMATE 2020. [DOI: 10.3390/cli8030040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We have examined the heat and cold-related mortality risk subject to cold and heat extremes by using a generalized additive model (GAM) regression technique to quantify the effect of the stimulus of mortality in the presence of covariate data for 2007–2014 in Nicosia, Cyprus. The use of the GAM technique with multiple linear regression allowed for the continuous covariates of temperature and diurnal temperature range (DTR) to be modeled as smooth functions and the lag period was considered to relate mortality to lagged values of temperature. Our findings indicate that the previous three days’ temperatures were strongly predictive of mortality. The mortality risk decreased as the minimum temperature (Tmin) increased from the coldest days to a certain threshold temperature about 20–21°C (different for each age group and gender), above which the mortality risk increased as Tmin increased. The investigated fixed factors analysis showed an insignificant association of gender-mortality, whereas the age-mortality association showed that the population over 80 was more vulnerable to temperature variations. It was recommended that the minimum mortality temperature is calculated using the minimum daily temperatures because it has a stronger correlation to the probability for risk of mortality. It is still undetermined as to what degree a change in existing climatic conditions will increase the environmental stress to humans as the population is acclimatized to different climates with different threshold temperatures and minimum mortality temperatures.
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173
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Shi W, Sun Q, Du P, Tang S, Chen C, Sun Z, Wang J, Li T, Shi X. Modification Effects of Temperature on the Ozone-Mortality Relationship: A Nationwide Multicounty Study in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:2859-2868. [PMID: 32022552 DOI: 10.1021/acs.est.9b05978] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Both ozone exposure and extreme temperatures are found to be significantly associated with mortality; however, inconsistent results have been obtained on the modification effects of temperature on the ozone-mortality association. In the present study, we conducted a nationwide time-series analysis in 128 counties from 2013-2018 to examine whether temperature modifies the association between short-term ozone exposure with nonaccidental and cause-specific mortality in China. First, we analyzed the effects of ozone exposure on mortality at different temperature levels. Then, we calculated the pooled effects through a meta-analysis across China. We found that high-temperature conditions (>75th percentile in each county) significantly enhanced the effects of ozone on nonaccidental, cardiovascular, and respiratory mortality, with increases of 0.44% (95% confidence interval (CI): 0.36 and 0.51%), 0.42% (95% CI: 0.32 and 0.51%) and 0.50% (95% CI: 0.31 and 0.68%), respectively, for a 10 μg/m3 increase in ozone at high temperatures. Stronger effects on nonaccidental and cardiovascular mortality were observed at high temperatures among elderly individuals aged 65 years and older compared with the younger people. Our findings provide evidence that health damage because of ozone may be influenced by the impacts of increasing temperatures, which point to the importance of mitigating ozone exposure in China under the context of climate change to further reduce the public health burden.
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Affiliation(s)
- Wanying Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Qinghua Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Peng Du
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Song Tang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Chen Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Zhiying Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Jiaonan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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174
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Park S, Kario K, Chia Y, Turana Y, Chen C, Buranakitjaroen P, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Zhang Y, Shin J, Van Minh H, Tomitani N, Kabutoya T, Sukonthasarn A, Verma N, Wang T, Wang J. The influence of the ambient temperature on blood pressure and how it will affect the epidemiology of hypertension in Asia. J Clin Hypertens (Greenwich) 2020; 22:438-444. [PMID: 31851429 PMCID: PMC8029770 DOI: 10.1111/jch.13762] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/21/2019] [Indexed: 12/14/2022]
Abstract
Epidemiologic studies have consistently demonstrated an increased risk of cardiovascular disease during colder temperatures. Hemodynamic changes associated with cold temperature and an increase in thrombogenicity may both account for the increase in cardiovascular risk and mortality. Studies using both in-office and out-of-office BP measurements have consistently shown an elevation in BP during the colder seasons. The large difference in BP between cold and warm months may increase the incidence of hypertension and reduce the hypertension control rate, potentially resulting in increased cardiovascular risk, especially among those at risk of cardiovascular disease. The current trends in global warming and climate change may have a profound impact on the epidemiology of hypertension and cardiovascular disease, as changes in the climate may significantly affect both BP variability and cardiovascular disease, especially in those with high cardiovascular risk and the elderly. Furthermore, climate change could have a significant influence on hypertension in Asia, considering the unique characteristics of hypertensive patients in Asia. As an increase in ambient temperature decreases the mean daytime average and morning surge in BP, but increases the nocturnal BP, it is difficult to predict how environmental changes will affect the epidemiology and prognosis of hypertension in the Asian-Pacific region. However, these seasonal variations in BP could be minimized by adjusting the housing conditions and using anticipation medicine. In this review, we discuss the impact of seasonal variation in the ambient temperature on hypertension and cardiovascular disease and discuss how this may impact the epidemiology of hypertension and cardiovascular disease.
