The relationship between diurnal temperature range and COPD hospital admissions in Changchun, China

Phylogenetic conservation in plant phenological traits varies between temperate and subtropical climates in China

Phenological traits, such as leaf and flowering dates, are proven to be phylogenetically conserved. The relationship between phylogenetic conservation, plant phenology, and climatic factors remains unknown. Here, we assessed phenological features among flowering plants as evidence for phylogenetic conservatism, the tendency for closely related species to share similar ecological and biological attributes. We use spring phenological traits data from 1968-2018 of 65 trees and 49 shrubs in Xi'an (temperate climate) and Guiyang (subtropical climate) to understand plant phenological traits' relationship with phylogeny. Molecular datasets are employed in evolutionary models to test the phylogenetic conservatism in spring phenological characteristics in response to climate-sensitive phenological features. Significant phylogenetic conservation was found in the Xi'an plant's phenological traits, while there was a non-significant conservation in the Guiyang plant species. Phylogenetic generalized least squares (PGLS) models correlate with phenological features significantly in Xi'an while non-significantly in Guiyang. Based on the findings of molecular dating, it was suggested that the Guiyang species split off from their relatives around 46.0 mya during the middle Eocene of the Tertiary Cenozoic Era, while Xi'an species showed a long evolutionary history and diverged from their relatives around 95 mya during the late Cretaceous Mesozoic Era. First leaf dates (FLD) indicative of spring phenology, show that Xi'an adjourned the case later than Guiyang. Unlike FLD, first flower dates (FFD) yield different results as Guiyang flowers appear later than Xi'an's. Our research revealed that various factors, including phylogeny, growth form, and functional features, influenced the diversity of flowering phenology within species in conjunction with local climate circumstances. These results are conducive to understanding evolutionary conservation mechanisms in plant phenology concerning evolutionary processes in different geographical and climate zones.

Effect modification of the association between temperature variability and hospitalization for cardiovascular disease by comorbid diabetes mellitus: A nationwide time-stratified case-crossover analysis

AIMS

We aimed to explore the association between short-term exposure to temperature variability (TV), and cardiovascular hospitalization stratified by the presence of comorbid diabetes.

METHODS

We collected data on nationwide hospitalization for cardiovascular diseases and daily weather conditions during 2011-2018 in Japan. TV was calculated as the standard deviation of daily minimum and maximum temperatures within 0-7 lag days. We applied a two-stage time-stratified case-crossover design to estimate the association between TV and cardiovascular hospitalization with and without comorbid diabetes, adjusting for temperature and relative humidity. Furthermore, specific cardiovascular disease causes, demographic characteristics, and seasons were used for stratification.

RESULTS

In 3,844,910 hospitalizations for cardiovascular disease, each 1 °C increase in TV was associated with a 0.44% (95% CI: 0.22%, 0.65%) increase in the risk of cardiovascular admission. We observed a 2.07% (95% CI: 1.16%, 2.99%) and 0.61% (95% CI: -0.02%, 1.23%) increase per 1 °C in risk of heart failure admission in individuals with and those without diabetes, respectively. The higher risk among individuals with diabetes was mostly consistent in the analyses stratified by age, sex, body mass index, smoking status, and season.

CONCLUSION

Comorbid diabetes may increase susceptibility to TV in relation to acute cardiovascular disease hospitalization.

Diurnal temperature range and hospital admission due to cardiovascular and respiratory diseases in Dezful, a city with hot climate and high DTR fluctuation in Iran: an ecological time-series study

The results of previous studies have indicated the effects of temperature changes on health status. The present study was conducted to investigate the effects of diurnal temperature range (DTR) and hospital admission on cardiovascular and respiratory diseases in Dezful, in Iran. In this ecological time-series study, data related to hospital admissions based on ICD-10, meteorological, and climatological data were gathered over a period of six years from 2014 to 2019. A distributed lag nonlinear model combined with a quasi-Poisson regression was then used to assess the impact of DTR on cardiovascular and respiratory hospital admissions. Potential confounders, including wind speed, air pollution, seasonality, time trend, weekends and holidays, days of week, and humidity were controlled. In extreme low DTRs, the cumulative effects of cardiovascular admissions significantly increased in total, and in warm and cold seasons (Lag_0-21, P ≤ 0.05). In addition, in extreme high DTRs, the cumulative effects of cardiovascular significantly decreased in total (Lag_0-13 and Lag_0-21, P ≤ 0.05), and in warm (Lag_0-21, P ≤ 0.05) and cold seasons (Lag_0-21, P ≤ 0.05). Moreover, respiratory admissions significantly decreased in total (Lag_0-21, P ≤ 0.05) and in warm season (Lag_0-21, P ≤ 0.05).Our result indicates that extreme low DTRs could increase the risk of daily cardiovascular admissions, and extreme high DTRs may cause a protective effect on daily respiratory and cardiovascular admissions in some regions with high fluctuations in DTR.

