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Jingesi M, Lan S, Hu J, Dai M, Huang S, Chen S, Liu N, Lv Z, Ji J, Li X, Wang P, Cheng J, Peng J, Yin P. Association between thermal stress and cardiovascular mortality in the subtropics. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2093-2106. [PMID: 37878088 DOI: 10.1007/s00484-023-02565-6] [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: 01/09/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Affiliation(s)
- Maidina Jingesi
- 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
| | - Shuhua Lan
- 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
| | - Jing Hu
- 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
| | - Mengyi Dai
- 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
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyi Chen
- 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
| | - Ning Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Peng Wang
- 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
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen, 518020, 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.
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Xia Y, Shi C, Li Y, Jiang X, Ruan S, Gao X, Chen Y, Huang W, Li M, Xue R, Wen X, Peng X, Chen J, Zhang L. Effects of ambient temperature on mortality among elderly residents of Chengdu city in Southwest China, 2016-2020: a distributed-lag non-linear time series analysis. BMC Public Health 2023; 23:149. [PMID: 36681785 PMCID: PMC9863161 DOI: 10.1186/s12889-022-14931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With complex changes in the global climate, it is critical to understand how ambient temperature affects health, especially in China. We aimed to assess the effects of temperature on daily mortality, including total non-accidental, cardiovascular disease (CVD), respiratory disease, cerebrovascular disease, and ischemic heart disease (IHD) mortality between 2016 and 2020 in Chengdu, China. METHODS We obtained daily temperature and mortality data for the period 2016-2020. A Poisson regression model combined with a distributed-lag nonlinear model was used to examine the association between temperature and daily mortality. We investigated the effects of individual characteristics by sex, age, education level, and marital status. RESULTS We found significant non-linear effects of temperature on total non-accidental, CVD, respiratory, cerebrovascular, and IHD mortality. Heat effects were immediate and lasted for 0-3 days, whereas cold effects persisted for 7-10 days. The relative risks associated with extreme high temperatures (99th percentile of temperature, 28 °C) over lags of 0-3 days were 1.22 (95% confidence interval [CI]: 1.17, 1.28) for total non-accidental mortality, 1.40 (95% CI: 1.30, 1.50) for CVD morality, 1.34 (95% CI: 1.24, 1.46) for respiratory morality, 1.33 (95% CI: 1.20, 1.47) for cerebrovascular mortality, and 1.38 (95% CI: 1.20, 1.58) for IHD mortality. The relative risks associated with extreme cold temperature (1st percentile of temperature, 3.0 °C) over lags of 0-14 days were 1.32 (95% CI: 1.19, 1.46) for total mortality, 1.45 (95% CI: 1.24, 1.68) for CVD morality, 1.28 (95% CI: 1.09, 1.50) for respiratory morality, 1.36 (95% CI: 1.09, 1.70) for cerebrovascular mortality, and 1.26 (95% CI: 0.95, 1.68) for IHD morality. We found that hot and cold affects were greater in those over 85 years of age, and that women, individuals with low education levels, and those who were widowed, divorced, or never married, were more vulnerable. CONCLUSIONS This study showed that exposure to hot and cold temperatures in Chengdu was associated with increased mortality, with people over 85 years old, women, those with low education levels, and unmarried individuals being more affected by hot and cold temperatures.
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Affiliation(s)
- Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No.6, Longxiang Road, Wuhou District, Chengdu, 610041 China
| | - Yu Chen
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No.826, Huichuan Road, Ziliujing District, Zigong, 643000 China
| | - Mingjiang Li
- Panzhi Hua Center for Disease Control and Prevention, Dong District, No.996, Jichang Road617067, Panzhi Hua, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No.996, Binhebei RoadLizhou District, Guangyuan, 628017 China
| | - Xianying Wen
- Mianyang Center for Disease Control and Prevention, Gaoxin District, No.50, Mianxingdong Road, Mianyang, 621000 China
| | - Xiaojuan Peng
- Yaan Center for Disease Control and Prevention, No.9, Fangcao Road, Yucheng District, Yaan, 625000 China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
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Lai ETC, Chau PH, Cheung K, Kwan M, Lau K, Woo J. Perception of extreme hot weather and the corresponding adaptations among older adults and service providers-A qualitative study in Hong Kong. Front Public Health 2023; 11:1056800. [PMID: 36875383 PMCID: PMC9980346 DOI: 10.3389/fpubh.2023.1056800] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/09/2023] [Indexed: 02/12/2023] Open
Abstract
Background Extreme hot weather events are happening with increasing frequency, intensity and duration in Hong Kong. Heat stress is related to higher risk of mortality and morbidity, with older adults being particularly vulnerable. It is not clear whether and how the older adults perceive the increasingly hot weather as a health threat, and whether community service providers are aware and prepared for such future climate scenario. Methods We conducted semi-structure interviews with 46 older adults, 18 staff members of community service providers and two district councilors of Tai Po, a north-eastern residential district of Hong Kong. Transcribed data were analyzed using thematic analysis until data saturation was reached. Results It was agreed upon among the older adult participants that the weather in recent years has become increasingly hot and this led to some health and social problems for them, although some participants perceived that hot weather did not have any impact in their daily lives and they were not vulnerable. The community service providers and district councilors reported that there is a lack of relevant services in the community to support the older adults in hot weather; and there is generally a lack of public education regarding the heat-health issue. Conclusions Heatwaves are affecting older adults' health in Hong Kong. Yet, discussions and education effort regarding the heat-health issue in the public domain remain scarce. Multilateral efforts are urgently needed to co-create a heat action plan to improve community awareness and resilience.
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Affiliation(s)
- Eric T C Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ken Cheung
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Michelle Kwan
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kevin Lau
- Department of Civil, Environmental and Natural Resources Engineering, Luleå Tekniska Universitet, Luleå, Sweden
| | - Jean Woo
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Psistaki K, Dokas IM, Paschalidou AK. Analysis of the heat- and cold-related cardiovascular mortality in an urban mediterranean environment through various thermal indices. ENVIRONMENTAL RESEARCH 2023; 216:114831. [PMID: 36402186 DOI: 10.1016/j.envres.2022.114831] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
During the last decades the effects of thermal stress on public health have been a great concern worldwide. Thermal stress is determined by air temperature in combination with other meteorological parameters, such as relative humidity and wind speed. The present study is focused on the Mediterranean city of Thessaloniki, Greece and it aims to explore the association between thermal stress and mortality from cardiovascular diseases, using both air temperature and other thermal indices as indicators. For that, an over-dispersed Poisson regression function was used, in combination with distributed lag non-linear models, in order to capture the delayed and nonlinear effects of temperature. Our results revealed a reverse J-shaped exposure-response curve for the total population and females and a U-shaped association for males. In all cases examined, the minimum mortality temperature was identified around the 80th percentile of each distribution. It is noteworthy that despite the fact that the highest risks of cardiovascular mortality were estimated for exposure to extreme temperatures, moderate temperatures were found to cause the highest burden of mortality. On the whole, our estimations demonstrated that the population in Thessaloniki is more susceptible to cold effects and in regard with gender, females seem to be more vulnerable to ambient thermal conditions.
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Affiliation(s)
- K Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, 68200, Greece
| | - I M Dokas
- Department of Civil Engineering, Democritus University of Thrace, Greece
| | - A K Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, 68200, Greece.
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Psistaki K, Dokas IM, Paschalidou AK. The Impact of Ambient Temperature on Cardiorespiratory Mortality in Northern Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:555. [PMID: 36612877 PMCID: PMC9819162 DOI: 10.3390/ijerph20010555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
It is well-established that exposure to non-optimum temperatures adversely affects public health, with the negative impact varying with latitude, as well as various climatic and population characteristics. This work aims to assess the relationship between ambient temperature and mortality from cardiorespiratory diseases in Eastern Macedonia and Thrace, in Northern Greece. For this, a standard time-series over-dispersed Poisson regression was fit, along with a distributed lag nonlinear model (DLNM), using a maximum lag of 21 days, to capture the non-linear and delayed temperature-related effects. A U-shaped relationship was found between temperature and cardiorespiratory mortality for the overall population and various subgroups and the minimum mortality temperature was observed around the 65th percentile of the temperature distribution. Exposure to extremely high temperatures was found to put the highest risk of cardiorespiratory mortality in all cases, except for females which were found to be more sensitive to extreme cold. It is remarkable that the highest burden of temperature-related mortality was attributed to moderate temperatures and primarily to moderate cold. The elderly were found to be particularly susceptible to both cold and hot thermal stress. These results provide new evidence on the health response of the population to low and high temperatures and could be useful to local authorities and policy-makers for developing interventions and prevention strategies for reducing the adverse impact of ambient temperature.