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Affiliation(s)
- Sungha Park
- Division of CardiologyYonsei Cardiovascular HospitalYonsei University Health SystemSeoulKorea
- Integrative Research Center for Cerebrovascular and Cardiovascular DiseasesYonsei University College of MedicineSeoulKorea
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Chen‐Huan Chen
- Department of MedicineSchool of Medicine National Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular CenterJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Boon Wee Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingapore CitySingapore
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Naoko Tomitani
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Apichard Sukonthasarn
- Cardiology DivisionDepartment of Internal MedicineFaculty of MedicineChiang Mai UniversityChiang MaiThailand
| | - Narsingh Verma
- Department of PhysiologyKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsShanghai Key Laboratory of HypertensionThe Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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175
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Qi J, Ruan Z, Qian Z(M, Yin P, Yang Y, Acharya BK, Wang L, Lin H. Potential gains in life expectancy by attaining daily ambient fine particulate matter pollution standards in mainland China: A modeling study based on nationwide data. PLoS Med 2020; 17:e1003027. [PMID: 31951613 PMCID: PMC6968855 DOI: 10.1371/journal.pmed.1003027] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 12/20/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Ambient fine particulate matter pollution (PM2.5) is one leading cause of disease burden, but no study has quantified the association between daily PM2.5 exposure and life expectancy. We aimed to assess the potential benefits in life expectancy by attaining the daily PM2.5 standards in 72 cities of China during 2013-2016. METHODS AND FINDINGS We applied a two-stage approach for the analysis. At the first stage, we used a generalized additive model (GAM) with a Gaussian link to examine the city-specific short-term association between daily PM2.5 and years of life lost (YLL); at the second stage, a random-effects meta-analysis was used to generate the regional and national estimations. We further estimated the potential gains in life expectancy (PGLE) by assuming that ambient PM2.5 has met the Chinese National Ambient Air Quality Standard (NAAQS, 75 μg/m3) or the ambient air quality guideline (AQG) of the World Health Organization (WHO) (25 μg/m3). We also calculated the attributable fraction (AF), which denoted the proportion of YLL attributable to a higher-than-standards daily mean PM2.5 concentration. During the period from January 18, 2013 to December 31, 2016, we recorded 1,226,849 nonaccidental deaths in the study area. We observed significant associations between daily PM2.5 and YLL: each 10 μg/m3 increase in three-day-averaged (lag02) PM2.5 concentrations corresponded to an increment of 0.43 years of life lost (95% CI: 0.29-0.57). We estimated that 168,065.18 (95% CI: 114,144.91-221,985.45) and 68,684.95 (95% CI: 46,648.79-90,721.11) years of life lost can be avoided by achieving WHO's AQG and Chinese NAAQS in the study area, which corresponded to 0.14 (95% CI: 0.09-0.18) and 0.06 (95% CI: 0.04-0.07) years of gain in life expectancy for each death in these cities. We observed differential regional estimates across the 7 regions, with the highest gains in the Northwest region (0.28 years of gain [95% CI: 0.06-0.49]) and the lowest in the North region (0.08 [95% CI: 0.02-0.15]). Furthermore, using WHO's AQG and Chinese NAAQS as the references, we estimated that 1.00% (95% CI: 0.68%-1.32%) and 0.41% (95% CI: 0.28%-0.54%) of YLL could be attributable to the PM2.5 exposure at the national level. Findings from this study were mainly limited by the unavailability of data on individual PM2.5 exposure. CONCLUSIONS This study indicates that significantly longer life expectancy could be achieved by a reduction in the ambient PM2.5 concentrations. It also highlights the need to formulate a stricter ambient PM2.5 standard at both national and regional levels of China to protect the population's health.