Impact of environmental factors and bacterial interactions on dust mite allergens in different indoor dust

Indoor dust is the main carrier of indoor pollutants, especially dust mite allergens and bacteria, they can trigger asthma, rhinitis, eczema and other allergic diseases. However, the interactions between dust mite allergens and bacterial communities in different types of indoor dust are not clear. The study focused on particulate and flocculent fibrous dust, explored the concentrations of Der p 1 (Dermatophagoides pteronyssinus) and Der f 1 (D. farinae) in 46 households in Changchun and their environmental influences, characterized the bacterial communities by high-throughput sequencing, and the interactions between Der p 1, Der f 1 and bacterial communities were explored. The results showed that Der p 1 and Der f 1 tended to accumulate more in flocculent fibrous dust, and Der p 1 predominated in the indoor dust samples. The floor height, years of housing occupancy and the living areas all affected the concentrations of dust mite allergens. In bacterial community, Proteobacteria, Firmicutes and Actinobacteria were leading phyla in the two types of dust. Kocuria, Blastococcus and Massilia were dominating genera in particulate dust and Acinetobacter, Lactobacillus, Corynebacterium_1 were dominating genera in flocculent fibrous dust. The overall diversity and species richness of bacteria in particulate dust were significantly higher than those in flocculent dust (p < 0.001). The living area was an important environmental factor affecting the bacterial community in flocculent fibrous dust (p < 0.01). The interaction between the relative abundance of Proteobacteria, Firmicutes and Actinobacteria and dust mite allergen concentrations significantly differed between the two dust types, indicating that bacteria could be used both as food and to establish symbiotic relationships with household dust mites (HDMs) hosts and provide nutrition.

Human Health, Environmental Quality and Governance Quality: Novel Findings and Implications From Human Health Perspective

Human health and wellbeing are intimately linked to the state of the environment. The current study emphasizes the role of environmental quality, government policies, and human health. This paper provides a detailed literature review of existing findings regarding our key variables of interest. The results argue that the implications of poor government policies and environmental pollution for rising economic development have led to poor environmental quality and health issues for humans. Based on earlier investigations, the present study reviewed the state-of-the-art review and determined innovative insights for outdoor and indoor environment difficulties. This study provides a detailed review of human health, environmental quality, and governance quality. In addition, the study conducts an empirical analysis using the annual data of low-income countries from 1996 to 2020. Government actions and health systems must be modified immediately to address these rising concerns successfully. The report offers policy recommendations for addressing health, governance, and environmental change mitigation issues, all of which are directly or indirectly related to the study. This article presents an overview of environmental change's health impacts and explores how health hazards may be reduced or eliminated through effective adaptation strategies.

Analysis of the effect of meteorological factors on hemorrhagic fever with renal syndrome in Taizhou City, China, 2008–2020

Background

Hemorrhagic fever with renal syndrome (HFRS) is endemic in Zhejiang Province, China, while few studies have concentrated on the influence of meteorological factors on HFRS incidence in the area.

Methods

Data on HFRS and meteorological factors from January 1, 2008 to December 31, 2020 in Taizhou City, Zhejiang Province were collected. Multivariate analysis was conducted to the relationship between meteorological factors including minimum temperatures, relative humidity, and cumulative rainfall with HFRS.

Results

The HFRS incidence peaked in November and December and it was negatively correlated with average and highest average temperatures. Compared with median of meteorological factors, the relative risks (RR) of weekly average temperature at 12 ℃, weekly highest temperature at 18 ℃relative humidity at 40%, and cumulative rainfall at 240 mm were most significant and RRs were 1.41 (95% CI: 1.09–1.82), 1.32 (95% CI: 1.05–1.66), 2.18 (95% CI: 1.16–4.07), and 1.91 (95% CI: 1.16–2.73), respectively. Average temperature, precipitation, relative humidity had interactions on HFRS and the risk of HFRS occurrence increased with the decrease of average temperature and the increase of precipitation.

Conclusion

Our study results are indicative of the association of environmental factors with the HFRS incidence, probable recommendation could be use of environmental factors as early warning signals for initiating the control measure and response. 

