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Ni W, Stafoggia M, Zhang S, Ljungman P, Breitner S, Bont JD, Jernberg T, Atar D, Agewall S, Schneider A. Short-Term Effects of Lower Air Temperature and Cold Spells on Myocardial Infarction Hospitalizations in Sweden. J Am Coll Cardiol 2024; 84:1149-1159. [PMID: 39230547 DOI: 10.1016/j.jacc.2024.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Lower air temperature and cold spells have been associated with an increased risk of various diseases. However, the short-term effect of lower air temperature and cold spells on myocardial infarction (MI) remains incompletely understood. OBJECTIVES The purpose of this study was to investigate the short-term effects of lower air temperature and cold spells on the risk of hospitalization for MI in Sweden. METHODS This population-based nationwide study included 120,380 MI cases admitted to hospitals in Sweden during the cold season (October to March) from 2005 to 2019. Daily mean air temperature (1 km2 resolution) was estimated using machine learning, and percentiles of daily temperatures experienced by individuals in the same municipality were used as individual exposure indicators to account for potential geographic adaptation. Cold spells were defined as periods of at least 2 consecutive days with a daily mean temperature below the 10th percentile of the temperature distribution for each municipality. A time-stratified case-crossover design incorporating conditional logistic regression models with distributed lag nonlinear models using lag 0 to 1 (immediate) and 2 to 6 days (delayed) was used to evaluate the short-term effects of lower air temperature and cold spells on total MI, non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). RESULTS A decrease of 1-U in percentile temperature at a lag of 2 to 6 days was significantly associated with increased risks of total MI, NSTEMI, and STEMI, with ORs of 1.099 (95% CI: 1.057-1.142), 1.110 (95% CI: 1.060-1.164), and 1.076 (95% CI: 1.004-1.153), respectively. Additionally, cold spells at a lag of 2 to 6 days were significantly associated with increased risks for total MI, NSTEMI, and STEMI, with ORs of 1.077 (95% CI: 1.037-1.120), 1.069 (95% CI: 1.020-1.119), and 1.095 (95% CI: 1.023-1.172), respectively. Conversely, lower air temperature and cold spells at a lag of 0 to 1 days were associated with decreased risks for MI. CONCLUSIONS This nationwide case-crossover study reveals that short-term exposures to lower air temperature and cold spells are associated with an increased risk of hospitalization for MI at lag 2 to 6 days.
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Affiliation(s)
- Wenli Ni
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Germany; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Germany
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Dan Atar
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway
| | - Stefan Agewall
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Neuherberg, Germany
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Bai X, Ming X, Zhao M, Zhou L. Explore the effect of apparent temperature and air pollutants on the admission rate of acute myocardial infarction in Chongqing, China: a time-series study. BMJ Open 2024; 14:e084376. [PMID: 38658006 PMCID: PMC11043748 DOI: 10.1136/bmjopen-2024-084376] [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: 01/17/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE Limited research has been conducted on the correlation between apparent temperature and acute myocardial infarction (AMI), as well as the potential impact of air pollutants in modifying this relationship. The objective of this study is to investigate the lagged effect of apparent temperature on AMI and assess the effect modification of environmental pollutants on this association. DESIGN A time-series study. SETTING AND PARTICIPANTS The data for this study were obtained from the Academy of Medical Data Science at Chongqing Medical University, covering daily hospitalisations for AMI between 1 January 2015 and 31 December 2016. Meteorological and air pollutant data were provided by China's National Meteorological Information Centre. OUTCOME MEASURES We used a combined approach of quasi-Poisson generalised linear model and distributed lag non-linear model to thoroughly analyse the relationships. Additionally, we employed a generalised additive model to investigate the interaction between air pollutants and apparent temperature on the effect of AMI. RESULT A total of 872 patients admitted to hospital with AMI were studied based on the median apparent temperature (20.43°C) in Chongqing. Low apparent temperature (10th, 7.19℃) has obvious lagged effect on acute myocardial infarction, first appearing on the 8th day (risk ratio (RR) 1.081, 95% CI 1.010 to 1.158) and the greatest risk on the 11th day (RR 1.094, 95% CI 1.037 to 1.153). No lagged effect was observed at high apparent temperature. In subgroup analysis, women and individuals aged 75 and above were at high risk. The interaction analysis indicates that there exist significant interactions between PM2.5 and high apparent temperature, as well as nitrogen dioxide (NO2) and low apparent temperature. CONCLUSION The occurrence of decreased apparent temperature levels was discovered to be linked with a heightened relative risk of hospitalisations for AMI. PM2.5 and NO2 have an effect modification on the association between apparent temperature and admission rate of AMI.