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Affiliation(s)
- Kyriaki Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, 68200 Orestiada, Greece
| | - Ioannis M. Dokas
- Department of Civil Engineering, Democritus University of Thrace, 67100 Xanthi, Greece
| | - Anastasia K. Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, 68200 Orestiada, Greece
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Ho HC, Lau K, Ren C, Wang D. Systematic identification of heat events associated with emergency admissions to enhance the heat-health action plan in a subtropical city: a data-driven approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:89273-89282. [PMID: 35849238 DOI: 10.1007/s11356-022-21963-8] [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: 01/24/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
According to the United Nations Office for Disaster Risk Reduction (UNDRR), a heat-health action plan should address various impacts of hazards at different levels, including an early warning system to monitor risks and behaviour enhancement to increase disaster preparedness. It is necessary to comply with guidelines regarding heat duration/intensity. In this study, we developed a data-driven approach to rapidly and systematically estimate the impacts of various heat events on emergency admissions among the adult population (n = 7,086,966) in Hong Kong in order to enhance the heat-health action plan. Immediate, short-term, and long-term impacts determined by 1-day, 4-day, and 8-day windows were estimated to identify specific heat events suitable for early warnings. In addition, underestimated risk, determined by a continuous increase in heat risk after days without significant emergency admissions, was estimated to evaluate potential maladaptive behaviours among a specific subpopulation. Based on age- and gender-specific analyses, 1D, 1D1N, and 2D2N were observed to have a stronger immediate impact on emergency admissions. 1D1N and 2D2N also showed notable short-term and long-term impacts. Based on heat vulnerability factors (age and gender), 2D2N was a higher-priority extreme heat event for early warning measures than 1D1N. Furthermore, men aged 19 to 64 had the highest underestimated risk. Specifically, they had IRR values of 1.113 [1.087, 1.140], 1.061 [1.035, 1.087], and 1.069 [1.043, 1.095] during lag days 3-5 of 3D2N, respectively, possibly due to a lack of adaptive behaviour. By adopting our approach, the duration of heat events with significant health impacts can be identified in order to further enhance relevant heat stress information. This framework can be applied to other cities with a similar background for rapid assessment.
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Affiliation(s)
- Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, Hong Kong.
| | - Kevin Lau
- Department of Civil, Environmental and Natural Resources Engineering, Luleå University of Technology, Luleå, Sweden.
| | - Chao Ren
- Division of Landscape Architecture, Faculty of Architecture, The University of Hong Kong, Hong Kong, Hong Kong
| | - Dan Wang
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
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Song J, Lu Y, Zhao Q, Zhang Y, Yang X, Chen Q, Guo Y, Hu K. Effect modifications of green space and blue space on heat-mortality association in Hong Kong, 2008-2017. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156127. [PMID: 35605868 DOI: 10.1016/j.scitotenv.2022.156127] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite emerging recognition of the benefits of green and blue spaces on human health, evidence for their effect modifications on heat-mortality associations is limited. We aimed to investigate the effect modifications of green and blue spaces on heat-mortality associations among different age and sex groups and at different heat levels. METHODS Daily mortality and meteorological data from 2008 to 2017 in Hong Kong, China were collected. The Normalized Difference Vegetation Index and distance to coast were used as proxies for green and blue space exposure, respectively. Time-series analyses was performed using fitting generalized linear mixed models with an interaction term between heat and levels of exposure to either green or blue space. Age-, sex-, and heat level-stratified analyses were also conducted. RESULTS With a 1 °C increase in temperature above the 90th percentile (29.61 °C), mortality increased by 5.7% (95% confidence interval [CI]: 1.6, 10.1%), 5.4% (1.4, 9.5%), and 4.6% (0.8, 8.9%) for low, medium and high levels of green space exposure, respectively, and by 7.5% (3.9, 11.2%) and 3.5% (0.3, 6.8%) for low and high levels of blue space exposure, respectively. Significant effect modifications of green and blue spaces were not observed for the whole population or any specific age and sex group, either at a moderate heat level or a heat level (Ps > 0.05). CONCLUSIONS No significant effect modifications of green and blue spaces on heat-related mortality risk were observed in Hong Kong. These findings challenge the existing evidence on the prominent protective role of green and blue spaces in mitigating heat-related mortality risks.
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Affiliation(s)
- Jinglu Song
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou 215123, China.
| | - Yi Lu
- Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon Tong, Hong Kong, China.
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China.
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan 316021, China.
| | - Qian Chen
- Ocean College, Zhejiang University, Zhoushan 316021, China.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Zijingang Campus, Hangzhou 310058, China.
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Dastoorpoor M, Khodadadi N, Masoumi K, Khanjani N, Idani E, Borsi SH, Goudarzi G, Raji H, Sharafkhani R. Physiological equivalent temperature (PET) and non-accidental, cardiovascular and respiratory disease mortality in Ahvaz, Iran. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:2767-2782. [PMID: 34417925 DOI: 10.1007/s10653-021-01063-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
Climate change may be associated with human morbidity and mortality through direct and indirect effects. Ahvaz is one of the hottest cities in the world. The aim of this study was to investigate the relation between physiological Equivalent Temperature (PET) and non-accidental, cardiovascular and respiratory disease mortality in Ahvaz, Iran. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on death. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted.The results showed that in cold stress [1st percentile of PET (2.7 °C) relative to 25th percentile (11.9 °C)] the risk of total respiratory mortality, respiratory mortality in men, and mortality in people under 65 year olds, significantly decreased in the cumulative lags of 0-2, 0-6 and 0-13; but the risk of respiratory mortality increased in the elderly and in the final lags. In contrast, heat stress [99th percentile of PET (44.9 °C) relative to 75th percentile (43.4 °C)] significantly increased the risk of total cardiovascular mortality (CVD), cardiovascular mortality in men, ischemic heart disease and cerebrovascular disease mortality in lags 0 and 0-2. It seems that high PET values increase the risk of cardiovascular mortality, while low PET values increase respiratory mortality only among the elderly in Ahvaz.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Masoumi
- Department of Emergency Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Esmaeil Idani
- Department of Internal Medicine, School of Medicine, ShahidBeheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Hamid Borsi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Gholamreza Goudarzi
- Department of Environmental Health, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Li J, Hu Y, Li H, Lin Y, Tong S, Li Y. Assessing the impact of air pollutants on clinical visits for childhood allergic respiratory disease induced by house dust mite in Shanghai, China. Respir Res 2022; 23:48. [PMID: 35248029 PMCID: PMC8897928 DOI: 10.1186/s12931-022-01967-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/21/2022] [Indexed: 01/16/2023] Open
Abstract
Background The prevalence of allergic respiratory disease (ARD) is increasing worldwide during the last few decades, causing a great disease burden especially for children. Air pollution has been increasingly considered as a potential contributor to this trend, but its role in ARD induced by house dust mite (HDM-ARD) remains unclear, especially in time-series study. Methods A positive reporting of respiratory allergy to named allergens was included by serum specific IgE testing. A time series Quasi-Poisson regression with distributed lag non-linear model, combined with generalized linear model was used to examine the effects of air pollutants on ARD, HDM-ARD and ARD induced by non-house dust mite (NHDM-ARD). Results A total of 16,249 cases of ARD, including 8,719 HDM-ARD and 8,070 NHDM-ARD from 1 Jan 2013 to 31 Dec 2017 were involved in this study. Air pollutants were significantly associated with clinical visits for childhood ARD and HDM-ARD. Exposure to higher O3 and interquartile range (IQR) increment in O3 (40.6 µg/m3) increased the risks of clinical visits for childhood HDM-ARD (RRlag0-5 for the 95th percentile of O3: 1.26, 95% confidence interval (CI): 1.03, 1.55; RRlag0-5 for IQR increment (40.6 µg/m3): 1.09, 95% CI: 1.01, 1.17) and ARD (RRlag0-5 for the 95th percentile of O3: 1.19, 95% CI: 1.03, 1.38; RRlag0-5 for IQR increment (40.6 µg/m3): 1.06, 95% CI: 1.01, 1.12). In addition, higher O3 was associated with increased RR of boys with ARD (RRlag0-5 for the 95th percentile: 1.26, 95% CI: 1.05, 1.51; RRlag0-5 for IQR increment (40.6 µg/m3): 1.09, 95% CI: 1.02, 1.16) and HDM-ARD (RRlag0-5 for the 95th percentile: 1.36, 95% CI: 1.06, 1.75; RRlag0-5 for IQR increment (40.6 µg/m3): 1.11, 95% CI: 1.02, 1.22), but not in girls. Conclusions Exposure to O3 appeared to be a trigger of clinical visits for childhood ARD, especially for HDM-ARD and boys. These findings provide novel evidence on the impact of air pollution on HDM-ARD, which may have significant implications for designing effective intervention programs to control and prevent childhood ARD, especially HDM-ARD, in China and other similar developing countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01967-1.
