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Khan L, Kawano T, Hutton J, Asamoah-Boaheng M, Scheuermeyer FX, Christian M, Baranowski L, Barbic D, Christenson J, Grunau B. The association of extreme environmental heat with incidence and outcomes of out-of-hospital cardiac arrest in British Columbia: A time series analysis. Resusc Plus 2024; 17:100560. [PMID: 38328748 PMCID: PMC10847945 DOI: 10.1016/j.resplu.2024.100560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 02/09/2024] Open
Abstract
Background The impact of extreme heat on out-of-hospital cardiac arrest (OHCA) incidence and outcomes is under-studied. We investigated OHCA incidence and outcomes over increasing temperatures. Methods We included non-traumatic EMS (Emergency Medical Services)-assessed OHCAs in British Columbia during the warm seasons of 2020-2021. We fit a time-series quasi-Poisson generalized linear model to estimate the association between temperature and incidence of both EMS-assessed, EMS-treated, and EMS-untreated OHCAs. Second, we employed a logistic regression model to estimate the association between "heatwave" periods (defined as a daily mean temperature > 99th percentile for ≥ 2 consecutive days, plus 3 lag days) with survival and favourable neurological outcomes (cerebral performance category ≤ 2) at hospital discharge. Results Of 5478 EMS-assessed OHCAs, 2833 were EMS-treated. OHCA incidence increased with increasing temperatures, especially exceeding a daily mean temperature of 25 °C Compared to the median daily mean temperature (16.9 °C), the risk of EMS-assessed (relative risk [RR] 3.7; 95%CI 3.0-4.6), EMS-treated (RR 2.9; 95%CI 2.2-3.9), and EMS-untreated (RR 4.3; 95%CI 3.2-5.7) OHCA incidence were higher during days with a temperature over the 99th percentile. Of EMS-treated OHCAs, during the heatwave (n = 179) and non-heatwave (n = 2654) periods, 4 (2.2%) and 270 (10%) survived and 4 (2.2%) and 241 (9.2%) had favourable neurological outcomes, respectively. Heatwave period OHCAs had decreased odds of survival (adjusted OR 0.28; 95%CI 0.10-0.79) and favourable neurological outcome (adjusted OR 0.31; 95%CI 0.11-0.89) at hospital discharge, compared to other periods. Conclusion Extreme heat was associated with a higher incidence of OHCA, and lower odds of survival and favourable neurological status at hospital discharge.
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Affiliation(s)
- Laiba Khan
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- Faculty of Science, University of British Columbia, British Columbia, Canada
| | - Takahisa Kawano
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- Department of Emergency Medicine, University of Fukui Hospital, Fukui Prefecture, Japan
| | - Jacob Hutton
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- British Columbia Emergency Health Services, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
| | - Michael Asamoah-Boaheng
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
- Department of Emergency Medicine. St. Paul’s Hospital, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
| | - Frank X. Scheuermeyer
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
- Department of Emergency Medicine. St. Paul’s Hospital, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
| | - Michael Christian
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- British Columbia Emergency Health Services, British Columbia, Canada
- Division of Critical Care Medicine, University of British Columbia, British Columbia, Canada
| | - Leon Baranowski
- British Columbia Emergency Health Services, British Columbia, Canada
| | - David Barbic
- Department of Emergency Medicine, University of British Columbia, Canada
- Department of Emergency Medicine. St. Paul’s Hospital, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
| | - Jim Christenson
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
- Department of Emergency Medicine. St. Paul’s Hospital, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
| | - Brian Grunau
- British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- British Columbia Emergency Health Services, British Columbia, Canada
- Department of Emergency Medicine, University of British Columbia, Canada
- Department of Emergency Medicine. St. Paul’s Hospital, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
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Kim S, Byun G, Lee JT. Association between non-optimal temperature and cardiovascular hospitalization and its temporal variation at the intersection of disability. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166874. [PMID: 37683874 DOI: 10.1016/j.scitotenv.2023.166874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND While previous research has identified populations susceptible to non-optimal temperatures, disability has been largely overlooked. Given the growing number of persons with disabilities (PwD) and their social and health disadvantages, understanding how disability intersects with temperature-related health effects is crucial. This study aimed to investigate the associations between non-optimal temperatures and cardiovascular disease (CVD) hospitalization and examine how these associations vary over time considering the existence of disability. METHODS We used the National Health Insurance Service-National Sample Cohort to investigate the association between non-optimal temperatures and CVD hospitalization in South Korea, 2002-2019. We obtained daily mean temperature from the Korea Meteorological Administration's automated synoptic observing system. We applied a space-time-stratified case-crossover design using a conditional quasi-Poisson regression with a distributed lag non-linear model, adjusting for relative humidity, wind speed, and public holidays. We examined temporal variations in temperature-CVD hospitalization associations using a time window approach. All analyses