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Ren Y, Li J, Yang J, Hu L, Xu Z, Fu R, Wu K, Guo M, Hu M, Ran L, Li X, Qiu H, Liao L, Zhang M, Luo Y, Zhou S, Ding F. Meteorological parameters and hospital-acquired falls-A multicenter retrospective study based on 10 years of adverse events reporting system data. Heliyon 2024; 10:e34193. [PMID: 39071631 PMCID: PMC11279767 DOI: 10.1016/j.heliyon.2024.e34193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024] Open
Abstract
Objective and rationale Hospital-acquired falls are common and serious adverse events in medical institutions, with high incidence and injury rates. Studying the occurrence patterns of hospital-acquired falls is important for preventing falls in hospitalized patients. However, the effect of meteorological factors on hospital-acquired falls has not been elucidated. Therefore, this study explored the impact of meteorological parameters on hospital-acquired falls in Chongqing, China, and provided new ideas for the clinical prevention of falls in patients. Methods Correlation analysis and distributed lag nonlinear models were employed to analyze the relationship between 3890 cases of hospital-acquired falls and meteorological data in 13 hospitals in 11 districts and counties in Chongqing from January 2013 to April 2023. Results The number of hospital-acquired falls demonstrated a nonlinear correlation with the daily average relative humidity and negatively correlated with sunshine duration; however, temperature, air pressure, and wind speed were not correlated. Compared to the reference humidity (87 %), the immediate effects of daily average relative humidity (65-68 % and 90-97 %) increased the risk of hospital-acquired falls on the same day (relative risk [RR]:1.027-1.243). When the daily average relative humidity was 95-97 %, lags of 0-1 d and 8-12 d had greater effects on falls (RR:1.073-1.243). The daily average relative humidities of 62-74 % and 91-97 % were statistically significant at cumulative relative risk (CRR)of 4, 7, 10, and 14 d with a cumulative lag (CRR: 1.111-4.277). On sex and age stratification, the lag and cumulative effects of relative humidity more significantly impacted falls in women and patients aged ≥65 years. Conclusion Daily average relative humidity had a nonlinear correlation and lag effect on hospital-acquired falls; therefore, medical institutions should pay attention to the effect of relative humidity on hospital-acquired falls in patients, especially old and female patients.
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Affiliation(s)
- Yuanyuan Ren
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jinyan Li
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jun Yang
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Lei Hu
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zhihui Xu
- Nursing Department, Hechuan District People's Hospital of Chongqing, Chongqing, 401533, China
| | - Rongjuan Fu
- Nursing Department, Dianjiang People's Hospital of Chongqing, Chongqing, 408300, China
| | - Kaihui Wu
- Nursing Department, Nanchuan District People's Hospital of Chongqing, Chongqing, 408400, China
| | - Min Guo
- Nursing Department, The 13th People's Hospital of Chongqing, Chongqing, 400050, China
| | - Mei Hu
- Nursing Department, Chongqing University Three Gorges Hospital, Chongqing, 404100, China
| | - Liu Ran
- Department of Endocrinology, Changshou District People's Hospital of Chongqing, Chongqing, 401220, China
| | - Xia Li
- Nursing Department, Qijiang District People's Hospital, Chongqing, 401420, China
| | - Huicheng Qiu
- Nursing Department, Liangping District People's Hospital, Chongqing, 405200, China
| | - Lianmei Liao
- Nursing Department, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401121, China
| | - Mengmeng Zhang
- Nursing Department, Banan District People's Hospital of Chongqing, Chongqing, 401320, China
| | - Yetao Luo
- Department of Nosocomial Infection Control, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, China
| | - Sumei Zhou
- Emergency Department, The First Affiliated Hospital of Chongqing Medical University, 400016, China
| | - Fu Ding
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
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Roudreo B, Puangthongthub S. Alleviation of PM2.5-associated Risk of Daily Influenza Hospitalization by COVID-19 Lockdown Measures: A Time-series Study in Northeastern Thailand. J Prev Med Public Health 2024; 57:108-119. [PMID: 38374709 PMCID: PMC10999304 DOI: 10.3961/jpmph.23.349] [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: 08/04/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous. METHODS This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand's Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels. RESULTS Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) concentration exceeded those later observed during the pandemic (p<0.001). In single-pollutant models, a 10 μg/m3 increase in PM2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p<0.01). After adjustment for co-pollutants, PM2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p<0.01). However, the PM2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak. CONCLUSIONS Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.
