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Bu Y, Sun Z, Tao Y, Zhao X, Zhao Y, Liang Y, Hang X, Han L. The synergistic effect of high temperature and relative humidity on non-accidental deaths at different urbanization levels. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 940:173612. [PMID: 38823719 DOI: 10.1016/j.scitotenv.2024.173612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/11/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024]
Abstract
Numerous studies have examined the impact of temperature on mortality, yet research on the combined effect of temperature and humidity on non-accidental deaths remains limited. This study investigates the synergistic impact of high temperature and humidity on non-accidental deaths in China, assessing the influence of urban development and urbanization level. Utilizing the distributed lag nonlinear model (DLNM) of quasi-Poisson regression, we analyzed the relationship between Wet Bulb Globe Temperature (WBGT) and non-accidental deaths in 30 Chinese cities from 2010 to 2016, including Guangzhou during 2012-2016. We stratified temperature and humidity across these cities to evaluate the influence of varying humidity levels on deaths under high temperatures. Then, we graded the duration of heat and humidity in these cities to assess the impact of deaths with different durations. Additionally, the cities were categorized based on gross domestic product (GDP), and a vulnerability index was calculated to examine the impact of urban development and urbanization level on non-accidental deaths. Our findings reveal a pronounced synergistic effect of high temperature and humidity on non-accidental deaths, particularly at elevated humidity levels. The synergies of high temperature and humidity are extremely complex. Moreover, the longer the duration of high temperature and humidity, the higher the risk of non-accidental death. Furthermore, areas with higher urbanization exhibited lower relative risks (RR) associated with the synergistic effects of heat and humidity. Consequently, it is imperative to focus on damp-heat related mortality among vulnerable populations in less developed regions.
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Affiliation(s)
- Yaqin Bu
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China; State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China
| | - Zhaobin Sun
- State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China.
| | - Yan Tao
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China
| | - Xiuge Zhao
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Yuxin Zhao
- State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China
| | - Yinglin Liang
- State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China
| | - Xiaoyi Hang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ling Han
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Yan S, Liu G, Chen X. Spatiotemporal distribution characteristics and influencing factors of the rate of cardiovascular hospitalization in Ganzhou city of China. Front Cardiovasc Med 2023; 10:1225878. [PMID: 38188258 PMCID: PMC10770874 DOI: 10.3389/fcvm.2023.1225878] [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: 05/27/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Aims The objective of this study was to analyze hospitalization rates for cardiovascular diseases (CVD) in Ganzhou City, Jiangxi Province of China from 2015 to 2020 and to uncover the spatiotemporal distribution characteristics and influencing factors, and thus to provide reference for the prevention and control of CVD and public health resources planning. Methods The hospitalization data for CVDs from 2016 to 2020 was obtained from the First Affiliated Hospital of Gannan Medical University, and ArcGIS 10.8, SaTScan 9.5, and Matlab 20.0 were used to analyze the spatial autocorrelation, spatiotemporal scan statistics, and potential affecting factors of the hospitalization rates. Results The hospitalization rate for CVDs in Ganzhou City showed a slightly increasing trend from 2016 to 2020, with higher rates in winter and summer than that in spring and autumn, and the individuals aged 61 and above constitute a higher proportion compared to other age groups. Additionally, there was a positive correlation between hospitalization rates for CVDs and the counties and districts in Ganzhou City, with high-high aggregation areas mainly distributed in Nankang District, the western urban area of Ganzhou City. The spatial scan analysis identified three different types of significant aggregation areas: high-risk, low-risk, and middle-risk areas. The high-risk area was mainly centered around Zhanggong District or Shangyu County in the central and western regions, with a disease hospitalization rate 2-3 times higher than the rest areas. The study also found that environmental meteorological factors such as the annual average concentration of NO2, O3, average annual temperature, and annual maximum temperature diurnal range had a significant positive effect on hospitalization rates for CVDs in Ganzhou City, with O3 concentration and average annual temperature having significant positive indirect spatial spillover effects. Conclusion Winter and summer are the seasons with high hospitalization rate of cardiovascular diseases. County residents aged 61 and above are the higher-risk population that needs to pay more attention on for prevention and control of CVD in Ganzhou City, which exhibits significant spatiotemporal clustering. The urban areas of Zhanggong and Nankang in Ganzhou City are the key areas for prevention and control of CVD. The hospitalization rate of CVD in Ganzhou City is influenced by the aforementioned four environmental meteorological factors, with the annual maximum temperature diurnal range showing the most significant positive direct effect.