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Khodadadi N, Dastoorpoor M, Khanjani N, Ghasemi A. Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes in Ahvaz, Iran. Reprod Health 2022; 19:33. [PMID: 35109854 PMCID: PMC8811963 DOI: 10.1186/s12978-022-01344-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
Background Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results The results showed that the low values of UTCI index (11.6 °C, in lags 0–6, 0–13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0–13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. Conclusions It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes. Scientists have found that climate change has adverse effects on human health. Because pregnant women are one of the most vulnerable groups, these negative impacts may affect their fetuses, which make up the next generation. In this study, we examined the effect of temperature on some pregnancy outcomes, including low birth weight, preterm labor, spontaneous abortion, preeclampsia and gestational hypertension in Ahvaz city, which is one of the hottest cities in the world. One way to assess temperature impact on humans is by using temperature indicators. In this study we used the Universal Thermal Climate Index (UTCI) for this purpose. The data at different time intervals were collected and evaluated with specific models. Our results showed that low values of UTCI, which is equivalent to cold weather, significantly increase the risk of preterm labor. But, high levels of UTCI, which means hot weather, significantly increase the risk of stillbirth. In conclusion; both hot and cold weather can be associated with adverse pregnancy outcomes in Ahvaz city. Therefore, pregnant women should protect themselves from exposure to hot and cold weather.
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Affiliation(s)
- Narges Khodadadi
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Afsaneh Ghasemi
- Department of Public Health, School of Public Health, Fasa University of Medical Sciences, Fasa, Iran.
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11
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Dastoorpoor M, Khanjani N, Khodadadi N. Association between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes in Ahvaz, southwest of Iran. BMC Pregnancy Childbirth 2021; 21:415. [PMID: 34088277 PMCID: PMC8178880 DOI: 10.1186/s12884-021-03876-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 05/13/2021] [Indexed: 12/16/2022] Open
Abstract
Background There are few epidemiological studies on the relation between temperature changes and adverse pregnancy outcomes. The purpose of this study was to determine the relation between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on adverse pregnancy outcomes. In this study the effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results High PET (45.4 C°, lag = 0) caused a significant increase in risk of stillbirth. Also, high levels of PET (45.4, 43.6, 42.5 C°, lag = 0–6) and low levels of PET (9.9, 16.9 C°, lags = 0, 0–13, 0–21) significantly increased the risk of LBW. But, low levels of PET (6.4, 9.9, 16.9 C°, lags = 0–6, 0–13) reduced the risk of gestational hypertension. Conclusion The results of this study showed that hot and cold thermal stress may be associated with increased risk of stillbirth, and LBW in Ahvaz.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khodadadi
- Department of Epidemiology and Biostatistics, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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12
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Zhang W, Du G, Xiong L, Liu T, Zheng Z, Yuan Q, Yang J, Wu Y, Zhu R, Hu G. Extreme temperatures and cardiovascular mortality: assessing effect modification by subgroups in Ganzhou, China. Glob Health Action 2021; 14:1965305. [PMID: 34482804 PMCID: PMC8425637 DOI: 10.1080/16549716.2021.1965305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Many people die from cardiovascular diseases each year, and extreme temperatures are regarded as a risk factor for cardiovascular deaths. However, the relationship between temperature and cardiovascular deaths varies in different regions because of population density, demographic inequality, and economic situation, and the evidence in Ganzhou, China is limited and inconclusive. Objective This study aimed to assess extreme temperature-related cardiovascular mortality and identify the potential vulnerable people. Methods After controlling other meteorological measures, air pollution, seasonality, relative humidity, day of the week, and public holidays, we examined temperature-related cardiovascular mortality along 21 lag days by Poisson in Ganzhou, China. Results A J-shaped relationship was observed between mean temperature and cardiovascular mortality. Extremely low temperatures substantially increased the relative risks (RR) of cardiovascular mortality. The effect of cold temperature was delayed by 2–6 days and persisted for 4–10 days. However, the risk of cardiovascular mortality related to extremely high temperatures was not significant (p > 0.05). Subgroup analysis indicated that extremely low temperatures had a stronger association with cardiovascular mortality in people with cerebrovascular diseases (RR: 1.282, 95% confidence interval [CI]: 1.020–1.611), males (RR: 1.492, 95% CI: 1.175–1.896), married people (RR: 1.590, 95% CI: 1.224–2.064), and people above the age of 65 years (RR: 1.641, 95% CI: 1.106–2.434) than in people with ischemic heart disease, females, unmarried people, and the elderly (≥65 years old), respectively. Conclusions The type of cardiovascular disease, sex, age, and marital status modified the effects of extremely low temperatures on the risk of cardiovascular mortality. These findings may help local governments to establish warning systems and precautionary measures to reduce temperature-related cardiovascular mortality.
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Affiliation(s)
- Wei Zhang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gang Du
- Ganzhou Center For Disease Control And Prevention, Ganzhou, Jiangxi, China
| | - Liang Xiong
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Tingting Liu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zuobing Zheng
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Qiong Yuan
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jiahui Yang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yangna Wu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Rongfei Zhu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gonghua Hu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
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13
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Borghei Y, Moghadamnia MT, Sigaroudi AE, Ghanbari A. Association between climate variables (cold and hot weathers, humidity, atmospheric pressures) with out-of-hospital cardiac arrests in Rasht, Iran. J Therm Biol 2020; 93:102702. [PMID: 33077123 DOI: 10.1016/j.jtherbio.2020.102702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/13/2020] [Accepted: 08/15/2020] [Indexed: 11/19/2022]
Abstract
Climate change is one of the most important concerns for public health that affects communities and is a threat to human health. Few cross-sectional studies investigated the effects of extreme temperature as a risk factor on the cardiovascular system and the Out-of-Hospital Cardiac Arrests (OHCA).The current study aims to investigate the association between climate variables (cold and hot weathers, humidity, atmospheric pressures) with Out-of-Hospital Cardiac Arrests in Rasht, Iran.This is an ecological time-series study, which investigated 392 patients with OHCA that were hospitalized in Dr. Heshmat Medical center of Rasht city in a 3-years period. Data on meteorological variables were obtained from the General Meteorological Department of Guilan Province. Information regarding the number of cardiac arrest admissions was obtained from the sole specialized cardiac hospital of Rasht. Data were analyzed using R software.Hot weather decreases the number of cardiac attacks on the same day (lag 0), while the cold weather (relative risk (RR) = 1.408; confidence interval (CI): 1.014-1.955) increases the number of OHCA cases and unsuccessful cardiopulmonary resuscitation (CPRs). Low humidity (RR = 1.76; CI: 1.006-3.79) is associated with increased unsuccessful CPRs. High atmospheric pressures (RR = 1.166; CI: 1.001 to 1.787) are also associated with an increased number of cardiac arrest admissions. For women, men, and those aged >65 years of old, exposure with severe cold (RR = 1.335; CI: 1.014-1.758) and hot weathers, respectively, increases and decreases the number of cardiac arrest admissions.Cold weather has immediate impacts on the incidence of OHCA cases and unsuccessful CPRs. Decreasing humidity also increases the number of and decreases the success rate of CPRs. Increasing the awareness of patients with cardiovascular diseases (CVDs as well as improving the preparedness of emergency care teams can decrease the impacts of climate variables.
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Affiliation(s)
- Yasaman Borghei
- Department of Medical, Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran; Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mohammad Taghi Moghadamnia
- Department of Medical, Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran; Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran.
| | - Abdolhossein Emami Sigaroudi
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Ali Ghanbari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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14
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Tsekeri E, Kolokotsa D, Santamouris M. On the association of ambient temperature and elderly mortality in a Mediterranean island - Crete. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 738:139843. [PMID: 32531601 DOI: 10.1016/j.scitotenv.2020.139843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/06/2020] [Accepted: 05/28/2020] [Indexed: 05/28/2023]
Abstract
Extreme weather conditions affect human health. This study analyses the association of high and low temperature with cardiovascular and respiratory diseases on people over 65 years old for the years 2007 to 2015, in the region of Chania, Greece. The mortality is examined by time series analysis and further investigated by Poisson, and Negative Binomial regression, showing that one-lag in maximum temperature strongly affects the health of the elderly. Finally, cluster analysis is used from May to October, which is confirmed by discriminant analysis.
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Affiliation(s)
- Elisavet Tsekeri
- Energy Management in the Built Environment Research Lab, Environmental Engineering School, Technical University of Crete, Technical University Campus, Kounoupidiana, GR 73100 Chania, Greece.
| | - Dionysia Kolokotsa
- Energy Management in the Built Environment Research Lab, Environmental Engineering School, Technical University of Crete, Technical University Campus, Kounoupidiana, GR 73100 Chania, Greece.
| | - Mat Santamouris
- The Anitta Lawrence Chair of High-Performance Architecture, Faculty of Built Environment, University of New South Wales, Sydney, NSW 2052, Australia.
