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Sharma A, Yajing K, Lin MC, Deng L, Lin YK, Chianghsieh LH, Sung FC, Wang YC. Emergency room visits (ERVs) among occupational groups associated with ambient conditions in Taiwan. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02084-w. [PMID: 38958673 DOI: 10.1007/s00420-024-02084-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE This population-based study explored emergency room visits (ERVs) from all-causes, circulatory and respiratory diseases among different occupational groups in Taiwan associated with ambient average temperature. METHOD Daily area-age-sex specific ERVs records were obtained from the Taiwan's Ministry of Health and Welfare from 2009 to 2018. Distributed lag-nonlinear model (DLNM) was used to estimate the exposure-response relationships between daily average temperature and ERVs for all-causes, circulatory and respiratory diseases by occupational groups. Random-effects meta-analysis was used to pool the overall cumulative relative risk (RR) and 95% confidence interval (CI). RESULTS The exposure-response curves showed ERVs of all-cause and respiratory diseases increased with rising temperature across all occupational groups. These effects were consistently stronger among younger (20-64 years old) and outdoor workers. In contrast, ERVs risk from circulatory diseases increased significantly during cold snaps, with a substantially higher risk for female workers. Interestingly, female workers, regardless of indoor or outdoor work, consistently showed a higher risk of respiratory ERVs during hot weather compared to males. Younger workers (20-64 years old) exhibited a higher risk of ERVs, likely due to job profiles with greater exposure to extreme temperatures. Notably, the highest risk of all-causes ERVs was observed in outdoor male laborers (union members), followed by farmers and private employees, with the lowest risk among indoor workers. Conversely, female indoor workers and female farmers faced the highest risk of respiratory ERVs. Again, female farmers with consistent outdoor exposure had the highest risk of circulatory ERVs during cold conditions. CONCLUSION Our findings highlighted the complexity of temperature-related health risks associated with different occupational contexts. The population-level insights into vulnerable occupational groups could provide valuable comprehension for policymakers and healthcare practitioners.
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Affiliation(s)
- Ayushi Sharma
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
- Department of Civil Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Kang Yajing
- Department of Labor and Human Resources, Faculty of Social Sciences, Chinese Culture University, No. 55, Huagang Road, Yangmingshan, Taipei City, 11114, Taiwan
| | - Min-Chun Lin
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Liwen Deng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, College of City Management, University of Taipei, 101, Sec. 2, Zhongcheng Road, Taipei, 111, Taiwan
| | - Lin-Han Chianghsieh
- Institute of Environmental Engineering & Management, National Taipei University of Technology, Taipei, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan.
- Research center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 11529, Taiwan.
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Agache I, Canelo-Aybar C, Annesi-Maesano I, Cecchi L, Rigau D, Rodríguez-Tanta LY, Nieto-Gutierrez W, Song Y, Cantero-Fortiz Y, Roqué M, Vasquez JC, Sola I, Biagioni B, Chung F, D'Amato G, Damialis A, Del Giacco S, Vecillas LDL, Dominguez-Ortega J, Galàn C, Gilles S, Giovannini M, Holgate S, Jeebhay M, Nadeau K, Papadopoulos N, Quirce S, Sastre J, Traidl-Hoffmann C, Walusiak-Skorupa J, Sousa-Pinto B, Alonso-Coello P, Salazar J, Jutel M, Akdis CA. The impact of outdoor pollution and extreme temperatures on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma. Allergy 2024; 79:1725-1760. [PMID: 38311978 DOI: 10.1111/all.16041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/05/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024]
Abstract
Air pollution is one of the biggest environmental threats for asthma. Its impact is augmented by climate change. To inform the recommendations of the EAACI Guidelines on the environmental science for allergic diseases and asthma, a systematic review (SR) evaluated the impact on asthma-related outcomes of short-term exposure to outdoor air pollutants (PM2.5, PM10, NO2, SO2, O3, and CO), heavy traffic, outdoor pesticides, and extreme temperatures. Additionally, the SR evaluated the impact of the efficacy of interventions reducing outdoor pollutants. The risk of bias was assessed using ROBINS-E tools and the certainty of the evidence by using GRADE. Short-term exposure to PM2.5, PM10, and NO2 probably increases the risk of asthma-related hospital admissions (HA) and emergency department (ED) visits (moderate certainty evidence). Exposure to heavy traffic may increase HA and deteriorate asthma control (low certainty evidence). Interventions reducing outdoor pollutants may reduce asthma exacerbations (low to very low certainty evidence). Exposure to fumigants may increase the risk of new-onset asthma in agricultural workers, while exposure to 1,3-dichloropropene may increase the risk of asthma-related ED visits (low certainty evidence). Heatwaves and cold spells may increase the risk of asthma-related ED visits and HA and asthma mortality (low certainty evidence).
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
| | - David Rigau
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - L Yesenia Rodríguez-Tanta
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Wendy Nieto-Gutierrez
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Yang Song
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Yahveth Cantero-Fortiz
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Roqué
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Carlos Vasquez
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ivan Sola
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Benedetta Biagioni
- Allergy and Clinical Immunology Unit San Giovanni di Dio Hospital, Florence, Italy
| | | | - Gennaro D'Amato
- Medical School of Respiratory Diseases, University of Naples Federico II, Naples, Italy
| | - Athanasios Damialis
- Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Leticia de Las Vecillas
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Javier Dominguez-Ortega
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carmen Galàn
- Department of Botany, Ecology and Plant Physiology, International Campus of Excellence on Agrifood (ceiA3), University of Córdoba, Córdoba, Spain
| | - Stefanie Gilles
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stephen Holgate
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mohamed Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, University of Cape Town, Rondebosch, South Africa
| | - Kari Nadeau
- John Rock Professor of Climate and Population Studies; Chair, Department of Environmental Health, Interim Director, Center for Climate, Health, and The Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nikolaos Papadopoulos
- Allergy and Clinical Immunology Unit, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Joaquin Sastre
- Instituto Carlos III, Ministry of Science and Innovation, Allergy Service, Fundación Jiménez Díaz, Faculty of Medicine Universidad Autónoma de Madrid and CIBERES, Madrid, Spain
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Center Munich-German Research Center for Environmental Health, Augsburg, Germany
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Bernardo Sousa-Pinto
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pablo Alonso-Coello
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Josefina Salazar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marek Jutel
- Department of Clinical Immunology, ALL-MED Medical Research Institute, Wrocław Medical University, Wroclaw, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
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Boura D, Spanakis M, Markakis G, Notas G, Lionis C, Tzanakis N, Paraskakis E. Exploring the Relationship between Wind Patterns and Hospital Admissions Due to Respiratory Symptoms in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:717. [PMID: 38929296 PMCID: PMC11201383 DOI: 10.3390/children11060717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Respiratory disorders significantly impact adolescents' health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory health, particularly in regions characterized by distinct annual wind patterns. Crete is situated in the central-eastern Mediterranean Sea and frequently faces southerly winds carrying Sahara Desert sand from Africa and northerly winds from the Aegean Sea. This retrospective study analyzes long-term wind direction data and their relationship to respiratory symptoms observed in children up to 14 years old admitted at the University Hospital of Heraklion between 2002 and 2010. Symptoms such as headache, dyspnea, dry cough, dizziness, tachypnea, throat ache, and earache were predominantly reported during the presence of southern winds. Fever, productive cough, and chest pain were more frequently reported during northern winds. Cough was the most common symptom regardless of the wind pattern. Southern winds were significantly associated with higher probabilities of productive or non-productive cough, headache, dyspnea, tachypnea, dizziness, earache, and throat ache. Northern winds were related to a higher incidence of productive cough. Rhinitis, asthma, allergies, pharyngitis, and sinusitis were related to southern winds, while bronchiolitis and pneumonia were associated with northern winds. These findings underscore the critical role of local climatic factors, emphasizing their potential impact on exacerbating respiratory conditions in children. Moreover, they point out the need for further research to elucidate the underlying mechanisms and develop targeted interventions for at-risk populations.
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Affiliation(s)
- Despoina Boura
- Department of Respiratory Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece; (D.B.); (N.T.)
| | - Marios Spanakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, 71003 Heraklion, Greece;
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research & Technology–Hellas, 71110 Heraklion, Greece
| | - George Markakis
- Department of Social Work, Faculty of Health Sciences, Hellenic Mediterranean University, 71004 Heraklion, Greece;
| | - George Notas
- Department of Emergency Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Nikolaos Tzanakis
- Department of Respiratory Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece; (D.B.); (N.T.)
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, 71500 Heraklion, Greece
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Deng L, Chen X, Ma P, Wu Y, Okoye CO, Du D, Deng Q. The combined effect of oxidative stress and TRPV1 on temperature-induced asthma: Evidence in a mouse model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123313. [PMID: 38185356 DOI: 10.1016/j.envpol.2024.123313] [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: 10/20/2023] [Revised: 12/17/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
Temperature is one of the possible activators for asthma. As global warming continues, the health hazard of high temperatures is increasing. It is unclear, nevertheless, how high temperatures affect asthma. The research aims to examine how asthma is affected by high temperatures and underlying molecular mechanisms. The BALB/c mice were adopted in a model of asthma. The mice were exposed at 24 °C, 38 °C and 40 °C for 4h on weekdays from day 1 to day 30. After the experiment, the lung function was measured in vivo, and then serum protein, pulmonary inflammation and immunohistochemistry assay was assessed in vitro. As the temperature increased from 24 °C to 40 °C, there was a significant increase in serum protein, while there is no discernible difference in serum protein of OVA-sIgE and OVA-sIgG between the OVA (38 °C) group and OVA (24 °C) group. The immunohistochemistry assay showed a change in the pro-inflammatory cytokines. The histopathological analysis exhibited the change of airway structure after high-temperature exposure, especially for exposure at 40 °C. The results of signals protein showed a remarkable rise of TRPV1 for OVA+40 °C. Our results revealed that high temperatures may make asthmatic airway dysfunction severe, and the higher the temperature, the more serious asthma. The oxidative stress and TRPV1 receptor can be a potential drug target for asthma. It will provide a new tool for precision medicine in asthma.