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Affiliation(s)
- Xiuyuan Bai
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xin Ming
- Chongqing Health Center for Women and Children, Chongqing, China
- Department of quality management section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Mingming Zhao
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li Zhou
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
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Zhai G, Gao Z, Wang R. Cardiovascular admission risk attributable to hot apparent temperature: a study in a rural area of northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-16. [PMID: 38598234 DOI: 10.1080/09603123.2024.2338898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/31/2024] [Indexed: 04/11/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide, posing a significant threat to public health. Research on the relationship between CVD and temperature has primarily focused on developed urban settings, with limited studies conducted in rural regions with lower levels of development. Additionally, compared to relative risks, attributable risks can provide more information when assessing the risk of CVD hospitalizations associated with exposure to apparent temperature (AT). Apparent temperature is a composite temperature index that takes into account both meteorological factors and temperature, providing an objective reflection of human thermal sensation. Therefore, this study investigates the impact of AT on CVD hospitalization and quantifies the burden of CVD admission in the rural areas of China. We employed the distributed lag non-linear model (DLNM) to estimate the relationship between AT and the relative risk (RR) of CVD hospitalization. Finally, we used attributable risk methods to quantify this relationship further.
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Affiliation(s)
- Guangyu Zhai
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, People's Republic of China
| | - Ziyao Gao
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, People's Republic of China
| | - Rong Wang
- College of Resources and Environment, Lanzhou University, Lanzhou, People's Republic of China
- Department of Science and Technology, Lanzhou University of Technology, Lanzhou, People's Republic of China
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4
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Zhai G, Gao Z, Zhou W. Effects of apparent temperature on cardiovascular disease admissions in rural areas of Linxia Hui Autonomous Prefecture. Sci Rep 2023; 13:14971. [PMID: 37696907 PMCID: PMC10495458 DOI: 10.1038/s41598-023-42232-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023] Open
Abstract
Cardiovascular disease (CVD) is a major threat to public health worldwide. The relationship between CVD and temperature has been widely reported in developed countries and regions. However, there are few studies of severe CVD in poor rural areas of developing countries. Therefore, this study aimed to explore the relationship between CVD and apparent temperature (AT) in a rural area of Linxia Hui Autonomous Prefecture, China. Daily CVD admission data and meteorological data were collected from Linxia between 2014 and 2015. The media of AT was used as the reference temperature to estimate the cumulative relative risk (RR) of CVD admission. The distributed lag non-linear models were used to examine the association between AT and cumulative RR of CVD admission at lag 0-21 days. In Linxia, high AT (20 °C) had a persistent adverse effect on cumulative RR of CVD admissions, and the RR increased with increasing lag days. Cold (- 10 °C) had a protective effect on the first and later lag days (lag 0-14 and lag 0-21). Adults (aged < 65 years) and females were more susceptible to the effects of heat than males and the elderly (aged ≥ 65 years). In Linxia, China, extremely high AT is an important risk factor for CVD hospitalizations in suburban and rural populations.
