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Li X, Zhang Y, Tian Z, Wang J, Zhao J, Lyu Y, Ni Y, Guo Y, Cui Z, Zhang W, Li C. Lag effect of ambient temperature on respiratory emergency department visits in Beijing: a time series and pooled analysis. BMC Public Health 2024; 24:1363. [PMID: 38773497 PMCID: PMC11106889 DOI: 10.1186/s12889-024-18839-6] [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: 07/10/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Although the association between ambient temperature and mortality of respiratory diseases was numerously documented, the association between various ambient temperature levels and respiratory emergency department (ED) visits has not been well studied. A recent investigation of the association between respiratory ED visits and various levels of ambient temperature was conducted in Beijing, China. METHODS Daily meteorological data, air pollution data, and respiratory ED visits data from 2017 to 2018 were collected in Beijing. The relationship between ambient temperature and respiratory ED visits was explored using a distributed lagged nonlinear model (DLNM). Then we performed subgroup analysis based on age and gender. Finally, meta-analysis was utilized to aggregate the total influence of ambient temperature on respiratory ED visits across China. RESULTS The single-day lag risk for extreme cold peaked at a relative risk (RR) of 1.048 [95% confidence interval (CI): 1.009, 1.088] at a lag of 21 days, with a long lag effect. As for the single-day lag risk for extreme hot, a short lag effect was shown at a lag of 7 days with an RR of 1.076 (95% CI: 1.038, 1.114). The cumulative lagged effects of both hot and cold effects peaked at lag 0-21 days, with a cumulative risk of the onset of 3.690 (95% CI: 2.133, 6.382) and 1.641 (95% CI: 1.284, 2.098), respectively, with stronger impact on the hot. Additionally, the elderly were more sensitive to ambient temperature. The males were more susceptible to hot weather than the females. A longer cold temperature lag effect was found in females. Compared with the meta-analysis, a pooled effect of ambient temperature was consistent in general. In the subgroup analysis, a significant difference was found by gender. CONCLUSIONS Temperature level, age-specific, and gender-specific effects between ambient temperature and the number of ED visits provide information on early warning measures for the prevention and control of respiratory diseases.
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Affiliation(s)
- Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Zhenbiao Tian
- Beijing Red Cross Emergency Center, Beijing, 100085, China
| | - Jianping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuanjun Lyu
- Department of Endocrinology, Tianjin Hospital, Tianjin, China
| | - Ying Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China.
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Wen B, Kliengchuay W, Suwanmanee S, Aung HW, Sahanavin N, Siriratruengsuk W, Kawichai S, Tawatsupa B, Xu R, Li S, Guo Y, Tantrakarnapa K. Association of cause-specific hospital admissions with high and low temperatures in Thailand: a nationwide time series study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101058. [PMID: 38596004 PMCID: PMC11000193 DOI: 10.1016/j.lanwpc.2024.101058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/20/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
Background Non-optimum temperatures are associated with a considerable mortality burden. However, evidence of temperature with all-cause and cause-specific hospital admissions in tropical countries like Thailand is still limited. Methods Daily all-cause and cause-specific hospital admissions for outpatient and inpatient visits were collected from 77 provinces in Thailand from January 2013 to August 2019. A two-stage time-series approach was applied to assess the association between non-optimum temperatures and hospital admission. We first fitted the province-specific temperature-morbidity association and then obtained the national association in the second stage using a random-effects meta-analysis regression. The attributable fraction (AF) of hospital admissions with 95% empirical confidence interval (eCI) was calculated. Findings A total of 878,513,460 all-cause outpatient admissions and 32,616,600 all-cause inpatient admissions were included in this study. We observed a J-shaped relationship with the risk of hospital admissions increasing for both cold and hot temperatures. The overall AFs of all-cause hospital admissions due to non-optimum temperatures were 7.57% (95% eCI: 6.47%, 8.39%) for outpatient visits and 6.17% (95% eCI: 4.88%, 7.20%) for inpatient visits. Hot temperatures were responsible for most of the AFs of hospital admissions, with 6.71% (95% eCI: 5.80%, 7.41%) for outpatient visits and 4.50% (95% eCI: 3.62%, 5.19%) for inpatient visits. The burden of hospital admissions was greater in females and in children and adolescents (0-19 years). The fractions of hospital admissions attributable to non-optimum temperatures exhibited variation among disease categories and geographical areas. Interpretation The results indicate that low and high temperature has a significant impact on hospital admissions, especially among the females, and children and adolescents (0-19 years). The current investigation could provide evidence for policymakers to develop adaptation strategies and mitigate the adverse effects of climate change on public health in Thailand and other tropical countries. Funding National Research Council of Thailand (NRCT): E-Asia Joint Research Program: Climate change impact on natural and human systems (N33A650979).
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Wissanupong Kliengchuay
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Environment, Health and Social Impact Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - San Suwanmanee
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Htoo Wai Aung
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Narut Sahanavin
- Faculty of Physical Education, Srinakharnwirot University, Nakhon Nayok, Thailand
| | | | - Sawaeng Kawichai
- Research Institute of Health Science, Chiang Mai University, Chiang Rai, Thailand
| | | | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Kraichat Tantrakarnapa
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Environment, Health and Social Impact Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Zhou W, Wang Q, Li R, Zhang Z, Kadier A, Wang W, Zhou F, Ling L. Heatwave exposure in relation to decreased sleep duration in older adults. ENVIRONMENT INTERNATIONAL 2024; 183:108348. [PMID: 38064924 DOI: 10.1016/j.envint.2023.108348] [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: 03/19/2023] [Revised: 10/31/2023] [Accepted: 11/21/2023] [Indexed: 01/25/2024]
Abstract
Few studies have delved into the effects of heatwaves on sleep duration loss among older adults. Our study examined correlations between heatwave exposure and sleep duration reductions in this demographic. Utilizing data of 7,240 older adults drawn from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2018, we assessed sleep duration differences between the baseline year (2015) and follow-up year (2018). Absolute reductions in sleep duration were defined as differences of ≥ 1, 1.5, or 2 h. Changes in sleep duration were categorized based on cut-offs of 5 and 8 h, including excessive decrease, moderate to short and persistent short sleep duration types. 12 heatwave definitions combining four thresholds (90th, 92.5th, 95th, and 97.5th percentiles of daily minimum temperature) and three durations (≥2, ≥3 and ≥ 4 days) were used. Heatwave exposure was determined by the difference in the number of 12 preceding months' heatwave days or events in 2015 and the number of 12 preceding months' heatwave days or events in 2018. The results showed that increased heatwave events (defined as ≥ P90th percentile & lasting three days) were associated with a higher likelihood of ≥ 1-hour sleep reduction and persistent short sleep duration. An increase in heatwave event (defined as ≥ P95th percentile & lasting three days) was linked to shifts from moderate to short sleep duration. For the association between an absolute reduction in sleep duration and heatwave exposure, while higher thresholds signified greater sleep reduction risks, the effect estimates of longer durations were not uniformly consistent. We observed that air pollution and green space modified the relationship between heatwaves and sleep duration. Females, urban residents, and individuals with chronic diseases were identified as vulnerable populations. This study found that increased heatwave exposure was associated with a higher risk of sleep duration loss in older adults.
