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Feng J, Cao D, Zheng D, Qian ZM, Huang C, Shen H, Liu Y, Liu Q, Sun J, Jiao G, Yang X, McMillin SE, Wang C, Lin H, Zhang X, Zhang S. Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160726. [PMID: 36502973 DOI: 10.1016/j.scitotenv.2022.160726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.
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Affiliation(s)
- Jin Feng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dawei Cao
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Dashan Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 102200, China; Institute of Healthy China, Tsinghua University, Beijing 102200, China
| | - Huiqing Shen
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Yi Liu
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, Zhejiang, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing 102200, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing 102200, China
| | - Stephen Edward McMillin
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xinri Zhang
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China.
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
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Xu E, Li Y, Li T, Li Q. Association between ambient temperature and ambulance dispatch: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:66335-66347. [PMID: 35499723 DOI: 10.1007/s11356-022-20508-3] [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: 02/07/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Previous studies have quantified the associations between ambient temperature and dispatch of ambulances, but the conclusions are still controversial. Therefore, a systematic review and meta-analysis were conducted to summarize all the current evidence. A systematic review of published literature was undertaken to characterize the effect of temperature on ambulance dispatch. We completed the literature search by the end of January 5, 2022. The pooled estimates for different temperature exposures were calculated using a random effects model. Differences among temperature pooled estimates were determined using subgroup analysis. This study was registered with PROSPERO under the number CRD42021284434. This is the first meta-analysis investigating the association between temperature and ambulance dispatch. A total of 25 studies were eligible for this study. The overall increased risks of high temperature, expressed as relative risks, were 1.734 (95% CI: 1.481-2.031). Subgroup analysis found that for the study using daily mean temperature, the high temperature increased the risk of ambulance dispatch by 15.2% (RR = 1.152, 95%CI: 1.081-1.228). In the ambulance dispatch of all-cause subgroups, the RR was 1.179 (95% CI: 1.085-1.282). The results also reported a significant association between low temperature and ambulance dispatch (RR = 1.130, 95% CI: 1.052-1.213). In the subgroup, the RR for cardiovascular disease was 1.209 (95% CI: 1.033-1.414), and respiratory disease was 1.126 (95% CI: 1.012-1.253). Sensitivity analysis indicated that the results were robust, and no obvious publication bias was observed. High temperature and low temperature are important factors influencing the dispatch of ambulances. These findings help improve the understanding of temperature effect on ambulance dispatch, demonstrating the need to consider wider surveillance of acute health outcomes in different environments.
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Affiliation(s)
- Er Xu
- Hospital Infection Management Office, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Yanni Li
- Public Health Department, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Tingting Li
- Department of Endocrinology, Rheumatology and Immunology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Qing Li
- Hospital Infection Management Office, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China.
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, Anhui, People's Republic of China.
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Zhong Q, Zhang H, Sun X. Exposure to Abnormally Hot Temperature and the Demand for Commercial Health Insurance. Front Public Health 2022; 10:842665. [PMID: 35145944 PMCID: PMC8821154 DOI: 10.3389/fpubh.2022.842665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Using the China Health and Retirement Longitudinal Study, this paper studies the impact of abnormal hot temperature on residents' demand for commercial health insurance. The results show that for every 1°F rise in abnormal temperature, the probability of people buying commercial health insurance increased by 6%. Furthermore, the abnormal hot temperature has a more significant impact on the commercial health insurance demand of women, residents in the South and residents in the East. Channel analysis shows that abnormal hot temperature affects the demand for commercial health insurance through two channels: increasing residents' concern about climate risk and affecting health. This paper provides evidence for actively promoting sustainable development and improving the construction of medical security system.
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Affiliation(s)
- Qian Zhong
- Department of Financial Engineering, School of Finance, Guangdong University of Foreign Studies, Guangzhou, China
| | - Hao Zhang
- Department of Financial Engineering, School of Finance, Guangdong University of Foreign Studies, Guangzhou, China
| | - Xiaoke Sun
- Department of Insurance, School of Finance, Guangdong University of Foreign Studies, Guangzhou, China
- *Correspondence: Xiaoke Sun
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Wong MS, Ho HC, Tse A. Geospatial context of social and environmental factors associated with health risk during temperature extremes: Review and discussion. GEOSPATIAL HEALTH 2020; 15. [PMID: 32575974 DOI: 10.4081/gh.2020.814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/21/2020] [Indexed: 06/11/2023]
Abstract
This study reviews forty-six publications between 2008 and 2017 dealing with socio-environmental impacts on adverse health effects of temperature extremes, in a geospatial context. The review showed that most studies focus on extremely hot weather but lack analysis of how spatial heterogeneity across a region can influence cold mortality/morbidity. There are limitations regarding the use of temperature datasets for spatial analyses. Only a few studies have applied air temperature datasets with high spatial resolution to health studies, but none of these studies have used anthropogenic heat as a factor for analysis of health risk. In addition, the elderly is generally recognized as a vulnerable group in most studies, but the interaction between old age and temperature risk varies by location. Other socio-demographic factors such as low income, low education and accessibility to community shelters may also need to be considered in the future. There are only a few studies which investigate the interaction between temperature and air pollution in a geospatial context, despite the fact that this is a known interaction that can influence health risk under extreme weather. In conclusions, although investigation of temperature effects on health risk is already at the "mature stage", studies of socio-environmental influences on human health under extreme weather in a geospatial context is still being investigated. A comprehensive assessment is required to analyse how the spatial aspects of the geophysical and social environments can influence human health under extreme weather, in order to develop a better community plan and health protocols for disaster preparedness.