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Affiliation(s)
- Guangyu Zhai
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China
| | - Ziyao Gao
- School of Economics and Management, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China.
| | - Wenjuan Zhou
- Gansu Provincial Hospital, Lanzhou, 730000, Gansu, People's Republic of 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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6
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Neira M, Erguler K, Ahmady-Birgani H, Al-Hmoud ND, Fears R, Gogos C, Hobbhahn N, Koliou M, Kostrikis LG, Lelieveld J, Majeed A, Paz S, Rudich Y, Saad-Hussein A, Shaheen M, Tobias A, Christophides G. Climate change and human health in the Eastern Mediterranean and Middle East: Literature review, research priorities and policy suggestions. ENVIRONMENTAL RESEARCH 2023; 216:114537. [PMID: 36273599 PMCID: PMC9729515 DOI: 10.1016/j.envres.2022.114537] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 05/17/2023]
Abstract
Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health status and housing conditions, among other. In the Eastern Mediterranean and Middle East (EMME), climatic factors known to affect human health include extreme heat, water shortages and air pollution. Furthermore, the epidemiology of vector-borne diseases (VBDs) and the health consequences of population displacement are also influenced by climate change in this region. To inform future policies for adaptation and mitigation measures, and based on an extensive review of the available knowledge, we recommend several research priorities for the region. These include the generation of more empirical evidence on exposure-response functions involving climate change and specific health outcomes, the development of appropriate methodologies to evaluate the physical and psychological effects of climate change on vulnerable populations, determining how climate change alters the ecological determinants of human health, improving our understanding of the effects of long-term exposure to heat stress and air pollution, and evaluating the interactions between adaptation and mitigation strategies. Because national boundaries do not limit most climate-related factors expected to impact human health, we propose that adaptation/mitigation policies must have a regional scope, and therefore require collaborative efforts among EMME nations. Policy suggestions include a decisive region-wide decarbonisation, the integration of environmentally driven morbidity and mortality data throughout the region, advancing the development and widespread use of affordable technologies for the production and management of drinking water by non-traditional means, the development of comprehensive strategies to improve the health status of displaced populations, and fostering regional networks for monitoring and controlling the spread of infectious diseases and disease vectors.
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Affiliation(s)
- Marco Neira
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus.
| | - Kamil Erguler
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus
| | | | | | - Robin Fears
- European Academies Science Advisory Council (EASAC), Halle (Saale), Germany
| | | | - Nina Hobbhahn
- European Academies Science Advisory Council (EASAC), Halle (Saale), Germany
| | - Maria Koliou
- University of Cyprus Medical School, Nicosia, Cyprus
| | - Leondios G Kostrikis
- Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus; Cyprus Academy of Sciences, Letters, and Arts, Nicosia, Cyprus
| | - Jos Lelieveld
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus; Max Planck Institute for Chemistry, Mainz, Germany
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, United Kingdom
| | - Shlomit Paz
- Department of Geography and Environmental Studies, University of Haifa, Haifa, Israel
| | - Yinon Rudich
- Department of Earth and Planetary Sciences, The Weismann Institute of Science, Rehovot, Israel
| | - Amal Saad-Hussein
- Environment and Climate Change Research Institute, National Research Centre, Cairo, Egypt
| | - Mohammed Shaheen
- Damour for Community Development - Research Department, Palestine
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - George Christophides
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus; Department of Life Sciences, Imperial College London, London, United Kingdom.
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7
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Redfors B, Simonato M, Chen S, Vincent F, Zhang Z, Thiele H, Eitel I, Patel MR, Ohman EM, Maehara A, Ben-Yehuda O, Stone GW. Ambient temperature and infarct size, microvascular obstruction, left ventricular function and clinical outcomes after ST-segment elevation myocardial infarction. Coron Artery Dis 2022; 33:81-90. [PMID: 34569991 DOI: 10.1097/mca.0000000000001099] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Incidence and prognosis of ST-segment elevation myocardial infarction (STEMI) vary according to ambient temperature and season. We sought to assess whether season and temperature on the day of STEMI are associated with infarct size, microvascular obstruction (MVO), left ventricular ejection fraction (LVEF) and clinical outcomes after primary percutaneous coronary intervention (PCI). METHODS Individual patient data from 1598 patients undergoing primary PCI in six randomized clinical trials were pooled. Infarct size was evaluated by cardiac magnetic resonance within 30 days in all trials. Patients were categorized either by whether they presented on a day of temperature extremes (minimum temperature <0 °C or maximum temperature >25 °C) or according to season. RESULTS A total of 558/1598 (34.9%) patients presented with STEMI on a day of temperature extremes, and 395 (24.7%), 374 (23.4%), 481 (30.1%) and 348 (21.8%) presented in the spring, summer, fall and winter. After multivariable adjustment, temperature extremes were independently associated with larger infarct size (adjusted difference 2.8%; 95% CI, 1.3-4.3; P < 0.001) and smaller LVEF (adjusted difference -2.3%; 95% CI, -3.5 to -1.1; P = 0.0002) but not with MVO (adjusted P = 0.12). In contrast, infarct size, MVO and LVEF were unrelated to season (adjusted P = 0.67; P = 0.36 and P = 0.95, respectively). Neither temperature extremes nor season were independently associated with 1-year risk of death or heart failure hospitalization (adjusted P = 0.79 and P = 0.90, respectively). CONCLUSION STEMI presentation during temperature extremes was independently associated with larger infarct size and lower LVEF but not with MVO after primary PCI, whereas season was unrelated to infarct severity.