The Impact of Central Heating on the Urban Thermal Environment Based on Multi-Temporal Remote Sensing Images

Research on the impact of anthropogenic heat discharge in a thermal environment is significant in climate change research. Central heating is more common in the winter in Northeast China as an anthropogenic heat. This study investigates the impact of central heating on the thermal environment in Shenyang, Changchun, and Harbin based on multi-temporal land surface temperature retrieval from remote sensing. An equivalent heat island index method was proposed to overcome the problem of the method based on a single-phase image, which cannot evaluate all the central heating season changes. The method improves the comprehensiveness of a thermal environment evaluation by considering the long-term heat accumulation. The results indicated a significant increase in equivalent heat island areas at night with 22.1%, 17.3%, and 19.5% over Shenyang, Changchun, and Harbin. The increase was significantly positively correlated with the central heating supply (with an R-value of 0.89 for Shenyang, 0.93 for Changchun, and 0.86 for Harbin; p < 0.05). The impact of central heating has a more significant effect than the air temperature. The results provide a reference for future studies of urban thermal environment changes.

Temporal trends of the association between temperature variation and hospitalizations for schizophrenia in Hefei, China from 2005 to 2019: a time-varying distribution lag nonlinear model

Along with climate change, unstable weather patterns are becoming more frequent. However, the temporal trend associated with the effect of temperature variation on schizophrenia (SCZ) is not clear. Daily time-series data on SCZ and meteorological factors for 15-year between January 1, 2005 and December 31, 2019 were collected. And we used the Poisson regression model combined with the time-varying distribution lag nonlinear model (DLNM) to explore the temporal trend of the association between three temperature variation indicators (diurnal temperature range, DTR; temperature variability, TV; temperature change between neighboring days, TCN) and SCZ hospitalizations, respectively. Meanwhile, we also explore the temporal trend of the interaction between temperature and temperature variation. Stratified analyses were performed in different gender, age, and season. Across the whole population, we found a decreasing trend in the risk of SCZ hospitalizations associated with high DTR (from 1.721 to 1.029), TCN (from 1.642 to 1.066), and TV (TV0-1, from 1.034 to 0.994; TV0-2, from 1.041 to 0.994, TV0-3, from 1.044 to 0.992, TV0-4, from 1.049 to 0.992, TV0-5, from 1.055 to 0.993, TV0-6, from 1.059 to 0.991, TV0-7, from 1.059 to 0.990), but an increasing trend in low DTR (from 0.589 to 0.752). Subgroup analysis results further revealed different susceptible groups. Besides, the interactive effect suggests that temperature variation may cause greater harm under low-temperature conditions. There was a synergy between TCN and temperature on the addition and multiplication scales, which were 1.068 (1.007, 1.133) and 0.067 (0.009, 0.122), respectively. Our findings highlight public health interventions to mitigate temperature variation effects needed to focus not only on high temperature variations but also moderately low temperature variations. Future hospitalizations for SCZ associated with temperature variation may be more severely affected by temperature variability from low temperature environments. The temporal trend is associated with the effect of temperature variation on schizophrenia (SCZ).

The association between diurnal temperature range and clinic visits for upper respiratory tract infection among college students in Wuhan, China

The effects of daily mean temperature on health outcomes have been discussed in many previous studies, but few have considered the adverse impacts on upper respiratory tract infection (URTI) due to variance of temperature in one day. Diurnal temperature range (DTR) was a novel indicator calculated as maximum temperature minus minimum temperature on the same day. In this study, generalized additive model (GAM) with quasi-Poisson distribution was used to investigate the association between DTR and the number of daily outpatient visits for URTI among college students. Data about meteorological factors and air pollutants were provided by Hubei Meteorological Bureau and Wuhan Environmental Protection Bureau, respectively. Outpatient visits data were collected from the Hospital of Wuhan University from January 1, 2016, to December 31, 2018. Short-term exposure to DTR was associated with the increased risk of outpatient for URTI among all college students. Per 1 °C increased in DTR was associated with 0.73% (95%CI: 0.24, 1.21) increased in outpatient visits of all college students for URTI at lag 0 day. The greatest effect values were observed in males [1.35% (95%CI: 0.33,2.39)] at lag 0-6 days, and in females [0.86% (95%CI: 0.24, 1.49)] at lag 0-1 days. DTR had more adverse health impact in autumn and winter. Public health departments should consider the negative effect of DTR to formulate more effective prevention and control measures for protecting vulnerable people.