used the minimum hospitalization temperature (20.0 °C) as reference and were stratified by disability status. RESULTS The cumulative exposure-response curve in persons without disabilities showed a J-shape with a relative risk (RR) of 1.07 (95 % confidence interval [CI]: 0.99, 1.15) at extreme heat (99th percentile) and 1.09 (95 % CI: 0.97, 1.23) at extreme cold (1st percentile). The cumulative exposure-response curve in PwD showed an M-shape with the highest RR at chill (1.22 [95 % CI: 1.13, 1.32]) and moderate cold temperature (1.11 [95 % CI: 1.01, 1.21]), defined as the 30th and 5th percentiles, respectively. The impacts of heat and cold decreased over time for persons without disabilities but increased for PwD. CONCLUSIONS Our study found differential temperature-related impacts on CVD hospitalization based on disability status, and PwD were maladapted to heat and cold over time. This suggests the importance of considering disability when investigating temperature-related health disparity and adopting disability-inclusive adaptation strategies.
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Affiliation(s)
- Sera Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea; School of the Environment, Yale University, New Haven, CT 06511, USA
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea; School of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea.
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Du Y, Jing M, Lu C, Zong J, Wang L, Wang Q. Global Population Exposure to Extreme Temperatures and Disease Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13288. [PMID: 36293869 PMCID: PMC9603138 DOI: 10.3390/ijerph192013288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The frequency and duration of extreme temperature events continues to increase worldwide. However, the scale of population exposure and its quantitative relationship with health risks remains unknown on a global scale, limiting our ability to identify policy priorities in response to climate change. Based on data from 171 countries between 2010 and 2019, this study estimated the exposure of vulnerable populations to extreme temperatures, and their contemporary and lag associations with disease burden attributed to non-optimal temperatures. Fixed-effects models and dynamic panel models were applied. Increased vulnerable population exposure to extreme temperatures had adverse contemporary effects on the burden of disease attributed to non-optimal temperature. Health risks stemming from extreme cold could accumulate to a greater extent, exhibiting a larger lag effect. Population exposure to extreme cold was mainly distributed in high-income countries, while extreme heat occurred more in low-income and middle-income countries. However, the association between population exposure to extreme cold and burden of disease was much stronger in low-income and middle-income countries than in high-income countries, whereas the effect size of population exposure to extreme heat was similar. Our study highlighted that differential strategies should be determined and implemented according to the characteristics in different countries.
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Affiliation(s)
- Yajie Du
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Ming Jing
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Science), Jinan 250353, China
| | - Chunyu Lu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Jingru Zong
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Lingli Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Qing Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
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Shashar S, Kloog I, Erez O, Shtein A, Yitshak-Sade M, Sarov B, Novack L. Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome. PLoS One 2020; 15:e0232877. [PMID: 32421729 PMCID: PMC7234374 DOI: 10.1371/journal.pone.0232877] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/22/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temperature values were obtained from a spatiotemporally resolved estimation model performing predictions at a 1×1km spatial resolution. In "Warm" pregnancies >50% of gestation occurred during the spring-summer period. In cold pregnancies >50% of gestation occurred during the fall and winter. Generalized estimating equation multivariable models were used to estimate the association between temperature and incidence of preeclampsia. RESULTS 1) The incidence of preeclampsia in at least one pregnancy was 7% (2173/64,566); 2) during "warm" pregnancies, an elevation of one IQR of the average temperature in the 1st or the 3rd trimesters was associated with an increased risk to develop preeclampsia [patients with Jewish ethnicity: 1st trimester: relative risk (RR) of 2.38(95%CI 1.50; 3.80), 3rd trimester 1.94(95%CI 1.34;2.81); Bedouins: 1st trimester: RR = 2.91(95%CI 1.98;4.28), 3rd trimester: RR = 2.37(95%CI 1.75;3.20)]; 3) In "cold" pregnancies, an elevation of one IQR of average temperature was associated with a lower risk to develop preeclampsia among patients with Bedouin-Arab ethnicity RR = 0.68 (95% CI 0.49-0.94) for 1st trimester and RR = 0.62 (95% CI 0.44-0.87) for 3rd trimester. CONCLUSIONS 1) Elevated averaged temperature during the 1st or 3rd trimesters in "warm" pregnancies confer an increased risk for the development of preeclampsia, especially in nomadic patients; 2) Of interest, during cold pregnancies, elevated averaged temperature was associated with a lower risk to develop preeclampsia for nomadic patients. 3) These findings suggest temperature might be associated with perturbations in maternal heat homeostasis resulting in reallocation of energy resources and their availability to the fetus that may increase the risk for preeclampsia. This observation is especially relevant in the context of global warming and its effects on maternal/fetal reproductive health.