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Affiliation(s)
- Linjing Deng
- School of Emergency Management, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China.
| | - Xunfeng Chen
- Biofuels Institute of Jiangsu university, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China
| | - Ping Ma
- Laboratory of Environment-Immunological and Neurological Diseases, Hubei University of Science and Technology, Xianning, 437100, China
| | - Yang Wu
- Laboratory of Environment-Immunological and Neurological Diseases, Hubei University of Science and Technology, Xianning, 437100, China
| | - Charles Obinwanne Okoye
- School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China; Department of Zoology & Environmental Biology, University of Nigeria, Nsukka, 410001, Nigeria
| | - Daolin Du
- School of Emergency Management, Jiangsu University, 212000, Zhenjiang, China; School of environment and safety engineering, Jiangsu University, 212000, Zhenjiang, China
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Wang F, Duan C, Li Y, Huang H, Shia BC. Spatiotemporal varying coefficient model for respiratory disease mapping in Taiwan. Biostatistics 2023; 25:40-56. [PMID: 36484310 DOI: 10.1093/biostatistics/kxac046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 12/17/2023] Open
Abstract
Respiratory diseases have been global public health problems for a long time. In recent years, air pollutants as important risk factors have drawn lots of attention. In this study, we investigate the influence of $\pm2.5$ (particulate matters in diameter less than 2.5 ${\rm{\mu }} m$) on hospital visit rates for respiratory diseases in Taiwan. To reveal the spatiotemporal pattern of data, we propose a Bayesian disease mapping model with spatially varying coefficients and a parametric temporal trend. Model fitting is conducted using the integrated nested Laplace approximation, which is a widely applied technique for large-scale data sets due to its high computational efficiency. The finite sample performance of the proposed method is studied through a series of simulations. As demonstrated by simulations, the proposed model can improve both the parameter estimation performance and the prediction performance. We apply the proposed model on the respiratory disease data in 328 third-level administrative regions in Taiwan and find significant associations between hospital visit rates and $\pm2.5$.
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Affiliation(s)
- Feifei Wang
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Congyuan Duan
- School of Mathematics, Sun Yat-Sen University, Guangdong, 510275, China
| | - Yang Li
- Center for Applied Statistics, School of Statistics, and Statistical Consulting Center, Renmin University of China, Beijing, 100872, China
| | - Hui Huang
- School of Mathematics, Sun Yat-Sen University, Guangdong, 510275, China
| | - Ben-Chang Shia
- AI Development Center of Taiwan Institute of Artificial Intelligence, Fu Jen Catholic University, New Taipei City, 24205, Taiwan
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Wang W, Ma Y, Qin P, Liu Z, Zhao Y, Jiao H. Assessment of mortality risks due to a strong cold spell in 2022 in China. Front Public Health 2023; 11:1322019. [PMID: 38131020 PMCID: PMC10733490 DOI: 10.3389/fpubh.2023.1322019] [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: 10/15/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Background With the intensification of global climate warming, extreme low temperature events such as cold spells have become an increasingly significant threat to public health. Few studies have examined the relationship between cold spells and mortality in multiple Chinese provinces. Methods We employed health impact functions for temperature and mortality to quantify the health risks of the first winter cold spell in China on November 26th, 2022, and analyzed the reasons for the stronger development of the cold spell in terms of the circulation field. Results This cold spell was a result of the continuous reinforcement of the blocking high-pressure system in the Ural Mountains, leading to the deepening of the cold vortex in front of it. Temperature changes associated with the movement of cold fronts produced additional mortality risks and mortality burdens. In general, the average excess risk (ER) of death during the cold spell in China was 2.75%, with a total cumulative excess of 369,056 deaths. The health risks associated with temperatures were unevenly distributed spatially in China, with the ER values ranging from a minimum of 0.14% to a maximum of 5.72%, and temperature drops disproportionately affect southern regions of China more than northern regions. The cumulative excess deaths exibited the highest in eastern and central China, with 87,655 and 80,230 respectively, and the lowest in northwest China with 27,474 deaths. Among the provinces, excess deaths pronounced the highest in Shandong with 29,492 and the lowest in Tibet with only 196. Conclusion The study can provide some insight into the mortality burden of cold spells in China, while emphasising the importance of understanding the complex relationship between extreme low temperature events and human health. The outcomes could provide valuable revelations for informing pertinent public health policies.
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Affiliation(s)
- Wanci Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Pengpeng Qin
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Zongrui Liu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Yuhan Zhao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Haoran Jiao
- Liaoning Provincial Meteorological Bureau, Shenyang, China
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Du R, Jiao W, Ma J, Zhou Q, Liang ZS, Sun S, Ahmed OG, Rowan NR, Pinto JM, Ramanathan M, Zhang Z. Association between ambient temperature and chronic rhinosinusitis. Int Forum Allergy Rhinol 2023; 13:1906-1914. [PMID: 36897288 DOI: 10.1002/alr.23152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Chronic exposure to particulate matter air pollution (PM2.5 ) is associated with chronic rhinosinusitis (CRS). Elevated ambient temperature may increase PM2.5 levels and thereby exacerbate sinonasal symptoms. This study investigates the association between high ambient temperature and the risk of CRS diagnosis. METHODS Patients with CRS were diagnosed at Johns Hopkins hospitals from May to October 2013-2022, and controls were matched patients without CRS meanwhile. A total of 4752 patients (2376 cases and 2376 controls) were identified with a mean (SD) age of 51.8 (16.8) years. The effect of maximum ambient temperature on symptoms was estimated with a distributed lag nonlinear model (DLNM). Extreme heat was defined as 35.0°C (95th percentile of the maximum temperature distribution). Conditional logistic regression models estimated the association between extreme heat and the risk of CRS diagnosis. RESULTS Exposure to extreme heat was associated with increased odds of exacerbation of CRS symptoms (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03-1.19). The cumulative effect of extreme heat during 0-21 lag days was significant (OR 2.37, 95% CI 1.60-3.50) compared with the minimum morbidity temperature (MMT) at 25.3°C. Associations were more pronounced among young and middle-aged patients and patients with abnormal weight. CONCLUSIONS We found that short-term exposure to high ambient temperature is associated with increased CRS diagnosis, suggesting a cascading effect of meteorological phenomena. These results highlight climate change's potentially deleterious health effects on upper airway diseases, which could have a significant public health impact.
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Affiliation(s)
- Runming Du
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Wangteng Jiao
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Qinfeng Zhou
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Zhi-Sheng Liang
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, China
| | - Omar G Ahmed
- Division of Rhinology, Sinus, Sleep & Skull Base Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, Illinois, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Zhenyu Zhang
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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8
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Pedersen ES, Kuehni CE. Heat-related hospitalisations for asthma - challenges for research. Thorax 2023; 78:850-851. [PMID: 37380356 DOI: 10.1136/thorax-2023-220326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Eva Sl Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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9
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Konstantinoudis G, Minelli C, Lam HCY, Fuertes E, Ballester J, Davies B, Vicedo-Cabrera AM, Gasparrini A, Blangiardo M. Asthma hospitalisations and heat exposure in England: a case-crossover study during 2002-2019. Thorax 2023; 78:875-881. [PMID: 37068951 PMCID: PMC10447396 DOI: 10.1136/thorax-2022-219901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/27/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Previous studies have reported an association between warm temperature and asthma hospitalisation. They have reported different sex-related and age-related vulnerabilities; nevertheless, little is known about how this effect has changed over time and how it varies in space. This study aims to evaluate the association between asthma hospitalisation and warm temperature and investigate vulnerabilities by age, sex, time and space. METHODS We retrieved individual-level data on summer asthma hospitalisation at high temporal (daily) and spatial (postcodes) resolutions during 2002-2019 in England from the NHS Digital. Daily mean temperature at 1 km×1 km resolution was retrieved from the UK Met Office. We focused on lag 0-3 days. We employed a case-crossover study design and fitted Bayesian hierarchical Poisson models accounting for possible confounders (rainfall, relative humidity, wind speed and national holidays). RESULTS After accounting for confounding, we found an increase of 1.11% (95% credible interval: 0.88% to 1.34%) in the asthma hospitalisation risk for every 1°C increase in the ambient summer temperature. The effect was highest for males aged 16-64 (2.10%, 1.59% to 2.61%) and during the early years of our analysis. We also found evidence of a decreasing linear trend of the effect over time. Populations in Yorkshire and the Humber and East and West Midlands were the most vulnerable. CONCLUSION This study provides evidence of an association between warm temperature and hospital admission for asthma. The effect has decreased over time with potential explanations including temporal differences in patterns of heat exposure, adaptive mechanisms, asthma management, lifestyle, comorbidities and occupation.
