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Qi J, Zhang J, Wang Y, Huang J, Aboubakri O, Yin P, Li G. The temporal variation in the effects of extreme temperature on respiratory mortality: Evidence from 136 cities in China, 2006-2019. ENVIRONMENT INTERNATIONAL 2024; 189:108800. [PMID: 38850671 DOI: 10.1016/j.envint.2024.108800] [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: 11/27/2023] [Revised: 05/29/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND In the context of climate change and urbanization, the temporal variation of the adverse health effect of extreme temperature has attracted increasing attention. METHODS The meteorological data and the daily death records of mortality from respiratory diseases of 136 Chinese cities were from 2006 to 2019. Heat wave and cold spell were selected as the indicator events of extreme high temperature and extreme low temperature, respectively. The generalized linear model and time-varying distributed lag model were used to perform a two-stage time-series analysis to evaluate the temporal variation of the mortality risk associated with extreme temperature in the total population, sub-populations (sex- and age- specific) and different regions (climatic zone and relative humidity level). RESULTS During the study period, relative risk (RR) of respiratory mortality associated with heat wave decreased from 1.22 (95 %CI: 1.07-1.39) to 1.13 (95 %CI: 1.01-1.26) in the total population, and RR of respiratory mortality associated with cold spell decreased from 1.30 (95 %CI: 1.14-1.49) to 1.17 (95 %CI: 1.08-1.26). The impact of heat wave reduced in the males (P = 0.044) and in the females as with cold spell (P < 0.001). The respiratory mortality risk of people over 65 associated with cold spell decreased (P = 0.040 for people aged 65-74 and P < 0.001 for people over 75). The effect of cold spell reduced in cities from tropical or arid zone (P = 0.035). The effects of both heat wave and cold spell decreased in cities with the relative humidity in the first quartile (P = 0.046 and 0.010, respectively). CONCLUSION The impact of heat wave on mortality of respiratory diseases decreased mainly in males and cities with the lowest relative humidity, while the impact of cold spell reduced in females, people over 65 and tropical and arid zone, suggesting adaptation to extreme temperature of Chinese residents to some extent.
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Affiliation(s)
- Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Jin Zhang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Yuxin Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University School of Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Omid Aboubakri
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Shanxi Key Laboratory of Environmental Health Impairment and Prevention, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Shanxi Medical University, Taiyuan, China.
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Singh N, Areal AT, Breitner S, Zhang S, Agewall S, Schikowski T, Schneider A. Heat and Cardiovascular Mortality: An Epidemiological Perspective. Circ Res 2024; 134:1098-1112. [PMID: 38662866 PMCID: PMC11042530 DOI: 10.1161/circresaha.123.323615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
As global temperatures rise, extreme heat events are projected to become more frequent and intense. Extreme heat causes a wide range of health effects, including an overall increase in morbidity and mortality. It is important to note that while there is sufficient epidemiological evidence for heat-related increases in all-cause mortality, evidence on the association between heat and cause-specific deaths such as cardiovascular disease (CVD) mortality (and its more specific causes) is limited, with inconsistent findings. Existing systematic reviews and meta-analyses of epidemiological studies on heat and CVD mortality have summarized the available evidence. However, the target audience of such reviews is mainly limited to the specific field of environmental epidemiology. This overarching perspective aims to provide health professionals with a comprehensive overview of recent epidemiological evidence of how extreme heat is associated with CVD mortality. The rationale behind this broad perspective is that a better understanding of the effect of extreme heat on CVD mortality will help CVD health professionals optimize their plans to adapt to the changes brought about by climate change and heat events. To policymakers, this perspective would help formulate targeted mitigation, strengthen early warning systems, and develop better adaptation strategies. Despite the heterogeneity in evidence worldwide, due in part to different climatic conditions and population dynamics, there is a clear link between heat and CVD mortality. The risk has often been found to be higher in vulnerable subgroups, including older people, people with preexisting conditions, and the socioeconomically deprived. This perspective also highlights the lack of evidence from low- and middle-income countries and focuses on cause-specific CVD deaths. In addition, the perspective highlights the temporal changes in heat-related CVD deaths as well as the interactive effect of heat with other environmental factors and the potential biological pathways. Importantly, these various aspects of epidemiological studies have never been fully investigated and, therefore, the true extent of the impact of heat on CVD deaths remains largely unknown. Furthermore, this perspective also highlights the research gaps in epidemiological studies and the potential solutions to generate more robust evidence on the future consequences of heat on CVD deaths.
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Affiliation(s)
- Nidhi Singh
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Ashtyn Tracy Areal
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
| | - Siqi Zhang
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Stefan Agewall
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
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3
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Liang C, Yuan J, Tang X, Kan H, Cai W, Chen J. The influence of humid heat on morbidity of megacity Shanghai in China. ENVIRONMENT INTERNATIONAL 2024; 183:108424. [PMID: 38219539 DOI: 10.1016/j.envint.2024.108424] [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: 08/25/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Increased attention has been paid to humid-heat extremes as they are projected to increase in both frequency and intensity. However, it remains unclear how compound extremes of heat and humidity affects morbidity when the climate is projected to continue warming in the future, in particular for a megacity with a large population. METHODS We chose the Wet-Bulb Globe Temperature (WBGT) index as the metric to characterize the humid-heat exposure. The historical associations between daily outpatient visits and daily mean WBGT was established using a Distributed Lag Non-linear Model (DLNM) during the warm season (June to September) from 2013 to 2015 in Shanghai, a prominent megacity of China. Future morbidity burden related to the combined effect of high temperature and humidity were projected under four greenhouse gases (GHGs) emission scenarios (SSP126, SSP245, SSP370 and SSP585). RESULTS The humid-heat weather was significantly associated with a higher risk of outpatient visits in Shanghai than the high-temperature conditions. Relative to the baseline period (2010-2019), the morbidity burden due to humid-heat weather was projected to increase 4.4 % (95 % confidence interval (CI): 1.1 %-10.1 %) even under the strict emission control scenario (SSP126) by 2100. Under the high-GHGs emission scenario (SSP585), this burden was projected to be 25.4 % (95 % CI: 15.8 %-38.4 %), which is 10.1 % (95 % CI: 6.5 %-15.8 %) more than that due to high-temperature weather. Our results also indicate that humid-hot nights could cause large morbidity risks under high-GHGs emission scenarios particularly in heat-sensible diseases such as the respiratory and cardiovascular disease by the end of this century. CONCLUSIONS Humid heat exposures significantly increased the all-cause morbidity risk in the megacity Shanghai, especially in humid-hot nights. Our findings suggest that the combined effect of elevated temperature and humidity is projected to have more substantial impact on health compared to high temperature alone in a warming climate.