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Affiliation(s)
- Benjawan Roudreo
- Industrial Toxicology and Risk Assessment Graduate Program, Department of Environmental Science, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
- Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Sitthichok Puangthongthub
- Industrial Toxicology and Risk Assessment Graduate Program, Department of Environmental Science, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
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Tran HM, Chuang TW, Chuang HC, Tsai FJ. Climate change and mortality rates of COPD and asthma: A global analysis from 2000 to 2018. ENVIRONMENTAL RESEARCH 2023; 233:116448. [PMID: 37352955 DOI: 10.1016/j.envres.2023.116448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Climate change plays a significant role in global health threats, particularly with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma, but the long-term global-scale impact of climate change on these diseases' mortality remains unclear. OBJECTIVE This study aims to investigate the impact of climate change on the age-standardized mortality rates (ASMR) of COPD and asthma at national levels. METHODS We used Global Burden of Disease (GBD) data of ASMR of COPD and asthma from 2000 to 2018. The climate change index was represented as the deviance percentage of temperature (DPT) and relative humidity (DPRH), calculated based on 19-year temperature and humidity averages. Annual temperature, RH, and fine particulate matter (PM2.5) levels in 185 countries/regions were obtained from ERA5 and the OECD's environmental statistics database. General linear mixed-effect regression models were used to examine the associations between climate change with the log of ASMR (LASMR) of COPD and asthma. RESULTS After adjusting for annual PM2.5, SDI level, smoking prevalence, and geographical regions, a 0.26% increase in DPT was associated with decreases of 0.016, 0.017, and 0.014 per 100,000 people in LASMR of COPD and 0.042, 0.046, and 0.040 per 100,000 people in LASMR of asthma for both genders, males, and females. A 2.68% increase in DPRH was associated with increases of 0.009 and 0.011 per 100,000 people in LASMR of COPD. We observed a negative association of DPT with LASMR for COPD in countries/regions with temperatures ranging from 3.8 to 29.9 °C and with LASMR for asthma ranging from -5.3-29.9 °C. However, we observed a positive association of DPRH with LASMR for both COPD and asthma in the RH range of 41.2-67.2%. CONCLUSION Climate change adaptation and mitigation could be crucial in reducing the associated COPD and asthma mortality rates, particularly in regions most vulnerable to temperature and humidity fluctuations.
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Affiliation(s)
- Huan Minh Tran
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Ting-Wu Chuang
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; National Heart & Lung Institute, Imperial College London, UK.
| | - Feng-Jen Tsai
- Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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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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Fu J, Liu Y, Zhao Y, Chen Y, Chang Z, Xu KF, Huang C, Fan Z. Association between the temperature difference and acute exacerbations of chronic obstructive pulmonary disease: A time-series analysis with 143,318 hospital admissions in Beijing, China. Front Public Health 2023; 11:1112926. [PMID: 36778544 PMCID: PMC9909227 DOI: 10.3389/fpubh.2023.1112926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Purpose Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has the adverse influence on quality of life and creates significant healthcare costs. However, there were sparse studies investigating the correlation between AECOPD hospital admissions and temperature change. Therefore, it is noteworthy to investigate the impact of various temperature differences and recognize the susceptible population. The purpose of this study was to investigate the impact of temperature differences on AECOPD hospital admissions, and to give potentially helpful material for disease preventative efforts. Methods The distributed lag non-linear model was adopted to characterize the exposure-response relationship and to assess the impact of temperature difference. The stratified analysis and sensitivity analysis were also conducted to determine the susceptible populations and examine the robustness of the results. Results There were 143,318 AECOPD hospital admissions overall during the study period. The AECOPD hospital admissions had significant association with the daily mean temperature difference (DTDmean) such as the extreme-cold temperature difference (1st DTDmean), the ultra-cold temperature difference (5th DTDmean), the ultra-hot temperature difference (95th DTDmean) and the extreme-hot temperature difference (99th DTDmean). Besides, there was the "U-shaped" association between DTDmean and 21 days cumulative relative risk of AECOPD. Conclusion The AECOPD hospital admissions was correlated with the DTDmean temperature differences, especially the extreme-cold and extreme-hot temperature difference. Moreover, people older than 65 years were more susceptible to the extreme-hot and extreme-cold temperature difference.