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Affiliation(s)
- Sagi Shashar
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben Gurion University, Beersheba, Israel
| | - Offer Erez
- Division of Obstetrics and Gynecology, Maternity Department "D", Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Alexandra Shtein
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben Gurion University, Beersheba, Israel
| | - Maayan Yitshak-Sade
- Department of Environmental Health Exposure, Epidemiology, and Risk Program Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Batia Sarov
- Department of Public Health, Faculty of Heath Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
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Urban A, Kyselý J, Plavcová E, Hanzlíková H, Štěpánek P. Temporal changes in years of life lost associated with heat waves in the Czech Republic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:137093. [PMID: 32044496 DOI: 10.1016/j.scitotenv.2020.137093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/09/2020] [Accepted: 02/01/2020] [Indexed: 06/10/2023]
Abstract
Seniors constitute the population group generally most at risk of mortality due to heat stress. As life expectancy increases and health conditions of elderly people improve over time, vulnerability of the population to heat changes as well. We employed the years-of-life-lost (YLL) approach, considering life expectancy at the time of each death, to investigate how population ageing affects temporal changes in heat-related mortality in the Czech Republic. Using an updated gridded meteorological database, we identified heat waves during 1994-2017, and analysed temporal changes in their impacts on YLL and mortality. The mean impact of a heat-wave day on relative excess mortality and YLL had declined by approximately 2-3% per decade. That decline abated in the current decade, however, and the decreasing trend in mean excess mortality as well as YLL vanished when the short-term mortality displacement effect was considered. Moreover, the cumulative number of excess deaths and YLL during heat waves rose due to increasing frequency and intensity of heat waves during the examined period. The results show that in studies of temporal changes it is important to differentiate between mean effects of heat waves on mortality and the overall death burden associated with heat waves. Analysis of the average ratio of excess YLL/death per heat-wave day indicated that the major heat-vulnerable population group shifted towards older age (70+ years among males and 75+ years among females). Our findings highlight the importance of focusing heat-protection measures especially upon the elderly population, which is most heat-vulnerable and whose numbers are rising.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Jan Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Global Change Research Institute of the Czech Academy of Sciences, Brno, Czech Republic
| | - Eva Plavcová
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Hana Hanzlíková
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Geophysics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Petr Štěpánek
- Global Change Research Institute of the Czech Academy of Sciences, Brno, Czech Republic; Institute of Geophysics of the Czech Academy of Sciences, Prague, Czech Republic; Czech Hydrometeorological Institute, Regional Office Brno, Brno, Czech Republic
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Park J, Chae Y, Choi SH. Analysis of Mortality Change Rate from Temperature in Summer by Age, Occupation, Household Type, and Chronic Diseases in 229 Korean Municipalities from 2007⁻2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091561. [PMID: 31060210 PMCID: PMC6539054 DOI: 10.3390/ijerph16091561] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/24/2019] [Accepted: 04/28/2019] [Indexed: 01/05/2023]
Abstract
This study analyzed mortality change rate (MCR: daily change rate of mortality at a given temperature per average summer mortality) for 229 municipalities in Korea considering age, occupation, household type, chronic diseases, and regional temperature distribution. We found that the MCR for heat wave differs depending on socioeconomic factors and the temperature distribution in the region. The MCRs for the elderly (≥65 years of age), outdoor workers, one-person households, and chronic disease patients start to increase at lower temperatures and react more sensitively to temperature than others. For the socioeconomic factors considered in this study, occupation was found to be the most significant factor for the MCR differences (outdoor workers 1.17 and others 1.10 above 35 °C, p < 0.01). The MCRs of elderly outdoor workers increased consistently with temperature, while the MCRs of younger outdoor workers decreased at 33 °C, the heat wave warning level in Korea. The MCRs in lower temperature regions start to increase at 28 °C, whereas the MCRs start to increase at 30 °C in higher temperature regions. The results of this study suggest that heat wave policies should be based on contextualized impacts considering age, occupation, household type, chronic disease, and regional temperature distribution.