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Affiliation(s)
- Shanshan Yan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Guoqiu Liu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiaoyuan Chen
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
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Li M, Fang W, Meng R, Hu J, He G, Hou Z, Zhou M, Zhou C, Zhu S, Xiao Y, Yu M, Huang B, Xu X, Lin L, Jin D, Qin M, Yin P, Xu Y, Liu T, Ma W. The comparison of mortality burden between exposure to dry-cold events and wet-cold events: A nationwide study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166859. [PMID: 37673238 DOI: 10.1016/j.scitotenv.2023.166859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/17/2023] [Accepted: 09/03/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Most previous studies have focused on the health effect of temperature or humidity, and few studies have explored the combined health effects of exposure to temperature and humidity. This study aims to estimate the relationship between humidity-cold events and mortality, and then to compare the mortality burden between exposure to dry-cold events and wet-cold events, and finally to explore whether there was an additive interaction of temperature and humidity on mortality. METHODS In the study, Daily mortality data during 2006-2017 were collected from Centers for Disease Control and Prevention in China, and daily mean temperature and daily mean relative humidity data from 698 weather stations in China were obtained from the China Meteorological Data Sharing Service system. We first employed time-series design with a distributed lag nonlinear model and a multivariate meta-analysis model to examine the association between humidity-cold events with mortality. RESULTS We found that humidity-cold events significantly increased mortality risk, and the effect of wet-cold events (RR:1.24, 95%CI:1.20,1.29) was higher than that of dry-cold events (RR:1.14, 95%CI:1.10,1.18). Dry-cold events and wet-cold events accounted for 2.41 % and 2.99 % excess deaths, respectively with higher burden for the elderly ≥85 years old, Central China and CVD. In addition, there is a synergistic additive interaction between low temperature and high humidity in winter. CONCLUSION This study showed that humidity-cold events significantly increased mortality risk, and the effect of wet-cold events was higher than that of dry-cold events.
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Affiliation(s)
- Muyun Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wen Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
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Zhan ZY, Fang HY, Xu XY, Hu ZJ. Interactions of particulate matter with temperature, heat index and relative humidity on pediatric hand, foot, and mouth disease in a subtropical city. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122385. [PMID: 37648054 DOI: 10.1016/j.envpol.2023.122385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
The associations of hand, foot, and mouth disease (HFMD) with meteorological variables and particulate matter (PM) remain controversial, and limited evidence is available on heat index (HI) and coarse particulate (PM10-2.5). Moreover, temperature and humidity are considered major risk factors but their interaction with PM remains unclear. We combined the distributed lag non-linear and quasi-Poisson models to estimate the non-linear and lagged associations of meteorological variables and PM with HFMD based on reported HFMD during 2015-2019 in Fuzhou, China. The multiplicative term of interaction was used to explore the relationship between HFMD and meteorological variables or PM at different levels of another variable. Stratified analyses were used to identify vulnerable subpopulations. We observed inverted-V-shaped relationships between HFMD and temperature and HI, and the W- and N-shaped for relative humidity (RH) and PM, respectively. Extreme high (i.e., the 95th percentile) temperature, HI and RH increased the HFMD with relative risks (RR) of 4.00 (95% confidence interval, 2.79-5.75), 2.20 (1.71-2.83) and 1.54 (1.35-1.75) referent to the minimum effect value of 10.3 °C, 69.4 and 54.8%, respectively. Higher concentrations of PM rapidly increased the HFMD. Infants under 2 years suffered more from temperature, HI and PM. There were synergistic effects between meteorological variables and PM on HFMD. For instance, the RRs of temperature (30 °C) and RH (40%) on HFMD increased from 3.68 (2.24-6.06) to 6.44 (4.29-9.66) and from 0.45 (0.14-1.47) to 2.15 (0.90-5.12) at low (<25%) and high (>75%) categories of PM2.5, respectively. While the RRs of 70 μg/m3 of PM10 and PM10-2.5 increased from 0.65 (0.32-1.31) to 2.93 (1.63-5.26) and from 0.86 (0.23-3.21) to 3.26 (1.23-8.62) at low and high categories of HI. These findings are essential for the development a prediction and warning systems and prevention and control strategies for HFMD.