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Affiliation(s)
- Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanbo Liu
- Department of International Medical Services, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiong Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhenge Chang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai-Feng Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Cheng Huang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China,Cheng Huang ✉
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China,*Correspondence: Zhongjie Fan ✉
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Ho JY, Lam HYC, Huang Z, Liu S, Goggins WB, Mo PKH, Chan EYY. Factors affecting outdoor physical activity in extreme temperatures in a sub-tropical Chinese urban population: an exploratory telephone survey. BMC Public Health 2023; 23:101. [PMID: 36641429 PMCID: PMC9840260 DOI: 10.1186/s12889-022-14788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/29/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Physical activity (PA) can be affected by extreme temperatures, however fewer studies have identified factors impacting this relationship. This study sought to identify factors associated with changes of outdoor PA during extreme cold/heat events in a sub-tropical Chinese urban population, including factors of sociodemographic, health conditions, temperature-related awareness and attitude, and protective behaviours. METHODS Two telephone surveys were conducted a week after extreme cold/heat events in 2016 and 2017 among a cohort of Hong Kong residents over age 15. Data was collected on self-reported changes in outdoor PA level during the periods of extreme temperatures, health status, comorbidities, sociodemographic, and temperature-related awareness, and behavioural variables. We conducted multivariable logistic regression analyses to assess predictors of change in outdoor PA over the two extreme temperature events. RESULTS AND CONCLUSION Among 435 participants (42.8% response rate), over a third of the participants reported decreased outdoor PA level in extreme temperature events, while 10% reported an increase in extreme heat. Self-reported cardiovascular diseases were associated with decreased PA level in extreme cold, while hypertension was associated with unchanged/increased PA level in extreme heat. These results suggest physical activity to be an important consideration in the understanding of climate change-and-health pathways and meriting further research.
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Affiliation(s)
- Janice Y. Ho
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly Y. C. Lam
- grid.7445.20000 0001 2113 8111Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Zhe Huang
- grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China
| | | | - William B. Goggins
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K. H. Mo
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y. Y. Chan
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China ,grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China ,GX Foundation, Hong Kong, China ,grid.4991.50000 0004 1936 8948Nuffield Department of Medicine, University of Oxford, Oxford, UK
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How Vulnerable Are Patients with COPD to Weather Extremities?—A Pilot Study from Hungary. Healthcare (Basel) 2022; 10:healthcare10112309. [DOI: 10.3390/healthcare10112309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most common causes of death globally, with increasing prevalence and years lived with disability (YLD). We aimed to investigate how extreme weather conditions were associated with the number of daily COPD-related emergency visits. We collected data regarding the number of daily emergency department (ED) visits made by patients with COPD in 2017, along with all relevant daily meteorological data for the same year. An analysis of the relationship between the number of COPD-related ED visits and extreme meteorological events was carried out. Extremely low temperatures (OR = 1.767) and dew points (OR = 1.795), extremely high atmospheric pressure (OR = 1.626), a high amount of precipitation (OR = 1.270), and light wind speed (OR = 1.560) were identified as possible risk factors for a higher number of COPD-related ED visits. In contrast, extremely high temperatures (OR = 0.572) and dew points (OR = 0.606) were found to be possible protective factors for COPD-related ED visits. By determining the meteorological risk factors for a high number of COPD-related ED visits, our study may help provide invaluable data for identifying vulnerable patient groups based on weather events, thus making more optimal capacity planning at the ED possible.