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Affiliation(s)
- Jongchul Park
- Korea Environment Institute, 370 Sicheong-daero, Sejong 30147, Korea.
| | - Yeora Chae
- Korea Environment Institute, 370 Sicheong-daero, Sejong 30147, Korea.
| | - Seo Hyung Choi
- Korea Environment Institute, 370 Sicheong-daero, Sejong 30147, Korea.
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Kim H, Kim H, Byun G, Choi Y, Song H, Lee JT. Difference in temporal variation of temperature-related mortality risk in seven major South Korean cities spanning 1998-2013. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 656:986-996. [PMID: 30625685 DOI: 10.1016/j.scitotenv.2018.11.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
Temporal variation of temperature-related mortality risk is an important issue in climate change era. However, difference in this temporal variation across cities in South Korea remains unclear. The aim of this study was to explore whether temporal variation might differ spatially across seven metropolitan cities of Korea during the period of 1998-2013. We estimated cumulative associations between temperature (up to previous 14 days of exposure) and all-cause mortality, and compared cumulative associations between the first eight years (1998-2005) and the last eight years (2006-2013). Multivariate meta-regression analysis was performed to investigate what factors might be associated with spatial and temporal variation in cumulative associations. We found that Busan, Daegu, and Gwangju experienced decrease in heat effect from 1998-2005 to 2006-2013, while Incheon experienced increase in heat effect. By comparing mortality risk at 99th percentile of temperature to mortality risk at minimum mortality temperature, percentage increase of mortality risk changed from 4.8% (95% CI: -1.3, 11.3) to 0.4% (95% CI: -6.0, 7.4) in Busan, from 17.2% (95% CI: 10.2, 24.7) to 4.0% (95% CI: -1.4, 9.8) in Daegu, from 20.3% (95% CI: 11.5, 29.7) to 2.2% (95% CI: -3.5, 8.3) in Gwangju, and from 3.5% (95% CI: 0.2, 6.8) to 7.9% (95% CI: 5.0, 10.9) in Incheon, respectively. Change in average temperature from 1998-2005 to 2006-2013 was negatively associated with change in heat effect even though average temperature in most of the cities fluctuated over time. We also found that all seven cities had decrease in effect of moderate cold temperature from 1998-2005 to 2006-2013. Such decrease was associated with improvement in medical resources. Results of this study suggest that plans for adaptation to temperature-related risks should differ across populations because adaptation to temperature varies across populations and within the same population over different time.
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Affiliation(s)
- Honghyok Kim
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Hyomi Kim
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Garam Byun
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Yongsoo Choi
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Hyeonjin Song
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Jong-Tae Lee
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea; Department of Environmental Health, Korea University, Seoul, Republic of Korea; School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
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Choi Y, Kim H, Lee JT. Temporal variability of short term effects of PM 10 on mortality in Seoul, Korea. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 644:122-128. [PMID: 29981511 DOI: 10.1016/j.scitotenv.2018.06.275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/25/2018] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
Health effects of PM10 on mortality have been studies worldwide. However, not many studies have questioned possibility that short-term effects of PM10 can be changed over time. Identifying temporal variability of the effects would be of help to getting more valid PM10 effect estimates which are a major basis for public health policies. In this study, temporal variability of short-term effects of PM10 for mortality was investigated from 2001 to 2015 in Seoul, Korea. A time series analysis was used to estimate the effects of PM10 on all-cause, circulatory, and respiratory mortality. Study period was divided into five years of moving time window, and relative risks and its 95% confidence intervals were estimated using distributed lag model for each time window. The annual average of PM10 in Seoul decreased from 52.6 μg/m3 in 2001 to 40.5 μg/m3 in 2015. There were significant temporal trends in PM10 effects regarding each mortality. The effects of PM10 tend to slightly increase in early of the study period and then dropped in recent years. An increase of 2 days of cumulative exposure of PM10 was associated with 0.31% (95% confidence interval: 0.15, 0.46) increase in all-cause mortality for 2001-2005 period, 0.61% (95% confidence interval: 0.34, 0.89) increase in 2005-2009 period, and -0.06% (95% confidence interval: -0.38, 0.25) increase in 2011-2015 period. We found evidence that short-term effects of PM10 on mortality have been changed over time in Seoul, Korea. The observed temporal trend might attributable from two factors which are change of PM10 compositions and population vulnerability. If effects of PM10 vary over time, considering its change would be necessary not only in the estimation of the PM10 effect but also its application for a variety of public health policies.