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Affiliation(s)
- Zhi-Ying Zhan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China
| | - Hai-Yin Fang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China; Fuzhou Center for Disease Control and Prevention, Fuzhou 350004, Fujian Province, China
| | - Xin-Ying Xu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China
| | - Zhi-Jian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China.
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Seong K, Jiao J, Mandalapu A. Hourly Associations between Heat Index and Heat-Related Emergency Medical Service (EMS) Calls in Austin-Travis County, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6853. [PMID: 37835122 PMCID: PMC10572679 DOI: 10.3390/ijerph20196853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023]
Abstract
This paper aims to investigate the following research questions: (1) what are the hourly patterns of heat index and heat-related emergency medical service (EMS) incidents during summertime?; and (2) how do the lagged effects of heat intensity and hourly excess heat (HEH) vary by heat-related symptoms? Using the hourly weather and heat-related EMS call data in Austin-Travis County, Texas, this paper reveals the relationship between heat index patterns on an hourly basis and heat-related health issues and evaluates the immediate health effects of extreme heat events by utilizing a distributed lag non-linear model (DLNM). Delving into the heat index intensity and HEH, our findings suggest that higher heat intensity has immediate, short-term lagged effects on all causes of heat-related EMS incidents, including in cardiovascular, respiratory, neurological, and non-severe cases, while its relative risk (RR) varies by time. HEH also shows a short-term cumulative lagged effect within 5 h in all-cause, cardiovascular, and non-severe symptoms, while there are no statistically significant RRs found for respiratory and neurological cases in the short term. Our findings could be a reference for policymakers when devoting resources, developing extreme heat warning standards, and optimizing local EMS services, providing data-driven evidence for the effective deployment of ambulances.
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Affiliation(s)
- Kijin Seong
- Urban Information Lab, School of Architecture, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Junfeng Jiao
- Urban Information Lab, School of Architecture, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Akhil Mandalapu
- Department of Public Health, The University of Texas at Austin, Austin, TX 78712, USA;
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Pang X, Ge M. Effect of geographical factors on reference values of creatine kinase isoenzyme. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:553-563. [PMID: 36941512 PMCID: PMC10027583 DOI: 10.1007/s00484-023-02429-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 10/16/2022] [Accepted: 01/10/2023] [Indexed: 05/25/2023]
Abstract
The aim of this study was to investigate the geographical spatial distribution of creatine kinase isoenzyme (CK-MB) in order to provide a scientific basis for clinical examination. The reference values of CK-MB of 8697 healthy adults in 137 cities in China were collected by reading a large number of literates. Moran index was used to determine the spatial relationship, and 24 factors were selected, which belonged to terrain, climate, and soil indexes. Correlation analysis was conducted between CK-MB and geographical factors to determine significance, and 9 significance factors were extracted. Based on R language to evaluate the degree of multicollinearity of the model, CK-MB Ridge model, Lasso model, and PCA model were established, through calculating the relative error to choose the best model PCA, testing the normality of the predicted values, and choosing the disjunctive kriging interpolation to make the geographical distribution. The results show that CK-MB reference values of healthy adults were generally correlated with latitude, annual sunshine duration, annual mean relative humidity, annual precipitation amount, and annual range of air temperature and significantly correlated with annual mean air temperature, topsoil gravel content, topsoil cation exchange capacity in clay, and topsoil cation exchange capacity in silt. The geospatial distribution map shows that on the whole, it is higher in the north and lower in the south, and gradually increases from the southeast coastal area to the northwest inland area. If the geographical factors are obtained in a location, the CK-MB model can be used to predict the CK-MB of healthy adults in the region, which provides a reference for us to consider regional differences in clinical diagnosis.