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Affiliation(s)
- Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin (Min) Qian
- College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri, United States of America
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bipin Kumar Acharya
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (LW); (HL)
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- * E-mail: (LW); (HL)
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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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Lin S, Han L, Li D, Wang T, Wu Z, Zhang H, Xiao Z, Wu Y, Huang J, Wang M, Zhu Y. The Association between Meteorological Factors and the Prevalence of Acute-on-chronic Liver Failure: A Population-based Study, 2007-2016. J Clin Transl Hepatol 2019; 7:341-345. [PMID: 31915603 PMCID: PMC6943211 DOI: 10.14218/jcth.2019.00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/13/2019] [Accepted: 12/06/2019] [Indexed: 12/04/2022] Open
Abstract
Background and Aims: The aim of this study was to investigate the effect(s) of meteorological factors on the prevalence of acute-on-chronic liver failure (ACLF) based on 10-years' worth of population data. Methods: We retrospectively collected ACLF case data from January 2007 to December 2016 from three major hospitals in Fuzhou City, China. Climatic data, including rainfall, mean temperature, differences in temperature (delta temperature) and mean humidity for each month were downloaded from the China Climatic Data Service Center. Following data collection, Poisson regression analysis was used to estimate the effect(s) of climatic factors on the risk of the prevalence of ACLF. Results: The population consisted of a total of 3510 cases, with a mean age of 44.7 ± 14.8 years-old and with 79.8% being male. Upon analyzing the population data, we found a growing trend and seasonal pattern of monthly counts of ACLF-related hospitalization throughout the past decade. Specifically, the primary peak of ACLF prevalence was in January and the secondary peak was in July. Poisson regression showed mean temperature (risk ratio = 0.991, 95%CI = 0.986-0.996) and mean humidity (risk ratio = 1.011, 95%CI = 1.006-1.017) to be independently correlated with the monthly cases of ACLF. The results suggest that every unit increase of mean temperature (1°C) and mean humidity (1%) are associated with 0.991- and 1.011-fold changes of ACLF cases, respectively. Rainfall and delta temperature did not appear to affect the prevalence of this disease. Conclusions: The hospitalization for ACLF peaks in January and July. Low temperature and high humidity appear to function as factors contributing to this seasonal pattern.
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Affiliation(s)
- Su Lin
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Lifen Han
- Department of Infectious Disease, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dongliang Li
- Department of Hepatobiliary Disease, 900 Hospital of PLA, Fuzhou, Fujian, China
| | - Ting Wang
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Zimu Wu
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Haoyang Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | | | - Yinlian Wu
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jiaofeng Huang
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Mingfang Wang
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yueyong Zhu
- Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Correspondence to: Yueyong Zhu, Department of Liver Research Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China. Tel: +86-591-87981656, Fax: +86-591-87982526, E-mail:
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178
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Regional Temperature-Sensitive Diseases and Attributable Fractions in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010184. [PMID: 31888051 PMCID: PMC6982219 DOI: 10.3390/ijerph17010184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/23/2019] [Accepted: 12/25/2019] [Indexed: 12/12/2022]
Abstract
Few studies have been carried out to systematically screen regional temperature-sensitive diseases. This study was aimed at systematically and comprehensively screening both high- and low-temperature-sensitive diseases by using mortality data from 17 study sites in China located in temperate and subtropical climate zones. The distributed lag nonlinear model (DLNM) was applied to quantify the association between extreme temperature and mortality to screen temperature-sensitive diseases from 18 kinds of diseases of eight disease systems. The attributable fractions (AFs) of sensitive diseases were calculated to assess the mortality burden attributable to high and low temperatures. A total of 1,380,713 records of all-cause deaths were involved. The results indicate that injuries, nervous, circulatory and respiratory diseases are sensitive to heat, with the attributable fraction accounting for 6.5%, 4.2%, 3.9% and 1.85%, respectively. Respiratory and circulatory diseases are sensitive to cold temperature, with the attributable fraction accounting for 13.3% and 11.8%, respectively. Most of the high- and low-temperature-sensitive diseases seem to have higher relative risk in study sites located in subtropical zones than in temperate zones. However, the attributable fractions for mortality of heat-related injuries were higher in temperate zones. The results of this research provide epidemiological evidence of the relative burden of mortality across two climate zones in China.