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Affiliation(s)
- Chen Liang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China.
| | - Xu Tang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Haidong Kan
- IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenjia Cai
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China
| | - Jianmin Chen
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
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Jingesi M, Lan S, Hu J, Dai M, Huang S, Chen S, Liu N, Lv Z, Ji J, Li X, Wang P, Cheng J, Peng J, Yin P. Association between thermal stress and cardiovascular mortality in the subtropics. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2093-2106. [PMID: 37878088 DOI: 10.1007/s00484-023-02565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Affiliation(s)
- Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Shuhua Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ning Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen, 518020, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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Kai X, Hong Z, Hong Y, Wang X, Li C. Short-term impact of diurnal temperature range on cardiovascular diseases mortality in residents in northeast China. Sci Rep 2023; 13:11037. [PMID: 37419976 PMCID: PMC10328923 DOI: 10.1038/s41598-023-38129-2] [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: 09/18/2022] [Accepted: 07/03/2023] [Indexed: 07/09/2023] Open
Abstract
It has been reported that cardiovascular disease (CVD) has become one of the major threats to global public health and is associated with climate change. Several previous studies have shown the influence of ambient temperature on CVD, but lack some evidence for the short-term effect of diurnal temperature range (DTR) on CVD mortality in northeast China. This is the first study to assess the correlation between DTR and CVD mortality in Hulunbuir located in northeast China. Daily CVD mortality data and meteorological data were collected from 2014 to 2020. A quasi-Poisson generalized linear regression with a distributed lag non-linear model (DLNM) was applied to exploring the short-term impact of DTR on CVD mortality. Stratified analyses by gender, age, and season were conducted and the short-term impacts of extremely high DTR on CVD mortality were investigated. In this study, a total of 21,067 CVD mortality cases were recorded in Hulunbuir, China from 2014 to 2020. Compared to the reference value (11.20 [Formula: see text]C, 50[Formula: see text] percentile), a "U-shaped" non-linear relationship between DTR and CVD mortality was observed, and extremely high DTR increased the risk of CVD mortality. The short-term effect of extremely high DTR occurred immediately and lasted up to 6 days. In addition, the male and the age [Formula: see text] 65 groups were more likely to be affected by extremely high DTR compared with the female and the age < 65 groups, respectively. The results also showed that extremely high DTR in cold season had a more adverse effect on CVD mortality than warm season. This study suggests that extremely high DTR for cold season should be paid enough attention to for residents in northeast China. The male and the age [Formula: see text] 65 groups were more vulnerable to the impacts of DTR. The study results may provide some suggestions for decision-making by local public health authorities to avoid the adverse impacts of high DTR, and improve the health of residents, especially vulnerable groups in cold season.
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Affiliation(s)
- Xuan Kai
- Department of Mathematics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China
| | - Zhimin Hong
- Department of Mathematics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China.
| | - Yang Hong
- Department of Mechanics, School of Sciences, Inner Mongolia University of Technology, Hohhot, 010051, China
| | - Xiaolei Wang
- Department of Ultrasound, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Chunyang Li
- Department of Neurology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
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Rai M, Breitner S, Huber V, Zhang S, Peters A, Schneider A. Temporal variation in the association between temperature and cause-specific mortality in 15 German cities. ENVIRONMENTAL RESEARCH 2023; 229:115668. [PMID: 36958378 DOI: 10.1016/j.envres.2023.115668] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND There is limited evidence of temporal changes in the association between air temperature and the risk of cause-specific cardiovascular [CVD] and respiratory [RD] mortality. METHOD We explored temporal variations in the association between short-term exposures to air temperature and non-accidental and cause-specific CVD and RD mortality in the 15 largest German cities over 24 years (1993-2016) using time-stratified time series analysis. We applied location-specific confounder-adjusted Poisson regression with distributed lag non-linear models with a lag period of 14 days to estimate the temperature-mortality associations. We then pooled the estimates by a multivariate meta-analytical model. We analysed the whole study period and the periods 1993-2004 and 2005-16, separately. We also carried out age- and sex-stratified analysis. Cold and heat effects are reported as relative risk [RR] at the 1st and the 99th temperature percentile, relative to the 25th and the 75th percentile, respectively. RESULT We analysed a total of 3,159,292 non-accidental, 1,063,198 CVD and 183,027 RD deaths. Cold-related RR for CVD mortality was seen to rise consistently over time from 1.04 (95% confidence interval [95% CI] 1.02, 1.06) in the period 1993-2004 to 1.10 (95% CI 1.09, 1.11) in the period 2005-16. A similar increase in cold-related RR was also observed for RD mortality with risk increasing from 0.99 (95% CI 0.96, 1.03) to 1.07 (95% CI 1.03, 1.10). Cold-related ischemic, cerebrovascular, and heart failure mortality risk were seen to be increasing over time. Similarly, COPD, the commonly speculated driver of heat-related RD mortality was found to have a constant heat-related risk over time. Males were increasingly vulnerable to cold with time for all causes of death. Females showed increasing sensitivity to cold for CVD mortality. Our results indicated a significant increased cold and heat vulnerability of the youngest age-groups (<64) to non-accidental and RD mortality, respectively. Similarly, the older age group (>65) were found to have significantly increased susceptibility to cold for CVD mortality. CONCLUSION We found evidence of rising population susceptibility to both heat- and cold-related CVD and RD mortality risk from 1993 to 2016. Climate change mitigation and targeted adaptation strategies might help to reduce the number of temperature-related deaths in the future.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Wang Y, Lin L, Xu Z, Wang L, Huang J, Zhou M, Li G. Have residents adapted to heat wave and cold spell in the 21st century? Evidence from 136 Chinese cities. ENVIRONMENT INTERNATIONAL 2023; 173:107811. [PMID: 36878108 DOI: 10.1016/j.envint.2023.107811] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Global climate change has increased the probability and intensity of extreme weather events. The adverse health effect of extreme temperature has gone through a temporal variation over years. Time-series data including city-level daily cardiovascular death records and meteorological data were collected from 136 Chinese cities during 2006 and 2019. A time-varying distributed lag model with interaction terms was applied to assess the temporal change of mortality risk and attributable mortality of heat wave and cold spell. The mortality effect of heat wave generally increased and that of cold spell decreased significantly in the total population during the study period. The heat wave effect increased especially among the female and people aged 65 to 74. As for the cold spell, the reduced susceptibility was detected both in the temperate and cold climatic zone. Our findings appeal for counterpart measures corresponding to sub-populations and regions responding to future extreme climate events from the public and individuals.