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15
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Arifwidodo SD, Chandrasiri O. Urban heat stress and human health in Bangkok, Thailand. ENVIRONMENTAL RESEARCH 2020; 185:109398. [PMID: 32203732 DOI: 10.1016/j.envres.2020.109398] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 06/10/2023]
Abstract
Heat stress has been recognized as one of the consequences of climate change in urban areas. Its adverse effects on the urban population range from economy, social, environment, and human health. With the increasing urbanization and economic development in cities, heat stress is expected to worsen. This particular study aims to achieve two objectives: (1) to understand the determinants of heat stress, especially the roles of the urban environment in exacerbating the heat stress, and (2) to explore the effects of heat stress to human health using self-reported health assessment. We employed a cross-sectional study using a survey questionnaire from 505 respondents living in the urban area of Bangkok, Thailand. We found that socioeconomic conditions of the individual and urban environment were significant determinants of urban heat stress. Low-income urban populations living in high-density areas with less green open space were more likely to experience heat stress. We also found that heat stress significantly affects human health. Those who reported a higher level of heat stress were more likely to have adverse health and well-being outcomes. The findings suggest that the increased risk of heat stress represents a major problem in the Bangkok, Thailand. It is necessary to address heat stress in adaptation policy and measures at the city levels amid the continued increase of global temperature and climate change.
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Affiliation(s)
- Sigit D Arifwidodo
- Department of Landscape Architecture, Faculty of Architecture, Kasetsart University, Thailand.
| | - Orana Chandrasiri
- International Health Policy Program, Ministry of Public Health, Thailand
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16
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Song J, Huang B, Kim JS, Wen J, Li R. Fine-scale mapping of an evidence-based heat health risk index for high-density cities: Hong Kong as a case study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 718:137226. [PMID: 32087579 DOI: 10.1016/j.scitotenv.2020.137226] [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: 10/01/2019] [Revised: 01/21/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
The most recent extreme heat recorded in Europe re-alerts the world to the threat of heat stress. Future extreme heat events are reported to be more frequent, long-lasting, and intense. The intense exposure to hot temperatures can cause an excess of heat-related deaths, leading to an increasing risk of heat-related health. In reducing Heat Health Risk (HHR), the use of fine-scale evidence-based mapping of heat-related health risk index (HHRI) and its underlying contributors is essential for policy-making and site-specific action plans. However, its use is still considered to be at an early stage, especially in high-density cities like Hong Kong. This study conducted a spatially explicit assessment of HHR in Hong Kong and constructed a HHRI based on indicators categorized through Principle Component Analysis (PCA) into four meaningful components representing social/language, social isolation, socioeconomic, and urbanization/environmental risks. The applicability of the index was validated against heat-related mortality data at the community level. The community-level maps of HHRI and its subcomponents revealed that portions of Kowloon Peninsula had always suffered exceptionally high HHR ten years ago and after, but the hot spots and problematic communities experienced displacement and the dominant underlying factors of their HHR also varied. Results also showed that HHRI correlated fairly well with the heat-related deaths ratio (R2 = 0.60) at the community level for most of Hong Kong (62.33% of all communities that contain 81.69% of total population). Our analysis results helped generate an evidence-based index to assess HHR in high-density cities like Hong Kong and provided fine-scale maps of the index and its subcomponents, with the aim of benefiting site-specific policy making and optimizing the existing action plans.
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Affiliation(s)
- Jinglu Song
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu Province, China; Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Bo Huang
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong; Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Joon Sik Kim
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu Province, China
| | - Jiahong Wen
- School of Environmental and Geographical Sciences, Shanghai Normal University, Shanghai 200234, China
| | - Rongrong Li
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
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17
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Lam HCY, Huang Z, Liu S, Guo C, Goggins WB, Chan EYY. Personal Cold Protection Behaviour and Its Associated Factors in 2016/17 Cold Days in Hong Kong: A Two-Year Cohort Telephone Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051672. [PMID: 32143415 PMCID: PMC7084253 DOI: 10.3390/ijerph17051672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 12/22/2022]
Abstract
Background: Despite larger health burdens attributed to cold than heat, few studies have examined personal cold protection behaviours (PCPB). This study examined PCPB during cold waves and identified the associated factors in a subtropical city for those without central heating system. Methods: A cohort telephone survey was conducted in Hong Kong during a colder cold wave (2016) and a warmer cold wave (2017) among adults (≥15). Socio-demographic information, risk perception, self-reported adverse health effects and patterns of PCPB during cold waves were collected. Associated factors of PCPB in 2017 were identified using multiple logistic regression. Results: The cohort included 429 subjects. PCPB uptake rates were higher during the colder cold wave (p < 0.0005) except for ensuring indoor ventilation. Of the vulnerable groups, 63.7% had low self-perceived health risks. High risk perception, experience of adverse health effects during the 2016 cold wave, females and older groups were positive associated factors of PCPB in 2017 (p < 0.05). Conclusions: PCPB changed with self-risk perception. However vulnerable groups commonly underestimated their own risk. Indoor ventilation may be a concern during cold days in settings that are less prepared for cold weather. Targeted awareness-raising promotion for vulnerable groups and practical strategies for ensuring indoor ventilation are needed.
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Affiliation(s)
- Holly Ching Yu Lam
- National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, London SW3 6LR, UK;
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; (Z.H.); (S.L.); (C.G.)
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - Zhe Huang
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; (Z.H.); (S.L.); (C.G.)
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - Sida Liu
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; (Z.H.); (S.L.); (C.G.)
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - Chunlan Guo
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; (Z.H.); (S.L.); (C.G.)
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - William Bernard Goggins
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong, China;
| | - Emily Ying Yang Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; (Z.H.); (S.L.); (C.G.)
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, New Territories, Hong Kong, China;
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LF, UK
- Correspondence: ; Tel.: +852-2252-8411
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Hu Y, Xu Z, Jiang F, Li S, Liu S, Wu M, Yan C, Tan J, Yu G, Hu Y, Yin Y, Tong S. Relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 706:135975. [PMID: 31841850 DOI: 10.1016/j.scitotenv.2019.135975] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/05/2019] [Accepted: 12/05/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Non-optimal weather conditions and air pollution pose a significant threat to children's health. However, the relative impact of different environmental exposures on childhood allergic diseases remains unclear. OBJECTIVES This study aimed to quantify the relative impact of meteorological factors and air pollutants on childhood allergic diseases in Shanghai, China. METHODS Data on clinical visits due to childhood asthma, allergic rhinitis (AR) and atopic dermatitis (AD) from 2007 to 2017 in Shanghai were collected from Shanghai Children's Medical Center and Xinhua Hospital. The meteorological data (i.e. daily mean temperature, temperature difference, air pressure, air pressure difference, precipitation, relative humidity, sunshine and wind speed) for the same period were obtained from the Shanghai Meteorological Center. Air pollution data (PM10, PM2.5, NO2, SO2 and O3) were provided by the Shanghai Environmental Protection Agency. Quasi-Poisson regression with distributed lag non-linear models and Poisson regression combined with generalized linear models were used to assess the relative impact of meteorological factors and air pollutants on childhood allergic diseases. RESULTS There were a total of 2,410,392 cases of childhood allergic diseases, including 975,771 asthma, 646,975 AR and 787,646 AD. Most of environmental factors were significantly associated with childhood allergic diseases. Daily mean temperature (standard β: -0.076 (95% confidence interval (CI): -0.086, -0.067)) and air pressure (standard β: 0.075 (95% CI: 0.068, 0.082)) seemed to play more important roles than other environmental factors in the occurrence of these allergic diseases. The numbers of these allergic diseases attributable to an interquartile range (IQR) change in meteorological factors also appeared to be greater than those attributable to an IQR change in air pollutants. CONCLUSIONS Both climatic variation and air pollution were associated with childhood allergic diseases, but the former appeared to play a more important role in the occurrence of these diseases. These findings may have significant implications for the development of tailored strategies to prevent these rapidly-increasing diseases worldwide.
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Affiliation(s)
- Yabin Hu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shenghui Li
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
| | - Shijian Liu
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meiqin Wu
- Shanghai Key Laboratory of Environmental and Child Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chonghuai Yan
- Shanghai Key Laboratory of Environmental and Child Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Guangjun Yu
- Shanghai Children's Hospital, Shanghai, China
| | - Yi Hu
- Shanghai Children's Hospital, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China.