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Affiliation(s)
- Xinrui Pang
- College of Tourist and Environment Science, Shaanxi Normal University, Xi’an, Shaanxi 710119 China
| | - Miao Ge
- College of Tourist and Environment Science, Shaanxi Normal University, Xi’an, Shaanxi 710119 China
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Fang W, Li Z, Gao J, Meng R, He G, Hou Z, Zhu S, Zhou M, Zhou C, Xiao Y, Yu M, Huang B, Xu X, Lin L, Xiao J, Jin D, Qin M, Yin P, Xu Y, Hu J, Liu T, Huang C, Ma W. The joint and interaction effect of high temperature and humidity on mortality in China. ENVIRONMENT INTERNATIONAL 2023; 171:107669. [PMID: 36508749 DOI: 10.1016/j.envint.2022.107669] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Although many studies have reported the mortality effect of temperature, there were few studies on the mortality risk of humidity, let alone the joint effect of temperature and humidity. This study aimed to investigate the joint and interaction effect of high temperature and relative humidity on mortality in China, which will deepen understanding the health risk of mixture climate exposure. METHODS The mortality and meteorological data were collected from 353 locations in China (2013-2017 in Jilin, Hunan, Guangdong and Yunnan provinces, 2009-2017 in Zhejiang province, and 2006-2011 in other Provinces). We defined location-specific daily mean temperature ≥ 75th percentile of distribution as high temperature, while minimum mortality relative humidity as the threshold of high relative humidity. A time-series model with a distributed lag non-linear model was first employed to estimate the location-specific associations between humid-hot events and mortality, then we conducted meta-analysis to pool the mortality effect of humid-hot events. Finally, an additive interaction model was used to examine the interactive effect between high temperature and relative humidity. RESULTS The excess rate (ER) of non-accidental mortality attributed to dry-hot events was 10.18% (95% confidence interval (CI): 8.93%, 11.45%), which was higher than that of wet-hot events (ER = 3.21%, 95% CI: 0.59%, 5.89%). The attributable fraction (AF) of mortality attributed to dry-hot events was 10.00% (95% CI: 9.50%, 10.72%) with higher burden for females, older people, central China, cardiovascular diseases and urban city. While for wet-hot events, AF was much lower (3.31%, 95% CI: 2.60%, 4.30%). We also found that high temperature and low relative humidity had synergistic additive interaction on mortality risk. CONCLUSION Dry-hot events may have a higher risk of mortality than wet-hot events, and the joint effect of high temperature and low relative humidity may be greater than the sum of their individual effects.
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Affiliation(s)
- Wen Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhixing Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Jinghua Gao
- School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
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Mei Y, Li A, Zhao M, Xu J, Li R, Zhao J, Zhou Q, Ge X, Xu Q. Associations and burdens of relative humidity with cause-specific mortality in three Chinese cities. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:3512-3526. [PMID: 35947256 DOI: 10.1007/s11356-022-22350-z] [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: 03/30/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to investigate the association between relative humidity (RH) and various cause of mortality, and then quantify the RH-related mortality fraction of low and high RH under the assumption that causal effects exist. Daily cause-specific mortality counts from 2008 to 2011, and contemporaneous meteorological data in three Chinese cities were collected. Distributed lag nonlinear models were adopted to quantify the nonlinear and delayed effects of RH on mortality risk. Low and high RH were defined as RH lower or higher than the minimum mortality risk RH (MMRH), respectively. Corresponding RH-related mortality fractions were calculated in the explanatory analysis. From the three cities, 736,301 deaths were collected. RH (mean ± standard deviation) were 50.9 ± 20.0 for Beijing, 75.5 ± 8.6 for Chengdu, and 70.8 ± 14.6 for Nanjing. We found that low RH in Beijing and high RH (about 80-90%) in Chengdu was associated with increased all-cause mortality risk. Both low and high RH may increase the CVD mortality risk in Beijing. Both low and high (about 80-85%) RH may increase the COPD mortality risk in Chengdu. Low RH (about < 45%) was associated with increased diabetes mortality risk in Nanjing. Effects of extreme low and extreme high RH were delayed in these cities, except that extreme low effects on COPD mortality appeared immediately in Chengdu. The effects of extreme low RH are higher than that of the extreme high RH in Beijing and Nanjing, while contrary in Chengdu. Finally, under the causal effect assumption, 6.80% (95% eCI: 2.90, 10.73) all-cause mortality and 12.48% (95% eCI: 7.17, 16.80) CVD deaths in Beijing, 9.59% (95% eCI: 1.38, 16.88) COPD deaths in Chengdu, and 23.79% (95% eCI: 0.92, 387.93) diabetes mortality in Nanjing were attributable to RH. Our study provided insights into RH-mortality risk, helped draw relative intervention policies, and is also significant for future predictions of climate change effects under different scenarios.