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Affiliation(s)
- Wensu Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiong Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Rui Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhirong Zhang
- School of Mathematics, Sun Yat-Sen University, Sun Yat-sen University, Guangzhou, China
| | - Aimulaguli Kadier
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjuan Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fenfen Zhou
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Clinical Research Design Division, Clinical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Wang FL, Wang WZ, Zhang FF, Peng SY, Wang HY, Chen R, Wang JW, Li PF, Wang Y, Zhao MH, Yang C, Zhang LX. Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities. Mil Med Res 2023; 10:41. [PMID: 37670366 PMCID: PMC10478241 DOI: 10.1186/s40779-023-00478-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Climate change profoundly shapes the population health at the global scale. However, there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease (CKD). METHODS In the present study, we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018. Standard time-series regression models and random-effects meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span, respectively. RESULTS A total of 768,129 hospitalizations for CKD was recorded during the study period. The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD, especially in sub-tropical cities. With a 1 °C increase in daily mean temperature, the cumulative relative risks (RR) over lag 0-7 d were 1.008 [95% confidence interval (CI) 1.003-1.012] for nationwide. The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%. Stronger associations were observed among younger patients and those with obstructive nephropathy. Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days (RR = 1.116, 95% CI 1.069-1.166) above the effect of daily mean temperature. CONCLUSIONS Short-term heat exposure may increase the risk of hospitalization for CKD. Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.
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Affiliation(s)
- Fu-Lin Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 100191, China
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
| | - Wan-Zhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Fei-Fei Zhang
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
| | - Su-Yuan Peng
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
| | - Huai-Yu Wang
- National Institute of Health Data Science at Peking University, Beijing, 100191, China
| | - Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China
| | - Jin-Wei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China
| | - Peng-Fei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China
| | - Yang Wang
- National Climate Center, China Meteorological Administration, Beijing, 100081, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China
- Peking-Tsinghua Center for Life Sciences, Beijing, 100034, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China.
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, 100034, China.
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China.
| | - Lu-Xia Zhang
- National Institute of Health Data Science at Peking University, Beijing, 100191, China.
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, 100034, China.
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China.
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Li Z, Fan Y, Su H, Xu Z, Ho HC, Zheng H, Tao J, Zhang Y, Hu K, Hossain MZ, Zhao Q, Huang C, Cheng J. The 2022 Summer record-breaking heatwave and health information-seeking behaviours: an infodemiology study in Mainland China. BMJ Glob Health 2023; 8:e013231. [PMID: 37730248 PMCID: PMC10510944 DOI: 10.1136/bmjgh-2023-013231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/20/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION Heatwave is a major global health concern. Many countries including China suffered a record-breaking heatwave during the summer of 2022, which may have a significant effect on population health or health information-seeking behaviours but is yet to be examined. METHODS We derived health information-seeking data from the Baidu search engine (similar to Google search engine). The data included city-specific daily search queries (also referred to Baidu Search Index) for heat-sensitive diseases from 2021 to 2022, including heatstroke, hospital visits, cardiovascular diseases and diabetes, respiratory diseases, mental health and urological diseases. For each city, the record-breaking heatwave days in 2022 were matched to days in the same calendar month in 2021. RESULTS The 2022 record-breaking heatwave hit most cities (83.64%) in Mainland China. The average heatwave duration was 13 days and the maximum temperature was 3.60°C higher than that in 2021 (p<0.05). We observed increased population behaviours of seeking information on respiratory diseases (RR=1.014, 95% CI: 1.008 to 1.020), urological diseases (RR=1.011, 95% CI: 1.006 to 1.016) and heatstroke (RR=1.026, 95% CI: 1.016 to 1.036) associated with the heatwave intensity in 2022 (per 1°C increase). The heatwave duration in 2022 (per 1 day increase) was also associated with an increase in seeking information on cardiovascular diseases and diabetes (RR=1.003, 95% CI: 1.002 to 1.004), urological diseases (RR=1.005, 95% CI: 1.002 to 1.008), mental health (RR=1.009, 95% CI: 1.006 to 1.012) and heatstroke (RR=1.038, 95% CI: 1.032 to 1.043). However, there were substantial geographical variations in the effect of the 2022 heatwave intensity and duration on health information-seeking behaviours. CONCLUSION This infodemiology study suggests that the 2022 summer unprecedented heatwave in Mainland China has significantly increased population demand for health-related information, especially for heatstroke, urological diseases and mental health. Population-based research of real-time disease data is urgently needed to estimate the negative health impact of the exceptional heatwave in Mainland China and elsewhere.