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Affiliation(s)
- Garyfallos Konstantinoudis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Cosetta Minelli
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Elaine Fuertes
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Joan Ballester
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Bethan Davies
- UK Small Area Health Statistics Unit, imperial College London, London, UK
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene Tropical Medicine, London, UK
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10
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Motlogeloa O, Fitchett JM. Climate and human health: a review of publication trends in the International Journal of Biometeorology. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02466-8. [PMID: 37129619 PMCID: PMC10153057 DOI: 10.1007/s00484-023-02466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
The climate-health nexus is well documented in the field of biometeorology. Since its inception, Biometeorology has in many ways become the umbrella under which much of this collaborative research has been conducted. Whilst a range of review papers have considered the development of biometeorological research and its coverage in this journal, and a few have reviewed the literature on specific diseases, none have focused on the sub-field of climate and health as a whole. Since its first issue in 1957, the International Journal of Biometeorology has published a total of 2183 papers that broadly consider human health and its relationship with climate. In this review, we identify a total of 180 (8.3%, n = 2183) of these papers that specifically focus on the intersection between meteorological variables and specific, named diagnosable diseases, and explore the publication trends thereof. The number of publications on climate and health in the journal increases considerably since 2011. The largest number of publications on the topic was in 2017 (18) followed by 2021 (17). Of the 180 studies conducted, respiratory diseases accounted for 37.2% of the publications, cardiovascular disease 17%, and cerebrovascular disease 11.1%. The literature on climate and health in the journal is dominated by studies from the global North, with a particular focus on Asia and Europe. Only 2.2% and 8.3% of these studies explore empirical evidence from the African continent and South America respectively. These findings highlight the importance of continued research on climate and human health, especially in low- and lower-middle-income countries, the populations of which are more vulnerable to climate-sensitive illnesses.
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Affiliation(s)
- Ogone Motlogeloa
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer M Fitchett
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa.
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11
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Sharma A, Deng L, Wang YC. Estimation of effects of extreme temperature on the risk of hospitalisation in Taiwan. J Epidemiol Community Health 2023; 77:375-383. [PMID: 36944498 DOI: 10.1136/jech-2022-220142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Extreme temperatures are triggering and exacerbating hospital admissions and health burdens; however, it is still understudied. Therefore, we evaluated the effects of the average temperature on overall hospitalisation and the average length of hospital stay. METHODS Daily area-specific age-sex stratified hospitalisation records from 2006 to 2020 were collected from the National Health Research Institutes of Taiwan. The distributed lag non-linear model was used to estimate the area-specific relative risk (RR) and 95% CI associated with daily average temperature. Overall cumulative RR was pooled from area-specific RRs using random effects meta-analysis. Temperature effects of extreme high and low thresholds were also evaluated based on the 99th (32°C) and 5th (14°C) percentiles, respectively. RESULTS Our findings suggested that the elderly (age ≥65 years) are vulnerable to temperature effects, while differential gender effects are not explicit in Taiwan. A higher risk of in-patient visits was seen among the elderly during extreme low temperatures (RR 1.08; 95% CI 1.04 to 1.11) compared with extreme high temperatures (RR 1.07; 95% CI 1.05 to 1.10). Overall, high-temperature extremes increased the risk of hospitalisation with an RR of 1.05 (95% CI 1.03 to 1.07) among the all-age-sex population in Taiwan. Additionally, lag-specific analysis of the study revealed that high-temperature effects on in-patient visits are effective on the same day of exposure, while cold effects occurred after 0-2 days of exposure. The average length of hospital stays can also increase with high-temperature extremes among age group 41-64 years and the elderly. CONCLUSION Public health preparedness should consider the increased load on health facilities and health expenditures during extreme temperatures.
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Affiliation(s)
- Ayushi Sharma
- Department of Environmental Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
- Department of Civil Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
| | - Liwen Deng
- Department of Environmental Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, Chung Yuan Christian University, College of Engineering, Chung Li, Taoyuan, Taiwan
- Research Center for Environmental Changes, Academia Sinica, Nankang, Taipei, Taiwan
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12
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Han A, Deng S, Yu J, Zhang Y, Jalaludin B, Huang C. Asthma triggered by extreme temperatures: From epidemiological evidence to biological plausibility. ENVIRONMENTAL RESEARCH 2023; 216:114489. [PMID: 36208788 DOI: 10.1016/j.envres.2022.114489] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/25/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is rapidly growing evidence indicating that extreme temperature is a crucial trigger and potential activator of asthma; however, the effects of extreme temperature on asthma are inconsistently reported and the its potential mechanisms remain undefined. OBJECTIVES This review aims to estimate the impacts of extreme heat, extreme cold, and temperature variations on asthma by systematically summarizing the existing studies from epidemiological evidence to biological plausibility. METHODS We conducted a systematic search in PubMed, Embase, and Web of Science from inception to June 30, 2022, and we retrieved articles of epidemiology and biological studies which assessed associations between extreme temperatures and asthma. This protocol was registered with PROSPERO (CRD42021273613). RESULTS From 12,435 identified records, 111 eligible studies were included in the qualitative synthesis, and 37 articles were included in the meta-analysis (20 for extreme heat, 16 for extreme cold, and 15 for temperature variations). For epidemiological evidence, we found that the synergistic effects of extreme temperatures, indoor/outdoor environments, and individual vulnerabilities are important triggers for asthma attacks, especially when there is extreme heat or cold. Meta-analysis further confirmed the associations, and the pooled relative risks for asthma attacks in extreme heat and extreme cold were 1.07 (95%CI: 1.03-1.12) and 1.20 (95%CI: 1.12-1.29), respectively. Additionally, this review discussed the potential inflammatory mechanisms behind the associations between extreme temperatures and asthma exacerbation, and highlighted the regulatory role of immunological pathways and transient receptor potential ion channels in asthma triggered by extreme temperatures. CONCLUSIONS We concluded that both extreme heat and cold could significantly increase the risk of asthma. Additionally, we proposed a potential mechanistic framework, which is important for understanding the disease pathogenesis that uncovers the complex mechanisms of asthma triggered by extreme temperatures and protects the sensitive individuals from impacts of extreme weather events and climate change.
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Affiliation(s)
- Azhu Han
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shizhou Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiarui Yu
- Shenzhen Health Development Research and Data Management Center, Shenzhen 518028, China, School of Arts and Sciences, Columbia University, New York City, NY, USA
| | - Yali Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China.
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13
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Hwang JK, Na JY, Lee KS, Oh JW, Choi YJ. Seasonal differences in the effects of local concentrations of atmospheric substances and meteorological elements on asthma exacerbation of children in metropolitan area, Korea: A 13-year retrospective single-center study. Front Pediatr 2023; 11:1028901. [PMID: 37187585 PMCID: PMC10175777 DOI: 10.3389/fped.2023.1028901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Purpose Air pollutants contribute to asthma exacerbation, and the types of air pollutants involved in acute asthma exacerbation may differ depending on climate and environmental conditions. This study aimed to identify factors affecting asthma exacerbation in each of the four seasons so that to prevent acute asthma exacerbation and to establish effective treatment strategies for each season. Methods Pediatric patients aged 0-18 years old hospitalized or admitted to the emergency room for asthma exacerbation at Hanyang University Guri Hospital between January 1, 2007, and December 31, 2019 were recruited. The number of asthma exacerbations comprised the total number of patients admitted to the emergency room or hospitalized for asthma and treated with systemic steroids. The association between the number of asthma exacerbations/week and average concentrations of atmospheric substances and meteorological elements in that week were analyzed. Multiple linear regression analyses were performed to examine the association between various atmospheric variables and the number of asthma exacerbations. Results The number of asthma exacerbations was found to be associated with the concentration of particulate matter with an aerodynamic diameter of ≤10 μm in that week in autumn. No atmospheric variables exhibited an association in other seasons. Conclusions Air pollutants and meteorological factors affecting asthma exacerbation vary by season. Moreover, their effects may change via their interaction with each other. The results of this study suggest that it will be helpful to establish differentiated measures for each season to prevent asthma exacerbation.
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Affiliation(s)
- Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Jae Yoon Na
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Young-Jin Choi
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
- Correspondence: Young-Jin Choi
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Yu L, Zhu J, Shao M, Wang J, Ma Y, Hou K, Li H, Zhu J, Fan X, Pan F. Relationship between meteorological factors and mortality from respiratory diseases in a subtropical humid region along the Yangtze River in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:78483-78498. [PMID: 35697982 DOI: 10.1007/s11356-022-21268-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
As the health impacts of climate change take on a more serious form, this study for the first time investigates the effect of meteorological factors on the risk of death from respiratory diseases (RD) in Wuhu, a representative city along the Yangtze River in subtropical humid region. Daily meteorological element data and RD deaths in Wuhu City were collected from 2014 to 2020. Time series analysis was conducted using distributed lagged nonlinear model (DLNM) combined with generalized additive model (GAM), and stratified by age and gender. In 7 years, a total of 8016 RD death cases were collected in Wuhu, China. The results demonstrated that the maximum impacts of short-term exposure to exceedingly low temperatures mean (Tmean) were at lag 9, with the maximum relative risk (RR) of 1.044 (lag 1, 95% CI: 1.001, 1.098). The risk of exceedingly high Tmean reached its maximum at lag 0 (RR = 1.070, 95% CI: 1.018, 1.125). Low relative humidity (RH) was negatively associated with the risk of RD death, with the lowest RR values occurring at lag 12 (RR = 0.987, 95% CI: 0.975, 0.999). No significant correlation was found for diurnal temperature range (DTR). Stratified analysis showed that Tmean exposure remained statistically significant for male, female and elderly, while RH and DTR only seemed to increase the mortality risk in the young. In a word, short-term exposure to extreme temperatures may increase the RD mortality risk in the population, and young people needed to be aware that exposure to exceedingly high RH and DTR also increased the risk.