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Guo YT, Bernard Goggins W, Chan EYY, Ho KF. Individual socioeconomic status as a modifier of the association between high ambient temperature and hospital admissions: a time series study in Hong Kong, 2010-2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:67353-67361. [PMID: 35524101 PMCID: PMC9492594 DOI: 10.1007/s11356-022-20512-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Few studies have examined individual socioeconomic status (SES) as a potential modifier of ambient temperature-health associations, especially for temperature-related hospitalizations. We fit penalized distributed lag non-linear models within generalized additive models to study the short-term associations (0-3 days) between temperature and hospital admissions stratified by common causes, age, and individual SES, as determined by whether patients received public assistance (PA) to cover their medical fee at the time of hospitalizations, during the hot season (May 15 to October 15) in Hong Kong for the years 2010-2019. We calculated the ratio of relative risk (RRR) and corresponding 95% confidence interval (CI) to statistically test the difference of the associations between PA groups. For 75 + patients, the PA group had significantly increased risks of hospitalizations at higher temperature for most causes, with relative risks (RR, 99th %ile vs. 25%ile) and 95% CIs of 1.138 (1.099, 1.179), 1.057 (1.008, 1.109), and 1.163 (1.094, 1.236) estimated for all non-cancer non-external, circulatory, and respiratory admissions, respectively. There were slight decreases of RRs with higher temperature for 75 + patients without PA. The strengths of temperature-hospitalization associations were strongly and significantly different between PA groups for all examined causes for 75 + patients, with the most considerable discrepancy found for ischemic heart disease (RRR = 1.266; 95% CI, 1.137, 1.410). Hospitalizations for patients aged 15-74 were less affected by heat, and the difference of the associations between groups was small. Individual SES is a significant modifier of high temperature-hospitalization associations in Hong Kong among the elderly. Public health interventions are needed to better protect this subpopulation from adverse health impacts of high temperature.
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Affiliation(s)
- Yi Tong Guo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Emily Ying Yang Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Chong KC, Chen Y, Chan EYY, Lau SYF, Lam HCY, Wang P, Goggins WB, Ran J, Zhao S, Mohammad KN, Wei Y. Association of weather, air pollutants, and seasonal influenza with chronic obstructive pulmonary disease hospitalization risks. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 293:118480. [PMID: 34763018 DOI: 10.1016/j.envpol.2021.118480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 05/21/2023]
Abstract
The influences of weather and air pollutants on chronic obstructive pulmonary disease (COPD) have been well-studied. However, the heterogeneous effects of different influenza viral infections, air pollution and weather on COPD admissions and re-admissions have not been thoroughly examined. In this study, we aimed to elucidate the relationships between meteorological variables, air pollutants, seasonal influenza, and hospital admissions and re-admissions due to COPD in Hong Kong, a non-industrial influenza epicenter. A total number of 507703 hospital admissions (i.e., index admissions) and 301728 re-admission episodes (i.e., episodes within 30 days after the previous discharge) for COPD over 14 years (1998-2011) were obtained from all public hospitals. The aggregated weekly numbers were matched with meteorological records and outdoor air pollutant concentrations. Type-specific and all-type influenza-like illness positive (ILI+) rates were used as proxies for influenza activity. Generalized additive models were used in conjunction with distributed-lag non-linear models to estimate the associations of interest. According to the results, high concentrations of fine particulate matter, oxidant gases, and cold weather were strong independent risk factors of COPD outcomes. The cumulative adjusted relative risks exhibited a monotone increasing trend except for ILI+ B, and the numbers were statistically significant over the entire observed range of ILI+ total and ILI+ A/H3N2 when the reference rate was zero. COPD hospitalization risk from influenza infection was higher in the elderly than that in the general population. In conclusion, our results suggest that health administrators should impose clean air policies, such as strengthening emissions control on petrol vehicles, to reduce pollution from oxidant gases and particulates. An extension of the influenza vaccination program for patients with COPD may need to be encouraged: for example, vaccination may be included in hospital discharge planning, particularly before the winter epidemic.
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Affiliation(s)
- Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong; Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong
| | - Yu Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Emily Ying Yang Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Steven Yuk Fai Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Holly Ching Yu Lam
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Pin Wang
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut, United States
| | - William Bernard Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Zhao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong; Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Kirran N Mohammad
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Yuchen Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong.