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Affiliation(s)
- Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Meiduo Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Jing Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Xiaoyu Ge
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China.
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China.
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Chen S, Dai M, Hu J, Cheng J, Duan Y, Zou X, Su Y, Liu N, Jingesi M, Chen Z, Yin P, Huang S, He Q, Wang P. Evaluating the predictive ability of temperature-related indices on the stroke morbidity in Shenzhen, China: Under cross-validation methods framework. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156425. [PMID: 35660600 DOI: 10.1016/j.scitotenv.2022.156425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Composite temperature-related indices have been utilized to comprehensively reflect the impact of multiple meteorological factors on health. We aimed to evaluate the predictive ability of temperature-related indices, choose the best predictor of stroke morbidity, and explore the association between them. METHODS We built distributed lag nonlinear models to estimate the associations between temperature-related indices and stroke morbidity and then applied two types of cross-validation (CV) methods to choose the best predictor. The effects of this index on overall stroke, intracerebral hemorrhage (ICH), and ischemic stroke (IS) morbidity were explored and we explained how this index worked using heatmaps. Stratified analyses were conducted to identify vulnerable populations. RESULTS Among 12 temperature-related indices, the alternative temperature-humidity index (THIa) had the best overall performance in terms of root mean square error when combining the results from two CVs. With the median value of THIa (25.70 °C) as the reference, the relative risks (RRs) of low THIa (10th percentile) reached a maximum at lag 0-10, with RRs of 1.20 (95%CI:1.10-1.31), 1.49 (95%CI:1.29-1.73) and 1.12 (95%CI:1.03-1.23) for total stroke, ICH and IS, respectively. According to the THIa formula, we matched the effects of THIa on stroke under various combinations of temperature and relative humidity. We found that, although the low temperature (<20 °C) had the greatest adverse effect, the modification effect of humidity on it was not evident. In contrast, lower humidity could reverse the protective effect of temperature into a harmful effect at the moderate-high temperature (24 °C-27 °C). Stratification analyses showed that the female was more vulnerable to low THIa in IS. CONCLUSIONS THIa is the best temperature-related predictor of stroke morbidity. In addition to the most dangerous cold weather, the government should pay more attention to days with moderate-high temperature and low humidity, which have been overlooked in the past.