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Affiliation(s)
- Björn Redfors
- Clinical Trials Center, Cardiovascular Research Foundation
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, USA
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Shmuel Chen
- Clinical Trials Center, Cardiovascular Research Foundation
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, USA
| | | | - Zixuan Zhang
- Clinical Trials Center, Cardiovascular Research Foundation
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig
| | - Ingo Eitel
- University Heart Center Lübeck, and the German Center for Cardiovascular Research, Lübeck, Germany
| | - Manesh R Patel
- Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina
| | - E Magnus Ohman
- Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina
| | - Akiko Maehara
- Clinical Trials Center, Cardiovascular Research Foundation
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, USA
| | - Ori Ben-Yehuda
- Clinical Trials Center, Cardiovascular Research Foundation
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, USA
| | - Gregg W Stone
- Clinical Trials Center, Cardiovascular Research Foundation
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, USA
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Li CY, Wu PJ, Chang CJ, Lee CH, Chung WJ, Chen TY, Tseng CH, Wu CC, Cheng CI. Weather Impact on Acute Myocardial Infarction Hospital Admissions With a New Model for Prediction: A Nationwide Study. Front Cardiovasc Med 2022; 8:725419. [PMID: 34970601 PMCID: PMC8712757 DOI: 10.3389/fcvm.2021.725419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/27/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cardiovascular disease is one of the leading causes of mortality worldwide. Acute myocardial infarction (AMI) is associated with weather change. The study aimed to investigate if weather change was among the risk factors of coronary artery disease to influence AMI occurrence in Taiwan and to generate a model to predict the probabilities of AMI in specific weather and clinical conditions. Method: This observational study utilized the National Health Insurance Research Database and daily weather reports from Taiwan Central Weather Bureau to evaluate the discharge records of patients diagnosed with AMI from various hospitals in Taiwan between January 1, 2008 and December 31, 2011. Generalized additive models (GAMs) were used to estimate the effective parameters on the trend of the AMI incidence rate with respect to the weather and health factors in the time-series data and to build a model for predicting AMI probabilities. Results: A total of 40,328 discharges were listed. The minimum temperature, maximum wind speed, and antiplatelet therapy were negatively related to the daily AMI incidence; however, a drop of 1° when the air temperature was below 15°C was associated with an increase of 1.6% of AMI incidence. By using the meaningful parameters including medical and weather factors, an estimated GAM was built. The model showed an adequate correlation in both internal and external validation. Conclusion: An increase in AMI occurrence in colder weather has been evidenced in the study, but the influence of wind speed remains uncertain. Our analysis demonstrated that the novel GAM model can predict daily onset rates of AMI in specific weather conditions.