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Affiliation(s)
- Zhiwei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Anhui Medical University, Hefei, China
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Anhui Medical University, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Anhui Medical University, Hefei, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Hung Chak Ho
- Department of Public and International Affairs, City University of Hong Kong, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Anhui Medical University, Hefei, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | | | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Anhui Medical University, Hefei, China
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Ning X, Li Y, Gao G, Zhang Y, Qin Y. Temporal and spatial characteristics of high temperatures, heat waves, and population distribution risk in China from 1951 to 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:96629-96646. [PMID: 37578588 DOI: 10.1007/s11356-023-28955-2] [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: 12/07/2022] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
Understanding the relationships between high temperatures (HT) and heat waves (HW) is vital for enhancing human health, especially in areas with dense population. This paper analyzes the temporal and spatial characteristics of different HT and HW intensities, their spatial influence, and the population distribution risk at different HW intensities for 844 meteorological stations between 1951 and 2019. The results indicate that (1) HT and extreme temperature (ET) days are symmetrically distributed along the Huhuanyong Line, from southeast to northwest China. The times, days, and accumulated temperatures of HW, the times, days, and accumulated temperature of strong heat waves (SHW), and the times, days, and accumulated temperature of extreme heat waves (EHW) were distributed similarly; (2) with the increase in high temperatures or heat waves from HT to ET or from HW to SHW, the proportion of stations with an upward trend was always greater in China, while stations with a downward trend were mainly located in the North China Plain and Huai River Basin. For HW, SHW, and EHW, the increasing range of times and days were less than the accumulated temperatures; (3) between 1990 and 2019, there was an expansion of the HW and SHW distribution area with an annual average of more than 10 days, and the EHW distribution area with an annual average of more than 3 days. Moreover, the number of people exposed to HW, SHW, and EHW also increased during this period; and (4) considering the population distribution characteristics and the regional HT and HW characteristics, society needs to form regional adaptation actions for different HT and HW intensities.
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Affiliation(s)
- Xiaoju Ning
- School of Resources and Environment, Henan University of Economics and Law, Zhengzhou, 450046, China
- Academician Laboratory for Urban and Rural Spatial Data Mining of Henan Province, Henan University of Economics and Law, Zhengzhou, 450046, China
| | - Yuanzheng Li
- School of Resources and Environment, Henan University of Economics and Law, Zhengzhou, 450046, China
- Academician Laboratory for Urban and Rural Spatial Data Mining of Henan Province, Henan University of Economics and Law, Zhengzhou, 450046, China
| | - Genghe Gao
- School of Resources and Environment, Henan University of Economics and Law, Zhengzhou, 450046, China
- Academician Laboratory for Urban and Rural Spatial Data Mining of Henan Province, Henan University of Economics and Law, Zhengzhou, 450046, China
| | - Yan Zhang
- Ecological Economy Research Center, Qiong Tai Normal University, Haikou, 570228, China
| | - Yaochen Qin
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education & College of Geography and Environmental Science, Henan University, Kaifeng, 475004, China.
- Key Research Institute of Yellow River Civilization and Sustainable Development & Collaborative Innovation Center on Yellow River Civilization jointly built by Henan Province and Ministry of Education, Henan University, Kaifeng, 475001, China.
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Deng S, Han A, Jin S, Wang S, Zheng J, Jalaludin BB, Hajat S, Liang W, Huang C. Effect of extreme temperatures on asthma hospital visits: Modification by event characteristics and healthy behaviors. ENVIRONMENTAL RESEARCH 2023; 226:115679. [PMID: 36913996 DOI: 10.1016/j.envres.2023.115679] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/16/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Although ambient temperature has been linked to asthma exacerbation, impacts associated with extreme temperature events remain unclear. This study aims to identify the events characteristics that elevate risk of asthma hospital visits, and to assess whether healthy behavior changes due to the COVID-19 prevention and control policy may modify the relationships. Data of asthma hospital visits from all medical facilities in Shenzhen, China during 2016-2020 were assessed in relation to extreme temperature events using a distributed lag model. Stratified analysis was conducted by gender, age and hospital department to identify susceptible populations. Through events defined by various duration days and temperature thresholds, we explored the modification by events intensity, length, occurrence time and healthy behaviors. The cumulative relative risk of asthma during heat waves compared to other days was 1.06 (95%CI: 1.00-1.13) and for cold spells was 1.17 (95%CI: 1.05-1.30), and that of males and school-aged children were generally higher than other sub-groups. There were significant effects of heat waves and cold spells on asthma hospital visits when the mean temperature was above 90th percentile (30 °C) and below 10th percentile (14 °C) respectively, and the relative risks were higher when events lasted longer, became stronger, occurred in daytime and in early summer or winter. During the healthy behaviors maintaining period, the risk of heat waves increased whilst the risk of cold spells reduced. Extreme temperatures may pose considerable impact on asthma and the health effect can be modified by the event characteristics and anti-epidemic healthy behaviors. Strategies of asthma control should consider the heightened threats of the intense and frequent extreme temperature events in the context of climate change.
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Affiliation(s)
- Shizhou Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Typhoon Institute, China Meteorological Administration & Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Azhu Han
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shuyan Jin
- Department of Prevention and Health Care, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Shuang Wang
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Jing Zheng
- Shenzhen Health Development Research and Data Management Center, Shenzhen, China
| | - Bin B Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
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Yong KH, Teo YN, Azadbakht M, Phung H, Chu C. The Scorching Truth: Investigating the Impact of Heatwaves on Selangor's Elderly Hospitalisations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105910. [PMID: 37239636 DOI: 10.3390/ijerph20105910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/06/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Global climate change has contributed to the intensity, frequency, and duration of heatwave events. The association between heatwaves and elderly mortality is highly researched in developed countries. In contrast, heatwave impact on hospital admissions has been insufficiently studied worldwide due to data availability and sensitivity. In our opinion, the relationship between heatwaves and hospital admissions is worthwhile to explore as it could have a profound impact on healthcare systems. Therefore, we aimed to investigate the associations between heatwaves and hospitalisations for the elderly by age group in Selangor, Malaysia, from 2010 to 2020. We further explored the impact of heatwaves on the risks of cause-specific hospital admissions across age groups within the elderly. This study applied generalized additive models (GAMs) with the Poisson family and distributed lag models (DLMs) to estimate the effect of heatwaves on hospitalisations. According to the findings, there was no significant increase in hospitalisations for those aged 60 and older during heatwaves; however, a rise in mean apparent temperature (ATmean) by 1 °C significantly increased the risk of hospital admission by 12.9%. Heatwaves had no immediate effects on hospital admissions among elderly patients, but significant delay effects were identified for ATmean with a lag of 0-3 days. The hospital admission rates of the elderly groups started declining after a 5-day average following the heatwave event. Females were found to be relatively more vulnerable than males during heatwave periods. Consequently, these results can provide a reference to improve public health strategies to target elderly people who are at the greatest risk of hospitalisations due to heatwaves. Development of early heatwave and health warning systems for the elderly would assist with preventing and reducing health risks while also minimising the burden on the whole hospital system in Selangor, Malaysia.