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Affiliation(s)
- Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Lin Lin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Environmental Research Group, MRC Centre for Environment and Health, Sir Michael Uren Building, Imperial College London, White City Campus, 80-92 Wood Lane, London W12 0BZ, United Kingdom.
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8
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Ma Y, Li H, Qin P, Cheng B, Feng F, Zhang Y, Jiao H. Extreme temperatures and circulatory mortality in a temperate continental monsoon climate city in Northeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:21661-21670. [PMID: 36272008 DOI: 10.1007/s11356-022-23622-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Epidemiological studies have proven that extreme temperatures have a significant threat to public health. This study aimed to investigate the association between extreme temperatures and circulatory mortality from January 1, 2014, to December 31, 2016, in Harbin, a city with a cold climate in Northeast China. We set a maximum lag of 27 days to evaluate the hysteresis effects of different temperatures on circulatory mortality using a distributed lag nonlinear model (DLNM). Results indicated that daily mean temperature and circulatory mortality presented approximately an L-shaped, and the cumulative relative risks (RRs) decreased continuously as the temperature increased in both low and high temperatures. Extremely low temperature showed a hysteresis and durability on circulatory mortality, with the largest RR of 1.023 (95%CI: 1.001-1.046) at lag 26, and RR of the cumulative cold effect of 0-27 days was 1.302 (95%CI: 1.160-1.462). The effect of extremely high temperatures presented more acute and intense, with the largest RR of 1.033 (95%CI: 1.004-1.063) at lag 0. RR of the cumulative hot effect of 0-3 days was 1.056 (1.008-1.106). In addition, females were more susceptible to extremely low temperatures, while males were more vulnerable to extremely high temperatures. This study demonstrated that extremely low temperatures have a stronger effect on circulatory mortality than extremely high temperatures in Harbin.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Heping Li
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Pengpeng Qin
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- Liaoning Provincial Meteorological Bureau, Shenyang, 111100, China
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Chung CY, Yang J, Yang X, He J. A novel mathematical model for estimating the relative risk of mortality attributable to the combined effect of ambient fine particulate matter (PM 2.5) and cold ambient temperature. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159634. [PMID: 36280065 DOI: 10.1016/j.scitotenv.2022.159634] [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: 08/22/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Exposures to ambient fine particulate matter (PM2.5) and cold ambient temperatures have been identified as important risk factors in contributing towards the global mortality from chronic obstructive pulmonary disease (COPD). Despite China currently being the country with the largest population in the world, previous relative risk (RR) models have considered little or no information from the ambient air pollution related cohort studies in the country. This likely provides a less accurate picture of the trend in air pollution attributable mortality in the country over time. A novel relative risk model called pollutant-temperature exposure (PTE) model is proposed to estimate the RR attributable to the combined effect of air pollution and ambient temperature in a population. In this paper, the pollutant concentration-response curve was extrapolated from the cohort studies in China, whereas the temperature response curve was extracted from a study in Yangtze River Delta (YRD) region. The performance of the PTE model was compared with the integrated exposure-response (IER) model using the data of YRD region, which revealed that the estimated relative risks of the PTE model were noticeably higher than the IER model during the winter season. Furthermore, the predictive ability of the PTE model was validated using actual data of Ningbo city, which showed that the estimated RR using the PTE model with 1-month moving average data showed a good result with the trend of actual COPD mortality, indicated by a lower root mean square error (RMSE = 0.956). By considering the combined effect of ambient air pollutant and ambient temperature, the PTE model is expected to provide more accurate relative risk estimates for the regions with high levels of ambient PM2.5 and seasonal variation of ambient temperature.
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Affiliation(s)
- Chee Yap Chung
- Department of Chemical and Environmental Engineering, University of Nottingham Ningbo China, Ningbo 315100, PR China
| | - Jie Yang
- Department of Mathematics, University of Hull, Hull HU6 7RX, UK
| | - Xiaogang Yang
- Department of Mechanical, Materials and Manufacturing Engineering, University of Nottingham Ningbo China, Ningbo 315100, PR China.
| | - Jun He
- Department of Chemical and Environmental Engineering, University of Nottingham Ningbo China, Ningbo 315100, PR China
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10
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Yan M, Xie Y, Zhu H, Ban J, Gong J, Li T. Cardiovascular mortality risks during the 2017 exceptional heatwaves in China. ENVIRONMENT INTERNATIONAL 2023; 172:107767. [PMID: 36716635 DOI: 10.1016/j.envint.2023.107767] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/11/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Climate change has made disastrous heatwaves more frequent. Heatwave-related health impacts are much more devastating for more intense heatwaves. In the summer of 2017, exceptional heatwaves occurred in many regions, including China. This study aims to evaluate the cardiovascular mortality risk associated with the 2017 exceptional heatwaves and compare the mortality risk of the severe heatwaves with those in other years. Using daily data for a spectrum of cardiovascular mortality and temperature for 102 Chinese counties (2014-2017), we estimated the association between heatwave and mortality by generalized linear mixed-effects models. Compared with matched non-heatwave days, mortality risks on heatwaves days in 2017 increased 27.8% (95% CI, 14.8-42.3%), 26.7% (8.0-48.5%), 30.1% (10.2-53.7%), 27.3% (1.4-59.9%), 32.2% (3.4-68.4%), and 25.2% (1.0-57.7%) for total circulatory diseases, cerebrovascular disease, ischemic heart disease (IHD), acute IHD, chronic IHD, and myocardial infarction. The 2017 exceptional heatwaves impacted ischemic heart disease mortality and myocardial infarction mortality more than heatwaves in 2014-2016. Here we show that the severe heatwaves in 2017 posed catastrophic death threats for those under-studied cardiovascular diseases.