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Affiliation(s)
- Yongsoo Choi
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Honghyok Kim
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.
| | - Jong-Tae Lee
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea; School of Health Policy and Management, College of Health Science, Korea University, Republic of Korea.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Naddafi K, Yekaninejad MS. The Effects of Apparent Temperature on Cardiovascular Mortality Using a Distributed Lag Nonlinear Model Analysis: 2005 to 2014. Asia Pac J Public Health 2018; 30:361-368. [PMID: 29671331 DOI: 10.1177/1010539518768036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relationship between apparent temperature and cardiovascular disease (CVD) mortality was studied in Rasht, Iran, from 2005 to 2014. The effects of apparent temperature on CVD mortality were investigated using the distributed lag nonlinear model. Data on all types of cardiovascular mortality cases according to the International Classification of Diseases were collected from the only cardiovascular hospital in Rasht, and the meteorological variables were obtained from Rasht Meteorological Center during the period of study. Our findings showed that low temperatures had significant impacts on CVD mortality, and a reverse J-shaped temperature-mortality relationship was found. Moreover, immediate effects of hot temperatures on CVD mortality with the strongest effects on the same day but delayed effects of cold temperature was observed. This study showed that exposure to both hot and cold apparent temperatures was associated with increased cardiovascular mortality in Rasht.
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- 1 Guilan University of Medical Sciences, Rasht, Iran.,2 Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- 2 Tehran University of Medical Sciences, Tehran, Iran.,3 Harvard Humanitarian Initiative, Cambridge, MA, USA
| | | | - Kazem Naddafi
- 2 Tehran University of Medical Sciences, Tehran, Iran
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Keshtkar A, Naddafi K, Yekaninejad MS. Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis. PeerJ 2017; 5:e3574. [PMID: 28791197 PMCID: PMC5546177 DOI: 10.7717/peerj.3574] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. RESULT After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]). CONCLUSION Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Harvard Humanitarian Initiative, Harvard University, Cambridge, United States of America
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Choi G, Bae HJ, Lim YH. Estimation of abnormal temperature effects on elderly mortality in South Korea using the temperature deviation index. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1291-1298. [PMID: 28229222 DOI: 10.1007/s00484-017-1307-3] [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: 10/18/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 06/06/2023]
Abstract
Recent studies have revealed that the effect of temperature on mortality has changed over time. One of the major contributors to the changes is adaptation. We aimed to understand the relationship between elderly mortality and temperature anomaly using the temperature deviation index (TDI), which considers exposure history. Summertime (May to September) mortality data from 1996 to 2014 and meteorological data from 1971 to 2014 were obtained for 16 regions covering South Korea. The TDI was defined as the target day's temperature abnormality compared to previous 25 years' apparent temperature (AT). The relationship between the TDI and elderly mortality for each region was examined by generalized linear modeling with Poisson distribution. Pooled estimates were computed to yield a national effect estimate. Stratified analyses were performed using the percentiles of AT and TDI. Most regions showed positive linear associations, and the associations ranged from 0.4 to 4.3% increase per unit increase of the TDI. In the pooled analyses, a unit increase of the TDI was associated with a 1.4% increase (95% confidence interval [CI] 0.93-1.87) in elderly mortality. In the stratified analysis, the relationship between the TDI and elderly mortality was significant at or above the 75th percentile of AT (1.32% increase; 95% CI 0.47-2.22). We suggest a positive association between the TDI and elderly mortality in South Korea. The association observed particularly in the highest percentile of AT in the stratified analysis suggests independent effects of temperature anomaly in addition to those of absolute AT.
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Affiliation(s)
- Giehae Choi
- Department of Epidemiology, University of North Carolina, Chapel hill, NC, USA
| | - Hyun-Joo Bae
- Korea Environment Institute, Sejong, Republic of Korea
| | - Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehakro, Jongno-Gu, Seoul, 110-799, Republic of Korea.