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19
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Ambulance Services Associated with Extreme Temperatures and Fine Particles in a Subtropical Island. Sci Rep 2020; 10:2855. [PMID: 32071336 PMCID: PMC7029034 DOI: 10.1038/s41598-020-59294-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/20/2020] [Indexed: 11/13/2022] Open
Abstract
This study evaluated the association between the risk of events requiring ambulance services and the ambient temperature and particulate matter of 2.5 μm (PM2.5) and 10 μm (PM10) for populations living in subtropical Taiwan. We used a distributed lag nonlinear model with a quasi-Poisson function to assess the roles of ambient temperature, PM10 and PM2.5 in the use of ambulance services for respiratory distress, coma and unconsciousness, chest pain, lying down in public, headaches/dizziness/vertigo/fainting/syncope and out-of-hospital cardiac arrest (OHCA). The relative risk (RR) and 95% confidence interval (CI) of each specific event were calculated in association with the ambient conditions. In general, the events that required ambulance services had a V-shaped or J-shaped association with the temperature, where the risks were higher at extreme temperatures. The RR of each event was significant when the patients were exposed to temperatures in the 5th percentile (<15 °C); patients with OHCA had the highest adjusted RR of 1.61 (95% CI = 1.47–1.77). The risks were also significant for coma/unconsciousness, headaches/dizziness/vertigo/fainting/syncope, and OHCA but not for respiratory distress, chest pain and lying down in public, after exposure to the 99th percentile temperatures of >30 °C. The risks for use of ambulance services increased with PM exposure and were significant for events of respiratory distress, chest pain and OHCA after exposure to the 99th percentile PM2.5 after controlling for temperatures. Events requiring ambulance services were more likely to occur when the ambient temperature was low than when it was high for the population on the subtropical island of Taiwan. The association of the risk of events requiring ambulance services with PM were not as strong as the association with low temperatures.
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Development of the Adjusted Wind Chill Equivalent Temperature (AWCET) for cold mortality assessment across a subtropical city: validation and comparison with a spatially-controlled time-stratified approach. BMC Public Health 2019; 19:1290. [PMID: 31615481 PMCID: PMC6794828 DOI: 10.1186/s12889-019-7612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/11/2019] [Indexed: 12/03/2022] Open
Abstract
Background Global warming has reduced the adaptability of the people living in subtropical regions to cope up with cold stress due to lengthening of hot days and shortening of transition period from hot to cold weather. However, existing studies on measuring cold stress are based on biometeorological indices designed for temperate regions. This may overestimate the impact of wind chill on mortality risk in subtropical cities. Methods This study developed an Adjusted Wind Chill Equivalent Temperature (AWCET) index. A spatially-controlled time-stratified approach was applied to evaluate the ability of AWCET for estimating cold mortality in subtropical cities, based on a mortality dataset (2008–2012) in Hong Kong. Results The use of AWCET could indicate increase in all-cause, cardiovascular, respiratory, and cancer-related mortality risk during the days with average temperature < = 1st [11.0 °C], <= 3rd [12.6 °C] and < = 5th [13.4 °C] percentiles. The results were stable and consistent based on both log-linear and curve-linear relationships between AWCET and mortality risk. AWCET was also compared with the New Wind Chill Equivalent Temperature (NWCET) designed for temperate regions, and has found that higher magnitude of mortality risk would be found when using AWCET for assessing all-cause and cause-specific mortality in Hong Kong, for days with average temperature < = 1st, <= 3rd and < = 5th percentiles. Conclusions AWCET is validated to be effective to access cold mortality in the context of subtropical cities. The use of AWCET may enhance the cold weather warning system in subtropical cities, as a supplementary tool to help demonstrating small administrative-level perceived temperature with volunteered geographic information.
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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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Aboubakri O, Khanjani N, Jahani Y, Bakhtiari B. The impact of heat waves on mortality and years of life lost in a dry region of Iran (Kerman) during 2005-2017. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1139-1149. [PMID: 31127424 DOI: 10.1007/s00484-019-01726-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/01/2019] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
The present study was conducted to compare the impact of heat waves on mortality and years of life lost (YLL) in Kerman, Iran during the years 2005-2017. Daily mean temperature in a combination of intensity and duration were used in order to define heat waves (90, 95, and 98th percentile and ≥ 2, 3, and 4 consecutive days). YLL was calculated according to Iran's life table and by considering the discount rate. In order to investigate the impact of heat waves in different lags and its cumulative effect on mortality and YLL, Poisson and linear models within distributed lag nonlinear models were used respectively. A maximum lag of 14 days was considered. The best model was selected based on AIC (Akaike Information Criteria). The model was adjusted for air pollutants, public holidays, days of the week, and humidity. The average daily mortality and YLL were 10.54 ± 4.31 deaths and 175.58 ± 91.39 years respectively. They were higher in men and in heat waves matching a definition of above the 98th temperature percentile and ≥ 3 days, than others. Except heat waves defined as the 98th percentile and ≥ 4 days, the impact of heat waves on mortality and YLL were the highest at lag 0. The cumulative relative risk of total mortality was significantly higher in heat waves above the 95 and 98th percentiles. The cumulative effect of heat waves on total YLL was significantly higher only above the 98th percentile. Men over 65 years old were the most vulnerable and had the highest mortality and YLL. Heat waves with temperatures above the 98th percentile that lasted at least 2 or 3 consecutive days had a significant effect in increasing both total YLL and mortality in Kerman, Iran.
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Affiliation(s)
- Omid Aboubakri
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Younes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bahram Bakhtiari
- Water Engineering Department, College of Agriculture, Shahid Bahonar University of Kerman, Kerman, Iran
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Ho HC, Wong MS. Urban environmental influences on the temperature-mortality relationship associated mental disorders and cardiorespiratory diseases during normal summer days in a subtropical city. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:24272-24285. [PMID: 31230236 DOI: 10.1007/s11356-019-05594-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Abstract
Temperature is associated with mortality risk across cities. However, there is lack of study investigating the summer effect on mortality associated with mental/behavioral disorders, especially in cities with subtropical climate. In addition, summer mortality in subtropical cities is different from tropical cities, and previous studies have not investigated the urban environmental inequality on heat mortality associated with mental/behavioral disorders. A register-based study was developed to estimate the temperature effects on decedents on days with 50th percentile of average daily temperature between 2007 and 2014 in Hong Kong (n = 133,359). Poisson regression was firstly applied to estimate the incidence rate ratio (IRR) from the summer temperature effects on all-cause mortality, cardiovascular mortality, respiratory mortality, and mortality associated with mental/behavioral disorders. For a 1 °C increase in average temperature on days with temperature ≥ 24.51 °C, IRRs of mortality associated with mental and behavioral disorders on lag 0 and lag 1 days were 1.033 [1.004, 1.062] and 1.030 [1.002, 1.060], while temperature effects on cardiovascular mortality and respiratory mortality during normal summer days (not extreme heat events) were not significant. A further investigation with linear regression has shown that decedents with mental/behavioral disorders on higher temperature days resided in areas with lower percentage of sky view, lower percentage of vegetation cover, higher level of neighborhood-level PM2.5, higher level of neighborhood-level NO, and higher level of neighborhood-level black carbon (BC). In order to develop protocols for community healthcare based on the "Leaving no one behind" scheme documented in the 2016 Sustainable Development Goals report of the United Nations, it is necessary to include heat effects on mental/behavioral disorders, especially people with dementia, for community planning and healthcare development.
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Affiliation(s)
- Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
- Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
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Ma C, Yang J, Nakayama SF, Honda Y. The association between temperature variability and cause-specific mortality: Evidence from 47 Japanese prefectures during 1972-2015. ENVIRONMENT INTERNATIONAL 2019; 127:125-133. [PMID: 30913457 DOI: 10.1016/j.envint.2019.03.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/10/2019] [Accepted: 03/10/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND In the context of climate change, extreme temperature events are known to be associated with increased mortality risk. However, data about the mortality risk related to temperature variability (TV) accounting for both intra- and inter-day variations in temperature are limited. OBJECTIVES The present study aims to quantify the associations between TV and cause-specific mortality in Japan, evaluate whether the effects of TV are modified by prefecture-level characteristics and examine the temporal trend in mortality risk of TV. METHODS Data on daily all-cause and 11 cause-specific mortality and meteorological variables in 47 Japanese prefectures from 1972 to 2015 were collected. TV was defined as the standard deviation of daily minimum and maximum temperatures during exposure days. A quasi-Poisson regression model combined with a distributed lag non-linear model was firstly applied to assess the prefecture-specific mortality effects of TV, adjusting for potential confounders. The pooled effects of TV at the national level were then obtained via a meta-analysis through the restricted maximum-likelihood estimation. Potential effect modification by prefecture characteristics was firstly examined using a meta-regression analysis, and the joint modification of season and humidity was then evaluated after including product terms in two-stage analyses. Finally, the temporal trend in TV effects was evaluated by a random-effect meta regression model after obtaining the prefecture-year-specific effects. RESULTS TV had significant adverse effects on all-cause and cause-specific mortality. The effects of TV were more detrimental to those with asthma and senility. In general, the estimates of mortality risk increased with longer exposure days. A 1 °C increase in TV at 0-7 days of exposure was associated with a 0.9% (95% confidence intervals: 0.82%-0.98%) increase in all-cause mortality. All-cause mortality risk of TV showed a decreasing trend during our study period. TV effects were larger in densely populated prefectures and on warm and humid days. CONCLUSIONS TV-related death is a significant issue in Japan that requires effective interventions.
