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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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Chodick G, Rotem RS, Miano TA, Bilker WB, Hennessy S. Adherence with statins and all-cause mortality in days with high temperature. Pharmacoepidemiol Drug Saf 2024; 33:e5817. [PMID: 38783416 DOI: 10.1002/pds.5817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/03/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE It has been suggested that statins may exert thermo-protective effects that can reduce mortality on hot days. We aimed to examine the relationship between statin adherence and mortality in days with high temperature. METHODS Utilizing data from a prior historical new-user cohort study, we analyzed a cohort of 229 918 individuals within a state-mandated health provider in Israel who initiated statin therapy between 1998 and 2006. Adherence to statins was assessed through the mean proportion of days covered (PDC) with statins during the follow-up period. The study's primary outcome was all-cause mortality during hot days. RESULTS During the study follow-up period, a total of 13 165 individuals (5.7%) died. In a multivariable model, a 10% increase in PDC with statins was associated with an HR of (0.85; 95% CI: 0.72-1.00) for deaths (n = 16) in extremely hot days (≥39°C). This association was numerically stronger compared to HR = 0.94 (0.93-0.94) in cooler days and displayed a significant difference between sexes. In males, the fully-adjusted HR for a 10% increase in PDC with statins was 0.66 (0.45-0.95), while in women, it was 0.98 (0.78-1.23). In contrast, no such effect modification was observed for death in cooler days. CONCLUSIONS These findings align with earlier research, supporting the notion that adherence with statin treatment may be associated with a reduced risk of death during extremely hot days, particularly among men.
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Affiliation(s)
- Gabriel Chodick
- School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- MaccabiTech, Maccabi Institute for Research, Maccabi Healthcare Service, Tel Aviv, Israel
| | - Ran S Rotem
- MaccabiTech, Maccabi Institute for Research, Maccabi Healthcare Service, Tel Aviv, Israel
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Todd A Miano
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Warren B Bilker
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sean Hennessy
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Zheng J, Lin H, Ling J, Huang J, Li D. The trends of disease burden due to high temperature in Mainland China from 1990 to 2019 and its prediction to 2030. Sci Rep 2023; 13:22238. [PMID: 38097708 PMCID: PMC10721800 DOI: 10.1038/s41598-023-49491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
The risk of high-temperature-related diseases is increasing owing to global warming. This study aimed to assess the trend of disease burden caused by high temperatures in Mainland China from 1990 to 2019 and to predict the trend of disease burden over the next 10 years. The latest data were downloaded from the Global Burden of Disease Database (GBD) for analysis, and the disease burden related to high temperature was described by mortality and disability-adjusted life-years (DALYs) and stratified by etiology, sex, and age. Statistical analyses were performed using the R software. In 2019, there were 13,907 deaths attributed to high temperatures in Mainland China, and this was 29.55% higher than the 10,735 deaths in 1990. Overall, the age-standardized mortality and DALYs attributed to high temperatures showed a downward trend from 1990 to 2019. We observed an etiological shift in high-temperature-related diseases. The age-standardized DALYs contribution attributed to high temperatures in 1990 was mainly from communicable, maternal, neonatal, and nutritional diseases (CMNND) (21.81/100,000), followed by injury (18.30/100,000) and non-communicable diseases (10.40/100,000). In 2019, the largest contribution shifted to non-communicable diseases (10.07/100,000), followed by injuries (5.21/100,000), and CMNND (2.30/100,000). The disease burden attributed to high temperatures was higher in males than in females and increased with age. In 2030, the mortality rate and DALYs due to high temperatures are predicted to decrease further, and the largest contribution will come from chronic non-communicable diseases, the occurrence of which will remain at a high level over the next 10 years. The burden of disease due to high temperatures in Mainland China is still heavy, mainly due to population aging and an increase in non-communicable diseases.
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Affiliation(s)
- Jiaolong Zheng
- Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, No. 156 Northern Xi'er Huan Road, Fuzhou, 350025, China
- Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Haiyan Lin
- Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, No. 156 Northern Xi'er Huan Road, Fuzhou, 350025, China
- Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jingyi Ling
- Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, No. 156 Northern Xi'er Huan Road, Fuzhou, 350025, China
- Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jiaofeng Huang
- Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350025, China
| | - Dongliang Li
- Department of Hepatobiliary Disease, The 900th Hospital of Joint Logistics Support Force, No. 156 Northern Xi'er Huan Road, Fuzhou, 350025, China.
- Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China.
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Zafeiratou S, Samoli E, Analitis A, Gasparrini A, Stafoggia M, de’ Donato FK, Rao S, Zhang S, Breitner S, Masselot P, Aunan K, Schneider A, Katsouyanni K. Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe. Environ Epidemiol 2023; 7:e269. [PMID: 37840857 PMCID: PMC10569755 DOI: 10.1097/ee9.0000000000000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/06/2023] [Accepted: 08/02/2023] [Indexed: 10/17/2023] Open
Abstract
Background Heat effects on respiratory mortality are known, mostly from time-series studies of city-wide data. A limited number of studies have been conducted at the national level or covering non-urban areas. Effect modification by area-level factors has not been extensively investigated. Our study assessed the heat effects on respiratory mortality at a small administrative area level in Norway, Germany, and England and Wales, in the warm period (May-September) within 1996-2018. Also, we examined possible effect modification by several area-level characteristics in the framework of the EU-Horizon2020 EXHAUSTION project. Methods Daily respiratory mortality counts and modeled air temperature data were collected for Norway, Germany, and England and Wales at a small administrative area level. The temperature-mortality association was assessed by small area-specific Poisson regression allowing for overdispersion, using distributed lag non-linear models. Estimates were pooled at the national level and overall using a random-effect meta-analysis. Age- and sex-specific models were also applied. A multilevel random-effects model was applied to investigate the modification of the heat effects by area-level factors. Results A rise in temperature from the 75th to 99th percentile was associated with a 27% (95% confidence interval [CI] = 19%, 34%) increase in respiratory mortality, with higher effects for females. Increased population density and PM2.5 concentrations were associated with stronger heat effects on mortality. Conclusions Our study strengthens the evidence of adverse heat effects on respiratory mortality in Northern Europe by identifying vulnerable subgroups and subregions. This may contribute to the development of targeted policies for adaptation to climate change.
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Affiliation(s)
- Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service (ASL ROMA 1), Rome, Italy
| | | | - Shilpa Rao
- Division for Climate and Environment, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kristin Aunan
- CICERO Center for International Climate Research, Norway
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College, London, United Kingdom
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