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Chen X, Luan M, Liu J, Yao Y, Li X, Wang T, Zhang H, Han Y, Lu X, Chen W, Hu X, Zheng M, Qiu X, Zhu T. Risk factors in air pollution exposome contributing to higher levels of TNFα in COPD patients. ENVIRONMENT INTERNATIONAL 2022; 159:107034. [PMID: 34906887 DOI: 10.1016/j.envint.2021.107034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollutants are found associated with various health effects in chronic obstructive pulmonary patients. Given the complicate chemical components of air pollutants, it is not clear which components are the main risk factors for these health effects. OBJECTIVES Based on the COPD in Beijing (COPDB) study and exposome concept, we examined comprehensively the air pollution components to screen out high-risk factors for systemic inflammation of COPD patients. METHODS Concentrations of PM with aerodynamic diameter ≤ 2.5 μm (PM2.5), ultrafine and accumulated-mode particles (UFPs and Acc), PM2.5-contained carbonaceous components/elements/water soluble ions, gaseous pollutants, temperature, and relative humidity (RH) were continuously monitored around participants. Urinary polycyclic aromatic hydrocarbons (PAHs) and cotinine, and serum tumor necrosis factor α (TNFα) were measured from 53 COPD and 82 non-COPD participants. Lifestyle variables were recorded using follow-up questionnaire. Linear mixed effects (LME) models were used to assess the associations of TNFα differences with exposure to air pollutants, meteorological variations, and lifestyle. RESULTS In COPD patients, the associations of TNFα differences with exposure to ozone, Cd, UFPs, Acc, 2-hydroxydibenzofuran, temperature and RH parameters, and several elements in PM2.5 were significant in certain time-windows. For example, per interquartile range (IQR) increase in average ozone concentration 14 d before visits was associated with 17.3% (95% confidence interval: 6.8%, 27.7%) TNFα difference. Associations between ozone, Cd, UFPs, Acc, the maximum value of RH, and 2-hydroxydibenzofuran exposure and TNFα differences remained robust in two-pollutant models, and contributed to 19.0%, 10.5%, 2.2%, 1.6%, 2.1%, and 1.5% TNFα differences, respectively. Among the high-risk factors for COPD patients, the responses to UFPs, Acc, and 2-hydroxydibenzofuran were not robust in non-COPD participants. DISCUSSION Ozone, Cd, UFPs, Acc, PAHs exposure and RH variation were high-risk factors of systemic inflammation for COPD patients, and the profile of high-risk factors were different from those in general population.
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Affiliation(s)
- Xi Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Hebei Technology Innovation Center of Human Settlement in Green Building, Shenzhen Institute of Building Research Co., Ltd., Xiongan 071700, China
| | - Mengxiao Luan
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Jinming Liu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Yuan Yao
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xiaoying Li
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Teng Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Hanxiyue Zhang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Yiqun Han
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Department of Epidemiology and Biostatistics, MRC Centre for Environmental and Health, Imperial College London, SW7 2AZ, UK
| | - Xinchen Lu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xinyan Hu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Mei Zheng
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xinghua Qiu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
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11
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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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12
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The effect of air temperature on hospital admission of adults with community acquired pneumonia in Baotou, China. Sci Rep 2021; 11:9353. [PMID: 33931697 PMCID: PMC8087821 DOI: 10.1038/s41598-021-88783-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 04/12/2021] [Indexed: 11/08/2022] Open
Abstract
The relationship between air temperature and the hospital admission of adult patients with community-acquired pneumonia (CAP) was analyzed. The hospitalization data pertaining to adult CAP patients (age ≥ 18 years) in two tertiary comprehensive hospitals in Baotou, Inner Mongolia Autonomous Region, China from 2014 to 2018 and meteorological data there in the corresponding period were collected. The exposure-response relationship between the daily average temperature and the hospital admission of adult CAP patients was quantified by using a distributed lag non-linear model. A total of 4466 cases of adult patients with CAP were admitted. After eliminating some confounding factors such as relative humidity, wind speed, air pressure, long-term trend, and seasonal trend, a lower temperature was found to be associated with a higher risk of adult CAP. Compared to 21 °C, lower temperature range of 4 to -12 °C was associated with a greater number of CAP hospitalizations among those aged ≥ 65 years, and the highest relative risk (RR) was 2.80 (95% CI 1.15-6.80) at a temperature of - 10 °C. For those < 65 years, lower temperature was not related to CAP hospitalizations. Cumulative lag RRs of low temperature with CAP hospitalizations indicate that the risk associated with colder temperatures appeared at a lag of 0-7 days. For those ≥ 65 years, the cumulative RR of CAP hospitalizations over lagging days 0-5 was 1.89 (95% CI 1.01-3. 56). In brief, the lower temperature had age-specific effects on CAP hospitalizations in Baotou, China, especially among those aged ≥ 65 years.