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179
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Jones RP. A pragmatic method to compare hospital bed provision between countries and regions: Beds in the States of Australia. Int J Health Plann Manage 2019; 35:746-759. [PMID: 31803962 DOI: 10.1002/hpm.2950] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/18/2019] [Indexed: 11/07/2022] Open
Abstract
A simple method is presented to evaluate bed numbers between countries using a logarithmic relationship between beds per 1000 deaths and deaths per 1000 population, both of which are readily available. The method relies on the importance of the nearness to death effect. This method was tested using data from Australian States. Beds per 1000 deaths varied considerably between States. This variation reduced after adjusting for the ratio of deaths per 1000 population which is a measure of population age structure. After this adjustment, most Australian States roughly approximate to the international average for developed countries while Tasmania was shown to have a chronic bed shortage, as has been recognized for many years. The Northern Territory and the Australian Capital Territory, both of which have the youngest populations, have more beds relative to the other States. The nearness to death effect must be incorporated into capacity planning models in order to give robust estimates of future bed demand and to evaluate differences between countries and health care systems.
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Affiliation(s)
- Rodney P Jones
- Population Health Analytics Department, Healthcare Analysis & Forecasting, Leominster, UK
- Health and Life Sciences, Coventry University, Coventry, UK
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180
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Du Z, Lin S, Marks T, Zhang W, Deng T, Yu S, Hao Y. Weather effects on hand, foot, and mouth disease at individual level: a case-crossover study. BMC Infect Dis 2019; 19:1029. [PMID: 31796004 PMCID: PMC6891988 DOI: 10.1186/s12879-019-4645-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) raises an urgent public health issue in the Asia-Pacific region, especially in China. The associations between weather factors and HFMD have been widely studied but with inconsistent results. Moreover, previous studies utilizing ecological design could not rule out the bias of exposure misclassification and unobserved confounders. METHODS We used case-crossover analysis to assess the associations of weather factors on HFMD. Individual HFMD cases from 2009 to 2012 in Guangdong were collected and cases located within 10 km of the meteorological monitoring sites were included. Lag effects were examined through the previous 7 days. In addition, we explored the variability by changing the distance within 20 km and 30 km. RESULTS We observed associations between HFMD and weather factors, including temperature and relative humidity. An approximately U-shaped relationship was observed for the associations of temperature on HFMD across the same day and the previous 7 days, while an approximately exponential-shaped was seen for relative humidity. Statistically significant increases in rates of HFMD were associated with each 10-unit increases in temperature [Excess rate (ER): 7.7%; 95% Confidence Interval (CI): 3.9, 11.7%] and relative humidity (ER: 1.9%; 95% CI: 0.7, 3.0%) on lag days 0-6, when assessing within 10 km of the monitoring sites. Potential thresholds for temperature (30.0 °C) and relative humidity (70.3%) detected showed associations with HFMD. The associations remained robust for 20 km and 30 km. CONCLUSIONS Our study found that temperature and relative humidity are significantly associated with the increased rates of HFMD. Thresholds and lag effects were observed between weather factors and HFMD. Our findings are useful for planning on targeted prevention and control of HFMD.