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kim H, Kim H, Park YH, Lee JT. Assessment of temporal variation for the risk of particulate matters on asthma hospitalization. ENVIRONMENTAL RESEARCH 2017; 156:542-550. [PMID: 28432994 DOI: 10.1016/j.envres.2017.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 06/07/2023]
Abstract
Increased ambient concentration of particulate matters are considered as one of major causes for increased prevalence or exacerbation of asthma or asthma like symptoms. Recently, possible temporal variation in risks of PM on mortality has been suggested. We investigated short-term effect of both PM10 and PM2.5 on asthma hospitalization, and assessed temporal variation of PM risks in Seoul, Korea, 2003-2011. Generalized additive model was used to estimate PM risks on asthma hospitalization with consideration by long-term trend, influenza epidemic, day of week, meteorological factors. To assess temporal variation of PM risks, year-round PM risks were estimated. Stratified analysis by season and age-group were also conducted. Estimated RRs of PM on asthma hospitalization by an increase of 10㎍/㎥were 1.0084 (95% CI: 1.0041-1.0127) and 1.0156 (95% CI: 1.0055-1.0259) respectively with 7-days lag periods (lag06). PM2.5 had stronger effect than PM10 for all age group. Elderly group was most affected by PM. For the analysis of temporal variation of PM risks, we found increasing trend in total population and the elderly group. In the season-specific analysis, we also found increasing trend in winter for PM10, and in spring for PM2.5. PM10 and PM2.5 has adverse effect on asthma hospitalization with evidence suggesting temporal variation in PM risks. Further research will be needed to confirm the temporal variation of PM risk on asthma hospitalization, and to identify casual factors affecting this temporal variation. This study results could be evidentiary materials for establishing valid public health policies to reduce health burden or economic burden of asthma.
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Affiliation(s)
- Hyomi Kim
- BK21PLUS Program in 'Embodiment: Health -Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.
| | - Honghyok Kim
- BK21PLUS Program in 'Embodiment: Health -Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.
| | - Yoon-Hyung Park
- College of Medicine Soonchunhyung University, Chunan, Republic of Korea.
| | - Jong-Tae Lee
- BK21PLUS Program in 'Embodiment: Health -Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea; Department of Environmental Health, Korea University, Seoul, Republic of Korea; School of Health Policy and Management, Collage of Health Science, Korea University, Republic of Korea.
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Onozuka D, Hagihara A. Spatiotemporal variation in heat-related out-of-hospital cardiac arrest during the summer in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 583:401-407. [PMID: 28117163 DOI: 10.1016/j.scitotenv.2017.01.081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/13/2017] [Accepted: 01/13/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although several studies have reported the impacts of extremely high temperature on cardiovascular diseases, few studies have investigated the spatiotemporal variation in the incidence of out-of-hospital cardiac arrest (OHCA) due to extremely high temperature in Japan. METHODS Daily OHCA data from 2005 to 2014 were acquired from all 47 prefectures of Japan. We used time-series Poisson regression analysis combined with a distributed lag non-linear model to assess the temporal variability in the effects of extremely high temperature on OHCA incidence in each prefecture, adjusted for time trends. Spatial variability in the relationships between extremely high temperature and OHCA between prefectures was estimated using a multivariate random-effects meta-analysis. RESULTS We analyzed 166,496 OHCA cases of presumed cardiac origin occurring during the summer (June to September) that met the inclusion criteria. The minimum morbidity percentile (MMP) was the 51st percentile of temperature during the summer in Japan. The overall cumulative relative risk at the 99th percentile vs. the MMP over lags 0-10days was 1.21 (95% CI: 1.12-1.31). There was also a strong low temperature effect during the summer periods. No substantial difference in spatial or temporal variability was observed over the study period. CONCLUSIONS Our study demonstrated spatiotemporal homogeneity in the risk of OHCA during periods of extremely high temperature between 2005 and 2014 in Japan. Our findings suggest that public health strategies for OHCA due to extremely high temperatures should be finely adjusted and should particularly account for the unchanging risk during the summer.