Effects of high-frequency temperature variabilities on the morbidity of chronic obstructive pulmonary disease: Evidence in 21 cities of Guangdong, South China

BACKGROUND

While temperature changes have been confirmed as one of the contributory factors affecting human health, the association between high-frequency temperature variability (HFTV, i.e., temperature variation at short time scales such as 1, 2, and 5 days) and the hospitalization of chronic obstructive pulmonary disease (COPD) was rarely reported.

OBJECTIVES

To evaluate the associations between high-frequency temperature variabilities (i.e., at 1, 2, and 5-day scales) and daily COPD hospitalization.

METHODS

We collected daily records of COPD hospitalization and meteorological variables from 2013 to 2017 in 21 cities of Guangdong Province, South China. A quasi-Poisson regression with a distributed lag nonlinear model was first employed to quantify the effects of two HFTV measures, i.e., the day-to-day (DTD) temperature change and the intraday-interday temperature variability (IITV), on COPD morbidity for each city. Second, we used multivariate meta-analysis to pool the city-specific estimates, and stratified analyses were performed by age and sex to identify vulnerable groups. Then, the meta-regression with city-level characteristics was employed to detect the potential sources of the differences among 21 cities.

RESULTS

A monotonic increasing curve of the overall exposure-response association was observed, suggesting that positive HFTV (i.e., increased DTD and IITV) will significantly increase the risk of COPD admission. Negative DTD was associated with reduced COPD morbidity while positive DTD elevated the COPD risk. An interquartile range (IQR) increase in DTD was associated with a 24% (95% CI: 12-38%) increase in COPD admissions. An IQR increase in IITV_0-1 was associated with 18% (95% CI: 7-27%) increase in COPD admissions. Males and people aged 0-64 years appeared to be more vulnerable to the DTD effect than others. Potential sources of the disparity among different cities include urbanization level, sex structure, industry structure, gross domestic product (GDP), health care services, and air quality.

CONCLUSIONS

The increases of DTD and IITV have significant adverse impacts on COPD hospitalization. As climate change intensifies, precautions need to be taken to mitigate the impacts of high-frequency temperature changes.

The Impact of Air Pollutants and Meteorological Factors on Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Study

RATIONALE Chronic obstructive lung disease (COPD) is a chronic progressive disease. Although smoking is the most important risk factor, 30% of COPD patients are never smokers, and environmental agents are also influential. The effects of air pollutants and meteorological factors on COPD exacerbations have not been studied extensively. OBJECTIVE We aimed to investigate the air pollutants and meteorological factors that impact the incidence of COPD exacerbations. METHODS We obtained clinical data of COPD exacerbation cases from The National Health Insurance Service (NHIS) and merged it with 24-hour average values of air pollutants and meteorological factors from national databases. Patients who reside in eight metropolitan cities, where observatory stations are densely located, were selected for analysis. RESULTS In 1,404,505 COPD patients between 2013 and 2018, 15,282 COPD exacerbations leading to hospitalization or emergency room visits were identified. Among the various air pollutants and meteorological factors, particulate matter (PM)2.5, PM10, NO2, SO2, CO, O3, average temperature and diurnal temperature range (DTR) were associated with COPD exacerbations. GAM model analysis with cubic splines showed an inverted U-shaped relationship with PM2.5, PM10, CO, NO2, SO2, O3, DTR and humidity, while it displayed a U-shaped pattern with the average temperature. Distinct patterns were found from 2015-2016 to 2017-2018. CONCLUSIONS PM2.5, PM10, CO, NO2, O3, SO2, average temperature, humidity, and DTR affected the incidence of COPD exacerbations in various patterns, up to 10 lag days.

Short-Term Effect of Temperature Change on Non-Accidental Mortality in Shenzhen, China