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Affiliation(s)
- Kun Hing Yong
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
| | - Yen Nee Teo
- Institute of Malaysian and International Studies, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Mohsen Azadbakht
- Department of Infrastructure Engineering, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
| | - Cordia Chu
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4111, Australia
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Liu J, Yu W, Pan R, He Y, Wu Y, Yan S, Yi W, Li X, Song R, Yuan J, Liu L, Wei N, Jin X, Li Y, Liang Y, Sun X, Mei L, Song J, Cheng J, Su H. Association between sequential extreme precipitation-heatwaves events and hospitalizations for schizophrenia: The damage amplification effects of sequential extremes. ENVIRONMENTAL RESEARCH 2022; 214:114143. [PMID: 35998693 DOI: 10.1016/j.envres.2022.114143] [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: 07/19/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES In the context of frequent global extreme weather events, there are few studies on the effects of sequential extreme precipitation (EP) and heatwaves (HW) events on schizophrenia. We aimed to quantify the effects of the events on hospitalizations for schizophrenia and compare them with EP and HW alone to explore the amplification effect of successive extremes on health loss. METHODS A time-series Poisson regression model combined with a distributed lag non-linear model was applied to estimate the association between sequential EP and HW events (EP-HW) and schizophrenia hospitalizations. The effects of EP-HW with different intervals and intensities on the admission of schizophrenia were compared. In addition, we calculated the mean attributable fraction (AF) and attributable numbers (AN) per exposure of extreme events to reflect the amplification effect of sequential extreme events on health hazards compared with individual extreme events. RESULTS EP-HW increased the risk of hospitalization for schizophrenia, with significant effects lasting from lag0 (RR and 95% CI: 1.150 (1.041-1.271)) to lag11 (1.046 (1.000-1.094)). Significant associations were found in the subgroups of male, female, married people, and those aged≥ 40 years old. Shorter-interval (0-3days) or higher-intensity EP-HW (both precipitation ≥ P97.5 and mean temperature ≥ P97.5) had a longer lag effect compared to EP-HW with longer intervals or lower intensity. We found that the mean AF and AN caused by each exposure to EP-HW (AF: 0.074% (0.015%-0.123%); AN: 4.284 (0.862-7.118)) were higher than those induced by each exposure to HW occurring alone (AF:0.032% (0.004%-0.058%); AN:1.845 (0.220-3.329)). CONCLUSIONS Sequential extreme precipitation-heatwaves events significantly increase the risk of hospitalizations for schizophrenia, with greater impact and disease burden than independently occurring extremes. The impact of consecutive extremes is supposed to be considered in local sector early warning systems for comprehensive public health decision-making.
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Affiliation(s)
- Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Wenping Yu
- Department of Geriatrics, Shandong Daizhuang Hospital, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China.
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11
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Adnan MSG, Dewan A, Botje D, Shahid S, Hassan QK. Vulnerability of Australia to heatwaves: A systematic review on influencing factors, impacts, and mitigation options. ENVIRONMENTAL RESEARCH 2022; 213:113703. [PMID: 35716815 DOI: 10.1016/j.envres.2022.113703] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Heatwaves have received major attention globally due to their detrimental effects on human health and the environment. The frequency, duration, and severity of heatwaves have increased recently due to changes in climatic conditions, anthropogenic forcing, and rapid urbanization. Australia is highly vulnerable to this hazard. Although there have been an increasing number of studies conducted in Australia related to the heatwave phenomena, a systematic review of heatwave vulnerability has rarely been reported in the literature. OBJECTIVES This study aims to provide a systematic and overarching review of the different components of heatwave vulnerability (e.g., exposure, sensitivity, and adaptive capacity) in Australia. METHODS A systematic review was conducted using the PRISMA protocol. Peer-reviewed English language articles published between January 2000 and December 2021 were selected using a combination of search keywords in Web of Science, Scopus, and PubMed. Articles were critically analyzed based on three specific heatwave vulnerability components: exposure, sensitivity, and adaptive capacity. RESULTS AND DISCUSSION A total of 107 articles meeting all search criteria were chosen. Although there has been an increasing trend of heat-related studies in Australia, most of these studies have concentrated on exposure and adaptive capacity components. Evidence suggests that the frequency, severity, and duration of heatwaves in Australian cities has been increasing, and that this is likely to continue under current climate change scenarios. This study noted that heatwave vulnerability is associated with geographical and climatic factors, space, time, socioeconomic and demographic factors, as well as the physiological condition of people. Various heat mitigation and adaptation measures implemented around the globe have proven to be efficient in reducing the impacts of heatwaves. CONCLUSION This study provides increased clarity regarding the various drivers of heatwave vulnerability in Australia. Such knowledge is crucial in informing extreme heat adaptation and mitigation planning.