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Affiliation(s)
- Lingxiang Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Junjun Zhu
- Wuhu Center for Disease Control and Prevention, Wuhu, Anhui Province, China
| | - Ming Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Jinian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Kai Hou
- Department of Landscape Architecture, School of Art, Xi'an University of Architecture and Technology, No. 13, Yanta Road, Xi'an, 710055, Shaanxi Province, China
| | - Huijun Li
- Department of Landscape Architecture, School of Art, Xi'an University of Architecture and Technology, No. 13, Yanta Road, Xi'an, 710055, Shaanxi Province, China
| | - Jiansheng Zhu
- Wuhu Center for Disease Control and Prevention, Wuhu, Anhui Province, China
| | - Xiaoyun Fan
- Department of Geriatric Respiratory and Critical Care, First Affiliated Hospital of Anhui Medical University, Number 218, Jixi Road, Hefei, 230022, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, 230022, Anhui, China.
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15
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Li S, Dong J. Impact of ambient temperature on hospital admissions for respiratory diseases in suburban rural villages in northwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:66373-66382. [PMID: 35499721 DOI: 10.1007/s11356-022-20446-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
Extreme temperature is strongly associated with human health, but few studies are available for the effects of extreme temperatures on respiratory disease (RD) in rural villages in Jiuquan, China over 2018-2019. In this study, we evaluate the effect of daily mean temperature on RD hospitalizations in suburban rural villages. A distribution lag non-linear model was constructed to analyze the relationship between the temperature and the daily risk of RD hospitalizations; and stratified analysis by sex and age group was performed. The effect of daily mean temperature on RD hospitalizations was non-linear and lagging. With a reference 25th percentile of temperature (-1.8 °C), exposure to extremely low temperature (-15.8 °C, 1st percentile), or moderate low temperature (-8.3 °C, 10th percentile) were associated with 1.396 (95% CI: 1.251, 1.558) and 1.216 (95% CI: 1.180, 1.253) increased risks of RD hospitalizations over lag 0-21 days. For RD morbidity, the effects of moderate high temperature (90th percentile of temperature, 22.5 °C) appeared at on the exposed day (lag 0), with the largest hot effect (RR 1.008, 95% CI 1.001, 1.020), while the effects of extremely high temperature (99th percentile of temperature, 27.0 °C) were insignificant. The effect of ambient temperature varied with gender and age. Both cold and high temperatures have more serious influence on males than females. In contrast, the elderly (age ≥ 65) seemed to be more sensitive in extremely low temperature (RR = 3.471; 95% CI, 2.183, 5.518; lag 0-21). The effect of moderate high temperature on the < 65 years group appeared for the first time at lag 0 (RR = 1.012; 95% CI, 1.001, 1.029). Both high temperature and low temperature increased the RD hospitalization risk; the harmful effect and duration of low temperature were greater than that of high temperature; the ≥ 65-year group and male were more sensitive to low temperature.
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Affiliation(s)
- Shixiong Li
- Jiayuguan Center for Disease Prevention and Control, Jiayuguan, 735100, China
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, China.
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Tran QA, Le VTH, Ngo VT, Le TH, Phung DT, Berman JD, Nguyen HLT. The Association Between Ambient Temperatures and Hospital Admissions Due to Respiratory Diseases in the Capital City of Vietnam. Front Public Health 2022; 10:903623. [PMID: 35937271 PMCID: PMC9350518 DOI: 10.3389/fpubh.2022.903623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine the short-term effects of ambient temperature on hospital admissions due to respiratory diseases among Hanoi residents. We collected 34,653 hospital admissions for 365 days (November 1, 2017, to November 31, 2018) from two hospitals in Hanoi. A quasi-Poisson regression model with time series analysis was used to explore the temperature-health outcome relationship's overall pattern. The non-linear curve indicated the temperatures with the lowest risk range from 22 degrees (Celcius) to 25 degrees (Celcius). On average, cold temperatures showed a higher risk than hot temperatures across all genders and age groups. Hospital admissions risk was highest at 13 degrees (Celcius) (RR = 1.39; 95% CI = 1.26–1.54) for cold effects and at 33 degrees (Celcius) (RR = 1.21, 95% CI = 1.04–1.39) for the hot effects. Temporal pattern analysis showed that the most effect on respiratory diseases occurred at a lag of 0 days for hot effect and at a lag of 1 day for cold effect. The risk of changing temperature among women and people over 5 years old was higher than other groups. Our results suggest that the risk of respiratory admissions was greatest when the temperature was low. Public health prevention programs should be enhanced to improve public awareness about the health risks of temperature changes, especially respiratory diseases risked by low temperatures.
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Affiliation(s)
- Quynh Anh Tran
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
| | - Vu Thuy Huong Le
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, United States
- *Correspondence: Vu Thuy Huong Le
| | - Van Toan Ngo
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
- Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Thi Hoan Le
- Environmental Health Department, Hanoi Medical University School of Public Health, Hanoi, Vietnam
| | - Dung T. Phung
- Centre for Environment and Population Health, Griffith University, Southport, QLD, Australia
| | - Jesse D. Berman
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, United States
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Ma Y, Wang H, Cheng B, Shen J, Li H, Guo Y, Cheng Y. Health risk of extreme low temperature on respiratory diseases in western China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:35760-35767. [PMID: 35060041 DOI: 10.1007/s11356-021-18194-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Previous studies have reported that daily average temperature is connected with respiratory diseases (RD), but proof is limited for the influence of the extreme low temperature on RD in Lanzhou, a northwestern China of temperate area. Generalized additive model (GAM) was built in this work to describe the relationship between daily mean temperature and RD in Lanzhou, China from 2012 to 2017. The results indicated that the exposure-response curve was inverse J-shaped, showing the lower the temperature, the larger the relative risk (RR). The RR of daily emergency room (ER) admissions in P5 extreme low temperature (the temperature below the fifth percentile, etc.) was larger than that in P10. The P5 extreme low temperature has the strongest effect at lag 0, and the RRs were 1.043 (95% CI: 1.030, 1.055) for the total, 1.031 (95% CI: 1.015, 1.046) for males and 1.058 (95% CI: 1.039, 1.077) for females. For different age groups, the largest RRs were 1.026 (95% CI: 1.013, 1.039) for the children (age < 16 years) at lag 5, 1.057 (95% CI: 1.030, 1.085) for the young adults (aged 16-45 years), 1.060 (95% CI: 1.023, 1.099) for the middle-aged (aged 46-60 years) and 1.121 (95% CI: 1.077, 1.166) for the elderly group of age > 60 years. Meanwhile, females and the elderly were more vulnerable to extreme temperature. The results could strengthen the scientific evidence of effects of extreme low temperature on RD in temperate areas.
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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.
| | - Hang Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Jiahui Shen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Heping Li
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yongtao Guo
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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Zhu Y, Yang T, Huang S, Li H, Lei J, Xue X, Gao Y, Jiang Y, Liu C, Kan H, Chen R. Cold temperature and sudden temperature drop as novel risk factors of asthma exacerbation: a longitudinal study in 18 Chinese cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 814:151959. [PMID: 34843761 DOI: 10.1016/j.scitotenv.2021.151959] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/31/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Few studies have explored the role of ambient temperature in asthma exacerbation. OBJECTIVE We aimed to explore the association of temperature with diurnal peak expiratory flow (PEF) variation and asthma exacerbation. METHOD We developed a longitudinal study among asthmatic adults in 18 Chinese cities. Subjects recorded PEF in dynamic pulmonary function monitoring from 2017 to 2020. Linear mixed-effect model and generalized additive model with distributed non-linear models were used to assess the effect of temperature and temperature change between neighboring days (TCN) on diurnal PEF variation and the risk of asthma exacerbation. RESULT We evaluated a total of 79,217 daily PEF monitoring records from 4467 adult asthmatic patients. There were significant increase of diurnal PEF variation and higher risk of asthma exacerbation with cold and sudden temperature drop. Compared with the referent temperature (99th percentile, 32 °C), exposure to moderate cold (25th percentile, 3 °C) and extreme cold (2.5th percentile, -7 °C) was associated with elevations of 1.28% and 1.16% in diurnal PEF variation over lag 0-2 days, respectively. The odds ratios of asthma exacerbation (determined by diurnal PEF variation >20%) at the two temperature cutoffs were 1.68 and 1.73. A sudden temperature drop (2.5th percentile of TCN, -5 °C) was associated with 1.13% elevation in diurnal PEF variation, and with increased risk of asthma exacerbation (odd ratio = 1.50) over lag 0-4 days. CONCLUSION This large multicenter study provided the first-hand empirical evidence that cold temperature and a temperature drop may increase the risk of asthma exacerbation.
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Affiliation(s)
- Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine and National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Suijie Huang
- Guangzhou Homesun Medical Technology Co.,Ltd, Guangdong Province, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H.Chan School of Public Health, Boston, MA, USA
| | - Jian Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaowei Xue
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China.