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Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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Onozuka D, Hagihara A. Within-summer variation in out-of-hospital cardiac arrest due to extremely long sunshine duration. Int J Cardiol 2017; 231:120-124. [DOI: 10.1016/j.ijcard.2016.12.179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022]
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English PB, Richardson MJ. Components of Population Vulnerability and Their Relationship With Climate-Sensitive Health Threats. Curr Environ Health Rep 2016; 3:91-8. [PMID: 26800675 DOI: 10.1007/s40572-016-0076-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Climate change is increasingly being framed as risks that will impact the poorest and most vulnerable communities among us. This has led to more efforts to estimate climate change risks across populations and in the context of human health and health equity. We describe the public health dimensions of climate vulnerability-exposure, population sensitivity, and adaptive capacity-and explore how these dimensions can modify population health impacts and their distribution. An overview of health disparities associated with specific climate risks is presented, and we offer potential solutions grounded in equitable urban development and improved characterization of climate vulnerabilities.
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Affiliation(s)
- P B English
- California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA, 94804, USA.
| | - M J Richardson
- Public Health Institute, 850 Marina Bay Parkway, Richmond, CA, 94804, USA
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Hess JJ, Ebi KL. Iterative management of heat early warning systems in a changing climate. Ann N Y Acad Sci 2016; 1382:21-30. [PMID: 27788557 DOI: 10.1111/nyas.13258] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/18/2016] [Accepted: 08/22/2016] [Indexed: 11/26/2022]
Abstract
Extreme heat is a leading weather-related cause of morbidity and mortality, with heat exposure becoming more widespread, frequent, and intense as climates change. The use of heat early warning and response systems (HEWSs) that integrate weather forecasts with risk assessment, communication, and reduction activities is increasingly widespread. HEWSs are frequently touted as an adaptation to climate change, but little attention has been paid to the question of how best to ensure effectiveness of HEWSs as climates change further. In this paper, we discuss findings showing that HEWSs satisfy the tenets of an intervention that facilitates adaptation, but climate change poses challenges infrequently addressed in heat action plans, particularly changes in the onset, duration, and intensity of dangerously warm temperatures, and changes over time in the relationships between temperature and health outcomes. Iterative management should be central to a HEWS, and iteration cycles should be of 5 years or less. Climate change adaptation and implementation science research frameworks can be used to identify HEWS modifications to improve their effectiveness as temperature continues to rise, incorporating scientific insights and new understanding of effective interventions. We conclude that, at a minimum, iterative management activities should involve planned reassessment at least every 5 years of hazard distribution, population-level vulnerability, and HEWS effectiveness.
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Affiliation(s)
- Jeremy J Hess
- Department of Environmental and Occupational Health Sciences, School of Public Health.,Department of Global Health, Schools of Medicine and Public Health.,Division of Emergency Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Kristie L Ebi
- Department of Environmental and Occupational Health Sciences, School of Public Health.,Department of Global Health, Schools of Medicine and Public Health
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Onozuka D, Hagihara A. Spatial and temporal variation in emergency transport during periods of extreme heat in Japan: A nationwide study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 544:220-9. [PMID: 26657368 DOI: 10.1016/j.scitotenv.2015.11.098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/20/2015] [Accepted: 11/20/2015] [Indexed: 05/24/2023]
Abstract
BACKGROUND Several studies have reported the burden of climate change on extreme heat-related mortality or morbidity. However, few studies have investigated the spatial and temporal variation in emergency transport during periods of extreme heat on a national scale. METHODS Daily emergency ambulance dispatch data from 2007 to 2010 were acquired from all 47 prefectures of Japan. The temporal variability in the relationship between heat and morbidity in each prefecture was estimated using Poisson regression combined with a distributed lag non-linear model and adjusted for time trends. The spatial variability in the heat-morbidity relationships between prefectures was estimated using a multivariate meta-analysis. RESULTS A total of 5,289,660 emergency transports were reported during the summer months (June through September) within the study period. The overall cumulative relative risk (RR) at the 99th percentile vs. the minimum morbidity percentile was 1.292 (95% CI: 1.251-1.333) for all causes, 1.039 (95% CI: 0.989-1.091) for cardiovascular diseases, and 1.287 (95% CI: 1.210-1.368) for respiratory diseases. Temporal variation in the estimated effects indicated a non-linear relationship, and there were differences in the temporal variations between heat and all-cause and cause-specific morbidity. Spatial variation between prefectures was observed for all causes (Cochran Q test, p<0.001; I(2)=45.8%); however, there was no significant spatial heterogeneity for cardiovascular (Cochran Q test, p=0.054; I(2)=15.1%) and respiratory (Cochran Q test, p=0.681; I(2)=1.0%) diseases. CONCLUSIONS Our nationwide study demonstrated differences in the spatial and temporal variations in the relative risk for all-cause and cause-specific emergency transport during periods of extreme heat in Japan between 2007 and 2010. Our results suggest that public health strategies aimed at controlling heat-related morbidity should be tailored according to region-specific weather conditions.