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Affiliation(s)
- Mohammed Sarfaraz Gani Adnan
- Department of Urban and Regional Planning, Chittagong University of Engineering and Technology (CUET), Chittagong, 4319, Bangladesh; Environmental Change Institute, School of Geography and the Environment, University of Oxford, OX1 3QY, United Kingdom.
| | - Ashraf Dewan
- School of Earth and Planetary Sciences, Curtin University, Perth, WA, 6102, Australia
| | - Dirk Botje
- School of Earth and Planetary Sciences, Curtin University, Perth, WA, 6102, Australia
| | - Shamsuddin Shahid
- Department of Hydraulics & Hydrology, Faculty of Civil Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
| | - Quazi K Hassan
- Department of Geomatics Engineering, University of Calgary, 2500 University Drive NW, Calgary Alberta, T2N 1N4, Canada
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12
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Ai S, Zhou H, Wang C, Qian ZM, McMillin SE, Huang C, Zhang T, Xu L, Li Z, Lin H. Effect and attributable burden of hot extremes on bacillary dysentery in 31 Chinese provincial capital cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:155028. [PMID: 35390371 DOI: 10.1016/j.scitotenv.2022.155028] [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: 01/04/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND High atmospheric temperature has been associated with the occurrence of bacillary dysentery (BD). Recent studies have suggested that hot extremes may influence health outcomes, however, none have examined the association between hot extremes and BD risk, especially at the national level. OBJECTIVES To assess the effect and attributable burden of hot extremes on BD cases and to identify populations at high risk of BD. METHODS Daily incident BD data of 31 provincial capital cities from 2010 to 2018 were collected from the Chinese Center for Disease Control and Prevention, weather data was obtained from the fifth generation of the European Re-Analysis Dataset. Three types of hot extremes, including hot day, hot night, and hot day and night, were defined according to single or sequential occurrence of daytime hot and nighttime hot within 24 h. A two-stage analytical strategy combined with distributed lag non-linear models (DLNM) was used to evaluate city-specific associations and national pooled estimates. RESULTS Hot extremes were significantly associated with the risk of BD on lagged 1-6 days. The overall cumulative relative risk (RR) was 1.136 [95% confidence interval (CI): 1.022, 1.263] for hot day, 1.181 (95% CI: 1.019, 1.369) for hot night, and 1.154 (95% CI: 1.038, 1.283) for hot day and night. Northern residents, females, and children younger than or equal to 14 years old were vulnerable under hot night, southern residents were vulnerable under hot day, and males were vulnerable under hot day and night. 1.854% (95% CI: 1.294%, 2.205%) of BD cases can be attributable to hot extremes, among which, hot night accounted for a large proportion. CONCLUSIONS Hot extremes may significantly increase the incidence risk and disease burden of BD. Type-specific protective measures should be taken to reduce the risk of BD, especially in those we found to be particularly vulnerable.
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Affiliation(s)
- Siqi Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haijian Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing 100089, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, United States of America
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, Saint Louis, MO 63103, United States of America
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Tuantuan Zhang
- School of Atmospheric Sciences, Sun Yat-sen University, Southern Laboratory of Ocean Science and Engineering, Zhuhai, Guangdong 519082, China; Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-sen University, Zhuhai, Guangdong 519082, China
| | - Lianlian Xu
- School of Atmospheric Sciences, Sun Yat-sen University, Southern Laboratory of Ocean Science and Engineering, Zhuhai, Guangdong 519082, China; Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-sen University, Zhuhai, Guangdong 519082, China
| | - Zhenjun Li
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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13
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Mason H, C King J, E Peden A, C Franklin R. Systematic review of the impact of heatwaves on health service demand in Australia. BMC Health Serv Res 2022; 22:960. [PMID: 35902847 PMCID: PMC9336006 DOI: 10.1186/s12913-022-08341-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Heatwaves have been linked to increased levels of health service demand in Australia. This systematic literature review aimed to explore health service demand during Australian heatwaves for hospital admissions, emergency department presentations, ambulance call-outs, and risk of mortality. STUDY DESIGN A systematic review to explore peer-reviewed heatwave literature published from 2000 to 2020. DATA SOURCES Articles were reviewed from six databases (MEDLINE, Scopus, Web of Science, PsychINFO, ProQuest, Science Direct). Search terms included: heatwave, extreme heat, ambulance, emergency department, and hospital. Studies were included if they explored heat for a period of two or more consecutive days. Studies were excluded if they did not define a threshold for extreme heat or if they explored data only from workers compensation claims and major events. DATA SYNTHESIS This review was prospectively registered with PROSPERO (# CRD42021227395 ). Forty-five papers were included in the final review following full-text screening. Following a quality assessment using the GRADE approach, data were extracted to a spreadsheet and compared. Significant increases in mortality, as well as hospital, emergency, and ambulance demand, were found across Australia during heatwave periods. Admissions for cardiovascular, renal, respiratory, mental and behavioural conditions exhibited increases during heatwaves. The most vulnerable groups during heatwaves were children (< 18 years) and the elderly (60+). CONCLUSIONS Heatwaves in Australia will continue to increase in duration and frequency due to the effects of climate change. Health planning is essential at the community, state, and federal levels to mitigate the impacts of heatwaves on health and health service delivery especially for vulnerable populations. However, understanding the true impact of heatwaves on health service demand is complicated by differing definitions and methodology in the literature. The Excess Heat Factor (EHF) is the preferred approach to defining heatwaves given its consideration of local climate variability and acclimatisation. Future research should explore evidence-based and spatially relevant heatwave prevention programs. An enhanced understanding of heatwave health impacts including service demand will inform the development of such programs which are necessary to promote population and health system resilience.
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Affiliation(s)
- Hannah Mason
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia
| | - Jemma C King
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia
| | - Amy E Peden
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia.,School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard C Franklin
- Discipline of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland, 4811, Australia.