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Affiliation(s)
- Chen-Yu Li
- Department of Finance, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Po-Jui Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chi-Jen Chang
- Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, Taiwan.,Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan.,Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Jung Chung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tien-Yu Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chien-Hao Tseng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chia-Chen Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng-I Cheng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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9
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Xu Z, Tong S, Ho HC, Lin H, Pan H, Cheng J. Associations of heat and cold with hospitalizations and post-discharge deaths due to acute myocardial infarction: what is the role of pre-existing diabetes? Int J Epidemiol 2021; 51:134-143. [PMID: 34387661 DOI: 10.1093/ije/dyab155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The existing evidence suggests that pre-existing diabetes may modify the association between heat and hospitalizations for acute myocardial infarction (AMI). METHODS This study included patients who were hospitalized for AMI from 1 January 2005 to 31 December 2013 in Brisbane, Australia, and also included those who died within 2 months after discharge. A time-stratified case-crossover design with conditional logistic regression was used to quantify the associations of heat and cold with hospitalizations and post-discharge deaths due to AMI in patients with and without pre-existing diabetes. Stratified analyses were conducted to explore whether age, sex and suburb-level green space and suburb-level socio-economic status modified the temperature-AMI relationship. Heat and cold were defined as the temperature above/below which the odds of hospitalizations/deaths due to AMI started to increase significantly. RESULTS There were 14 991 hospitalizations for AMI and 1811 died from AMI within 2 months after discharge during the study period. Significant association between heat and hospitalizations for AMI was observed only in those with pre-existing diabetes (odds ratio: 1.19, 95% confidence interval: 1.00-1.41) [heat (26.3°C) vs minimum morbidity temperature (22.2°C)]. Cold was associated with increased odds of hospitalizations for AMI in both diabetes and non-diabetes groups. Significant association between cold and post-discharge deaths from AMI was observed in both diabetes and non-diabetes groups. CONCLUSIONS Individuals with diabetes are more susceptible to hospitalizations due to AMI caused by heat and cold.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China.,School of Geography and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Haifeng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 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, Hefei, China
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10
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Li N, Ma J, Liu F, Zhang Y, Ma P, Jin Y, Zheng ZJ. Associations of apparent temperature with acute cardiac events and subtypes of acute coronary syndromes in Beijing, China. Sci Rep 2021; 11:15229. [PMID: 34315978 PMCID: PMC8316341 DOI: 10.1038/s41598-021-94738-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/07/2021] [Indexed: 11/09/2022] Open
Abstract
Limited evidence is available on apparent temperature (AT) and hospital admissions for acute cardiac events. We examined the associations of AT with admissions for acute cardiac events and acute coronary syndrome (ACS), and explored the effect difference between ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction ACS (NSTE-ACS). Poisson regression with distributed lag non-linear model was applied to examine the temperature-lag-admission associations. Stratified analyses were performed by gender and age-groups for acute cardiac events. A total of 11,657 acute cardiac events admissions were collected from hospital-based chest pain centers in Beijing, during 2017-2019. The single day effect of low AT (- 11 °C, 2.5th percentile) appeared on the 2nd day and persisted until the 11th day, with estimated relative risk (RR) ranging from 1.44 (95% CI: 1.159, 1.790) to 1.084 (95% CI: 1.022, 1.150) for acute cardiac events and from 1.034 (95% CI: 1.010, 1.059) to 1.006 (95% CI: 1.000, 1.011) for ACS. The single day effect of high AT (34 °C, 97.5th percentile) was only observed on the current day. The cold effect on acute cardiac events was more pronounced among female and older patients. The cumulative effect of high AT on STEMI admissions and low AT on NSTE-ACS reached a peak RR peak of 2.545 (95% CI: 1.016, 6.375) and 3.71 (95% CI: 1.315, 10.469) on lag 0-6 days, respectively. Both high and low ATs were associated with increased risk of acute cardiac events and ACS admissions. STEMI admissions may be more sensitive to high AT while NSTE-ACS to low AT.