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Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China; Future Cities Lab, Beihang University, China
| | - Huanhuan Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology and State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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11
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Xia Y, Shi C, Li Y, Jiang X, Ruan S, Gao X, Chen Y, Huang W, Li M, Xue R, Wen X, Peng X, Chen J, Zhang L. Effects of ambient temperature on mortality among elderly residents of Chengdu city in Southwest China, 2016-2020: a distributed-lag non-linear time series analysis. BMC Public Health 2023; 23:149. [PMID: 36681785 PMCID: PMC9863161 DOI: 10.1186/s12889-022-14931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With complex changes in the global climate, it is critical to understand how ambient temperature affects health, especially in China. We aimed to assess the effects of temperature on daily mortality, including total non-accidental, cardiovascular disease (CVD), respiratory disease, cerebrovascular disease, and ischemic heart disease (IHD) mortality between 2016 and 2020 in Chengdu, China. METHODS We obtained daily temperature and mortality data for the period 2016-2020. A Poisson regression model combined with a distributed-lag nonlinear model was used to examine the association between temperature and daily mortality. We investigated the effects of individual characteristics by sex, age, education level, and marital status. RESULTS We found significant non-linear effects of temperature on total non-accidental, CVD, respiratory, cerebrovascular, and IHD mortality. Heat effects were immediate and lasted for 0-3 days, whereas cold effects persisted for 7-10 days. The relative risks associated with extreme high temperatures (99th percentile of temperature, 28 °C) over lags of 0-3 days were 1.22 (95% confidence interval [CI]: 1.17, 1.28) for total non-accidental mortality, 1.40 (95% CI: 1.30, 1.50) for CVD morality, 1.34 (95% CI: 1.24, 1.46) for respiratory morality, 1.33 (95% CI: 1.20, 1.47) for cerebrovascular mortality, and 1.38 (95% CI: 1.20, 1.58) for IHD mortality. The relative risks associated with extreme cold temperature (1st percentile of temperature, 3.0 °C) over lags of 0-14 days were 1.32 (95% CI: 1.19, 1.46) for total mortality, 1.45 (95% CI: 1.24, 1.68) for CVD morality, 1.28 (95% CI: 1.09, 1.50) for respiratory morality, 1.36 (95% CI: 1.09, 1.70) for cerebrovascular mortality, and 1.26 (95% CI: 0.95, 1.68) for IHD morality. We found that hot and cold affects were greater in those over 85 years of age, and that women, individuals with low education levels, and those who were widowed, divorced, or never married, were more vulnerable. CONCLUSIONS This study showed that exposure to hot and cold temperatures in Chengdu was associated with increased mortality, with people over 85 years old, women, those with low education levels, and unmarried individuals being more affected by hot and cold temperatures.
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Affiliation(s)
- Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No.6, Longxiang Road, Wuhou District, Chengdu, 610041 China
| | - Yu Chen
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No.826, Huichuan Road, Ziliujing District, Zigong, 643000 China
| | - Mingjiang Li
- Panzhi Hua Center for Disease Control and Prevention, Dong District, No.996, Jichang Road617067, Panzhi Hua, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No.996, Binhebei RoadLizhou District, Guangyuan, 628017 China
| | - Xianying Wen
- Mianyang Center for Disease Control and Prevention, Gaoxin District, No.50, Mianxingdong Road, Mianyang, 621000 China
| | - Xiaojuan Peng
- Yaan Center for Disease Control and Prevention, No.9, Fangcao Road, Yucheng District, Yaan, 625000 China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
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12
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Jin J, Meng X, Wang D, Han B, Wu T, Xie J, Zhang Q, Xie D, Zhang Z. Association between ambient temperature and cardiovascular diseases related hospital admissions in Lanzhou, China. Heliyon 2023; 9:e12997. [PMID: 36747948 PMCID: PMC9898685 DOI: 10.1016/j.heliyon.2023.e12997] [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: 08/09/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, ranking first in the global disease burden. Evidence on association between temperature and cardiovascular disease is insufficient and inconsistent in developing countries. In this study, a distributed lag nonlinear model (DLNM) was used to determine the association between daily mean temperature and cardiovascular diseases (CVD) related admission in Lanzhou 2015-2019. We included 41,389 patients with CVD in this study. The relative risk (RR) of CVD admission increased significantly with temperature in lag 5-10 days, and we found harvesting effect of temperature in the study, shown as decreased RR in lag 15-30 days. The maximum RR was 1.15 (95% confidence interval [CI]: 1.03-1.30), corresponding to 24 °C. Both cold and heat effects of temperature could impact the CVD admission. Compared with the 25th percentile of temperature (2 °C), the cumulative relative risk (cumRR) of extreme cold (-5 °C, the 2.5th percentile of the temperature) was 0.69 (95% CI: 0.51-0.94) in lag 0-14, whereas the cumRR of moderate cold (-2 °C, the 10th percentile) was 0.83 (95% CI:0.71-0.97). Compared with the 75th percentile of temperature (20-°C), the cumRR of extreme heat (27 °C, the 97.5th percentile) was 0.93 (95% CI: 0.78-1.10) in lag 0, whereas the cumRR of moderate heat (24 °C, the 90th percentile) was 1.01 (95% CI: 0.94-1.08). In the stratified analysis, cold decreased RR significantly in female and ≥65 years, whereas heat increased it more obviously in male and ≥65 years. Ambient temperature and CVD admissions were positively associated, with the harvesting effect. Our findings demonstrate the adaption of residents in Lanzhou to cold temperature. Public and environmental policies and measures aimed at moderate heat may minimize CVD burden effectively.
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Affiliation(s)
- Jianjian Jin
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
| | - Xiaoxue Meng
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, China
| | - Dongmei Wang
- Department of Cardiology, Zhang Ye People's Hospital Affiliated to Hexi University, Zhangye, China
| | - Bing Han
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, China
| | - Tingting Wu
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
| | - Jing Xie
- Department of Ultrasound Medicine, Lanzhou First People's Hospital, Lanzhou, China
| | - Qi Zhang
- Department of Geriatrics, Gansu Provincial People's Hospital, Lanzhou, China
| | - Dingxiong Xie
- Gansu Provincial Institute of Cardiovascular Diseases, Lanzhou, China
- The Second Clinical Medical School, Gansu University of Traditional Chinese Medicine, Lanzhou, China
| | - Zheng Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, Lanzhou, China
- Key Laboratory for Cardiovascular Disease of Gansu Province, Lanzhou, China
- Cardiovascular Clinical Research Center of Gansu Province, China
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Yuan W, He BJ, Yang L, Liu X, Yan L. Heat-induced health impacts and the drivers: implications on accurate heat-health plans and guidelines. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:88193-88212. [PMID: 35829877 DOI: 10.1007/s11356-022-21839-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Urban heat challenges are increasingly severe, along with climate change and urbanisation. Despite significant environmental, economic, and social consequences, limited actions have been conducted to address urban heat challenges. To support the formulation of heat-health plans and guidelines at the city and community scale, this study presented results, through a questionnaire survey among 584 respondents in Shanghai, China, on heat-induced physiological and psychological impacts and analysed the variability of them with demographic characteristics. The results indicate that psychological impacts were more severe than physiological impacts in severity and susceptible people. Skin heat damage and digestive system diseases were ignored in previous studies, compared with fatal cardiovascular and respiratory diseases. Emotional irritability and difficulty in controlling temper were the two most prominent psychological symptoms. The elderly and health-vulnerable groups were more susceptible to heat-induced physiological and psychological impacts than other groups. Among different demographic groups, the most critical physiological and psychological symptoms could vary significantly. Afterwards, suggestions for heat-health plans or guidelines have been proposed. Overall, this study provides a reference for the understanding of heat-induced impacts and enhancing the capacity to cope with urban heat challenges.