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14
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Strathearn M, Osborne NJ, Selvey LA. Impact of low-intensity heat events on mortality and morbidity in regions with hot, humid summers: a scoping literature review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1013-1029. [PMID: 35059818 PMCID: PMC9042961 DOI: 10.1007/s00484-022-02243-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 05/05/2023]
Abstract
The objective of this study is to determine the impacts of low-intensity heat on human health in regions with hot, humid summers. Current literature has highlighted an increase in mortality and morbidity rates during significant heat events. While the impacts on high-intensity events are established, the impacts on low-intensity events, particularly in regions with hot, humid summers, are less clear. A scoping review was conducted searching three databases (PubMed, EMBASE, Web of Science) using key terms based on the inclusion criteria. We included papers that investigated the direct human health impacts of low-intensity heat events (single day or heatwaves) in regions with hot, humid summers in middle- and high-income countries. We excluded papers written in languages other than English. Of the 600 publications identified, 33 met the inclusion criteria. Findings suggest that low-intensity heatwaves can increase all-cause non-accidental, cardiovascular-, respiratory- and diabetes-related mortality, in regions experiencing hot, humid summers. Impacts of low-intensity heatwaves on morbidity are less clear, with research predominantly focusing on hospitalisation rates with a range of outcomes. Few studies investigating the impact of low-intensity heat events on emergency department presentations and ambulance dispatches were found. However, the data from a limited number of studies suggest that both of these outcome measures increase during low-intensity heat events. Low-intensity heat events may increase mortality. There is insufficient evidence of a causal effect of low-intensity heat events on increasing morbidity for a firm conclusion. Further research on the impact of low-intensity heat on morbidity and mortality using consistent parameters is warranted.
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Affiliation(s)
- Melanie Strathearn
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Nicholas J Osborne
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Linda A Selvey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia.
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15
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Liu J, Varghese BM, Hansen A, Borg MA, Zhang Y, Driscoll T, Morgan G, Dear K, Gourley M, Capon A, Bi P. Hot weather as a risk factor for kidney disease outcomes: A systematic review and meta-analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 801:149806. [PMID: 34467930 DOI: 10.1016/j.scitotenv.2021.149806] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The occurrence or exacerbation of kidney disease has been documented as a growing problem associated with hot weather. The implementation of effective prevention measures requires a better understanding of the risk factors that increase susceptibility. To fill gaps in knowledge, this study reviews the current literature on the effects of heat on kidney-disease outcomes (ICD-10 N00-N39), including morbidity and mortality. METHODS Databases were systematically searched for relevant literature published between 1990 and 2020 and the quality of evidence evaluated. We performed random effects meta-analysis to calculate the pooled relative risks (RRs) of the association between high temperatures (and heatwaves) and kidney disease outcomes. We further evaluated vulnerability concerning contextual population characteristics. RESULTS Of 2739 studies identified, 91 were reviewed and 82 of these studies met the criteria for inclusion in a meta-analysis. Findings showed that with a 1 °C increase in temperature, the risk of kidney-related morbidity increased by 1% (RR 1.010; 95% CI: 1.009-1.011), with the greatest risk for urolithiasis. Heatwaves were also associated with increased morbidity with a trend observed with heatwave intensity. During low-intensity heatwaves, there was an increase of 5.9% in morbidity, while during high-intensity heatwaves there was a 7.7% increase. There were greater RRs for males, people aged ≤64 years, and those living in temperate climate zones. Similarly, for every 1 °C temperature increase, there was a 3% (RR 1.031; 95% CI: 1.018-1.045) increase in the risk of kidney-related mortality, which also increased during heatwaves. CONCLUSIONS High temperatures (and heatwaves) are associated with an elevated risk of kidney disease outcomes, particularly urolithiasis. Preventive measures that may minimize risks in vulnerable individuals during hot spells are discussed.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Matthew A Borg
- School of Public Health, The University of Adelaide, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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16
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Su X, Song H, Cheng Y, Yao X, Li Y. The mortality burden of nervous system diseases attributed to ambient temperature: A multi-city study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 800:149548. [PMID: 34388642 DOI: 10.1016/j.scitotenv.2021.149548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUNDS Studies on the association between ambient temperature and human mortality have been widely reported, focusing on common diseases such as cardiopulmonary diseases. However, multi-city studies on the association between both high and low temperatures and mortality of nervous system diseases were scarce, especially on the evidence of vulnerable populations. METHODS Weekly meteorological data, air pollution data and mortality data of nervous system were collected in 5 cities in China. A quasi-Poisson regression with distributed lag non-linear model (DLNM) was applied to quantify the association between extreme temperatures and mortality of nervous system diseases. Multivariate meta-analysis was applied to estimate the pooled effects at the overall levels. The attributable fractions (AFs) were calculated to assess the mortality burden attributable to both high and low temperatures. Stratified analyses were also performed by gender and age-groups through the above steps. RESULTS A total of 12,132 deaths of nervous system diseases were collected in our study. The overall minimum mortality temperature was 23.9 °C (61.9th), the cumulative relative risks of extreme heat and cold for nervous system diseases were 1.33(95%CI: 1.10, 1.61) and 1.47(95%CI: 1.27, 1.71). The mortality burden attributed to non-optimal temperatures accounted for 29.54% (95%eCI: 13.45%, 40.52%), of which the mortality burden caused by low temperature and high temperature accounted for 25.89% (95%eCI: 13.03%, 34.36%) and 3.65% (95%eCI: 0.42%, 6.17%), respectively. The mortality burden attributable to ambient temperature was higher in both males and the elderly (>74 years old), with the AF of 31.85% (95%eCI: 20.68%, 39.88%) and 31.14% (95%eCI: -6.83%, 49.51%), respectively. CONCLUSIONS The non-optimal temperature can increase the mortality of nervous system diseases and the males and the elderly over 74 years have the highest attributable burden. The findings add the evidence of vulnerable populations of nervous system diseases against ambient temperatures.