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Affiliation(s)
- Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Youpeng Su
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ning Liu
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qingqing He
- School of Resource and Environmental Engineering, Wuhan University of Technology, Wuhan, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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10
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Guo M, Zhou M, Li B, Du C, Yao R, Wang L, Yang X, Yu W. Reducing indoor relative humidity can improve the circulation and cardiorespiratory health of older people in a cold environment: A field trial conducted in Chongqing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 817:152695. [PMID: 34974019 DOI: 10.1016/j.scitotenv.2021.152695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
The changing climate is one of the most important factors affecting public health. Older people are particularly threatened due to their less efficient immune systems. To evaluate the potential benefits of short-term indoor dehumidification on their circulation and cardiopulmonary health, we conducted a random, cross-over experiment with 36 healthy residents of an aged-care center in Chongqing, China in 2020. Vapor compression dehumidifiers were used over two 48-h periods. At the end of each 48 h, we immediately measured sixteen circulatory system biomarkers of inflammation, coagulation, and oxidative stress; lung function; blood pressure; and heart rate. Indoor temperature and relative humidity were monitored throughout the study period. Linear, mixed-effect models were used to associate health endpoints with indoor relative humidity. This intervention study showed that when the indoor relative humidity decreased from 75% to 45%: (1) the coagulation indicators, sCD40l, and PAI-1, decreased significantly, by 58.82% and 23.50%, respectively; (2) the inflammatory indicators, CRP, IL-6, and TNF-α decreased significantly, by 4.09%, 25.78%, and 10.60%, respectively; (3) PEF, FEV1 and FVC were increased significantly by 20.08%, 14.54%, and 15.75% respectively. To the best of our knowledge, this is the first study to examine the impact of short-term dehumidification on clinical and biochemical measures of cardiorespiratory health in humid areas, and our study suggests that RH in the dehumidified rooms (46.9 ± 8.7%) may be healthier than that in humid rooms (75.2 ± 7.9%). Humidity may be involved in the development of atherosclerosis by activating oxidative stress and mediating the secretion of inflammatory indicators. At the same time, platelet activation induced by oxidative stress stimulates thrombosis to increase cardiovascular risk in older people. Conclusion: This intervention study shows that in a Chinese city like Chongqing with serious indoor environmental humidity, indoor short-term dehumidification has obvious cardiopulmonary benefits for the healthy elderly.
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Affiliation(s)
- Miao Guo
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Min Zhou
- Department of Geriatrics, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400014, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Runming Yao
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Lexiang Wang
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China
| | - Xu Yang
- Lab of Environmental Biomedicine, School of Life Sciences, Central China Normal University, Wuhan 430079, China; Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments, Ministry of Education, Chongqing University, Chongqing 400045, China; National Centre for International Research of Low-carbon and Green Buildings, Ministry of Science and Technology, Chongqing University, Chongqing, China.
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11
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ASTM: Developing the web service for anthrax related spatiotemporal characteristics and meteorology study. QUANTITATIVE BIOLOGY 2022. [DOI: 10.15302/j-qb-022-0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Farré R, Rodríguez-Lázaro MA, Dinh-Xuan AT, Pons-Odena M, Navajas D, Gozal D. A Low-Cost, Easy-to-Assemble Device to Prevent Infant Hyperthermia under Conditions of High Thermal Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413382. [PMID: 34948991 PMCID: PMC8703827 DOI: 10.3390/ijerph182413382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 12/14/2022]
Abstract
High ambient temperature and humidity greatly increase the risk of hyperthermia and mortality, particularly in infants, who are especially prone to dehydration. World areas at high risk of heat stress include many of the low- and middle-income countries (LMICs) where most of their inhabitants have no access to air conditioning. This study aimed to design, evaluate, and test a novel low-cost and easy-to-assemble device aimed at preventing the risk of infant hyperthermia in LMICs. The device is based on optimizing negative heat transfer from a small amount of ice and transferring it directly to the infant by airflow of refrigerated air. As a proof of concept, a device was assembled mainly using recycled materials, and its performance was assessed under laboratory-controlled conditions in a climatic chamber mimicking realistic stress conditions of high temperature and humidity. The device, which can be assembled by any layperson using easily available materials, provided sufficient refrigerating capacity for several hours from just 1–2 kg of ice obtained from a domestic freezer. Thus, application of this novel device may serve to attenuate the adverse effects of heat stress in infants, particularly in the context of the evolving climatic change trends.
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Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain; (M.A.R.-L.); (D.N.)
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
- Institut Investigacions Biomèdiques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence:
| | - Miguel A. Rodríguez-Lázaro
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain; (M.A.R.-L.); (D.N.)
| | - Anh Tuan Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France;
| | - Martí Pons-Odena
- Immune and Respiratory Dysfunction Research Group, Institut de Recerca Sant Joan de Déu, Pediatric Intensive Care and Intermediate Care Department, Sant Joan de Déu University Hospital, Universitat de Barcelona, 08950 Esplugues de Llobregat, Spain;
| | - Daniel Navajas
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain; (M.A.R.-L.); (D.N.)