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Affiliation(s)
- Wei Yuan
- School of Civil Engineering and Architecture, Henan University of Technology, Zhengzhou, 450001, China
| | - Bao-Jie He
- Smart City Research Institute of Chongqing University in Liyang, Chongqing University, Liyang, 213300, Jiangsu, China
- Centre for Climate-Resilient and Low-Carbon Cities, School of Architecture and Urban Planning, Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing, 400045, China
- State Key Laboratory of Subtropical Building Science, South China University of Technology, Guangzhou, 510641, China
- Faculty of Built Environment, University of New South Wales, Sydney, 2052, Australia
| | - Linchuan Yang
- Department of Urban and Rural Planning, Southwest Jiaotong University, Chengdu, China
| | - Xiao Liu
- State Key Laboratory of Subtropical Building Science, South China University of Technology, Guangzhou, 510641, China
- Architectural Design & Research Institute Co., Ltd, South China University of Technology, Guangzhou, 510641, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Hong Kong, 999077, China
| | - Li Yan
- School of Civil Engineering and Architecture, Southwest University of Science and Technology, Mianyang, 621010, China.
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14
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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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15
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Li Y, Zheng C, An X, Hou Q. Acute effects of black carbon on mortality in nine megacities of China, 2008-2016: a time-stratified case-crossover study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:57873-57884. [PMID: 35357648 DOI: 10.1007/s11356-022-19899-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
Black carbon (BC) may have more adverse effects on human health than other constituents of PM2.5. The daily mean concentrations of BC in China are much higher than those in developed countries and are estimated to account for more than a quarter of global anthropogenic BC emissions. However, reports on the health effects of BC in China have been limited. Thus, a time-stratified case-crossover study was conducted to evaluate the impacts of BC on daily mortality risk in nine Chinese megacities from 2008-2016. Our results show that for all-cause mortality, when compared to the interquartile range (IQR) of BC concentration increased, odds ratios (ORs) were in the range of 1.01-1.06 (95% CIs: 0.99-1.10). For cardiovascular mortality, ORs were in the range of 1.02-1.07 (95% CIs: 1.003-1.12), and for respiratory mortality, ORs were in the range of 1.01-1.15 (95% CIs: 1.00-1.18). The effects of BC in the nine cities were robust after adjusting for PM2.5, or even became more prominent. Furthermore, BC had stronger effects in spring and winter in northern cities, whereas in mid-latitude cities, BC had stronger effects in the warm seasons. In southern cities, BC had stronger effects in the cool and dry seasons. Our findings support an association between residential exposure to BC and mortality and thus provide further evidence that BC negatively impacts human health and is helpful for decision-making.
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Affiliation(s)
- Yi Li
- State Key Laboratory of Severe Weather & Key Laboratory of Atmospheric Chemistry of CMA, Chinese Academy of Meteorological Sciences, Beijing, 100081, China
| | - Canjun Zheng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xingqin An
- State Key Laboratory of Severe Weather & Key Laboratory of Atmospheric Chemistry of CMA, Chinese Academy of Meteorological Sciences, Beijing, 100081, China
| | - Qing Hou
- State Key Laboratory of Severe Weather & Key Laboratory of Atmospheric Chemistry of CMA, Chinese Academy of Meteorological Sciences, Beijing, 100081, China.
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16
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Wang C, Lin J, Niu Y, Wang W, Wen J, Lv L, Liu C, Du X, Zhang Q, Chen B, Cai J, Zhao Z, Liang D, Ji JS, Chen H, Chen R, Kan H. Impact of ozone exposure on heart rate variability and stress hormones: A randomized-crossover study. JOURNAL OF HAZARDOUS MATERIALS 2022; 421:126750. [PMID: 34339988 DOI: 10.1016/j.jhazmat.2021.126750] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/12/2021] [Accepted: 07/24/2021] [Indexed: 06/13/2023]
Abstract
The biological mechanisms underlying the associations between atmospheric ozone exposure and adverse cardiometabolic outcomes are yet to be identified. Imbalanced autonomic nervous system (ANS) as well as activations of the sympatho-adrenomedullary (SAM) and hypothalamic-pituitary-adrenal (HPA) axes are among possible early biological responses triggered by ozone, and may eventually lead to cardiometabolic abnormalities. To determine whether acute ozone exposure causes ANS imbalance and increases the secretion of neuroendocrine stress hormones, we conducted a randomized, double-blind, crossover trial, under controlled 2-hour exposure to either ozone (200 ppb) or clean air with intermittent exercise among 22 healthy young adults. Here we found that, compared to clean air exposure, acute ozone exposure significantly decreased the high-frequency band of heart rate variability, even after adjusting for heart rate and pre-exposure to ambient air pollutants and meteorological factors. Ozone exposure also significantly increased the serum levels of stress hormones, including corticotrophin-releasing factor, adrenocorticotropic hormone, adrenaline, and noradrenaline. Metabolomics analysis showed that acute ozone exposure led to alterations in stress hormones, systemic inflammation, oxidative stress, and energy metabolism. Our results suggest that acute ozone exposure may trigger ANS imbalance and activate the HPA and SAM axes, offering potential biological explanations for the adverse cardiometabolic effects following acute ozone exposure.
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Affiliation(s)
- Cuiping Wang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Jingyu Lin
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yue Niu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Weidong Wang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Jianfen Wen
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lili Lv
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Xihao Du
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Qingli Zhang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Bo Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Jing Cai
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China
| | - Donghai Liang
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John S Ji
- Nicholas School of the Environment, Duke University, Durham, NC, USA; Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China.
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
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Batista E, Moncusi MA, López-Aguilar P, Martínez-Ballesté A, Solanas A. Sensors for Context-Aware Smart Healthcare: A Security Perspective. SENSORS (BASEL, SWITZERLAND) 2021; 21:6886. [PMID: 34696099 PMCID: PMC8537585 DOI: 10.3390/s21206886] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 12/24/2022]
Abstract
The advances in the miniaturisation of electronic devices and the deployment of cheaper and faster data networks have propelled environments augmented with contextual and real-time information, such as smart homes and smart cities. These context-aware environments have opened the door to numerous opportunities for providing added-value, accurate and personalised services to citizens. In particular, smart healthcare, regarded as the natural evolution of electronic health and mobile health, contributes to enhance medical services and people's welfare, while shortening waiting times and decreasing healthcare expenditure. However, the large number, variety and complexity of devices and systems involved in smart health systems involve a number of challenging considerations to be considered, particularly from security and privacy perspectives. To this aim, this article provides a thorough technical review on the deployment of secure smart health services, ranging from the very collection of sensors data (either related to the medical conditions of individuals or to their immediate context), the transmission of these data through wireless communication networks, to the final storage and analysis of such information in the appropriate health information systems. As a result, we provide practitioners with a comprehensive overview of the existing vulnerabilities and solutions in the technical side of smart healthcare.