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Affiliation(s)
- Xuemei Su
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Daxing District Center for Disease Control and Prevention, Beijing 102600, China
| | - Hejia Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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17
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Jalalzadeh Fard B, Mahmood R, Hayes M, Rowe C, Abadi AM, Shulski M, Medcalf S, Lookadoo R, Bell JE. Mapping Heat Vulnerability Index Based on Different Urbanization Levels in Nebraska, USA. GEOHEALTH 2021; 5:e2021GH000478. [PMID: 34723046 PMCID: PMC8533801 DOI: 10.1029/2021gh000478] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
Heatwaves cause excess mortality and physiological impacts on humans throughout the world, and climate change will intensify and increase the frequency of heat events. Many adaptation and mitigation studies use spatial distribution of highly vulnerable local populations to inform heat reduction and response plans. However, most available heat vulnerability studies focus on urban areas with high heat intensification by Urban Heat Islands (UHIs). Rural areas encompass different environmental and socioeconomic issues that require alternate analyses of vulnerability. We categorized Nebraska census tracts into four urbanization levels, then conducted factor analyses on each group and captured different patterns of socioeconomic vulnerabilities among resultant Heat Vulnerability Indices (HVIs). While disability is the major component of HVI in two urbanized classes, lower education, and races other than white have higher contributions in HVI for the two rural classes. To account for environmental vulnerability of HVI, we considered different land type combinations for each urban class based on their percentage areas and their differences in heat intensifications. Our results demonstrate different combinations of initial variables in heat vulnerability among urban classes of Nebraska and clustering of high and low heat vulnerable areas within the highest urbanized sections. Less urbanized areas show no spatial clustering of HVI. More studies with separation on urbanization level of residence can give insights into different socioeconomic vulnerability patterns in rural and urban areas, while also identifying changes in environmental variables that better capture heat intensification in rural settings.
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Affiliation(s)
- Babak Jalalzadeh Fard
- Department of Environmental, Agricultural, and Occupational HealthCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Rezaul Mahmood
- High Plains Regional Climate CenterSchool of Natural ResourcesUniversity of Nebraska‐LincolnLincolnNEUSA
| | - Michael Hayes
- Institute of Agriculture and Natural ResourcesSchool of Natural ResourcesUniversity of Nebraska‐LincolnLincolnNEUSA
| | - Clinton Rowe
- Department of Earth and Atmospheric SciencesCollege of Art and SciencesUniversity of Nebraska‐LincolnLincolnNEUSA
| | - Azar M. Abadi
- Department of Environmental, Agricultural, and Occupational HealthCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Martha Shulski
- High Plains Regional Climate CenterSchool of Natural ResourcesUniversity of Nebraska‐LincolnLincolnNEUSA
| | - Sharon Medcalf
- Department of EpidemiologyCenter for Biosecurity, Bio‐preparedness, and Emerging Infectious DiseasesCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Rachel Lookadoo
- Department of EpidemiologyCenter for Biosecurity, Bio‐preparedness, and Emerging Infectious DiseasesCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Jesse E. Bell
- Department of Environmental, Agricultural, and Occupational HealthCollege of Public HealthUniversity of Nebraska Medical CenterOmahaNEUSA
- High Plains Regional Climate CenterSchool of Natural ResourcesUniversity of Nebraska‐LincolnLincolnNEUSA
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Liu J, Varghese BM, Hansen A, Xiang J, Zhang Y, Dear K, Gourley M, Driscoll T, Morgan G, Capon A, Bi P. Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 153:106533. [PMID: 33799230 DOI: 10.1016/j.envint.2021.106533] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations. OBJECTIVE To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity. METHODS A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity. RESULTS The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as "mean temperature ≥90th percentile for ≥3 days" (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was "mean temperature ≥95th percentile for ≥3 days", with a RR of 1.064 (95%CI: 1.006-1.123). CONCLUSIONS Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Australia; School of Public Health, Fujian Medical University, China
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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Ma Y, Zhou L, Chen K. Burden of cause-specific mortality attributable to heat and cold: A multicity time-series study in Jiangsu Province, China. ENVIRONMENT INTERNATIONAL 2020; 144:105994. [PMID: 32745780 DOI: 10.1016/j.envint.2020.105994] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/12/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Previous epidemiological studies primarily examined the temperature-related mortality burden of all-cause or cardiovascular diseases (CVD) and respiratory diseases. However, evidence on the heat- and cold-attributable mortality burden from other specific causes is limited. This paper aimed to systematically examine the association of heat and cold with a comprehensive spectrum of plausible temperature-related diseases, and to estimate the mortality burdens attributable to heat and cold. In the time-series study of 11 cities in Jiangsu, China, distributed lag non-linear models were applied to estimate city-specific temperature-mortality associations, and then meta-analysis was conducted to pool the estimates. A total of 1,368,648 cases of death were included in this study. Both extreme heat and cold were associated with increased mortality risks from all-cause, CVD, respiratory diseases, nervous diseases, and external causes. Short-term exposures to heat and cold were associated with excess burden of mortality for several specific diseases, accounting for 16.38% (95% eCI, 7.27-22.31%) for myocardial infarction (MI), 12.41% (95% eCI, 8.81-15.07%) for stroke, 27.97% (95% eCI, 18.42-33.35%) for hypertensive heart disease, 25.18% (95% eCI, 18.42-29.63%) for chronic obstructive pulmonary disease, and 28.46% (95% eCI: 4.93-33.57%) for Alzheimer's and dementia. Diabetes was only associated with extreme heat, with 4.61% (95% eCI, 0.13-7.13%) of diabetes mortality attributable to heat. In total, 11.98% (95% eCI, 10.46-13.08%) of mortality was attributable to heat and cold, with 3.49% (95% eCI, 2.87-4.00%) attributable to heat and 8.48% (95% eCI, 7.31-9.49%) attributable to cold, and about 64% of this overall temperature-related mortality burden was found in 6 aforementioned specific causes and about 10% of mortality burden in external causes. Extreme heat and/or cold are associated with increased risks of mortality from a wide range of causes, including previously identified causes in cardiorespiratory diseases and under-studied causes such as diabetes and Alzheimer's and dementia. Future research is needed to confirm the substantial mortality burden of heat and cold.