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Affiliation(s)
- Chaochen Ma
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Shoji F Nakayama
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
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Sun S, Cao W, Mason TG, Ran J, Qiu H, Li J, Yang Y, Lin H, Tian L. Increased susceptibility to heat for respiratory hospitalizations in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 666:197-204. [PMID: 30798230 DOI: 10.1016/j.scitotenv.2019.02.229] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/13/2019] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Emerging studies have shown temperature-mortality association is changing over time, but little is known about the temporal changes of the temperature-morbidity association. OBJECTIVES We aimed to evaluate the temporal variations in both temperature-respiratory hospitalizations associations and temperature-related attributable risks in Hong Kong. METHODS We collected 17-year time-series data on daily ambient temperature and emergency hospital admissions for respiratory diseases between 2000 and 2016 in Hong Kong. Quasi-Poisson regression with a time-varying distributed lag nonlinear model was used to estimate the year-specific association between temperature and respiratory hospitalizations [total respiratory, pneumonia, and chronic obstructive pulmonary disease (COPD)] and the year-specific attributable fraction (AF) for heat and cold (defined as above/below the optimum temperature, respectively). RESULTS Heat-related risks and AFs increased continuously for total respiratory, pneumonia and COPD hospitalizations during the past 17 years, respectively. Cold-hospitalization associations and cold-related AFs showed heterogeneous patterns, showing a decreasing trend for pneumonia but a general increasing trend for COPD for both the associations and AFs. The total temperature-related AFs remained stable for total respiratory (p for trend = 0.136) and pneumonia (p for trend = 0.406), but showed an increasing trend for COPD (p for trend < 0.001) from 10% (95% empirical CI: 2%, 17%) in 2000 to 17% (95% empirical CI: 11%, 22%) in 2016. CONCLUSIONS Our findings indicate an increased susceptibility to heat but a decreased susceptibility to cold for respiratory hospitalizations during the past 17 years. The overall temperature-related hospitalization burden for respiratory diseases was generally stable in Hong Kong.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, The University of Hong Kong, Hong Kong, China; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Wangnan Cao
- Public Health and Healthy Ageing Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Tonya G Mason
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Jinjun Ran
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Hong Qiu
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Jinhui Li
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yang Yang
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong, China.
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Morakinyo TE, Ogungbenro SB, Abolude AT, Akinsanola AA. Quantifying the effect of rain events on outdoor thermal comfort in a high-density city, Hong Kong. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:19-27. [PMID: 30374601 DOI: 10.1007/s00484-018-1634-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/31/2018] [Accepted: 10/11/2018] [Indexed: 06/08/2023]
Abstract
Rainfall events often cause a modification to atmospheric conditions. The impact of this phenomenon on human thermal comfort has however been less well studied. Therefore, this paper quantifies the effect of rainfall events on human thermal comfort in a hot-humid subtropical city, Hong Kong. Firstly, rainfall events were categorized based on time of occurrence, i.e., morning (on or before 11:00 LST), afternoon (12:00-15:00, LST), early evening (16:00-18:00), and all-day events. Thereafter, human thermal comfort on typical non-rainy (sunny) days and rainy days was estimated and compared by using the radiation-driven physiological equivalent temperature (PET) and non-radiation-driven temperature-humidity index (THI) and compared. Results revealed variable and stable hourly patterns of PET and THI thermal classification, respectively under different rainfall event category. The insensitivity of THI values could be due to the retained strong contribution of both input parameters (air temperature and relative humidity) on both rainy and non-rainy (sunny) days. An understanding of the mechanism of thermal changes before, during, and after rainfall events based on statistical analysis suggests a strong interplay between moisture content and air temperature as determinants of thermal comfort in the hot-humid city and not necessarily the radiation parameter. This finding suggests that while PET clearly shows the impact of rain-event; it is principally due to the strong contribution of the lowered radiant temperature in its calculation while in reality, the critical determinants of thermal comfort in such period in a hot-humid subtropical environment like Hong Kong are the moisture content and ambient temperature. Finding from the study could enhance occupational health and safety management of outdoor workplaces.
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Affiliation(s)
| | | | - Akintayo Temi Abolude
- School of Energy and Environment, City University of Hong Kong, Kowloon, Hong Kong SAR
| | - Akintomide Afolayan Akinsanola
- Department of Meteorology and Climate Science, Federal University of Technology, Akure, Nigeria
- School of Energy and Environment, City University of Hong Kong, Kowloon, Hong Kong SAR
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Ma Y, Zhou J, Yang S, Yu Z, Wang F, Zhou J. Effects of extreme temperatures on hospital emergency room visits for respiratory diseases in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:3055-3064. [PMID: 30506386 DOI: 10.1007/s11356-018-3855-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
Extreme temperature is closely associated with human health, but limited evidence is available for the effects of extreme temperatures on respiratory diseases in China. The goal of this study is to evaluate the effects of extreme temperatures on hospital emergency room (ER) visits for respiratory diseases in Beijing, China. We used a distributed lag non-linear model (DLNM) coupled with a generalized additive model (GAM) to estimate the association between extreme temperatures and hospital ER visits for different age and gender subgroups in Beijing from 2009 to 2012. The results showed that the exposure-response curve between temperature and hospital ER visits was almost W-shaped, with increasing relative risks (RRs) at extremely low temperature. In the whole year period, strong acute hot effects were observed, especially for the elders (age > 65 years). The highest RR associated with the extremely high temperature was 1.36 (95% CI, 0.96-1.92) at lag 0-27. The longer-lasting cold effects were found the strongest at lag 0-27 for children (age ≤ 15 years) and the relative risk was 1.96 (95% CI, 1.70-2.26). We also found that females were more susceptible to extreme temperatures than males.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Jianding Zhou
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Sixu Yang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fei Wang
- Tacheng Meteorology Bureau, Xinjiang, 834700, China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
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Chen R, Miao F, Zheng J, Wu Y, Li Y. Effects of Consecutive Moderately Cold Days on Cardiovascular Disease Mortality in Shenzhen, China: A Preliminary Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1148-1151. [PMID: 30440594 DOI: 10.1109/embc.2018.8513273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite traditional risk factors such as aging and hyperlipemia for cardiovascular disease (CVD) mortality, many studies have also confirmed that both hot and cold ambient temperatures are associated with CVD mortality. This paper aims to explore the effects of consecutive moderately cold days on CVD mortality in the warm city Shenzhen during relatively cold months from 2011 to 2015. In this study, totally there were 4589 CVD death cases among the residents during a total of 24 relatively cold months. Effects of consecutive cold days on CVD mortality was evaluated by the daily percent increase of CVD mortality. Three temperature thresholds were selected, which were 15°, 14°, and 13°, respectively. The results showed that when the cold weather lasted 5 days and onwards, CVD mortality showed a continuous increment. When the temperature thresholds were 15°, 14°, or 13°, percent increase of CVD mortality at the consecutive 6th cold day reached 22%, 21%, and 24% respectively, and 26%, 38%, 33% at the consecutive 10th cold day, respectively. Thus, the consecutive moderately cold days in warm regions had continuous and accumulative negative effects on CVD mortality. The study may help local government to take timely prevention measures for moderately cold temperatures and thus to protect the wellbeing for the public.
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Kulkarni GE, Muley AA, Deshmukh NK, Bhalchandra PU. Autoregressive integrated moving average time series model for forecasting air pollution in Nanded city, Maharashtra, India. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s40808-018-0493-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Naddafi K, Yekaninejad MS. The Effects of Apparent Temperature on Cardiovascular Mortality Using a Distributed Lag Nonlinear Model Analysis: 2005 to 2014. Asia Pac J Public Health 2018; 30:361-368. [PMID: 29671331 DOI: 10.1177/1010539518768036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relationship between apparent temperature and cardiovascular disease (CVD) mortality was studied in Rasht, Iran, from 2005 to 2014. The effects of apparent temperature on CVD mortality were investigated using the distributed lag nonlinear model. Data on all types of cardiovascular mortality cases according to the International Classification of Diseases were collected from the only cardiovascular hospital in Rasht, and the meteorological variables were obtained from Rasht Meteorological Center during the period of study. Our findings showed that low temperatures had significant impacts on CVD mortality, and a reverse J-shaped temperature-mortality relationship was found. Moreover, immediate effects of hot temperatures on CVD mortality with the strongest effects on the same day but delayed effects of cold temperature was observed. This study showed that exposure to both hot and cold apparent temperatures was associated with increased cardiovascular mortality in Rasht.