Temperature change is an important meteorological indicator reflecting weather stability. This study aimed to examine the effects of ambient temperature change on non-accidental mortality using diurnal temperature change (DTR) and temperature change between neighboring days (TCN) from two perspectives, intra-day and inter-day temperature change, and further, to explore seasonal variations of mortality, identify the susceptible population and investigate the interaction between temperature change and apparent temperature (AT). We collected daily data on cause-specific mortality, air pollutants and meteorological indicators in Shenzhen, China, from 1 January 2013 to 29 December 2017. A Quasi-Poisson generalized linear regression combined with distributed lag non-linear models (DLNMs) were conducted to estimate the effects of season on temperature change-related mortality. In addition, a non-parametric bivariate response surface model was used to explore the interaction between temperature change and AT. The cumulative effect of DTR was a U-shaped curve for non-accidental mortality, whereas the curve for TCN was nearly monotonic. The overall relative risks (RRs) of non-accidental, cardiovascular and respiratory mortality were 1.407 (95% CI: 1.233-1.606), 1.470 (95% CI: 1.220-1.771) and 1.741 (95% CI: 1.157-2.620) from exposure to extreme large DTR (99th) in cold seasons. However, no statistically significant effects were observed in warm seasons. As for TCN, the effects were higher in cold seasons than warm seasons, with the largest RR of 1.611 (95% CI: 1.384-1.876). The elderly and females were more sensitive, and low apparent temperature had a higher effect on temperature change-related non-accidental mortality. Temperature change was positively correlated with an increased risk of non-accidental mortality in Shenzhen. Both female and elderly people are more vulnerable to the potential adverse effects, especially in cold seasons. Low AT may enhance the effects of temperature change.

What Are the Effects of Meteorological Factors on Exacerbations of Chronic Obstructive Pulmonary Disease?

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.

A review of the impact of outdoor and indoor environmental factors on human health in China

The Intergovernmental Panel on Climate Change (IPCC) reported that global climate change has led to the increased occurrence of extreme weather events. In the context of global climate change, more evidence indicates that abnormal meteorological conditions could increase the risk of epidemiological mortality and morbidity. In this study, using a systematic review, we evaluated a total of 175 studies (including 158 studies on outdoor environment and 17 studies on indoor environment) to summarize the impact of outdoor and indoor environment on human health in China using the database of PubMed, Web of Science, the Cochrane Library, and Embase. In particular, we focused on studies about cardiovascular and respiratory mortality and morbidity, the prevalence of digestive system diseases, infectious diseases, and preterm birth. Most of the studies we reviewed were conducted in three of the metropolises of China, including Beijing, Guangzhou, and Shanghai. For the outdoor environment, we summarized the effects of climate change-related phenomena on health, including ambient air temperature, diurnal temperature range (DTR), temperature extremes, and so on. Studies on the associations between temperature and human health accounted for 79.7% of the total studies reviewed. We also screened out 19 articles to explore the effect of air temperature on cardiovascular diseases in different cities in the final meta-analysis. Besides, modern lifestyle involves a large amount of time spent indoors; therefore, indoor environment also plays an important role in human health. Nevertheless, studies on the impact of indoor environment on human health are rarely reported in China. According to the limited reports, adverse indoor environment could impose a high health risk on children.

Association of diurnal temperature range with daily hospitalization for exacerbation of chronic respiratory diseases in 21 cities, China

Background

The association between diurnal temperature range (DTR) and hospitalization for exacerbation of chronic respiratory diseases (CRD) was rarely reported.

Objectives

To examine the association between DTR and daily hospital admissions for exacerbation of CRD and find out the potential effect of modifications on this association.

Method

Data on daily hospitalization for exacerbation of chronic obstructive pulmonary disease (COPD), asthma and bronchiectasis and meteorology measures from 2013 through 2017 were obtained from 21 cities in South China. After controlling the effects of daily mean temperature, relative humidity (RH), particulate matter < 2.5 μm diameter (PM_2.5) and other confounding factors, a standard generalized additive model (GAM) with a quasi-Poisson distribution was performed to evaluate the relationships between DTR and daily hospital admissions of CRD in a two-stage strategy. Subgroup analysis was performed to find potential modifications, including seasonality and population characteristics.

Result

Elevated risk of hospitalization for exacerbation of CRD (RR = 1.09 [95%CI: 1.08 to 1.11]) was associated with the increase in DTR (the 75th percentile versus the 25th percentile of DTR at lag0–6). The effects of DTR on hospital admissions for CRD were strong at low DTR in the hot season and high DTR in the cold season. The RR (the 75th percentile versus the 25th percentile of DTR at lag0–6) of hospitalization was 1.11 (95%CI: 1.08 to 1.12) for exacerbations of COPD and 1.09 (95%CI: 1.05 to 1.13) for asthma. The adverse effect of DTR on hospitalization for bronchiectasis was only observed in female patients (RR = 1.06 [95%CI: 1.03 to 1.10]).

Conclusion

Our study provided additional evidence for the association between DTR and daily hospitalization for exacerbation of CRD, and these associations are especially stronger in COPD patients and in the cold season than the hot season. Preventive measures to reduce the adverse impacts of DTR were needed for CRD patients.