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Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, 12144 USA
| | - Tia Marks
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, 12144 USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, 12144 USA
| | - Te Deng
- Healthcare Department, Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen, 518000 China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, 102206 China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
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181
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Short-term effects of ambient air pollution and outdoor temperature on biomarkers of myocardial damage, inflammation and oxidative stress in healthy adults. Environ Epidemiol 2019; 3:e078. [PMID: 33778346 PMCID: PMC7939428 DOI: 10.1097/ee9.0000000000000078] [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] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 10/24/2019] [Indexed: 01/02/2023] Open
Abstract
Supplemental Digital Content is available in the text. The mechanisms whereby ambient air pollution and temperature changes promote cardiac events remain incompletely described. Seventy-three nonsmoking healthy adults (mean age 23.3, SD 5.4 years) were followed with up to four repeated visits across 15 months in Beijing in 2014–2016. Biomarkers relevant to myocardial damage (high-sensitivity cardiac troponin I [hs-cTnI]), inflammation (growth differentiation factor-15 [GDF-15]), and oxidative stress (8-hydroxy-2′-deoxyguanosine [8-OHdG]) were measured at each visit, while ambient air pollution and temperature were monitored throughout the study. Linear mixed-effects models coupled with distributed lag nonlinear models were used to assess the impacts of each exposure measure on study outcomes. During follow-up, average daily concentrations of fine particulate matter and outdoor temperature were 62.9 µg/m3 (8.1–331.0 µg/m3) and 10.1 °C (−6.5°C to 29.5°C). Serum hs-cTnI levels were detectable in 18.2% of blood samples, with 27.4% of individuals having ≥1 detectable values. Higher levels of ambient particulates and gaseous pollutants (per interquartile range) up to 14 days before clinical visits were associated with significant alterations in hs-cTnI levels of 22.9% (95% CI, 6.4, 39.4) to 154.7% (95% CI, 94.4, 215.1). These changes were accompanied by elevations of circulating GDF-15 and urinary 8-OHdG levels. Both low (5th percentile, −2.5 °C) and high (95th percentile, 24.8°C) outdoor temperatures, with breakpoint at ~13.0°C as the reference level, were also associated with elevations of hs-cTnI levels. Short-term exposure to ambient air pollution and temperature was associated with cardiac troponin, a biomarker of myocardial damage, along with increased inflammation and oxidative stress responses. These findings extend our understanding of the biological mechanisms linking pervasive environmental exposure to adverse cardiac events.
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182
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Li A, Pei L, Zhao M, Xu J, Mei Y, Li R, Xu Q. Investigating potential associations between O3 exposure and lipid profiles: A longitudinal study of older adults in Beijing. ENVIRONMENT INTERNATIONAL 2019; 133:105135. [PMID: 31491592 DOI: 10.1016/j.envint.2019.105135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Little information exists on the lipidemic effects of ozone exposure. Few studies have focused on the different patterns of the association among older adults population, and little attention has been given to comprehensive lipid indices when evaluating the effect of O3 exposure on the metabolism. METHODS We conducted a longitudinal study involving 201 older adults in Beijing, China between 2016 and 2018. A mixed regression model was applied with random effects to investigate the relationship between O3 and lipid profiles. RESULTS O3 exposure positively correlated with TC, LDL-C, CRI-I, CRI-II and AC at short-term and medium-term exposure periods. The largest increases in TC, LDL-C, CRI-I and CRI-II were found in the 28-days moving average indicating accumulative effects over prolonged exposure period. A 10 μg/m3 increase of O3 at the 28-days moving average was associated with a significant increase of 3.9% (95% CI: 1.0, 6.9) in TC, 8.2% (95% CI: 4.2, 12.4) in LDL-C, 4.8% (95% CI: 1.1, 8.5) in CRI-I and 7.0% (95% CI: 2.7, 11.5) in CRI-II. Stratification by health status and characteristics revealed different patterns of lipid changes among older adults, lipid status, age, sex and BMI may modify the relationship between O3 exposure and lipid profiles. CONCLUSIONS Our findings suggest that short-term and medium-term O3 exposure is associated with lipid profiles abnormalities among the older adults. Evidence also suggests there are patterns within population which differ according to both health status and demographic characteristics.