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Mabon L, Shih WY. Identifying factors contributing to social vulnerability through a deliberative Q-Sort process: an application to heat vulnerability in Taiwan. NATURAL HAZARDS (DORDRECHT, NETHERLANDS) 2022; 112:2609-2623. [PMID: 35250170 PMCID: PMC8885317 DOI: 10.1007/s11069-022-05280-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED Extreme heat events are gaining ever more policy and societal attention under a warming climate. Although a breadth of expertises are required to understand drivers of vulnerability to hazards such as extreme heat, it is also acknowledged that expert assessments in group settings may be subject to biases and uneven power relations. In this Technical Note, we outline a structured deliberative process for supporting experts to work collaboratively to assess social vulnerability to a climate-related hazard, in this case extreme heat in Taiwanese cities. We argue that adapting elicitation approaches such as Q-Methodology for use in collaborative settings can help to organise expert discussion and enable dialogue and mutual learning, in a way that supports consensus-building on vulnerability assessment. Outcomes from our collaborative assessments suggest elderly people living alone, elderly people over 75, pre-existing circulatory diseases and level of participation in community decision-making may all be notable drivers of heat vulnerability in the Taiwanese context. Methodologically, we argue that collaborative sorting exercises offer a way to embed local and experiential knowledges into assessments of available evidence, but that strong facilitation and additional checks are necessary to ensure an inclusive process that reflects the diversity of perspectives involved. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11069-022-05280-4.
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Affiliation(s)
- Leslie Mabon
- School of Engineering and Innovation, The Open University, Milton Keynes, UK
| | - Wan-Yu Shih
- Department of Urban Planning and Disaster Management, Ming-Chuan University, Taipei, Taiwan
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Chen Y, Kong D, Fu J, Zhang Y, Zhao Y, Liu Y, Chang Z, Liu Y, Liu X, Xu K, Jiang C, Fan Z. Associations between ambient temperature and adult asthma hospitalizations in Beijing, China: a time-stratified case-crossover study. Respir Res 2022; 23:38. [PMID: 35189885 PMCID: PMC8862352 DOI: 10.1186/s12931-022-01960-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China. Methods We collected daily asthma hospitalizations, meteorological factors and air quality data in Beijing from 2012 to 2015. We applied a time-stratified case-crossover design and fitted a distributed lag non-linear model with a conditional quasi-Poisson regression to explore the association between ambient temperature and adult asthma hospitalizations. The effect modifications of these associations by gender and age were assessed by stratified analyses. We also computed the attributable fractions and numbers with 95% empirical confidence intervals (eCI) of asthma hospitalizations due to extreme and moderate temperatures. Results From 2012 to 2015, we identified a total of 18,500 hospitalizations for asthma among adult residents in Beijing, China. Compared with the optimal temperature (22 °C), the cumulative relative risk (CRR) over lag 0–30 days was 2.32 with a 95% confidence interval (CI) of 1.57–3.42 for extreme cold corresponding to the 2.5th percentile (− 6.5 °C) of temperature distribution and 2.04 (95% CI 1.52–2.74) for extreme heat corresponding to the 97.5th percentile (29 °C) of temperature distribution. 29.1% (95% eCI 17.5–38.0%) of adult asthma hospitalizations was attributable to non-optimum temperatures. Moderate cold temperatures yielded most of the burdens, with an attributable fraction of 20.3% (95% eCI 9.1–28.7%). The temperature-related risks of asthma hospitalizations were more prominent in females and younger people (19–64 years old). Conclusions There was a U-shaped association between ambient temperature and the risk of adult asthma hospitalizations in Beijing, China. Females and younger patients were more vulnerable to the effects of non-optimum temperatures. Most of the burden was attributable to moderate cold. Our findings may uncover the potential impact of climate changes on asthma exacerbations. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01960-8.
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Affiliation(s)
- Yuxiong Chen
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Dehui Kong
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Jia Fu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yongqiao Zhang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yakun Zhao
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yanbo Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Zhen'ge Chang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yijie Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Xiaole Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Kaifeng Xu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Chengyu Jiang
- Department of Biochemistry, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Zhongjie Fan
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China.
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Alsaiqali M, De Troeyer K, Casas L, Hamdi R, Faes C, Van Pottelbergh G. The Effects of Heatwaves on Human Morbidity in Primary Care Settings: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:832. [PMID: 35055653 PMCID: PMC8775418 DOI: 10.3390/ijerph19020832] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This study assesses the potential acute effects of heatwaves on human morbidities in primary care settings. METHODS We performed a time-stratified case-crossover study to assess the acute effects of heatwaves on selected morbidities in primary care settings in Flanders, Belgium, between 2000 and 2015. We used conditional logistic regression models. We assessed the effect of heatwaves on the day of the event (lag 0) and X days earlier (lags 1 to X). The associations are presented as Incidence Density Ratios (IDR). RESULTS We included 22,344 events. Heatwaves are associated with increased heat-related morbidities such as heat stroke IDR 3.93 [2.94-5.26] at lag 0, dehydration IDR 3.93 [2.94-5.26] at lag 1, and orthostatic hypotension IDR 2.06 [1.37-3.10] at lag 1. For cardiovascular morbidities studied, there was only an increased risk of stroke at lag 3 IDR 1.45 [1.04-2.03]. There is no significant association with myocardial ischemia/infarction or arrhythmia. Heatwaves are associated with decreased respiratory infection risk. The IDR for upper respiratory infections is 0.82 [0.78-0.87] lag 1 and lower respiratory infections (LRI) is 0.82 [0.74-0.91] at lag 1. There was no significant effect modification by age or premorbid chronic disease (diabetes, hypertesnsion). CONCLUSION Heatwaves are associated with increased heat-related morbidities and decreased respiratory infection risk. The study of heatwaves' effects in primary care settings helps evaluate the impact of heatwaves on the general population. Primary care settings might be not suitable to study acute life-threatening morbidities.
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Affiliation(s)
- Mahmoud Alsaiqali
- Epidemiology and Social Medicine (ESOC), University of Antwerp, 2610 Antwerp, Belgium;
| | - Katrien De Troeyer
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (K.D.T.); (G.V.P.)
| | - Lidia Casas
- Epidemiology and Social Medicine (ESOC), University of Antwerp, 2610 Antwerp, Belgium;
| | - Rafiq Hamdi
- Royal Meteorological Institute of Belgium, B-1180 Brussels, Belgium;
| | - Christel Faes
- Data Science Institute (DSI), I-BioStat, Hasselt University, BE-3500 Hasselt, Belgium;
| | - Gijs Van Pottelbergh
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (K.D.T.); (G.V.P.)
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Zafirah Y, Lin YK, Andhikaputra G, Deng LW, Sung FC, Wang YC. Mortality and morbidity of asthma and chronic obstructive pulmonary disease associated with ambient environment in metropolitans in Taiwan. PLoS One 2021; 16:e0253814. [PMID: 34228742 PMCID: PMC8259956 DOI: 10.1371/journal.pone.0253814] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022] Open
Abstract
Background This study investigated risks of mortality from and morbidity (emergency room visits (ERVs) and outpatient visits) of asthma and chronic obstructive pulmonary disease (COPD) associated with extreme temperatures, fine particulate matter (PM2.5), and ozone (O3) by sex, and age, from 2005 to 2016 in 6 metropolitan cities in Taiwan. Methods The distributed lag non-linear model was employed to assess age (0–18, 19–39, 40–64, and 65 years and above), sex-cause-specific deaths, ERVs, and outpatient visits associated with extreme high (99th percentile) and low (5th percentile) temperatures and PM2.5 and O3 concentrations at 90th percentile. Random-effects meta-analysis was adopted to investigate cause-specific pooled relative risk (RR) and 95% confidence intervals (CI) for the whole studied areas. Results Only the mortality risk of COPD in the elderly men was significantly associated with the extreme low temperatures. Exposure to the 90th percentile PM2.5 was associated with outpatient visits for asthma in 0–18 years old boys [RR = 1.15 (95% CI: 1.09–1.22)]. Meanwhile, significant elevation of ERVs of asthma for females aged 40–64 years was associated with exposure to ozone, with the highest RR of 1.21 (95% CI: 1.05–1.39). Conclusions This study identified vulnerable subpopulations who were at risk to extreme events associated with ambient environments deserving further evaluation for adaptation.
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Affiliation(s)
- Yasmin Zafirah
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, University of Taipei College of City Management, Taipei, Taiwan
| | - Gerry Andhikaputra
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
| | - Li-Wen Deng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
- Research Center for Environmental Changes, Academia Sinica, Nankang, Taipei, Taiwan
- * E-mail: ,
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Li M, Chen S, Zhao H, Tang C, Lai Y, Ung COL, Su J, Hu H. The short-term associations of chronic obstructive pulmonary disease hospitalizations with meteorological factors and air pollutants in Southwest China: a time-series study. Sci Rep 2021; 11:12914. [PMID: 34155257 PMCID: PMC8217527 DOI: 10.1038/s41598-021-92380-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/31/2021] [Indexed: 11/09/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is the fourth major cause of mortality and morbidity worldwide and is projected to be the third by 2030. However, there is little evidence available on the associations of COPD hospitalizations with meteorological factors and air pollutants in developing countries/regions of Asia. In particular, no study has been done in western areas of China considering the nonlinear and lagged effects simultaneously. This study aims to evaluate the nonlinear and lagged associations of COPD hospitalizations with meteorological factors and air pollutants using time-series analysis. The modified associations by sex and age were also investigated. The distributed lag nonlinear model was used to establish the association of daily COPD hospitalizations of all 441 public hospitals in Chengdu, China from Jan/2015-Dec/2017 with the ambient meteorological factors and air pollutants. Model parameters were optimized based on quasi Akaike Information Criterion and model diagnostics was conducted by inspecting the deviance residuals. Subgroup analysis by sex and age was also performed. Temperature, relative humidity, wind and Carbon Monoxide (CO) have statistically significant and consistent associations with COPD hospitalizations. The cumulative relative risk (RR) was lowest at a temperature of 19℃ (relative humidity of 67%). Both extremely high and low temperature (and relative humidity) increase the cumulative RR. An increase of wind speed above 4 mph (an increase of CO above 1.44 mg/m3) significantly decreases (increases) the cumulative RR. Female populations were more sensitive to low temperature and high CO level; elderly (74+) populations are more sensitive to high relative humidity; younger populations (< = 74) are more susceptible to CO higher than 1.44 mg/m3. Therefore, people with COPD should avoid exposure to adverse environmental conditions of extreme temperatures and relative humidity, low wind speed and high CO level, especially for female and elderly patients who were more sensitive to extreme temperatures and relative humidity.