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
- The Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), 08028 Barcelona, Spain
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO 65201, USA;
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13
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Asimakopoulos LO, Koureta A, Benetou V, Lagiou P, Samoli E. Investigating the association between temperature and hospital admissions for major psychiatric diseases: A study in Greece. J Psychiatr Res 2021; 144:278-284. [PMID: 34710664 DOI: 10.1016/j.jpsychires.2021.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/13/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023]
Abstract
Evidence has emerged regarding the role of seasonality and several meteorological parameters on bipolar disorder, schizophrenia and depression. We investigated the relationship between ambient and apparent temperature and hospital admissions of major psychiatric diseases in a psychiatric clinic of a General Hospital situated in Northern Greece during 2013-19. Temperature data was provided by the National Observatory of Athens and diagnosis for psychotic, schizophrenic, manic and bipolar and unipolar depression were retrieved from medical records. A total of 783 admissions were recorded. Poisson regression models adjusted for time trends were applied to analyze the impact of temperature on monthly admissions. A summer peak was observed for the bipolar disorder, irrespectively of substance/alcohol use status. Seasonality emerged also for psychotic and schizophrenic patients with a through in winter. An increase of 1 °C in either ambient or apparent temperature was associated with an increase 1-2% in the monthly admissions in most outcomes under investigation. Alcohol and drug abuse did not modify this effect. Although our results indicate effects of temperature on psychiatric admissions, they are not consistent across subgroups populations and need to be replicated by other methodologically superior studies.
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Affiliation(s)
- Lampros Orion Asimakopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece; General Hospital of Katerini, Katerini, 60100, Central Macedonia, Greece.
| | - Anastasia Koureta
- General Hospital of Katerini, Katerini, 60100, Central Macedonia, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 115 27, Greece
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14
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Huang HC, Suen PC, Liu JS, Chen CCH, Liu YB, Chen CC. Effects of Apparent Temperature on the Incidence of Ventricular Tachyarrhythmias in Patients With an Implantable Cardioverter-Defibrillator: Differential Association Between Patients With and Without Electrical Storm. Front Med (Lausanne) 2021; 7:624343. [PMID: 33521027 PMCID: PMC7843936 DOI: 10.3389/fmed.2020.624343] [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: 10/31/2020] [Accepted: 12/14/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Electrical storm (ES) has profound psychological effects and is associated with a higher mortality in patients with implantable cardioverter–defibrillator (ICD). Assessing the incidence and features of ES, is vital. Previous studies have shown winter peaks for ventricular tachyarrhythmia (VTA) in ICD patients. However, the effects of heat with a high relative humidity remain unclear. Thus, this study aimed to assess the nonlinear and lagged effects of apparent temperature [or heat index (HI)] on VTA among patients with and without ES after ICD implantation. Methods: Of 626 consecutive patients who had ICDs implanted from January 2004 to June 2017 at our hospital, 172 who experienced sustained VTAs in ICD recording were analyzed, and their clinical records were abstracted to assess the association between VTA incidence and HI by time-stratified case-crossover analysis. Cubic splines were used for the nonlinear effect of HI, with adjustment for air pollutant concentrations. Results: A significant seasonal effect for ES patients was noted. Apparent temperature, but not ambient temperature, was associated with VTA occurrences. The low and high HI thresholds for VTA incidence were <15° and >30°C, respectively, with a percentage change in odds ratios of 1.06 and 0.37, respectively, per 1°C. Lagged effects could only be demonstrated in ES patients, which lasted longer for low HI (in the next 4 days) than high HI (in the next 1 day). Conclusion: VTA occurrence in ICD patients was strongly associated with low HI and moderately associated with high HI. Lagged effects of HI on VTA were noted in patients with ES. Furthermore, patients with ES were more vulnerable to heat stress than those without ES. Patients with ICD implantation, particularly in those with ES, should avoid exposure to low and high HI to reduce the risk of VTAs, improve quality of life and possibly reduce mortality.