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Affiliation(s)
- Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Lu Pei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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183
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Adipocyte Hypoxia-Inducible Factor 2α Suppresses Atherosclerosis by Promoting Adipose Ceramide Catabolism. Cell Metab 2019; 30:937-951.e5. [PMID: 31668872 DOI: 10.1016/j.cmet.2019.09.016] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/10/2019] [Accepted: 09/26/2019] [Indexed: 12/18/2022]
Abstract
Obesity-induced adipose dysfunction is a major contributor to atherosclerosis. Cold exposure has been reported to affect atherosclerosis through regulation of adipose function, but the mechanism has not been well clarified. Here, adipocyte hypoxia-inducible factor 2α (HIF-2α) was upregulated after mild cold exposure at 16°C and mediated cold-induced thermogenesis. Adipocyte HIF-2α deficiency exacerbated Western-diet-induced atherosclerosis by increasing adipose ceramide levels, which blunted hepatocyte cholesterol elimination and thermogenesis. Mechanistically, Acer2, the gene encoding alkaline ceramidase 2, was identified as a novel target gene of HIF-2α, triggering ceramide catabolism. Adipose overexpression of ACER2 rescued adipocyte HIF-2α-deficiency-induced exacerbation of atherosclerosis. Furthermore, activation of adipose HIF-2α by the HIF prolyl hydroxylase inhibitor FG-4592 had protective effects on atherosclerosis, accompanied by a reduction in adipose and plasma ceramide and plasma cholesterol levels. This study highlights adipocyte HIF-2α as a putative drug target against atherosclerosis.
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184
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Versaci F, Biondi-Zoccai G, Giudici AD, Mariano E, Trivisonno A, Sciarretta S, Valenti V, Peruzzi M, Cavarretta E, Frati G, Scappaticci M, Federici M, Romeo F. Climate changes and ST-elevation myocardial infarction treated with primary percutaneous coronary angioplasty. Int J Cardiol 2019; 294:1-5. [PMID: 31301864 DOI: 10.1016/j.ijcard.2019.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/20/2019] [Accepted: 07/02/2019] [Indexed: 02/08/2023]
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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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186
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Lien WH, Owili PO, Muga MA, Lin TH. Ambient Particulate Matter Exposure and Under-Five and Maternal Deaths in Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203855. [PMID: 31614721 PMCID: PMC6843620 DOI: 10.3390/ijerph16203855] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 11/23/2022]
Abstract
The Asian region is one of the major emission sources of air pollution. Although ambient PM2.5 has been linked to several health risks in high-, low-, and middle-income countries, the further analysis of type impact is still rare but significant. The PM2.5 distribution retrieved from MODIS (Moderate Resolution Imaging Spectroradiometer) aerosol optical depth products within 16 years thus explored the associations between under-five and maternal mortality for 45 countries in Asia. Both the nonparametric (Generalized Additive Mixed-Effect) and parametric (Generalized Linear Mixed-Effect) models were employed to analyze the collected datasets. The results show that the levels of PM2.5 in Asian sub-regions were higher than the Global Air Quality Standards. Biomass PM2.5 concentrations was associated with increased the rate of under-five (Incidence Rate Ratio, IRR = 1.29, 95% CI, 1.13–1.47) and maternal (IRR = 1.09, 95% CI: 1.08–1.10) deaths in Asia. Anthropogenic PM2.5 was associated with increased rate of under-five deaths in Asia by 12%. The nonparametric method revealed that dust PM2.5 was positively associated with the under-five (β = 0.04, p < 0.001) and maternal (β = 0.07, p < 0.001) deaths in Asia. The rate of maternal deaths was increased by biomass/dust (IRR = 1.64, 95% CI: 1.63–1.65) and anthropogenic/dust (IRR = 1.22, 95% CI: 1.19–1.26) mixture types. In summary, long-term exposure to different types of ambient PM2.5 in high concentration increased the rate of under-five and maternal deaths, suggesting that policies focusing on preventive and control measures is imperative for developing an improved maternal, newborn, and child health in Asia.