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Affiliation(s)
- Na Li
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Fangjing Liu
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
| | - Yan Zhang
- Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China
| | - Pengkun Ma
- Institute of Urban Meteorology, Chinese Meteorological Administration, Beijing, China
| | - Yinzi Jin
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China. .,Institute for Global Health and Development, Peking University, Beijing, China.
| | - Zhi-Jie Zheng
- Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,Institute for Global Health and Development, Peking University, Beijing, China
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Rowland ST, Parks RM, Boehme AK, Goldsmith J, Rush J, Just AC, Kioumourtzoglou MA. The association between ambient temperature variability and myocardial infarction in a New York-State-based case-crossover study: An examination of different variability metrics. ENVIRONMENTAL RESEARCH 2021; 197:111207. [PMID: 33932478 PMCID: PMC8609500 DOI: 10.1016/j.envres.2021.111207] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Short-term temperature variability has been consistently associated with mortality, with limited evidence for cardiovascular outcomes. Previous studies have used multiple metrics to measure temperature variability; however, those metrics do not capture hour-to-hour changes in temperature. OBJECTIVES We assessed the correlation between sub-daily temperature-change-over-time metrics and previously-used metrics, and estimated associations with myocardial infarction (MI) hospitalizations. METHODS Hour-to-hour change-over-time was measured via three metrics: 24-hr mean absolute hourly first difference, 24-hr maximum absolute hourly first difference, and 24-hr mean hourly first difference. We first assessed the Spearman correlations between these metrics and four previously-used metrics (24-hr standard deviation of hourly temperature, 24-hr diurnal temperature range, 48-hr standard deviation of daily minimal and maximal temperatures, and 48-hr difference of daily mean temperature), using hourly data from the North America Land Data Assimilation System-2 Model. Subsequently, we estimated the association between these metrics and primary MI hospitalization in adult residents of New York State for 2000-2015 using a time-stratified case-crossover design. RESULTS The hour-to-hour change-over-time metrics were correlated, but not synonymous, with previously-used metrics. We observed 809,259 MI, 45% of which were among females and the mean (standard deviation) age was 70 (15). An increase from mean to 90th percentile in mean absolute first difference of temperature was associated with a 2.04% (95% Confidence Interval [CI]: 1.30-2.78%) increase in MI rate. An increase from mean to 90th percentile in mean first difference also yielded a positive association (1.86%; 95%CI: 1.09-2.64%). We observed smaller- or similar-in-magnitude positive associations for previously-used metrics. DISCUSSION First, short-term hour-to-hour temperature change was positively associated with MI risk. Second, all other variability metrics yielded positive associations with MI, with varying magnitude. In future research on temperature variability, researchers should define their research question, including which aspects of variability they intend to measure, and apply the appropriate metric. ALTERNATIVE All metrics of temperature variability, including short-term hour-to-hour temperature changes, were positively associated with MI risk, though the magnitude of effect estimates varied by metric.
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Affiliation(s)
- Sebastian T Rowland
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Robbie M Parks
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Amelia K Boehme
- Departments of Neurology, Columbia University Medical School and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Jeff Goldsmith
- Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Johnathan Rush
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Rowland ST, Boehme AK, Rush J, Just AC, Kioumourtzoglou MA. Can ultra short-term changes in ambient temperature trigger myocardial infarction? ENVIRONMENT INTERNATIONAL 2020; 143:105910. [PMID: 32622116 PMCID: PMC7708404 DOI: 10.1016/j.envint.2020.105910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/01/2020] [Accepted: 06/17/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND Climate change is increasing global average temperatures, as well as the frequency of extreme weather events. Both low and high ambient temperatures have been associated with elevated mortality; however, little is known about the cardiovascular impacts of hourly temperature. METHODS We assessed the association between hourly ambient temperature and risk of myocardial infarction (MI) across adult residents of New York State (NYS). We identified cases across NYS hospitals from 2000 to 2015 in the New York Department of Health Statewide Planning and Research Cooperative System dataset, using ICD codes. Hourly ambient temperature was assessed at each patient's residential ZIP code, up to 48 hours prior to MI. We employed a time-stratified case-crossover study design matching case to control periods on hour of day, day of week, month and year. RESULTS Of the 791,695 primary MI hospital admissions, 45% were female, the mean (standard deviation; SD) age was 70 (15) years, and 49% of cases occurred among New York City residents. The observed temperature range was -29 °C to 39 °C, with a mean of 10.8 °C (10.5 °C). Temperature in the 6 h preceding the MI was positively associated with risk of MI, across the range of observed temperatures, with null or nearly null associations for earlier hours. We estimated a cumulative percent increase in hourly myocardial infarction rate of 7.9% (95% confidence interval [CI]: 5.2%, 10.6%) for an 11 °C (median) to 27 °C (95th percentile) temperature increase for lag hours 0-5. Men, Medicare-ineligible individuals (age < 65), and those experiencing their first MI were most sensitive. CONCLUSION Our study provides evidence that increases in hourly ambient temperature can trigger myocardial infarction. Health-based definitions of extreme heat events may better capture the deleterious effects of heat by accounting for hourly temperature. Our findings can inform the design of more effective preparedness strategies for the increasingly frequent extreme heat events.