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13
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Analysis of Pneumonia Occurrence in Relation to Climate Change in Tanga, Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094731. [PMID: 33946714 PMCID: PMC8125699 DOI: 10.3390/ijerph18094731] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
In 2018, 70% of global fatalities due to pneumonia occurred in about fifteen countries, with Tanzania being among the top eight countries contributing to these deaths. Environmental and individual factors contributing to these deaths may be multifaceted, but they have not yet been explored in Tanzania. Therefore, in this study, we explore the association between climate change and the occurrence of pneumonia in the Tanga Region, Tanzania. A time series study design was employed using meteorological and health data of the Tanga Region collected from January 2016 to December 2018 from the Tanzania Meteorological Authority and Health Management Information System, respectively. The generalized negative binomial regression technique was used to explore the associations between climate indicators (i.e., precipitation, humidity, and temperature) and the occurrence of pneumonia. There were trend differences in climate indicators and the occurrence of pneumonia between the Tanga and Handeni districts. We found a positive association between humidity and increased rates of non-severe pneumonia (incidence rate ratio (IRR) = 1.01; 95% CI: 1.01–1.02; p ≤ 0.05) and severe pneumonia (IRR = 1.02; 95% CI: 1.01–1.03; p ≤ 0.05). There was also a significant association between cold temperatures and the rate of severe pneumonia in Tanga (IRR = 1.21; 95% CI: 1.11–1.33; p ≤ 0.001). Other factors that were associated with pneumonia included age and district of residence. We found a positive relationship between humidity, temperature, and incidence of pneumonia in the Tanga Region. Policies focusing on prevention and control, as well as promotion strategies relating to climate change-related health effects should be developed and implemented.
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14
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What Are the Effects of Meteorological Factors on Exacerbations of Chronic Obstructive Pulmonary Disease? ATMOSPHERE 2021. [DOI: 10.3390/atmos12040442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the greatest global public health challenges. Acute exacerbations of COPD lead to the accelerated deterioration of lung function, reduced quality of life, a higher number of hospitalizations, and increased mortality. The factor causing the exacerbation is usually an infectious agent, but the impact of environmental factors is being studied more thoroughly. Among them, meteorological factors are the least examined. Multiple studies have shown that lower temperatures during the cold season, as well as sudden temperature changes regardless of the season, have the most significant negative effect on patients with COPD. However, higher temperatures, especially during summer heatwaves, can also cause COPD exacerbation and it is expected that this will be an even more important health problem in the future considering climate changes. The effects of other meteorological factors on acute exacerbation of COPD, such as atmospheric pressure, solar radiation, rainfall, wind speed, and humidity are far less investigated and opposing results have been obtained in different studies. Thus, there is a need for further research in this area that would result in clinical recommendations and public health interventions that could decrease the global burden of COPD.
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15
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Zhan ZY, Tian Q, Chen TT, Ye Y, Lin Q, Han D, Ou CQ. Temperature Variability and Hospital Admissions for Chronic Obstructive Pulmonary Disease: Analysis of Attributable Disease Burden and Vulnerable Subpopulation. Int J Chron Obstruct Pulmon Dis 2020; 15:2225-2235. [PMID: 33061340 PMCID: PMC7519840 DOI: 10.2147/copd.s260988] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) is a major cause of chronic diseases causing considerable social and economic burden globally. Despite substantial evidence on temperature-COPD association, few studies have investigated the acute effect of temperature variability (TV), a potential trigger of exacerbation of COPD disease, and it remains unknown what fraction of the disease burden of COPD is attributable to TV. Patients and Methods Based on 71,070 COPD hospitalizations during 2013–2015 in Guangzhou, China, we conducted a time-series analysis using quasi-Poisson regression to assess the association between TV and hospital admission for COPD after adjusting for daily mean temperature. Short-term TV was captured by the standard deviation of hourly or daily temperatures across various exposure days. We also provided the fraction (total number) of COPD attributable to TV. Stratified analyses by admission route, sex, age, occupation, marital status and season were performed to identify vulnerable subpopulations. Results We found a linear relationship between TV and COPD hospitalization, with a 1°C increase in hourly TV and daily TV associated with 4.3% (95%CI: 2.2–6.4) and 4.0% (2.3–5.8) increases in COPD, respectively. The greater relative risks of TV identified males, people aged 0–64 years, blue collar, and divorced/widowed people as vulnerable population. There were 12.0% (8500 cases) of COPD hospitalization attributable to hourly TV during the study period. Daily TV produced similar estimates of relative effects (relative risk) but grater estimates of absolute effects (attributable fraction) than hourly TV. Conclusion We concluded that TV was an independent risk factor of COPD morbidity, especially among the susceptible subgroups. These findings would be helpful to guide the development of targeted public intervention.