Temperature Variability and Hospital Admissions for Chronic Obstructive Pulmonary Disease: Analysis of Attributable Disease Burden and Vulnerable Subpopulation

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.

Short-term effects of diurnal temperature range on hospital admission in Bangkok, Thailand

Diurnal temperature range (DTR) is a key indicator reflecting climate stability. Many previous studies have examined the effects of ambient temperature, both hot and cold, on human morbidity and mortality, but few studies have evaluated health effects of DTR, especially those in developing countries. This study aimed to investigate the association between short-term exposure to DTR and hospital admissions for cardiovascular and respiratory diseases in Bangkok, Thailand. We obtained daily meteorological variables from the Thai Meteorological Department from January 2006 through December 2014 and daily hospital admissions from the National Health Security Office during the same period. Quasi-Poisson generalized linear regression model combined with distributed lag non-linear model was used to examine the association between DTR and cardiovascular and respiratory hospital admissions controlling for daily average temperature, relative humidity, day of the week, public holiday, and seasonal and long-term trend. A J-shape relationship between DTR and hospital admissions was observed. With 7.8 °C DTR as a reference value, the relative risks for cardiovascular and respiratory hospital admission associated with extremely high DTR (11.6 °C) at cumulative lag 0-21 (21-day cumulative effects) were 1.206 (95% CI: 1.002-1.452) and 1.021 (95% CI: 0.856-1.218), respectively. The effects of extremely high DTR relative to a reference value did not significantly differ between males and females, as well as between young people (<65 years) and the elderly (≥65 years) for both cardiovascular and respiratory admission. When stratifying the effects by season, the effect of extremely high DTR in winter was greater than that in summer and rainy season. This study showed that short-term exposure to extremely high DTR was significantly associated with increased risk of hospital admissions for cardiovascular disease in Bangkok, especially during winter. Results from this study could provide important scientific evidence for policy decision making to protect populations from adverse health effects of DTR.

Impact of temperature changes between neighboring days on COPD in a city in Northeast China

Sudden temperature changes between neighboring days (T_24h) have adverse effects on human health. In this study, we used a time series analysis to evaluate the impact of T_24h on the number of hospital admissions for chronic obstructive pulmonary disease (COPD) from 2009 to 2012 in Changchun (the capital of Northeast China's Jilin province). We performed the analysis in a generalized additive model (GAM), and the controlling factors included long-term trends, day of the week effect, and the selected weather elements. We divided the entire study group into two gender subgroups (males and females) and two age subgroups (aged < 65 years and aged ≥ 65 years). T_24h showed the greatest effect on the entire study group at lag 3 days. In particular, the greatest effect of T_24h on females (males) occurred at lag 1 day (lag 3 days); the greatest effect of T_24h on the aged ≥ 65 years (aged < 65 years) occurred at lag 1 day (lag 6 days). This indicates that temperature changes between neighboring days have a relatively more acute effect on the elderly and the females than on the younger people and the males. When T_24h is less than zero, the highest RR of the number of hospital admissions for COPD occurred at lag 4 days during the warm season (1.025, 95% CI: 0.981, 1.069) and lag 3 days during the cold season (1.019, 95% CI: 0.988, 1.051). When T_24h is greater than zero, the highest RR of the number of hospital admissions for COPD occurred at lag 6 days during the warm season (1.026, 95% CI: 0.977, 1.077) and lag 5 days during the cold season (1.021, 95% CI: 0.986, 1.057). The results of this study could be provided to local health authorities as scientific guidelines for controlling and preventing COPD in Changchun, China.

Risk of temperature, humidity and concentrations of air pollutants on the hospitalization of AECOPD

AIM

To investigate the effect of temperature, humidity and the concentration of ambient air pollution on the hospitalization of AECOPD.

METHOD

Hospitalization record was obtained from Shenyang Medical Insurance Bureau, concluding patient's age, gender, income hospital time, outcome hospital; Generalized additive model was used to analyze the relationship between temperature, humidity, the concentration of ambient air pollution and the hospitalization of AECOPD.

RESULT

The effect of ozone on admission rate in male group was higher than that in female group. Ambient air pollution had a weak influence on age≤50 group. It was found that the optimal lag day for daily relative 40 humidity to age≤50 group, 50<age≤60, 60<age≤70 group and age>70 group was on lag5, lag4, lag4 and lag5, respectively.

CONCLUSION

Air pollution, relative humidity and temperature can increase the risk of admission for acute exacerbation of COPD, and in this process there was a lag effect.