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Affiliation(s)
- Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University; Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University.
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong.
| | - Agnes Tse
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University.
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Ma P, Wang S, Zhou J, Li T, Fan X, Fan J, Wang S. Meteorological rhythms of respiratory and circulatory diseases revealed by Harmonic Analysis. Heliyon 2020; 6:e04034. [PMID: 32509988 PMCID: PMC7264065 DOI: 10.1016/j.heliyon.2020.e04034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/29/2019] [Accepted: 05/18/2020] [Indexed: 12/02/2022] Open
Abstract
The intricately fluctuating onset of respiratory and circulatory diseases displays rhythms of multi-scaled meteorological conditions due to their sensitivity to weather changes. The intrinsic meteorological rhythms of these diseases are revealed in this bio-meteorological study via Fourier decomposition and harmonic analysis. Daily emergency room (ER) visit data for respiratory and circulatory diseases from three comprehensive hospitals in Haidian district of Beijing, China were used in the analysis. Meteorological data included three temperature metrics, relative humidity, sunshine duration, daily mean air pressure, and wind speed. The Fourier decomposition and harmonic analysis on ER visits and meteorological variables involve frequency, period, and power of all harmonics. The results indicated that: i) for respiratory morbidity, a strong climatic annual rhythm responding to annual temperature change was firstly revealed; its ratio of spectral density was 16-33%. Moreover, significant correlations existed between the high-frequency fluctuations (<30 d) of morbidity and short-term harmonics of humidity and solar duration. High-frequency harmonics of temperature and pressure showed no statistically significant effect. ii) With regard to all types of circulatory morbidity, their annual periodicity was weaker than that of respiratory diseases, whose harmonic energy took a ratio less than 8%. Besides, the power of all high-frequency harmonics of circulatory morbidity accounted for up to 70-90% in the original sequences, and their relationship to many short-term meteorological factors were significant, including the mean and maximum temperatures, wind speed, and solar duration. iii) The weekly rhythm appeared in respiratory ER visits with 15% of harmonic variance but not prominent in circulatory morbidity. In summary, by decomposing the sequence of respiratory and circulatory diseases as well as recognizing their meteorological rhythms, different responses to meteorological conditions on various time scales were identified.
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Affiliation(s)
- Pan Ma
- Institute of Environmental Meteorology and Health, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu 610225, Sichuan, China
- College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China
| | - Shigong Wang
- Institute of Environmental Meteorology and Health, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu 610225, Sichuan, China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Tanshi Li
- Chinese PLA General Hospital, Beijing 100000, China
| | - Xingang Fan
- Department of Geography and Geology, Western Kentucky University, Bowling Green, KY, 42101, USA
- College of Electronic Engineering, Chengdu University of Information Technology, Chengdu 610225, Sichuan, China
| | - Jin Fan
- Institute of Environmental Meteorology and Health, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu 610225, Sichuan, China
| | - Siyi Wang
- Institute of Environmental Meteorology and Health, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu 610225, Sichuan, China
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Wong HT, Lin JJ. The effects of weather on daily emergency ambulance service demand in Taipei: a comparison with Hong Kong. THEORETICAL AND APPLIED CLIMATOLOGY 2020; 141:321-330. [PMID: 32421067 PMCID: PMC7223070 DOI: 10.1007/s00704-020-03213-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 04/02/2020] [Indexed: 05/08/2023]
Abstract
Numerous studies have examined the effects of weather on emergency ambulance service (EAS) demand. Given Taipei's unique physical and social environments, empirical evidence collected from other regions may not be applicable. Collecting more information about the characteristics of vulnerable groups and the effects of weather could help the EAS managing authority in formulating cost-effective EAS policies. This study aims to look at the effects of weather on EAS demand in Taipei and to make a comparison with Hong Kong, which is also an Asian city and has a similar cultural context. The study analyzed over 370,000 EAS usage records from the Taipei City Fire Department. These records were aggregated into time series data according to patients' characteristics and then regressed on meteorological data via multivariate forward regression. The effect size differences of the variance explained by different groups of EAS users' regression models were compared. Afterward, the results of the regression analysis from Taipei were compared with those from a Hong Kong study. Elderly and critical patients in both cities showed significantly more sensitivity to weather than other patients. Further analysis showed that non-trauma cases were related to weather in Taipei. Although both cities had similar results, the Taipei study clearly showed that elderly and critical patients were more sensitive to weather than other patient subgroups. Health education programs should focus on the vulnerable groups identified in this study in order to increase their awareness and help them protect themselves before the onset of adverse weather conditions. By generating results that are directly applicable to Taipei, the formulation of inappropriate EAS policies can be prevented.
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Affiliation(s)
- Ho Ting Wong
- Institute of Health Care Management, Department of Business Management, National Sun Yat-sen University, 70 Lienhai Rd., Kaohsiung, 80424 Taiwan
| | - Jen-Jia Lin
- Department of Geography, National Taiwan University, Taipei City, Taiwan
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