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- 1 Guilan University of Medical Sciences, Rasht, Iran.,2 Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- 2 Tehran University of Medical Sciences, Tehran, Iran.,3 Harvard Humanitarian Initiative, Cambridge, MA, USA
| | | | - Kazem Naddafi
- 2 Tehran University of Medical Sciences, Tehran, Iran
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Seasonal temperature variability and emergency hospital admissions for respiratory diseases: a population-based cohort study. Thorax 2018; 73:951-958. [DOI: 10.1136/thoraxjnl-2017-211333] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/05/2018] [Accepted: 03/26/2018] [Indexed: 11/03/2022]
Abstract
BackgroundClimate change increases global mean temperature and changes short-term (eg, diurnal) and long-term (eg, intraseasonal) temperature variability. Numerous studies have shown that mean temperature and short-term temperature variability are both associated with increased respiratory morbidity or mortality. However, data on the impact of long-term temperature variability are sparse.ObjectiveWe aimed to assess the association of intraseasonal temperature variability with respiratory disease hospitalisations among elders.MethodsWe ascertained the first occurrence of emergency hospital admissions for respiratory diseases in a prospective Chinese elderly cohort of 66 820 older people (≥65 years) with 10–13 years of follow-up. We used an ordinary kriging method based on 22 weather monitoring stations in Hong Kong to spatially interpolate daily ambient temperature for each participant’s residential address. Seasonal temperature variability was defined as the SD of daily mean summer (June–August) or winter (December–February) temperatures. We applied Cox proportional hazards regression with time-varying exposure of seasonal temperature variability to respiratory admissions.ResultsDuring the follow-up time, we ascertained 12 689 cases of incident respiratory diseases, of which 6672 were pneumonia and 3075 were COPD. The HRs per 1°C increase in wintertime temperature variability were 1.20 (95% CI 1.08 to 1.32), 1.15 (1.01 to 1.31) and 1.41 (1.15 to 1.71) for total respiratory diseases, pneumonia and COPD, respectively. The associations were not statistically significant for summertime temperature variability.ConclusionWintertime temperature variability was associated with higher risk of incident respiratory diseases.
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Mohammadi R, Soori H, Alipour A, Bitaraf E, Khodakarim S. The impact of ambient temperature on acute myocardial infarction admissions in Tehran, Iran. J Therm Biol 2018; 73:24-31. [DOI: 10.1016/j.jtherbio.2018.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/06/2018] [Accepted: 02/11/2018] [Indexed: 12/27/2022]
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Sharafkhani R, Khanjani N, Bakhtiari B, Jahani Y, Sadegh Tabrizi J. Physiological Equivalent Temperature Index and mortality in Tabriz (The northwest of Iran). J Therm Biol 2018; 71:195-201. [DOI: 10.1016/j.jtherbio.2017.11.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/11/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
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Ho HC, Lau KKL, Ren C, Ng E. Characterizing prolonged heat effects on mortality in a sub-tropical high-density city, Hong Kong. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1935-1944. [PMID: 28735445 DOI: 10.1007/s00484-017-1383-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 04/10/2017] [Accepted: 05/15/2017] [Indexed: 05/21/2023]
Abstract
Extreme hot weather events are likely to increase under future climate change, and it is exacerbated in urban areas due to the complex urban settings. It causes excess mortality due to prolonged exposure to such extreme heat. However, there is lack of universal definition of prolonged heat or heat wave, which leads to inadequacies of associated risk preparedness. Previous studies focused on estimating temperature-mortality relationship based on temperature thresholds for assessing heat-related health risks but only several studies investigated the association between types of prolonged heat and excess mortality. However, most studies focused on one or a few isolated heat waves, which cannot demonstrate typical scenarios that population has experienced. In addition, there are limited studies on the difference between daytime and nighttime temperature, resulting in insufficiency to conclude the effect of prolonged heat. In sub-tropical high-density cities where prolonged heat is common in summer, it is important to obtain a comprehensive understanding of prolonged heat for a complete assessment of heat-related health risks. In this study, six types of prolonged heat were examined by using a time-stratified analysis. We found that more consecutive hot nights contribute to higher mortality risk while the number of consecutive hot days does not have significant association with excess mortality. For a day after five consecutive hot nights, there were 7.99% [7.64%, 8.35%], 7.74% [6.93%, 8.55%], and 8.14% [7.38%, 8.88%] increases in all-cause, cardiovascular, and respiratory mortality, respectively. Non-consecutive hot days or nights are also found to contribute to short-term mortality risk. For a 7-day-period with at least five non-consecutive hot days and nights, there was 15.61% [14.52%, 16.70%] increase in all-cause mortality at lag 0-1, but only -2.00% [-2.83%, -1.17%] at lag 2-3. Differences in the temperature-mortality relationship caused by hot days and hot nights imply the need to categorize prolonged heat for public health surveillance. Findings also contribute to potential improvement to existing heat-health warning system.
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Affiliation(s)
- Hung Chak Ho
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
- Department of Land Surveying and Geo-Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong.
| | - Kevin Ka-Lun Lau
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Institute of Future Cities, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Chao Ren
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Institute of Future Cities, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- School of Architecture, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Edward Ng
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Institute of Future Cities, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- School of Architecture, The Chinese University of Hong Kong, Sha Tin, Hong Kong
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Yi W, Chan APC. Effects of Heat Stress on Construction Labor Productivity in Hong Kong: A Case Study of Rebar Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091055. [PMID: 28895899 PMCID: PMC5615592 DOI: 10.3390/ijerph14091055] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/04/2017] [Accepted: 09/09/2017] [Indexed: 02/08/2023]
Abstract
Global warming is bringing more frequent and severe heat waves, and the result will be serious for vulnerable populations such as construction workers. Excessive heat stress has profound effects on physiological responses, which cause occupational injuries, fatalities and low productivity. Construction workers are particularly affected by heat stress, because of the body heat production caused by physically demanding tasks, and hot and humid working conditions. Field studies were conducted between August and September 2016 at two construction training grounds in Hong Kong. Onsite wet-bulb globe temperature (WBGT), workers' heart rate (HR), and labor productivity were measured and monitored. Based on the 378 data sets of synchronized environmental, physiological, construction labor productivity (CLP), and personal variables, a CLP-heat stress model was established. It was found that WBGT, percentage of maximum HR, age, work duration, and alcohol drinking habits were determining factors for predicting the CLP (adjusted R² = 0.68, p < 0.05). The model revealed that heat stress reduces CLP, with the percentage of direct work time decreasing by 0.33% when the WBGT increased by 1 °C. The findings in this study extend the existing practice notes by providing scientific data that may be of benefit to the industry in producing solid guidelines for working in hot weather.
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Affiliation(s)
- Wen Yi
- School of Engineering and Advanced Technology, College of Sciences, Massey University, Auckland 0745, New Zealand.
| | - Albert P C Chan
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Keshtkar A, Naddafi K, Yekaninejad MS. Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis. PeerJ 2017; 5:e3574. [PMID: 28791197 PMCID: PMC5546177 DOI: 10.7717/peerj.3574] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. RESULT After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]). CONCLUSION Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Harvard Humanitarian Initiative, Harvard University, Cambridge, United States of America
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Evaluating the Effectiveness of Cooling Vest in a Hot and Humid Environment. Ann Work Expo Health 2017; 61:481-494. [DOI: 10.1093/annweh/wxx007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 01/24/2017] [Indexed: 11/14/2022] Open
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Clyde MA, Palmieri Weber R, Iversen ES, Poole EM, Doherty JA, Goodman MT, Ness RB, Risch HA, Rossing MA, Terry KL, Wentzensen N, Whittemore AS, Anton-Culver H, Bandera EV, Berchuck A, Carney ME, Cramer DW, Cunningham JM, Cushing-Haugen KL, Edwards RP, Fridley BL, Goode EL, Lurie G, McGuire V, Modugno F, Moysich KB, Olson SH, Pearce CL, Pike MC, Rothstein JH, Sellers TA, Sieh W, Stram D, Thompson PJ, Vierkant RA, Wicklund KG, Wu AH, Ziogas A, Tworoger SS, Schildkraut JM. Risk Prediction for Epithelial Ovarian Cancer in 11 United States-Based Case-Control Studies: Incorporation of Epidemiologic Risk Factors and 17 Confirmed Genetic Loci. Am J Epidemiol 2016; 184:579-589. [PMID: 27698005 PMCID: PMC5065620 DOI: 10.1093/aje/kww091] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 03/22/2016] [Indexed: 12/14/2022] Open
Abstract
Previously developed models for predicting absolute risk of invasive epithelial ovarian cancer have included a limited number of risk factors and have had low discriminatory power (area under the receiver operating characteristic curve (AUC) < 0.60). Because of this, we developed and internally validated a relative risk prediction model that incorporates 17 established epidemiologic risk factors and 17 genome-wide significant single nucleotide polymorphisms (SNPs) using data from 11 case-control studies in the United States (5,793 cases; 9,512 controls) from the Ovarian Cancer Association Consortium (data accrued from 1992 to 2010). We developed a hierarchical logistic regression model for predicting case-control status that included imputation of missing data. We randomly divided the data into an 80% training sample and used the remaining 20% for model evaluation. The AUC for the full model was 0.664. A reduced model without SNPs performed similarly (AUC = 0.649). Both models performed better than a baseline model that included age and study site only (AUC = 0.563). The best predictive power was obtained in the full model among women younger than 50 years of age (AUC = 0.714); however, the addition of SNPs increased the AUC the most for women older than 50 years of age (AUC = 0.638 vs. 0.616). Adapting this improved model to estimate absolute risk and evaluating it in prospective data sets is warranted.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joellen M. Schildkraut
- Correspondence to Dr. Joellen M. Schildkraut, University of Virginia, Department of Public Health Sciences, PO Box 800765, 560 Ray C. Hunt Drive, Charlottesville, VA 22903 (e-mail: )
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Ding Z, Li L, Wei R, Dong W, Guo P, Yang S, Liu J, Zhang Q. Association of cold temperature and mortality and effect modification in the subtropical plateau monsoon climate of Yuxi, China. ENVIRONMENTAL RESEARCH 2016; 150:431-437. [PMID: 27376930 DOI: 10.1016/j.envres.2016.06.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/11/2016] [Accepted: 06/17/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Consistent evidence has shown excess mortality associated with cold temperature, but some important details of the cold-mortality association (e.g. slope and threshold) have not been adequately investigated and few studies focused on the cold effect in high-altitude areas of developing countries. We attempted to quantify the cold effect on mortality, identify the details, and evaluate effect modification in the distinct subtropical plateau monsoon climate of Yuxi, a high plateau region in southwest China. METHODS From daily mortality and meteorological data during 2009-2014, we used a quasi-Poisson model combined with a "natural cubic spline-natural cubic spline" distributed lag non-linear model to estimate the temperature-mortality relationship and then a simpler "hockey-stick" model to investigate the cold effect and details. RESULTS Cold temperature was associated with increased mortality, and the relative risk of cold effect (1st relative to 10th temperature percentile) on non-accidental, cardiovascular, and respiratory mortality for lag 0-21 days was 1.40 (95% confidence interval: 1.19-1.66), 1.61 (1.28-2.02), and 1.13 (0.78-1.64), respectively. A 1°C decrease below a cold threshold of 9.1°C (8th percentile) for lags 0-21 was associated with a 7.35% (3.75-11.09%) increase in non-accidental mortality. The cold-mortality association was not significantly affected by cause-specific mortality, gender, age, marital status, ethnicity, occupation, or previous history of hypertension. CONCLUSIONS There is an adverse impact of cold on mortality in Yuxi, China, and a temperature of 9.1°C is an important cut-off for cold-related mortality for residents.