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Affiliation(s)
- Edgar Batista
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
- SIMPPLE S.L., C. Joan Maragall 1A, 43003 Tarragona, Spain
| | - M. Angels Moncusi
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
| | - Pablo López-Aguilar
- Anti-Phishing Working Group EU, Av. Diagonal 621–629, 08028 Barcelona, Spain;
| | - Antoni Martínez-Ballesté
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
| | - Agusti Solanas
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
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18
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Mohammadi D, Zare Zadeh M, Zare Sakhvidi MJ. Short-term exposure to extreme temperature and risk of hospital admission due to cardiovascular diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:344-354. [PMID: 33615930 DOI: 10.1080/09603123.2019.1663496] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/26/2019] [Indexed: 06/12/2023]
Abstract
Objective: Numerous epidemiological studies have reported relevance of morbidity and mortality from cardiovascular diseases with short-term exposure to environmental temperature. In this study, we examined the hypothesis between temperature indices and hospital admission because of cardiovascular diseases. Methods: The daily number of CVDs was obtained from all hospitals of the Sabzevar city. A semi-parametric generalized additive model (GAM) following a quasi-Poisson distribution with distributed lag non-linear model (dlnm) was selected as a modeling framework for time-series analysis. Results: The overall CVD risk comparing the 1st percentile and the 99th percentile relative to the mean temperature (at lag 0) was 1.33 (95% CI, 1.11: 1.61), and 1.34 (95% CI, 1.10: 1.64), respectively. For all indicators, the extremely cold effects persisted for the initial 7 days. Conclusions: Our results suggest that extremely cold and extremely hot temperatures increase the relative risk of cardiovascular diseases.
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Affiliation(s)
- Danial Mohammadi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
| | - Mohammad Zare Zadeh
- Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
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19
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Abstract
BACKGROUND Air conditioning has been proposed as one of the key factors explaining reductions of heat-related mortality risks observed in the last decades. However, direct evidence is still limited. METHODS We used a multi-country, multi-city, longitudinal design to quantify the independent role of air conditioning in reported attenuation in risk. We collected daily time series of mortality, mean temperature, and yearly air conditioning prevalence for 311 locations in Canada, Japan, Spain, and the USA between 1972 and 2009. For each city and sub-period, we fitted a quasi-Poisson regression combined with distributed lag non-linear models to estimate summer-only temperature-mortality associations. At the second stage, we used a novel multilevel, multivariate spatio-temporal meta-regression model to evaluate effect modification of air conditioning on heat-mortality associations. We computed relative risks and fractions of heat-attributable excess deaths under observed and fixed air conditioning prevalences. RESULTS Results show an independent association between increased air conditioning prevalence and lower heat-related mortality risk. Excess deaths due to heat decreased during the study periods from 1.40% to 0.80% in Canada, 3.57% to 1.10% in Japan, 3.54% to 2.78% in Spain, and 1.70% to 0.53% in the USA. However, increased air conditioning explains only part of the observed attenuation, corresponding to 16.7% in Canada, 20.0% in Japan, 14.3% in Spain, and 16.7% in the USA. CONCLUSIONS Our findings are consistent with the hypothesis that air conditioning represents an effective heat adaptation strategy, but suggests that other factors have played an equal or more important role in increasing the resilience of populations.
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20
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Liu T, Zhou C, Zhang H, Huang B, Xu Y, Lin L, Wang L, Hu R, Hou Z, Xiao Y, Li J, Xu X, Jin D, Qin M, Zhao Q, Gong W, Yin P, Xu Y, Hu J, Xiao J, Zeng W, Li X, Chen S, Guo L, Rong Z, Zhang Y, Huang C, Du Y, Guo Y, Rutherford S, Yu M, Zhou M, Ma W. Ambient Temperature and Years of Life Lost: A National Study in China. Innovation (N Y) 2021; 2:100072. [PMID: 34557729 PMCID: PMC8454660 DOI: 10.1016/j.xinn.2020.100072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/12/2020] [Indexed: 12/27/2022] Open
Abstract
Although numerous studies have investigated premature deaths attributable to temperature, effects of temperature on years of life lost (YLL) remain unclear. We estimated the relationship between temperatures and YLL, and quantified the YLL per death caused by temperature in China. We collected daily meteorological and mortality data, and calculated the daily YLL values for 364 locations (2013–2017 in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces, and 2006–2011 in other locations) in China. A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates (YLL/100,000 population), and a multivariate meta-analysis model was used to pool location-specific associations. Then, YLL per death caused by temperatures was calculated. The temperature and YLL rates consistently showed U-shaped associations. A mean of 1.02 (95% confidence interval: 0.67, 1.37) YLL per death was attributable to temperature. Cold temperature caused 0.98 YLL per death with most from moderate cold (0.84). The mean YLL per death was higher in those with cardiovascular diseases (1.14), males (1.15), younger age categories (1.31 in people aged 65–74 years), and in central China (1.34) than in those with respiratory diseases (0.47), females (0.87), older people (0.85 in people ≥75 years old), and northern China (0.64) or southern China (1.19). The mortality burden was modified by annual temperature and temperature variability, relative humidity, latitude, longitude, altitude, education attainment, and central heating use. Temperatures caused substantial YLL per death in China, which was modified by demographic and regional characteristics. Years of life lost (YLL) is used to estimate the effects of temperature Both low and high temperatures can increase the YLLs Average 1.02 YLL per death is attributed to temperature exposure Temperature causes larger YLLs per death in males, younger people, and central China
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Affiliation(s)
- Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Haoming Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Biao Huang
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lijun Wang
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Ruying Hu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhulin Hou
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Junhua Li
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Mingfang Qin
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Qinglong Zhao
- Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Siqi Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yaodong Du
- Guangdong Provincial Climate Center, Guangzhou, 510080, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia
| | | | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
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21
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Zhang W, Du G, Xiong L, Liu T, Zheng Z, Yuan Q, Yang J, Wu Y, Zhu R, Hu G. Extreme temperatures and cardiovascular mortality: assessing effect modification by subgroups in Ganzhou, China. Glob Health Action 2021; 14:1965305. [PMID: 34482804 PMCID: PMC8425637 DOI: 10.1080/16549716.2021.1965305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Many people die from cardiovascular diseases each year, and extreme temperatures are regarded as a risk factor for cardiovascular deaths. However, the relationship between temperature and cardiovascular deaths varies in different regions because of population density, demographic inequality, and economic situation, and the evidence in Ganzhou, China is limited and inconclusive. Objective This study aimed to assess extreme temperature-related cardiovascular mortality and identify the potential vulnerable people. Methods After controlling other meteorological measures, air pollution, seasonality, relative humidity, day of the week, and public holidays, we examined temperature-related cardiovascular mortality along 21 lag days by Poisson in Ganzhou, China. Results A J-shaped relationship was observed between mean temperature and cardiovascular mortality. Extremely low temperatures substantially increased the relative risks (RR) of cardiovascular mortality. The effect of cold temperature was delayed by 2–6 days and persisted for 4–10 days. However, the risk of cardiovascular mortality related to extremely high temperatures was not significant (p > 0.05). Subgroup analysis indicated that extremely low temperatures had a stronger association with cardiovascular mortality in people with cerebrovascular diseases (RR: 1.282, 95% confidence interval [CI]: 1.020–1.611), males (RR: 1.492, 95% CI: 1.175–1.896), married people (RR: 1.590, 95% CI: 1.224–2.064), and people above the age of 65 years (RR: 1.641, 95% CI: 1.106–2.434) than in people with ischemic heart disease, females, unmarried people, and the elderly (≥65 years old), respectively. Conclusions The type of cardiovascular disease, sex, age, and marital status modified the effects of extremely low temperatures on the risk of cardiovascular mortality. These findings may help local governments to establish warning systems and precautionary measures to reduce temperature-related cardiovascular mortality.