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Affiliation(s)
- Wei-Hung Lien
- Graduate Institute of Space Science and Engineering, National Central University, Taoyuan City 32001, Taiwan.
| | - Patrick Opiyo Owili
- Department of Public Health, School of Health Sciences, University of Eastern Africa, Baraton, Eldoret 30100, Kenya.
| | - Miriam Adoyo Muga
- Department of Human Nutrition and Dietetics, School of Medicine and Health Sciences, Kabarak University, P.O. Box Private Bag 20157 Kabarak, Kenya.
| | - Tang-Huang Lin
- Center for Space and Remote Sensing Research, National Central University, Taoyuan City 32001, Taiwan.
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187
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Xu X, Chen Z, Huo X, Wang C, Li N, Meng X, Wang Q, Liu Q, Bi P, Li J. The effects of temperature on human mortality in a Chinese city: burden of disease calculation, attributable risk exploration, and vulnerability identification. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1319-1329. [PMID: 31240387 DOI: 10.1007/s00484-019-01746-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 06/09/2023]
Abstract
Few studies have examined the attributable fraction (AF) of temperature to mortality and Years of Life Lost (YLL), especially in developing countries. This study aims to explore the short-term effect of the cold and hot temperatures on the cause-specific YLL and mortality, discover the attributable contributions from the temperature variations, and identify the vulnerable populations in Weifang, China. Daily registered death information and meteorological data over the period 2010-2016 were obtained in Weifang, a northern Chinese city. Generalized additive Poisson and Gaussian regression models were used to assess the impacts of temperatures on both mortality and YLL, explore the AF of the temperature variations on mortality, after adjusting for other covariates. Both hot and cold temperatures have had significant negative impacts on cause-specific mortality counts and YLL, with heat presented an acute and short effect and the cold temperatures had delayed effects and lasted for several days. In terms of the attributable fraction calculations, the contributions from cold effects was higher than that of hot effects on non-accidental, cardiovascular, and respiratory deaths (YLL 10.88 vs. 1.23%, 19.58 vs. 1.71%, and 14.47 vs. 3.05%; mortality 13.97 vs. 1.65%, 19.20 vs. 1.59%, and 14.89 vs. 3.09%), respectively. The elderly and women and people with low education level were the most vulnerable. The findings will provide important scientific evidences and policy implications for developing adaptation strategies to reduce the adverse effect of cold and hot exposure in Weifang, in terms of resource allocation, healthcare workforce capacity building, and community health education, especially for the vulnerable groups.
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Affiliation(s)
- Xin Xu
- Affiliated Hospital of Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Zuosen Chen
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Xiyuan Huo
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Chunping Wang
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Ning Li
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Xianfeng Meng
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Qiang Wang
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, Beijing, People's Republic of China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, 5005, SA, Australia
| | - Jing Li
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China.
- "Health Shandong" Major Social Risk Prediction and Governance Collaborative Innovation Center, Weifang, 261053, Shandong Province, People's Republic of China.