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Affiliation(s)
- Meng Li
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Shengqi Chen
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Hanqing Zhao
- Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China
| | - Chengxiang Tang
- School of Public Administration, Guangzhou University, Guangzhou, China
| | - Yunfeng Lai
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Jinya Su
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, CO4 3SQ, UK.
| | - Hao Hu
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
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Shao M, Yu L, Xiao C, Deng J, Yang H, Xu W, Chen Y, Liu X, Ni J, Pan F. Short-term effects of ambient temperature and pollutants on the mortality of respiratory diseases: A time-series analysis in Hefei, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 215:112160. [PMID: 33773152 DOI: 10.1016/j.ecoenv.2021.112160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/27/2021] [Accepted: 03/13/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND The air pollution has become an important environmental health problem due to its adverse health effect. The objective of this study was to investigate the effects of ambient temperature and pollutants on mortality of respiratory diseases (RD) in Hefei, China, a typical inland city. METHODS Nonlinear exposure-response dependencies and delayed effects of urban daily mean temperature (DMT) and pollutants were evaluated by distributed lag non-linear models (DLNM). To further explore this effect, different genders and ages were also examined by stratified analysis. RESULTS A total of 12876 deaths from RD were collected from January 1, 2014 to December 31, 2018 in Hefei, China. There was a U-shaped correlation between DMT and RD mortality, and the RD mortality rised by 11.6% (95% CI: 2.2-22.0%) when the DMT was 35.8 °C (reference temperature is 20 °C). The results show that risk of death with short-term exposure to elevated concentrations of PM10 and SO2 was not significant. The maximum hysteresis and cumulative relative risk (RR) of RD mortality were 1.012 (95% CI: 1.003 ~ 1.021, lag 0 day) and 1.072 (95% CI: 1.014 ~1.133, lag 10 days) for each 10 μg/m3 augment in NO2; 1.005 (95% CI: 1.001-1.009, lag 0 day) and 1.027 (95% CI: 1.004-1.051, lag 10 days) for each 10 μg/m3 augment in O3; a negative association between CO exposure and the cumulative risk of death was observed (RR = 0.964, 95% CI: 0.935-0.993, lag 07 days). Subgroup analysis showed the effect of high temperatures, NO2, O3 and CO exposure was still statistically significant for the elderly and male. CONCLUSION The present study found that short-term exposure to high temperature, NO2, O3 and CO were significantly associated with the risk of RD mortality and male as well as elderly are more susceptible to these factors.
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Affiliation(s)
- Ming Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Lingxiang Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Changchun Xiao
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, Anhui 230032, China
| | - Jixiang Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Hui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Wei Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, Anhui 230032, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Xincheng Road, Dongguan, Guangdong 523808, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
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Lei X, Liu L, Chen R, Liu C, Hong J, Cao L, Lu Y, Dong X, Chen X, Qiu X, Xia M, Ding B, Qian L, Wang L, Zhou W, Gui Y, Kan H, Zhou Y, Zhang X. Temperature changes between neighboring days and childhood asthma: a seasonal analysis in Shanghai, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:827-836. [PMID: 33230642 DOI: 10.1007/s00484-020-02057-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 06/11/2023]
Abstract
Few evidences are available about the impact of temperature variation on childhood asthma in different seasons. This study aimed to assess the influence of temperature changes between neighboring days (TCN) on the exacerbation of asthma among children. Daily outpatient visits for childhood asthma (DOVCA) were collected from 17 main hospitals in Shanghai, China, from 2016 to 2018. A quasi-Poisson regression combined with distributed lagged nonlinear models was employed to estimate the association between TCN and asthma visits in cool or warm seasons, after controlling for short- and long-term trends, day of week, holidays, daily mean temperature, daily mean relative humidity, and air pollutants. The TCN varied from - 9.6 to 6.7 °C. The relationship between TCN and DOVCA greatly varied by season. In warm seasons, positive TCN (temperature rise) was associated with higher risks of asthma outpatient visits and negative TCN (temperature drop) was associated with lower risks; the associations were present on lag 1 day and lasted for 2 weeks; the cumulative relative risk of childhood asthma over 0 to 14 days was 1.98 (95% confidence interval: 1.42, 2.76) and 0.31 (95% confidence intervals: 0.21, 0.44) comparing a TCN of 2.5 °C (5th percentile) and - 3.2 °C (95th percentile) with 0 °C, respectively. In cool seasons, neither negative nor positive TCN showed significant risks. In conclusion, temperature rise might increase the risk of childhood asthma exacerbation and temperature drop might decrease the risks in warm seasons. There were no statistically significant influences in cool seasons.
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Affiliation(s)
- Xiaoning Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Lijuan Liu
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Yanming Lu
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201112, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai, China
| | - Xinchang Chen
- Guangdong Midea Refrigeration Equipment Co., Ltd, Foshan, Guangdong, China
| | - Xiangwei Qiu
- Guangdong Midea Refrigeration Equipment Co., Ltd, Foshan, Guangdong, China
| | - Min Xia
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Bo Ding
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201112, China
| | - Liling Qian
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Libo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yonghao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yufeng Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
| | - Xiaobo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, No. 399 Wanyuan Road, Shanghai, 201102, China.
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Tseng TJ, Wu CJJ, Chang AM. Theoretical asthma self-management program for Taiwanese adolescents with self-efficacy, outcome-expectancy, health behaviour, and asthma symptoms: A randomized controlled trial. Contemp Clin Trials Commun 2020; 19:100624. [PMID: 32875137 PMCID: PMC7451801 DOI: 10.1016/j.conctc.2020.100624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/04/2020] [Accepted: 07/13/2020] [Indexed: 02/04/2023] Open
Abstract
Background The asthma prevalence of Taiwanese adolescents continued to rise. With physical and psychological changes in adolescents, managing asthma can be quite challenges and affect social, emotional and physical wellbeing. Adolescents with high self-efficacy levels are more likely to be involved in prevention and management activities. The aim of this study was to develop an effective asthma self-management program taking account for adolescents' developmental stages and based on Bandura's self-efficacy model. Methods A two-arm, parallel group, randomized controlled trial was used. The outcomes were self-efficacy, outcome-expectancy, asthma prevention and self-management behaviour, and controlling asthma symptoms. Translation and back-translation process were used for original tools in English. Good consistent reliabilities of Chinese versions tools were identified. A t-test or Mann-Whiney U test was employed to determine any mean differences of outcome variables between groups overtime. Results A sample of 83 patients completed the study. The mean age was 14.2 years (SD = 1.8). Approximately 56.6% of the participants were males. 73% of participants (n = 61) had a mild to intermittent level of asthma severity. Significant improvements were found on self-efficacy, t = −2.8; outcome-expectancy, U = 646, prevention behaviours, t = −3.5, and management behaviours, t = −3.2, but non-significant results for the outcome of asthma control, U = 716. Conclusions The results provided evidence to support the efficacy of the asthma self-management program. The findings indicated the program improved adolescents’ self-confidence in managing their asthma symptoms. Future clinical practice should consider delivering an educational program using multifaceted and interactive learning strategies.
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Affiliation(s)
- Tzu-Jung Tseng
- Department of Nursing, Chang Gung University of Science and Technology, No.2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan
| | - Chiung-Jung Jo Wu
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast (USC), USC Moreton Bay campus, 1 Moreton Bay Parade, Petrie, QLD 4502, Australia.,Royal Brisbane and Women's Hospital (RBWH), Australia
| | - Anne M Chang
- School of Nursing, Queensland University of Technology (QUT), Victoria Park Road, Kelvin Grove, QLD 4059, Australia
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Veremchuk LV, Mineeva EE, Vitkina TI, Grigorieva EA, Gvozdenko TA, Golokhvast KS. The response ranges of pulmonary function and the impact criteria of weather and industrial influence on patients with asthma living in Vladivostok. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:235-242. [PMID: 32399235 PMCID: PMC7203380 DOI: 10.1007/s40201-020-00458-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To determine the response of pulmonary function (PF) to the influence of environmental factors in patients with different levels of asthma control. MATERIALS AND METHODS Patients with controlled (136 people) and uncontrolled (96 people) asthma living in the conditions of monsoon climate and technogenic pollution in Vladivostok were examined. Discriminant analysis that provides the basis for dividing initial data into classes, as according to standards and expert estimates, was used to calculate ranges of PF response in asthma patients. The selection of discriminant functions with the highest values of constant and coefficient made it possible to identify the optimal quantitative ranges. RESULTS Analysis of the discriminant value of Wilks' lambda (α) has shown that the intensity of PF response to climatic and technogenic factors varies depending on level of disease control (controlled asthma - α = 0.67-0.79, uncontrolled asthma - α =0.05-0.44). The criteria and ranges of PF response also differ depending on level of disease control. In controlled asthma, PF response reflects an adaptive-compensatory dependence. The reaction to the environmental factors is rather weak; therefore, it could be detected by only more sensitive examination method (body plethysmography). In uncontrolled asthma, the response to the influence of environment quality is active and could be clearly identified by spirography. CONCLUSIONS The climatic and technogenic environment of Vladivostok causes strong pathogenic impact on patients with uncontrolled asthma. The effects of dust fraction 0-1 μm, deeply penetrating into respiratory organs, and day-to-day variability of wind speed, which induces weather sensitivity, are particularly adverse.