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Affiliation(s)
- Zan Ding
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China; Yuxi Center for Disease Control and Prevention, Yuxi, Yunnan 653000, China
| | - Liujiu Li
- Yuxi Center for Disease Control and Prevention, Yuxi, Yunnan 653000, China
| | - Ruqin Wei
- Yuxi Center for Disease Control and Prevention, Yuxi, Yunnan 653000, China
| | - Wenya Dong
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Shaoyi Yang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Ju Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China.
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Lee KL, Chan YH, Lee TC, Goggins WB, Chan EYY. The development of the Hong Kong Heat Index for enhancing the heat stress information service of the Hong Kong Observatory. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1029-39. [PMID: 26546311 DOI: 10.1007/s00484-015-1094-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 05/26/2023]
Abstract
This paper presents a study to develop a heat index, for use in hot and humid sub-tropical climate in Hong Kong. The study made use of hospitalization data and heat stress measurement data in Hong Kong from 2007 to 2011. The heat index, which is called Hong Kong Heat Index (HKHI), is calculated from the natural wet bulb temperature, the globe temperature, and the dry bulb temperature together with a set of coefficients applicable to the high humidity condition in the summer of Hong Kong. Analysis of the response of hospitalization rate to variation in HKHI and two other heat indices, namely Wet Bulb Globe Temperature (WBGT) and Net Effective Temperature (NET), revealed that HKHI performed generally better than WBGT and NET in reflecting the heat stress impact on excess hospitalization ratio in Hong Kong. Based on the study results, two reference criteria of HKHI were identified to establish a two-tier approach for the enhancement of the heat stress information service in Hong Kong.
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Affiliation(s)
- K L Lee
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China
| | - Y H Chan
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China.
| | - T C Lee
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China
| | - William B Goggins
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Emily Y Y Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
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Qiu H, Tian L, Ho KF, Yu ITS, Thach TQ, Wong CM. Who is more vulnerable to death from extremely cold temperatures? A case-only approach in Hong Kong with a temperate climate. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:711-717. [PMID: 26370114 DOI: 10.1007/s00484-015-1065-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/04/2015] [Accepted: 09/08/2015] [Indexed: 06/05/2023]
Abstract
The short-term effects of ambient cold temperature on mortality have been well documented in the literature worldwide. However, less is known about which subpopulations are more vulnerable to death related to extreme cold. We aimed to examine the personal characteristics and underlying causes of death that modified the association between extreme cold and mortality in a case-only approach. Individual information of 197,680 deaths of natural causes, daily temperature, and air pollution concentrations in cool season (November-April) during 2002-2011 in Hong Kong were collected. Extreme cold was defined as those days with preceding week with a daily maximum temperature at or less than the 1st percentile of its distribution. Logistic regression models were used to estimate the effects of modification, further controlling for age, seasonal pattern, and air pollution. Sensitivity analyses were conducted by using the 5th percentile as cutoff point to define the extreme cold. Subjects with age of 85 and older were more vulnerable to extreme cold, with an odds ratio (OR) of 1.33 (95 % confidence interval (CI), 1.22-1.45). The greater risk of extreme cold-related mortality was observed for total cardiorespiratory diseases and several specific causes including hypertensive diseases, stroke, congestive heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. Hypertensive diseases exhibited the greatest vulnerability to extreme cold exposure, with an OR of 1.37 (95 % CI, 1.13-1.65). Sensitivity analyses showed the robustness of these effect modifications. This evidence on which subpopulations are vulnerable to the adverse effects of extreme cold is important to inform public health measures to minimize those effects.
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Affiliation(s)
- Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Kin-fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ignatius T S Yu
- Hong Kong Occupational and Environmental Health Academy, Tsim Sha Tsui, Hong Kong
| | - Thuan-Quoc Thach
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Chit-Ming Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
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Tian L, Qiu H, Sun S, Lin H. Emergency Cardiovascular Hospitalization Risk Attributable to Cold Temperatures in Hong Kong. Circ Cardiovasc Qual Outcomes 2016; 9:135-42. [DOI: 10.1161/circoutcomes.115.002410] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 01/27/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Linwei Tian
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Hong Qiu
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Shengzhi Sun
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Hualiang Lin
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
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Son JY, Gouveia N, Bravo MA, de Freitas CU, Bell ML. The impact of temperature on mortality in a subtropical city: effects of cold, heat, and heat waves in São Paulo, Brazil. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:113-21. [PMID: 25972308 PMCID: PMC4644507 DOI: 10.1007/s00484-015-1009-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 04/24/2015] [Accepted: 04/30/2015] [Indexed: 05/27/2023]
Abstract
Understanding how weather impacts health is critical, especially under a changing climate; however, relatively few studies have investigated subtropical regions. We examined how mortality in São Paulo, Brazil, is affected by cold, heat, and heat waves over 14.5 years (1996-2010). We used over-dispersed generalized linear modeling to estimate heat- and cold-related mortality, and Bayesian hierarchical modeling to estimate overall effects and modification by heat wave characteristics (intensity, duration, and timing in season). Stratified analyses were performed by cause of death and individual characteristics (sex, age, education, marital status, and place of death). Cold effects on mortality appeared higher than heat effects in this subtropical city with moderate climatic conditions. Heat was associated with respiratory mortality and cold with cardiovascular mortality. Risk of total mortality was 6.1% (95% confidence interval 4.7, 7.6%) higher at the 99th percentile of temperature than the 90th percentile (heat effect) and 8.6% (6.2, 11.1%) higher at the 1st compared to the 10th percentile (cold effect). Risks were higher for females and those with no education for heat effect, and males for cold effect. Older persons, widows, and non-hospital deaths had higher mortality risks for heat and cold. Mortality during heat waves was higher than on non-heat wave days for total, cardiovascular, and respiratory mortality. Our findings indicate that mortality in São Paulo is associated with both cold and heat and that some subpopulations are more vulnerable.
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Affiliation(s)
- Ji-Young Son
- School of Forestry & Environmental Studies, Yale University, 195 Prospect St., New Haven, CT, 06511, USA
| | - Nelson Gouveia
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mercedes A Bravo
- School of Forestry & Environmental Studies, Yale University, 195 Prospect St., New Haven, CT, 06511, USA
| | - Clarice Umbelino de Freitas
- Centro de Vigilância Epidemiológica, Secretaria de Saúde do Estado de São Paulo, Health Surveillance of the Municipality of Sao Paulo, Sao Paulo, Brazil
| | - Michelle L Bell
- School of Forestry & Environmental Studies, Yale University, 195 Prospect St., New Haven, CT, 06511, USA.
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