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Affiliation(s)
- Zhi-Ying Zhan
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China.,Department of Health Care Management and Social Medicine, School of Public Health, Fujian Medical University, Fuzhou, People's Republic of China
| | - Qi Tian
- Department of Information Resources, Guangzhou Health Information Center, Guangzhou, People's Republic of China
| | - Ting-Ting Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Yunshao Ye
- Department of Information Resources, Guangzhou Health Information Center, Guangzhou, People's Republic of China
| | - Qiaoxuan Lin
- Department of Information Resources, Guangzhou Health Information Center, Guangzhou, People's Republic of China
| | - Dong Han
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People's Republic of China
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16
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Qiu H, Xia X, Man CL, Ko FWS, Yim SHL, Kwok TCY, Ho KF. Real-Time Monitoring of the Effects of Personal Temperature Exposure on the Blood Oxygen Saturation Level in Elderly People with and without Chronic Obstructive Pulmonary Disease: A Panel Study in Hong Kong. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:6869-6877. [PMID: 32363866 DOI: 10.1021/acs.est.0c01799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Few studies have investigated the short-term effect of personal temperature exposure on blood oxygen saturation (SpO2). We conducted this longitudinal panel study with real-time monitoring of SpO2 and environmental exposure for 3 continuous days for 20 patients with chronic obstructive pulmonary disease (COPD) and 20 healthy volunteers in Hong Kong, to explore the time course (from minutes to hours) of change in SpO2 in response to temperature in elderly people. We employed a generalized additive mixed model to evaluate the acute effects of personal temperature exposure on changes in SpO2 and risk of oxygen desaturation while adjusting for seasonality, environmental co-exposures, and personal characteristics. We observed a concurrent decline in SpO2 by 0.27% (95% confidence interval [CI]: 0.22-0.32%) and an increase in the risk of oxygen desaturation by an OR of 1.14 (95% CI, 1.10-1.18) associated with a 1 °C increase in personal temperature, and the association lasted over several hours. Results showed that the decline in SpO2 in elderly people was associated with an increase in personal temperature exposure within minutes to hours, particularly in women and male patients with COPD. Temperature-induced oxygen desaturation may play a pivotal role in COPD exacerbation.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
| | - Xi Xia
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Chung Ling Man
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Fanny W S Ko
- Division of Respiratory Medicine, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Steve H L Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, HKSAR, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
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17
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Cui Y, Ai S, Liu Y, Qian ZM, Wang C, Sun J, Sun X, Zhang S, Syberg KM, Howard S, Qin L, Lin H. Hourly associations between ambient temperature and emergency ambulance calls in one central Chinese city: Call for an immediate emergency plan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 711:135046. [PMID: 31812379 DOI: 10.1016/j.scitotenv.2019.135046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Most studies examining the short-term effects of temperature on health were based on the daily scale, few were at the hourly level. Revealing the relationship between unfavorable temperatures on an hourly basis and health is conducive to the development of more accurate extreme temperature early warning systems and reasonable dispatch of ambulances. METHODS Hourly data on temperature, air pollution (including PM2.5, O3, SO2 and NO2) and emergency ambulance calls (EACs) for all-cause, cardiovascular and respiratory diseases from January 16, 2014 to December 31, 2016 were obtained from Luoyang, China. A distributed lag non-linear model (DLNM) was used to assess the association between hourly temperature and ambulance calls after adjusting for potential confounding factors. The fractions of EACs attributable to non-optimum temperatures were also estimated. RESULTS Hourly temperature was associated with increased ambulance calls with a varying lag pattern. Extreme hot temperature (>32.1 °C) was positively associated with all-cause, cardiovascular diseases at lag 0-30 h and lag 0-9 h, while no significant effects were found for respiratory morbidity. Extreme cold temperature (<-2.5 °C) was positively associated with all-cause, cardiovascular and respiratory morbidity at lag 56-157 h, 50-145 h and 123-170 h. An overall EACs fraction of 6.84% [Backward estimate, 95% confidence interval (CI): 5.01%, 8.59%] could be attributed to non-optimum temperatures, and more contributions were caused by cold [Backward estimate: 6.06% (95% CI: 5.10%, 8.48%)] than by heat [Backward estimate: 0.79% (95% CI: 0.12%, 1.45%)]. CONCLUSIONS Extreme hot temperature may lead to increased ambulance calls within a few hours, while extreme cold temperature may not increase ambulance calls until more than 2 days later. Effective measures, such as forming hourly temperature warning standards, optimizing ambulance services at extreme temperatures, etc., should be taken to reduce the unfavorable temperature - associated EACs burden.