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Affiliation(s)
- Lyudmila V. Veremchuk
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Elena E. Mineeva
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Tatyana I. Vitkina
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Elena A. Grigorieva
- Institute for Complex Analysis of Regional Problems Far Eastern Branch of Russian Academy of Sciences, Birobidzhan, Russian Federation
| | - Tatyana A. Gvozdenko
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Kirill S. Golokhvast
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
- Far Eastern Federal University, Vladivostok, Russian Federation
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Zhang Y, Liu X, Kong D, Fu J, Liu Y, Zhao Y, Lian H, Zhao X, Yang J, Fan Z. Effects of Ambient Temperature on Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results from a Time-Series Analysis of 143318 Hospitalizations. Int J Chron Obstruct Pulmon Dis 2020; 15:213-223. [PMID: 32099346 PMCID: PMC6996111 DOI: 10.2147/copd.s224198] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose To evaluate the associations between acute exacerbations of chronic obstructive pulmonary disease (AECOPD) hospitalizations and daily mean temperature (Tmean) as well as daily apparent temperature (AT), and to explore the practical values of these two indices in policymaking and patient education. Methods Daily AECOPD hospitalizations and Meteorological data in Beijing were obtained between 2013 and 2016. Distributed lag non-linear model was adopted to investigate the association between daily ambient temperature and AECOPD hospitalizations. The cumulative effects of cold/hot temperature were abstracted. For the extreme and moderate low-temperature effect estimates, we, respectively, computed the RR of AECOPD hospitalizations at the 1st and 10th percentiles of temperature in comparison with that at the 25th percentile of temperature. For the extreme and moderate high temperature effect estimates, we, respectively, computed the RR of AECOPD hospitalizations at the 99th and 90th percentiles of temperature in comparison with that at the 75th percentile of temperature. Results During the study period, 143, 318 AECOPD hospitalizations were collected. A reverse J-shape relationship was found between temperature and AECOPD hospitalizations. When comparing the effect of Tmean, higher RRs were associated with increases in AT on AECOPD hospitalizations but a lower value of Akaike’s Information Criterion for quasi-Poisson (Q-AIC). The RR of extremely low temperature of Tmean and AT were 1.55 (95% CI: 1.21,2.00) and 2.08 (95% CI: 1.44,3.01), respectively. Moderate low temperature also had an adverse impact on AECOPD hospitalizations. No associations were found between high temperature and AECOPD risk. We found the females and those aged <65 years to be more susceptible to temperature change. Conclusion Lower temperature is associated with a higher risk for AECOPD hospitalizations. Ambient temperature is probably a better predictor in terms of quantifying risk than mean temperature when studying temperature impact on health.
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Affiliation(s)
- Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Dehui Kong
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hui Lian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaoyi Zhao
- Department of Physical Medicine and Rehabilitation, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, People's Republic of China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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Chai G, He H, Su Y, Sha Y, Zong S. Lag effect of air temperature on the incidence of respiratory diseases in Lanzhou, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:83-93. [PMID: 31612311 DOI: 10.1007/s00484-019-01795-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 08/16/2019] [Accepted: 08/27/2019] [Indexed: 05/04/2023]
Abstract
Previous studies have found that ambient temperature was associated with respiratory disease. However, little evidence is available in Lanzhou, a semi-arid region in northwest China, and respiratory disease is not well understood. This study evaluated the risk of outpatient visits for respiratory diseases associated with ambient temperatures from 2007 to 2016 in Lanzhou. We used a distributed lag non-linear model coupled with a generalized additive model to estimate the association between daily temperature and hospital visits for respiratory diseases in age- and sex-specific groups. Over 10 years, 1,042,656 hospital visits were recorded for respiratory disease, the ratio between males and females was 1.21:1. The peak period of onset occurs from November of the current year to March of the following year. Both low and high temperatures were associated with an increased risk of hospital visits for respiratory illness. The results showed that a large temperature decrease was associated with a significant risk for respiratory disease, the maximum effect of a temperature drop was reached at lag 1~2 days, the extreme low temperature (- 16 °C) had the maximum RR at lag 1, and the RR value was 1.082 (95 % CI 1.025-1.142). The high temperatures (23 °C) had maximum RR for respiratory disease on the current day, and the RR value was 1.099 (95 % CI 1.049-1.152). The high temperatures had acute and short-term effects and declined quickly over time, while the effects in low-temperature ranges were persistent over longer lag periods. Females suffered more from cold-associated morbidity than males. The effects of both hot and cold temperatures were greater among adolescents aged 6-14 years. Our study suggests that ambient temperatures are associated with hospital visits for respiratory illness in Lanzhou, particularly for those who are female and young. Caregivers and health practitioners should be made aware of the potential threat posed by cold and hot temperatures.
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Affiliation(s)
- Guorong Chai
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Hua He
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Yana Su
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China
- College of Economics and Management, Lanzhou Institute of Technology, Lanzhou, 730050, People's Republic of China
| | - Yongzhong Sha
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Shengliang Zong
- School of Management, Lanzhou University, Lanzhou, 730000, People's Republic of China
- Hospital Management Research Center, Lanzhou University, Lanzhou, 730000, People's Republic of China
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Zhao Y, Huang Z, Wang S, Hu J, Xiao J, Li X, Liu T, Zeng W, Guo L, Du Q, Ma W. Morbidity burden of respiratory diseases attributable to ambient temperature: a case study in a subtropical city in China. Environ Health 2019; 18:89. [PMID: 31651344 PMCID: PMC6814053 DOI: 10.1186/s12940-019-0529-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/01/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND There are significant associations between ambient temperature and respiratory disease mortality. However, few studies have assessed the morbidity burdens of various respiratory diseases that are attributable to different temperature ranges in subtropical regions. METHODS Daily outpatient visits, weather variables, and air pollution data were collected from January 2013 to August 2017 in a hospital in Dongguan city. A standard time series quasi-Poisson regression with a distributed lag non-linear model (DLNM) was applied to estimate the associations between daily mean temperature and morbidity for total respiratory diseases, bronchiectasis, chronic obstructive pulmonary disease (COPD), and asthma. Attributable fractions were then calculated to quantify disease burden relative to different temperature components. Finally, we conducted stratified analysis by age group. RESULTS Both low and high temperatures were associated with an increased risk of morbidity secondary to respiratory diseases. Compared with the optimum temperature, the accumulated relative risk (RR) during the seven lag days was 1.13 with a 95% confidence interval (CI) of 1.01-1.26 for extreme heat and 1.02 (95% CI: 0.99-1.05) for extreme cold. Heat-related respiratory morbidity risk was higher than cold-related risk for the total population, but an opposite result was observed for the elderly. About 8.4% (95% CI: 2.8-13.3%) of respiratory morbidity was attributable to non-optimal temperatures, and moderate heat was responsible for most of the excess respiratory morbidity (7.5, 95% CI: 2.4-12.2%). CONCLUSIONS We found that exposure to non-optimal temperatures increased the risk of respiratory morbidity in subtropical region, and moderate heat contributed to most of the temperature-related respiratory morbidities. This indicates a need for further examination of moderate, rather than extreme, heat in subtropical region.
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Affiliation(s)
- Yiju Zhao
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan, China
| | - Zhao Huang
- The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | | | - Jianxiong Hu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Qingfeng Du
- Nanhai Hospital of Southern Medical University, Foshan, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
- Nanhai Hospital of Southern Medical University, Foshan, China.
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Lam HCY, Hajat S, Chan EYY, Goggins WB. Different sensitivities to ambient temperature between first- and re-admission childhood asthma cases in Hong Kong - A time series study. ENVIRONMENTAL RESEARCH 2019; 170:487-492. [PMID: 30641275 DOI: 10.1016/j.envres.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/07/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Asthma can be triggered by various factors due to different etiologies. Environmental factors remain a common trigger of asthma, especially amongst children, and such ambient exposures can be harder to avoid compared to behavioral triggers. As such, the contribution of environmental factors may be enhanced when considering repeat asthma cases compared to initial presentations. To test this hypothesis, we assessed associations between ambient temperature and hospital admissions for asthma in Hong Kong and stratified admission records into first and repeat asthma hospitalizations. METHODS The daily number of asthma hospitalizations among children aged 0-5 years in Hong Kong during 2007-2011 was regressed on daily mean temperature using distributed lagged nonlinear models, with adjustment for seasonal patterns, day-of-week effects, and other meteorological factors and air-pollutants. Analyses were stratified by summer/winter and by type of admission (first admission and repeated admission). RESULTS About 33% of the 12284 asthma hospitalizations were repeat admissions. Repeat admissions demonstrated higher sensitivity to high temperature in the summer. During this period, high temperatures were associated with increased risk of repeat admission but not with first admissions: RR (95% CI) comparing 31 °C vs. 29 °C across lags 0-15 days was 3.40 (1.26, 9.18) and 0.74 (0.31, 1.77) for repeat and first admissions respectively. In the cold season, all admissions increased with falls in temperature, with slightly stronger associations apparent for repeat admissions compared to first admission: 1.20 (1.00, 1.44) vs. 1.10 (0.96, 1.26) respectively comparing risk at 15 °C vs. 12 °C across lags 0-5 days. CONCLUSIONS To our knowledge, this is the first study to show stronger associations between ambient temperature and repeat asthma admissions compared to first admissions. The higher sensitivity among those experiencing repeat admissions may allow for more personalized disease management. Given the substantial differences in associations by admission type, future studies of ambient exposures on asthma should consider analyzing the two groups separately.