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Affiliation(s)
- Sebastian T Rowland
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States.
| | - Amelia K Boehme
- Departments of Neurology, Columbia University Medical School and Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Johnathan Rush
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
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Drought, Climate Change, and Dryland Wheat Yield Response: An Econometric Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145264. [PMID: 32708323 PMCID: PMC7399810 DOI: 10.3390/ijerph17145264] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 11/17/2022]
Abstract
Agriculture has been identified as one of the most vulnerable sectors affected by climate change. In the present study, we investigate the impact of climatic change on dryland wheat yield in the northwest of Iran for the future time horizon of 2041-2070. The Just and Pope production function is applied to assess the impact of climate change on dryland wheat yield and yield risk for the period of 1991-2016. The Statistical Downscaling Model (SDSM) is used to generate climate parameters from General Circulation Model (GCM) outputs. The results show that minimum temperature is negatively related to average yield in the linear model while the relationship is positive in the non-linear model. An increase in precipitation increases the mean yield in either model. The maximum temperature has a positive effect on the mean yield in the linear model, while this impact is negative in the non-linear model. Drought has an adverse impact on yield levels in both models. The results also indicate that maximum temperature, precipitation, and drought are positively related to yield variability, but minimum temperature is negatively associated with yield variability. The findings also reveal that yield variability is expected to increase in response to future climate scenarios. Given these impacts of temperature on rain-fed wheat crop and its increasing vulnerability to climatic change, policy-makers should support research into and development of wheat varieties that are resistant to temperature variations.
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Chen D, Mayvaneh F, Baaghideh M, Entezari A, Ho HC, Xiang Q, Jiao A, Zhang F, Hu K, Chen G, Zhao Q, Sun S, Zhang Y. Utilizing daily excessive concentration hours to estimate cardiovascular mortality and years of life lost attributable to fine particulate matter in Tehran, Iran. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 703:134909. [PMID: 31757557 DOI: 10.1016/j.scitotenv.2019.134909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/22/2019] [Accepted: 10/08/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Evidence for associations between fine particulate matter (PM2.5) and cardiovascular diseases (CVDs) in Iran is scarce. Given large within-day variations of PM2.5 concentration, using the daily mean of PM2.5 (PM2.5mean) as exposure metric might bias the health-related assessment. This study applied a novel indicator, daily excessive concentration hours (DECH), to evaluate the effect of ambient PM2.5 on CVD mortality and years of life lost (YLL) in Tehran, the capital city of Iran. METHODS Hourly concentration data for PM2.5, daily information for meteorology and records of registered cardiovascular deaths from 2012 to 2016 were obtained from Tehran, Iran. Daily excessive concentration hours of PM2.5 (PM2.5DECH) was defined as daily total concentration-hours exceeding 35 μg/m3. Using a time-series design, we applied generalized linear models to assess the attributable effects of PM2.5DECH and PM2.5mean on CVD mortality and YLL. RESULTS For an interquartile range (IQR) rise in PM2.5DECH, total CVD mortality at lag 0-10 days and YLL at lag 0-8 days increased 2.26% (95% confidence interval (CI): 0.85-3.69%) and 23.24 (6.07-40.42) person years, respectively. Corresponding increases were 3.45% (1.44-5.49%) and 35.21 (10.85-59.58) person years for an IQR rise in PM2.5mean. Significant associations between PM2.5 pollution (i.e., PM2.5mean and PM2.5DECH) and cause-specific cardiovascular health (i.e., mortality and YLL) were only identified in stroke. Subgroup analyses showed that male and people aged 0-64 years suffered more from PM2.5 pollution. Furthermore, we attributed a greater CVD burden to PM2.5DECH (1.67% for mortality and 2.67% for YLL) than PM2.5mean (0.63% for mortality and 0.70% for YLL) during the study period. CONCLUSIONS This study strengthened the evidence for the aggravated CVD mortality burden associated with short-term exposure to PM2.5. Our findings also suggested that PM2.5DECH might be a potential alternative indicator of exposure assessment in PM2.5-related health investigations.