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Affiliation(s)
- Wei Zhang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gang Du
- Ganzhou Center For Disease Control And Prevention, Ganzhou, Jiangxi, China
| | - Liang Xiong
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Tingting Liu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zuobing Zheng
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Qiong Yuan
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jiahui Yang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yangna Wu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Rongfei Zhu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gonghua Hu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
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22
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Rodrigues M, Santana P, Rocha A. Modelling climate change impacts on attributable-related deaths and demographic changes in the largest metropolitan area in Portugal: A time-series analysis. ENVIRONMENTAL RESEARCH 2020; 190:109998. [PMID: 32771365 DOI: 10.1016/j.envres.2020.109998] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/13/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
Previous studies have consistently analyzed the impact that extreme temperatures will have on human health. However, there are very few data on temperature-related mortality burden considering future demographic changes in a context of climate change in Portugal. This study aims to quantify the impact of climate change on heat-, cold-, and net change mortality burdens, taking into account the future demographic changes in Lisbon Metropolitan Area, Portugal. We applied a time-series generalized linear model with a quasi-Poisson model via a distributed lag nonlinear model to project temperature-related mortality burden for two climatological scenarios: a present (or reference, 1986-2005) scenario and a future scenario (2046-2065), in this case the Representative Concentration Pathway RCP8.5, which reflects the worst set of expectations (with the most onerous impacts). The results show that the total attributable fraction due to temperature, extreme and moderate cold, is statistically significant in the historical period and the future projected scenarios, while extreme and moderate heat were only significant in the projected future summer period. Net differences were attributed to moderate cold in the future winter months. Projections show a consistent and significant increase in future heat-related mortality burden. The attributable fraction due to heat in the future period, compared to the historical period, ranges from 0 to 1.5% for moderate heat and from 0 to 0.5% for extreme heat. Adaptation should be implemented at the local level, so as to prevent and diminish the effects on citizens and healthcare services, in a context of climate change.
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Affiliation(s)
- Mónica Rodrigues
- Department of Geography and Tourism, Centre of Studies on Geography and Spatial Planning, University of Coimbra, Portugal.
| | - Paula Santana
- Department of Geography and Tourism, Centre of Studies on Geography and Spatial Planning, University of Coimbra, Portugal
| | - Alfredo Rocha
- Department of Physics, Centre for Environmental and Marine Studies (CESAM), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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23
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Chen S, Xiao Y, Zhou M, Zhou C, Yu M, Huang B, Xu Y, Liu T, Hu J, Xu X, Lin L, Hu R, Hou Z, Li J, Jin D, Qin M, Zhao Q, Gong W, Yin P, Xu Y, Xiao J, Zeng W, Li X, Guo L, Zhang Y, Huang C, Ma W. Comparison of life loss per death attributable to ambient temperature among various development regions: a nationwide study in 364 locations in China. Environ Health 2020; 19:98. [PMID: 32933549 PMCID: PMC7491140 DOI: 10.1186/s12940-020-00653-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/08/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Several studies have investigated the associations between ambient temperature and years of life lost (YLLs), but few focused on the difference of life loss attributable to temperature among different socioeconomic development levels. OBJECTIVES We investigated the disparity in temperature-YLL rate relationships and life loss per death attributable to nonoptimal temperature in regions with various development levels. METHODS Three hundred sixty-four Chinese counties or districts were classified into 92 high-development regions (HDRs) and 272 low-development regions (LDRs) according to socioeconomic factors of each location using K-means clustering approach. We used distributed lag non-linear models (DLNM) and multivariate meta-analysis to estimate the temperature-YLL rate relationships. We calculated attributable fraction (AF) of YLL and temperature-related average life loss per death to compare mortality burden of temperature between HDRs and LDRs. Stratified analyses were conducted by region, age, sex and cause of death. RESULTS We found that non-optimal temperatures increased YLL rates in both HDRs and LDRs, but all subgroups in LDRs were more vulnerable. The disparity of cold effects between HDRs and LDRs was significant, while the difference in heat effect was insignificant. The overall AF of non-optimal temperature in LDRs [AF = 12.2, 95% empirical confidence interval (eCI):11.0-13.5%] was higher than that in HDRs (AF = 8.9, 95% eCI: 8.3-9.5%). Subgroups analyses found that most groups in LDRs had greater AFs than that in HDRs. The average life loss per death due to non-optimal temperature in LDRs (1.91 years, 95% eCI: 1.72-2.10) was also higher than that in HDRs (1.32 years, 95% eCI: 1.23-1.41). Most of AFs and life loss per death were caused by moderate cold in both HDRs and LDRs. CONCLUSIONS Mortality burden caused by temperature was more significant in LDRs than that in HDRs, which means that more attention should be paid to vulnerable populations in LDRs in planning adaptive strategies.