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Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
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Kim H, Kim H, Lee JT. Effects of ambient air particles on mortality in Seoul: Have the effects changed over time? ENVIRONMENTAL RESEARCH 2015; 140:684-690. [PMID: 26079317 DOI: 10.1016/j.envres.2015.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 05/27/2015] [Accepted: 05/31/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Several studies have shown that there may be temporal variation in PM short-term effect on mortality. This temporal pattern may play an important role in evaluating air quality policies. OBJECTIVES We investigated temporal variation in the association between PM and mortality in Seoul, Korea, 1998-2011. METHODS We adopted a generalized additive model and a series of time windows of five years to analyze temporal variation in associations between PM and all-cause, cardiovascular, and respiratory mortality. This time-window approach offers not only a comparison between one and the other half period but also successive variation. Time-varying associations were estimated only for days without Asian dust (dust storm blown from the Gobi desert) intrusion. RESULTS Annual average PM10 and PM2.5 total mass decreased from 70.0 to 46.9 µg/m(3) and 44.4 to 23.4 µg/m(3), respectively, during 2001-2011. A 10 µg/m(3) increase in PM10 was associated with 0.16% (95% CI=-0.03% to 0.35%) additional all-cause deaths in 2002-2006 and it increased to 0.26% (95% CI=0.05-0.48%) in 2007-2011. For PM2.5, the association increased from 0.35% (95% CI=-0.02% to 0.71%) to 0.48% (95% CI=0.08-0.88%). For cardiovascular and respiratory mortality, increasing trends with stronger estimates were found. CONCLUSIONS The present study showed temporally increasing trends in associations between PM and mortality. Current policies may not be as effective to reducing health risks attributable to PM as expected. Air quality interventions should be encouraged in terms of causal factors for time-varying association between PM and mortality.
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Affiliation(s)
- Honghyok Kim
- Department of Public Health Sciences, Graduate School, Korea University, 136-703 Seoul, Republic of Korea
| | - Hyomi Kim
- Department of Public Health Sciences, Graduate School, Korea University, 136-703 Seoul, Republic of Korea
| | - Jong-Tae Lee
- Department of Public Health Sciences, Graduate School, Korea University, 136-703 Seoul, Republic of Korea; Department of Environmental Health, College of Health Science, Korea University, 136-703 Seoul, Republic of Korea.
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Chau PH, Woo J. The Trends in Excess Mortality in Winter vs. Summer in a Sub-Tropical City and Its Association with Extreme Climate Conditions. PLoS One 2015; 10:e0126774. [PMID: 25993635 PMCID: PMC4439064 DOI: 10.1371/journal.pone.0126774] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 04/07/2015] [Indexed: 11/19/2022] Open
Abstract
While there is literature on excess winter mortality, there are few studies examining the evolution of its trend which may be changing in parallel with global warming. This study aimed to examine the trend in the excess mortality in winter as compared to summer among the older population in a sub-tropical city and to explore its association with extreme weather. We used a retrospective study based on the registered deaths among the older population in Hong Kong during 1976-2010. An Excess Mortality for Winter versus Summer (EMWS) Index was used to quantify the excess number of deaths in winter compared to summer. Multiple linear regressions were used to analyze the trends and its association with extreme weather. Overall, the EMWS Index for ischemic heart disease, cerebrovascular diseases, chronic lower respiratory diseases, pneumonia, and other causes were 43.0%, 34.2%, 42.7%, 23.4% and 17.6%, respectively. Significant decline was observed in the EMWS Index for chronic lower respiratory diseases and other causes. The trend in the index for cerebrovascular diseases depended on the age group, with older groups showing a decline but younger groups not showing any trend. Meteorological variables, in terms of extreme weather, were associated with the trends in the EMWS Index. We concluded that shrinking excess winter mortality from cerebrovascular diseases and chronic lower respiratory diseases was found in a sub-tropical city. These trends were associated with extreme weather, which coincided with global warming.
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Affiliation(s)
- Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong
- * E-mail:
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
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