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188
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Liu J, Ma Y, Wang Y, Li S, Liu S, He X, Li L, Guo L, Niu J, Luo B, Zhang K. The Impact of Cold and Heat on Years of Life Lost in a Northwestern Chinese City with Temperate Continental Climate. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193529. [PMID: 31547211 PMCID: PMC6801473 DOI: 10.3390/ijerph16193529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 12/16/2022]
Abstract
Cold spells and heat waves in a changing climate are well known as great public-health concerns due to their adverse effects on human health. However, very few studies have quantified health impacts of heat and cold in the region of Northwestern China. The purpose of the present study was to evaluate the effects of cold and heat on years of life lost (YLL) in Lanzhou, a city with temperate continental climate. We compiled a daily dataset including deaths, weather variables, and air pollutants in Lanzhou, China, from 2014–2017. We used a distributed lag non-linear model to estimate single-day and cumulative effects of heat and cold on daily YLL. Results indicated that both cold and heat were associated with increased YLL for registered residents in Lanzhou. Estimated heat effects appeared immediately in the first two days, while estimated cold effects lasted over a longer period (up to 30 days). Cold significantly increased the YLL of all residents except for males and those with respiratory diseases (≥65 years). Our results showed that both heat and cold had more pronounced effects on cardiovascular diseases compared to respiratory diseases. Males might be more vulnerable to heat, while females might suffer more YLL from cold. The effects of cold or heat on the elderly might appear earlier and last longer than those for other age groups.
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Affiliation(s)
- Jiangtao Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Yueling Ma
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Yuhong Wang
- Lanzhou Municipal Center for Disease Control, Lanzhou 730000, Gansu, China.
| | - Sheng Li
- Lanzhou Municipal Center for Disease Control, Lanzhou 730000, Gansu, China.
| | - Shuyu Liu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, Gansu, China.
| | - Xiaotao He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Lanyu Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Lei Guo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Jingping Niu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China.
| | - 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 77030, USA.
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189
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Huang Q, Lin SW, Hu WP, Li HY, Yao PS, Sun Y, Zeng YL, Huang QY, Kang DZ, Wu SY. Meteorological Variation Is a Predisposing Factor for Aneurismal Subarachnoid Hemorrhage: A 5-Year Multicenter Study in Fuzhou, China. World Neurosurg 2019; 132:e687-e695. [PMID: 31442657 DOI: 10.1016/j.wneu.2019.08.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The climatic characteristics of aneurysmal subarachnoid hemorrhage (aSAH) have been reported, but consensus has not yet been reached. It is of great significance to elucidate the relationships between meteorological variation and aSAH in regions with specific climate patterns. We analyzed the occurrence of aSAH in the capital city of Fujian Province, China, through a multicenter, 5-year study, and aimed to reveal the meteorological influences on aSAH in the coastal city of eastern Fujian under the subtropical marine monsoon condition. METHODS A total of 2555 consecutive patients with aSAH in Fuzhou were collected using specialized stroke admission database from January 2013 to December 2017. Meteorological parameters including temperature, atmospheric pressure, and humidity were obtained from China Surface Meteorological Station during the same period. Poisson regression was used to explore the association between meteorological parameters and aSAH to calculate the incidence rate ratios (IRRs) with corresponding 95% confidence intervals (CIs). Generalized additive model analysis further revealed the nonlinear relationships between weather and aSAH. RESULTS Daily minimum temperature (IRR 0.976, 95% CI 0.958-0.996) and maximum pressure (IRR 1.022, 95% CI 1.001-1.042) were independently correlated with the onset of aSAH. Low temperature (below 16°C) and excessive atmospheric pressure (above 1008 hPa) increased the risk of aSAH. In addition, March in spring and December in winter were the 2 ictus peaks in Fuzhou throughout the year. CONCLUSIONS Cold and excessive atmospheric pressure are triggers for the occurrence of aSAH; March in spring and December in winter are the predominant onset periods in Fuzhou.
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Affiliation(s)
- Qing Huang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China; School of Public Health, Fujian Medical University, Fuzhou, China
| | - Shao-Wei Lin
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Wei-Peng Hu
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Huang-Yuan Li
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Pei-Sen Yao
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yi Sun
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yi-Le Zeng
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qiu-Yu Huang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - De-Zhi Kang
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Si-Ying Wu
- School of Public Health, Fujian Medical University, Fuzhou, China.
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