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Affiliation(s)
- Dieyi Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Mohammad Baaghideh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Anqi Jiao
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Faxue Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Kejia Hu
- Department of Precision Health and Data Science, School of Public Health, Zhejiang University, Hangzhou 310003, China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China.
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15
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Upadhyay RK. Markers for Global Climate Change and Its Impact on Social, Biological and Ecological Systems: A Review. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/ajcc.2020.93012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Gholampour R, Darand M, Halabian AH. Impacts of cold and hot temperatures on mortality rate in Isfahan, Iran. J Therm Biol 2019; 86:102453. [DOI: 10.1016/j.jtherbio.2019.102453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/23/2019] [Accepted: 10/31/2019] [Indexed: 12/16/2022]
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Thu Dang TA, Wraith D, Bambrick H, Dung N, Truc TT, Tong S, Naish S, Dunne MP. Short - term effects of temperature on hospital admissions for acute myocardial infarction: A comparison between two neighboring climate zones in Vietnam. ENVIRONMENTAL RESEARCH 2019; 175:167-177. [PMID: 31128426 DOI: 10.1016/j.envres.2019.04.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/22/2019] [Accepted: 04/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Vietnam is one of the countries most affected by climate change, but few studies have focused on the population health effects of climate variation. Extreme heatwaves and cold spells might exacerbate underlying chronic conditions and precipitate hospitalization or early death. This study examined the short-term effects of ambient temperature extremes on hospital admissions (HAs) due to acute myocardial infarction (AMI) between different climate zones in the Central Coast region of Vietnam. METHODS Information from medical records of all 3328 cases of AMI HAs (with hospital records cross-checked by clinicians) was collected from three hospitals in the South-Central Coast region (tropical savanna climate) and North-Central Coast region (tropical monsoon climate) for the period 2008-2015. Meteorological data were obtained from the National Hydro-Meteorological and Environment Network Centre. We used distributed lag non-linear models to assess the association between daily average temperature and AMI HAs, accounting for long-term trend and other meteorological variables. RESULTS We found a negative and significant association between AMI HAs and temperature in the North-Central Coast region while conversely there was a positive and significant association in the South-Central Coast region. In the North-Central Coast region, the risk of AMI HAs increased by 11% (Relative risk (RR): 1.11, 95% CI: 0.91-1.35, p > 0.05) at moderately low temperatures (10th percentile of temperature range - 18.5 °C) and increased by 25% (RR: 1.25, 95% CI: 1.02-1.55, p < 0.05) at extremely low temperatures (5th percentile of temperature range - 16.8 °C). In the South-Central Coast region, the risk of AMI HAs increased by 18% (RR: 1.18, 95% CI: 0.95-1.47, p > 0.05) and 36% (RR: 1.36, 95% CI: 1.06-1.73, p < 0.05) at moderately high temperatures (90th percentile of temperature range -29.5 °C) and extreme high temperatures (95th percentile of temperature range - 29.9 °C), respectively. CONCLUSIONS Risk of AMI is associated with extremely high and extremely low temperature in Vietnam and the risk varies in relation to the local regional climate. Public health preparedness and multi-level interventions should attempt to reduce people's exposure in periods of disadvantageous temperatures.
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Affiliation(s)
- Thi Anh Thu Dang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
| | - Darren Wraith
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nguyen Dung
- People's Committee of Thua Thien Hue Province, Hue City, Thua Thien Hue, Viet Nam
| | - Thai Thanh Truc
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Department of Training and Scientific Research, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia; Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Anhui Medical University, Hefei, China
| | - Sue Naish
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael P Dunne
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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