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Affiliation(s)
- Yingjie Cui
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Siqi Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuying Liu
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhengmin Min Qian
- Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Jia Sun
- Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Xiangyan Sun
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kevin M Syberg
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Steven Howard
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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18
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Association of meteorological factors and atmospheric particulate matter with the incidence of pneumonia: an ecological study. Clin Microbiol Infect 2020; 26:1676-1683. [PMID: 32184173 DOI: 10.1016/j.cmi.2020.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Inconsistent results have been found between pneumonia and meteorological factors. We aimed to identify principal meteorological factors associated with pneumonia, and to estimate the effect size and lag time. METHODS This was nationwide population-based study used a healthcare claims database merged with a weather database in eight metropolitan cities in Korea. We applied a stepwise approach using the Granger causality test and generalized additive model to elucidate the association between weekly pneumonia incidence (WPI) and meteorological factors/air pollutants (MFAP). Impulse response function was used to examine the time lag. RESULTS In total, 2 011 424 cases of pneumonia were identified from 2007 to 2017. Among MFAP, diurnal temperature range (DTR), humidity and particulate matter ≤2.5 μm in diameter (PM2.5) showed statistically significant associations with WPI (p < 0.001 for all 3 MFAPs). The association of DTR and WPI showed an inverted U pattern for bacterial and unspecified pneumonia, whereas for viral pneumonia, WPI increased gradually in a more linear manner with DTR and no substantial decline. Humidity showed a consistent pattern in all three pneumonia categories. WPI steeply increased up to 10 to 20 μg/m³ of PM2.5 but did not show a further increase in higher concentrations. On the basis of the result, we examined the effect of MFAP in different lag times up to 3 weeks. CONCLUSIONS DTR, humidity and PM2.5 were identified as MFAP most closely associated with WPI. With the model, we were able to visualize the effect-time association of MFAP and WPI.
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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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Ragettli MS, Vicedo-Cabrera AM, Flückiger B, Röösli M. Impact of the warm summer 2015 on emergency hospital admissions in Switzerland. Environ Health 2019; 18:66. [PMID: 31412877 PMCID: PMC6694501 DOI: 10.1186/s12940-019-0507-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/12/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Only a few studies have examined the impact of a particular heat event on morbidity. The aim of this study was to evaluate the impact of the warm summer 2015 on emergency hospital admissions (EHA) in Switzerland. The summer 2015 ranks as the second hottest after 2003 in the history of temperature observation in Switzerland. METHODS Daily counts of EHA for various disease categories during summer 2015 were analyzed in relation to previous summers in Switzerland. Excess EHA for non-external causes during summer 2015 (June-August) were estimated by age group, gender, geographic region and disease category by comparing observed and expected cases. The latter were predicted from strata-specific quasi-Poisson regression models fitted to the daily counts of EHA for years 2012-2014. RESULTS Over the three summer months in 2015, an estimated 2.4% (95% confidence interval [CI] 1.6-3.2%) increase in EHA (non-external causes) occurred corresponding to 2,768 excess cases. Highest excess EHA estimates were found in the warmest regions (Ticino [8.4%, 95% CI 5.1-11.7%] and the Lake Geneva region [4.8%, 95% CI 3.0-6.7%]) and among the elderly population aged ≥75 years (5.1%, 95% CI 3.7-6.5%). Increased EHA during days with most extreme temperatures were observed for influenza and pneumonia, certain infectious diseases and diseases of the genitourinary system. CONCLUSIONS Summer 2015 had a considerable impact on EHA in Switzerland. The daily number of EHA mainly increased due to diseases not commonly linked to heat-related mortality. No excess morbidity was found for cardiovascular and most respiratory diseases. This suggests that current public health interventions should be reevaluated to prevent both heat-related illness and deaths.
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Affiliation(s)
- Martina S Ragettli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Ana M Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Benjamin Flückiger
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
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