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Affiliation(s)
- Yiqun Ma
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Lian Zhou
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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20
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Yu W, Guo Y, Shi L, Li S. The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach. PLoS Med 2020; 17:e1003141. [PMID: 32555635 PMCID: PMC7302440 DOI: 10.1371/journal.pmed.1003141] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/13/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To date, few studies have investigated the causal relationship between mortality and long-term exposure to a low level of fine particulate matter (PM2.5) concentrations. METHODS AND FINDINGS We studied 242,320 registered deaths in Queensland between January 1, 1998, and December 31, 2013, with satellite-retrieved annual average PM2.5 concentrations to each postcode. A variant of difference-in-differences (DID) approach was used to investigate the association of long-term PM2.5 exposure with total mortality and cause-specific (cardiovascular, respiratory, and non-accidental) mortality. We observed 217,510 non-accidental deaths, 133,661 cardiovascular deaths, and 30,748 respiratory deaths in Queensland during the study period. The annual average PM2.5 concentrations ranged from 1.6 to 9.0 μg/m3, which were well below the current World Health Organization (WHO) annual standard (10 μg/m3). Long-term exposure to PM2.5 was associated with increased total mortality and cause-specific mortality. For each 1 μg/m3 increase in annual PM2.5, we found a 2.02% (95% CI 1.41%-2.63%; p < 0.01) increase in total mortality. Higher effect estimates were observed in Brisbane than those in Queensland for all types of mortality. A major limitation of our study is that the DID design is under the assumption that no predictors other than seasonal temperature exhibit different spatial-temporal variations in relation to PM2.5 exposure. However, if this assumption is violated (e.g., socioeconomic status [SES] and outdoor physical activities), the DID design is still subject to confounding. CONCLUSIONS Long-term exposure to PM2.5 was associated with total, non-accidental, cardiovascular, and respiratory mortality in Queensland, Australia, where PM2.5 levels were measured well below the WHO air quality standard.
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Affiliation(s)
- Wenhua Yu
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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21
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Wang Y, Liu Y, Ye D, Li N, Bi P, Tong S, Wang Y, Cheng Y, Li Y, Yao X. High temperatures and emergency department visits in 18 sites with different climatic characteristics in China: Risk assessment and attributable fraction identification. ENVIRONMENT INTERNATIONAL 2020; 136:105486. [PMID: 31991239 DOI: 10.1016/j.envint.2020.105486] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/20/2019] [Accepted: 01/11/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Health impacts of high temperatures on hospital emergency department visits (EDVs) have been less reported, especially from developing countries. OBJECTIVES To investigate high temperature-EDVs relationship in various regions with different climatic characteristics, to explore the regional differences, to identify vulnerable populations, and to provide scientific evidence for climate change adaptation strategies in China. METHODS Daily data on weather, air pollution and EDVs were collected from 18 sites in China from June to August during 2014-2017. A quasi-Poisson generalized additive regression model was applied to examine the high temperature-EDVs relationship in each site. Site-specific risks of EDVs were pooled using a random effect meta-analysis model. Stratified analyses were performed by gender, age-groups, cause-specific EDVs and regions. Attributable fractions of EDVs due to high temperatures were calculated in different regions. RESULTS 1 °C increase in daily mean temperature was associated with 1.07% (95% CI, 0.46-1.67%) increase in EDVs across all study regions. The negative health effects from high temperatures were worse for the people living in southern China, in subtropical monsoon climate zone or in counties, with percentage change of 1.96% (95% CI, 0.92-3.02%), 1.35% (95% CI, 0.95-1.76%) and 1.41% (95% CI, 0.48-2.34%), respectively. People under 18 were more vulnerable to high temperatures. Exposure to high temperatures increased EDVs risks from endocrine, respiratory, and digestive diseases and injury. The attributable fraction due to high temperatures was 8.64% for overall EDVs, 11.70% for the people living in southern China, 10.80% for people living in subtropical monsoon climate zone and 12.65% for the county population. CONCLUSIONS Exposure to high temperatures resulted in extra burden to China's already overloaded hospital emergency departments. More resources are needed to meet increasing demands and effective preventative measurements are warranted to tackle such a challenge. Further studies should pay more attention to both heat and cold-related EDVs risks and socioeconomic cost for better climate change adaptation.
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Affiliation(s)
- Yu Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dianxiu Ye
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Na Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Yan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yibin Cheng
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoyuan Yao
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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22
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Xu Z, Hu X, Tong S, Cheng J. Heat and risk of acute kidney injury: An hourly-level case-crossover study in queensland, Australia. ENVIRONMENTAL RESEARCH 2020; 182:109058. [PMID: 31869688 DOI: 10.1016/j.envres.2019.109058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The effects of hourly differences in temperature on the risk of acute kidney injury have not been investigated so far. This study aimed to examine a very short-term effect of heat on the risk of acute kidney injury at an hourly level and assessed potential modification effects by age, gender and preexisting diseases. METHODS We performed a time-stratified case-crossover design with a conditional logistic regression model to examine the association between hourly temperature and hourly emergency department visits for acute kidney injury (N = 1815) in Queensland state of Australia, 2013-2015. Heat effect on acute kidney injury was reported for temperature increases from 50th percentile (26.1 °C) to 95th percentile (33.6 °C). RESULTS The effect of heat on acute kidney injury occurred in the same hour of heat exposure (odds ratio (OR): 1.37; 95% confidence interval (CI): 1.10, 1.71), with no temperature threshold observed. Males (OR: 2.48; 95% CI: 1.85, 3.32) and those aged >64 years (OR: 2.93; 95% CI: 2.01, 4.27), particularly those with pre-existing diabetes (OR: 2.51; 95% CI: 1.91, 3.30), hypertension (OR: 2.25; 95% CI: 1.61, 3.15), heart failure (OR: 2.21; 95% CI: 1.72, 2.84), or chronic kidney disease (OR: 2.59; 95% CI: 1.89, 3.55), were at great risks of acute kidney injury attack after exposure to heat. CONCLUSIONS General practitioners and specialists should remind their patients about this risk in summer. Tailored heat adaptation strategies protecting adults working outdoors are urgently needed, especially within the context of climate change.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia.
| | - Xinxin Hu
- The Third People's Hospital of Hefei, Hefei, China
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China; School of Public Health and Institute of Environment and Human Health, Anhui Medical, University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Jian Cheng
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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