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Affiliation(s)
- Holly Ching Yu Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, University of London, United Kingdom
| | - Emily Ying Yang Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - William Bernard Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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Lin YK, Maharani AT, Chang FT, Wang YC. Mortality and morbidity associated with ambient temperatures in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 651:210-217. [PMID: 30227291 DOI: 10.1016/j.scitotenv.2018.09.161] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 05/03/2023]
Abstract
BACKGROUND This study evaluated integrated risks of all-cause mortality, emergency room visits (ERVs), and outpatient visits associated with ambient temperature in all cities and counties of Taiwan. In addition, the modifying effects of socio-economic and environmental factors on temperature-health associations were also evaluated. METHODS A distributed lag non-linear model was applied to estimate the cumulative relative risks (RRs) with confidence intervals of all-cause mortality, ERVs, and outpatient visits associated with extreme temperature events. Random-effect meta-analysis was used to estimate the pooled RR of all-cause mortality, ERVs, and outpatient visits influenced by socio-economic and environmental factors. RESULTS Temperature-related risks varied with study area and health outcome. Meta-analysis showed greater all-cause mortality risk occurred in low temperatures than in high temperatures. Integrated RR of all-cause mortality was 1.71 (95% confidence interval [CI]:1.43-2.04) in the 5th percentile temperature and 1.10 (95% CI: 1.05-1.15) in the 95th percentile temperature, while the lowest mortality risk was in the 60th percentile temperature (22.2 °C). Risk for ERVs increased when temperature increased (RR was 1.21 [95% CI: 1.17-1.26] in 95th percentile temperature), but risk of outpatient visits increased at low temperatures (RR was 1.06 [95% CI: 1.01-1.12] in the 5th percentile temperature). Certain socio-economic factors significantly modified low-temperature-related mortality risks, including number of employed populations, elders living alone from lower-income families, and public and medical services. CONCLUSIONS This study found that mortality and outpatient visits were higher at low temperature, while ERVs risk was higher at high temperature. Future plans for public health and emerging medical services responding to extreme temperatures should consider regional and integrated evaluations of temperature-related health risks and modifying factors.
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Affiliation(s)
- Yu-Kai Lin
- Department of Health and Welfare, University of Taipei, College of City Management, 101, Sec. 2, Zhongcheng Road, Taipei 111, Taiwan
| | - Aussie Tahta Maharani
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Fang-Tzu Chang
- Department of Health and Welfare, University of Taipei, College of City Management, 101, Sec. 2, Zhongcheng Road, Taipei 111, Taiwan; Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan.
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Zhang A, Hu W, Li J, Wei R, Lin J, Ma W. Impact of heatwaves on daily outpatient visits of respiratory disease: A time-stratified case-crossover study. ENVIRONMENTAL RESEARCH 2019; 169:196-205. [PMID: 30466013 DOI: 10.1016/j.envres.2018.10.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/20/2018] [Accepted: 10/27/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES This study aims to estimate the impact of heatwaves from July 2010 to October 2012 on daily outpatient visits for respiratory disease (RD) in Cangnan, China and identify vulnerable populations. METHODS The definition of heatwave was a period at least 3 consecutive days with maximum temperature exceeding 35 °C in this study. A time-stratified case-crossover design was conducted to examine the relationship between heatwaves and outpatient visits for RD. Patient data for the period from 2010 to 2012 were collected from the Third People's Hospital of Cangnan and daily meteorological data for the same period were collected from the China Meteorological Data Service Center. Data regarding the air pollution index (API), a composite indicator of air pollution, were collected from the Data Center of the Chinese Ministry of Environmental Protection. RD were identified based on the 10th revision International Classification of Diseases (ICD-10) codes (J00-J99). A conditional Poisson regression model was applied to examine the heatwave-RD association using the Relative Risk (RR) while adjusting for meteorological and air pollution factors including temperature, rainfall, wind speed, pressure, humidity, sunshine hours and API. RESULTS During the study period, 4 heatwaves occurred and a total of 1732 outpatient visits for RD were reported. Heatwaves increased the frequency of RD outpatient visits and the highest RR of total RD was 1.155% and 95% Confidence Intervals (95% CI) was 1.084-1.232 at Lag 0. For subcategories, heatwaves increased the risk of infectious RD (Lag 0: RR =1.182, 95% CI: 1.106-1.263) and decreased the risk of non-infectious RD ((Lag 6: RR =0.750, 95% CI: 0.568-0.990). Moreover, heatwaves showed adverse effects on acute upper respiratory infection (Lag 0: RR =1.306, 95% CI: 1.177-1.450). The RR of outpatient visits for RD was statistically significant in females (Lag 0: RR =1.161, 95% CI: 1.046-1.298), males (Lag 4: RR =1.161, 95% CI: 1.096-1.261), young people aged 4-17 years (Lag 0: RR =1.741, 95% CI: 1.524-1.990) and elders aged 65 years or older (Lag 5: RR =1.412, 95% CI: 1.111-1.794) during heatwaves. CONCLUSIONS Heatwaves had a significant harmful impact on daily outpatient visits for RD in Cangnan, especially for vulnerable population identified. These results can be used not only to strengthen the health education and protection of these vulnerable populations, but also to assist relevant organizations with developing intervention programmes and improving disease prevention and community care.
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Affiliation(s)
- Anran Zhang
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Wenqi Hu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Jiawei Li
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Ran Wei
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Junfen Lin
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, PR China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China; Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
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Park HK. Air pollution and climate change: Effects on asthmatic patients. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.2.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Lam HCY, Li AM, Chan EYY, Goggins WB. The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study. Thorax 2016; 71:1097-1109. [PMID: 27343213 DOI: 10.1136/thoraxjnl-2015-208054] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 05/20/2016] [Accepted: 06/06/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have found associations between meteorological variables and asthma hospitalisations but the nature of these associations has varied and few studies have been done in subtropical areas or evaluated effect modification by age. OBJECTIVES This study aimed to evaluate associations between asthma hospitalisations and meteorological factors and to assess effect modification of these associations by age and season in Hong Kong. METHODS Poisson generalised additive models combined with distributed lag nonlinear models and piecewise linear models were used to model associations between daily asthma hospitalisations from 2004 to 2011 and meteorological factors and air pollutants, adjusting for day of week, seasonality and trend. Subgroup analyses by age and season were performed. RESULTS In the hot season, hospitalisations were lowest at 27°C, rose to a peak at 30°C, then plateaued between 30°C and 32°C. The cumulative relative risk for lags 0-3 days (RRlag0-3) for 30°C vs 27°C was 1.19 (95% CI 1.06 to 1.34). In the cold season, temperature was negatively associated with asthma hospitalisations. The cumulative RRlag0-3 for 12°C vs 25°C was 1.33 (95% CI 1.13 to 1.58). Adult admissions were most sensitive to temperatures in both seasons while admissions among children under 5 were least associated. Higher humidity and ozone levels in the hot season, and low humidity in the cold season were also associated with more asthma admissions. CONCLUSIONS People with asthma should avoid exposure to adverse conditions by limiting outdoor activities during periods of extreme temperatures, combinations of high humidity and high temperature, and low humidity and low temperature, and high ozone levels.
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Affiliation(s)
- Holly Ching-Yu Lam
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Albert Martin Li
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Emily Ying-Yang Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Soneja S, Jiang C, Fisher J, Upperman CR, Mitchell C, Sapkota A. Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A. Environ Health 2016; 15:57. [PMID: 27117324 PMCID: PMC4847234 DOI: 10.1186/s12940-016-0142-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/22/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Several studies have investigated the association between asthma exacerbations and exposures to ambient temperature and precipitation. However, limited data exists regarding how extreme events, projected to grow in frequency, intensity, and duration in the future in response to our changing climate, will impact the risk of hospitalization for asthma. The objective of our study was to quantify the association between frequency of extreme heat and precipitation events and increased risk of hospitalization for asthma in Maryland between 2000 and 2012. METHODS We used a time-stratified case-crossover design to examine the association between exposure to extreme heat and precipitation events and risk of hospitalization for asthma (ICD-9 code 493, n = 115,923). RESULTS Occurrence of extreme heat events in Maryland increased the risk of same day hospitalization for asthma (lag 0) by 3 % (Odds Ratio (OR): 1.03, 95 % Confidence Interval (CI): 1.00, 1.07), with a considerably higher risk observed for extreme heat events that occur during summer months (OR: 1.23, 95 % CI: 1.15, 1.33). Likewise, summertime extreme precipitation events increased the risk of hospitalization for asthma by 11 % in Maryland (OR: 1.11, 95 % CI: 1.06, 1.17). Across age groups, increase in risk for asthma hospitalization from exposure to extreme heat event during the summer months was most pronounced among youth and adults, while those related to extreme precipitation event was highest among ≤4 year olds. CONCLUSION Exposure to extreme heat and extreme precipitation events, particularly during summertime, is associated with increased risk of hospitalization for asthma in Maryland. Our results suggest that projected increases in frequency of extreme heat and precipitation event will have significant impact on public health.
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Affiliation(s)
- Sutyajeet Soneja
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Jared Fisher
- Department of Epidemiology, University of Maryland School of Public Health, College Park, 20742, MD, USA
| | - Crystal Romeo Upperman
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA
| | - Clifford Mitchell
- Maryland Department of Health and Mental Hygiene, Prevention and Health Promotion Administration, Baltimore, MD, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742, MD, USA.
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