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Affiliation(s)
- Hui-Chun Huang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Chin Suen
- Department of Nursing, College of Medicine, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan
| | - Jih-Shin Liu
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Cheryl Chia-Hui Chen
- Department of Nursing, College of Medicine, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Bin Liu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chu-Chih Chen
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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15
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Fan C, Liu F, Zhao X, Ma Y, Yang F, Chang Z, Xiao X. An alternative comprehensive index to quantify the interactive effect of temperature and relative humidity on hand, foot and mouth disease: A two-stage time series study including 143 cities in mainland China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 740:140106. [PMID: 32927545 DOI: 10.1016/j.scitotenv.2020.140106] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/25/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Comprehensive indices have been used to quantify the interactive effect of temperature and humidity on hand, foot and mouth disease (HFMD). The majority of them reflect how weather feels to humans. In this study, we propose an alternative index aiming to reflect the impacts of weather on HFMD and compare its performance with that of previous indices. METHODS We proposed an index defined as the product of temperature and a weight parameter raised to the rescaled relative humidity, denoted by THIa. We then compared its model fit and heterogeneity with those of previous indices (including the humidex, heat index and temperature) by a multicity two-stage time series analysis. We first built a common distributed lag nonlinear model to estimate the associations between different indices and HFMD for each city separately. We then pooled the city-specific estimates and compared the average model fit (measured by the QAIC) and heterogeneity (measured by I2) among the different indices. RESULTS We included the time series of HFMD and meteorological variables from 143 cities in mainland China from 2009 to 2014. By varying the weight parameter of THIa, the results suggested that 100% relative humidity can amplify the effects of temperature on HFMD 1.6-fold compared to 50% relative humidity. By comparing different candidate indices, THIa performed the best in terms of the average of the model fits (QAIC = 9449.37), followed by humidex, heat index and temperature. In addition, the estimated exposure-response curves between THIa and HFMD were consistent across climate regions with minimum heterogeneity (I2 = 65.90), whereas the others varied across climate regions. CONCLUSIONS This study proposed an alternative comprehensive index to characterize the interactive effects of temperature and humidity on HFMD. In addition, the results also imply that previous human-based indices might not be sufficient to reflect the complicated associations between weather and HFMD.
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Affiliation(s)
- Chaonan Fan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fengfeng Liu
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Ma
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fan Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhaorui Chang
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, China.
| | - Xiong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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16
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Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. ENVIRONMENTAL RESEARCH 2019; 171:80-91. [PMID: 30660921 DOI: 10.1016/j.envres.2019.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 05/13/2023]
Abstract
Heat waves and high air temperature are associated with increased morbidity and mortality. However, the majority of research conducted on this topic is focused on high income areas of the world. Although heat waves have the most severe impacts on vulnerable populations, relatively few studies have studied their impacts in low and middle income countries (LMICs). The aim of this paper is to review the existing evidence in the literature on the impact of heat on human health in LMICs. We identified peer-reviewed epidemiologic studies published in English between January 1980 and August 2018 investigating potential associations between high ambient temperature or heat waves and mortality or morbidity. We selected studies according to the following criteria: quantitative studies that used primary and/or secondary data and report effect estimates where ambient temperature or heat waves are the main exposure of interest in relation to human morbidity or mortality within LMICs. Of the total 146 studies selected, eighty-two were conducted in China, nine in other countries of East Asia and the Pacific, twelve in South Asia, ten in Sub-Saharan Africa, eight in the Middle East and North Africa, and seven in each of Latin America and Europe. The majority of studies (92.9%) found positive associations between heat and human morbidity/mortality. Additionally, while outcome variables and study design differed greatly, most utilized a time-series study design and examined overall heath related morbidity/mortality impacts in an entire population, although it is notable that the selected studies generally found that the elderly, women, and individuals within the low socioeconomic brackets were the most vulnerable to the effects of high temperature. By highlighting the existing evidence on the impact of extreme heat on health in LMICs, we hope to determine data needs and help direct future studies in addressing this knowledge gap. The focus on LMICs is justified by the lack of studies and data studying the health burden of higher temperatures in these regions even though LMICs have a lower capacity to adapt to high temperatures and thus an increased risk.
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Affiliation(s)
- Hunter Green
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA
| | - Jennifer Bailey
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jennifer Vanos
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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