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Affiliation(s)
- Siqi Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022 China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050 China
| | - Chunliang Zhou
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Ruying Hu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Junhua Li
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Donghui Jin
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Mingfang Qin
- Yunnan Center for Disease Control and Prevention, Kunming, 650022 China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050 China
| | - Yiqing Xu
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
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Chen K, Breitner S, Wolf K, Hampel R, Meisinger C, Heier M, von Scheidt W, Kuch B, Peters A, Schneider A. Temporal variations in the triggering of myocardial infarction by air temperature in Augsburg, Germany, 1987-2014. Eur Heart J 2020; 40:1600-1608. [PMID: 30859207 DOI: 10.1093/eurheartj/ehz116] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/17/2018] [Accepted: 02/18/2019] [Indexed: 11/12/2022] Open
Abstract
AIMS The association between air temperature and mortality has been shown to vary over time, but evidence of temporal changes in the risk of myocardial infarction (MI) is lacking. We aimed to estimate the temporal variations in the association between short-term exposures to air temperature and MI in the area of Augsburg, Germany. METHODS AND RESULTS Over a 28-years period from 1987 to 2014, a total of 27 310 cases of MI and coronary deaths were recorded. Daily meteorological parameters were measured in the study area. A time-stratified case-crossover analysis with a distributed lag non-linear model was used to estimate the risk of MI associated with air temperature. Subgroup analyses were performed to identify subpopulations with changing susceptibility to air temperature. Results showed a non-significant decline in cold-related MI risks. Heat-related MI relative risk significantly increased from 0.93 [95% confidence interval (CI): 0.78-1.12] in 1987-2000 to 1.14 (95% CI: 1.00-1.29) in 2001-14. The same trend was also observed for recurrent and non-ST-segment elevation MI events. This increasing population susceptibility to heat was more evident in patients with diabetes mellitus and hyperlipidaemia. Future studies using multicentre MI registries at different climatic, demographic, and socioeconomic settings are warranted to confirm our findings. CONCLUSION We found evidence of rising population susceptibility to heat-related MI risk from 1987 to 2014, suggesting that exposure to heat should be considered as an environmental trigger of MI, especially under a warming climate.
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Affiliation(s)
- Kai Chen
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, Munich, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany
| | - Regina Hampel
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany
| | - Christa Meisinger
- Ludwig-Maximilians-Universität München, UNIKA-T, Neusässer Str. 47, Augsburg, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München-German Research, Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany.,MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Stenglinstr. 2, Augsburg, Germany
| | - Wolfgang von Scheidt
- Department of Internal Medicine I - Cardiology, Central Hospital of Augsburg, Stenglinstr. 2, Augsburg, Germany
| | - Bernhard Kuch
- Department of Internal Medicine I - Cardiology, Central Hospital of Augsburg, Stenglinstr. 2, Augsburg, Germany.,Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Stoffelsberg 4, Nördlingen, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, Munich, Germany.,Partner-Site Munich, German Research Center for Cardiovascular Research (DZHK), Biedersteiner Straße 29, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, Neuherberg, Germany
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Silveira IH, Cortes TR, Oliveira BFA, Junger WL. Temperature and cardiovascular mortality in Rio de Janeiro, Brazil: effect modification by individual-level and neighbourhood-level factors. J Epidemiol Community Health 2020; 75:69-75. [PMID: 32863272 DOI: 10.1136/jech-2020-215002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Many factors related to susceptibility or vulnerability to temperature effects on mortality have been proposed in the literature. However, there is limited evidence of effect modification by some individual-level factors such as occupation, colour/race, education level and community-level factors. We investigated the effect modification of the temperature-cardiovascular mortality relationship by individual-level and neighbourhood-level factors in the city of Rio de Janeiro, Brazil. METHODS We used a case-crossover study to estimate the total effect of temperature on cardiovascular mortality in Rio de Janeiro between 2001 and 2018, and the effect modification by individual-level and neighbourhood-level factors. Individual-level factors included sex, age, colour/race, education, and place of death. Neighbourhood-level characteristics included social development index (SDI), income, electricity consumption and demographic change. We used conditional Poisson regression models combined with distributed lag non-linear models, adjusted for humidity and public holidays. RESULTS Our results suggest a higher vulnerability to high temperatures among the elderly, women, non-hospitalised deaths, and people with a lower education level. Vulnerability to low temperatures was higher among the elderly, men, non-white people, and for primary education level. As for neighbourhood-level factors, we identified greater vulnerability to low and high temperatures in places with lower SDI, lower income, lower consumption of electricity, and higher demographic growth. CONCLUSION The effects of temperature on cardiovascular disease mortality in Rio de Janeiro vary according to individual-level and neighbourhood-level factors. These findings are valuable to inform policymakers about the most vulnerable groups and places, in order to develop more effective and equitable public policies.
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Affiliation(s)
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Huang H, Deng X, Yang H, Zhou X, Jia Q. Spatio-Temporal Mechanism Underlying the Effect of Urban Heat Island on Cardiovascular Diseases. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1455-1466. [PMID: 33083322 PMCID: PMC7554388 DOI: 10.18502/ijph.v49i8.3889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: We explored the spatio-temporal characteristics of urban heat island (UHI) effect on cardiovascular diseases (CVDs). Methods: The land surface temperatures (LST) were retrieved from four Landsat remote-sensing images’ data, the temperature data from 95 meteorological stations, and analysis data on CVDs mortality. Based on these data, landscape pattern indexes were used to analyze the pattern-process-function and the mechanism. Results: During 1984–2017, the effects of UHI on CVDs increased, thereby increased the mortality by 28.8%. The affected areas gradually expand from the central area of the city and undergo three evolution stages; the highly affected areas are mainly distributed in central and southern regions, and patches increase in number. The areas and ratio of high-level patches also show an upward tendency, increasing dominance in the overall landscape. Patches of the overall landscape become more complicated in shape, whereas those of high-level ones become less complicated. Concentration degree of the overall landscape decreases gradually with the types of landscapes patches increasing, reaching a rather even space distribution. Conclusion: Increased temperatures exacerbated by UHI lead to increased CVD mortality. As cities expand, the effects of UHI on CVDs increase in terms of both intensity and areas, with the overall landscape in uneven distribution, high-level affected areas in point distribution, and low-level ones in large-area concentration.
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Affiliation(s)
- Huanchun Huang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Xin Deng
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Hailin Yang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Xinhui Zhou
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Qi Jia
- College of Arts and Design, Zhengzhou University of Light Industry, Zhengzhou, China
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Guo S, Niu Y, Cheng Y, Chen R, Kan J, Kan H, Li X, Li J, Cao J. Association between ambient temperature and daily emergency hospitalizations for acute coronary syndrome in Yancheng, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:3885-3891. [PMID: 31823267 DOI: 10.1007/s11356-019-07084-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
Acute coronary syndrome (ACS) is a major public health concern worldwide. Few studies have directly evaluated the associations between ambient temperature and ACS incidence. To explore the association between ambient temperature and ACS emergency hospitalizations in the area of subtropical monsoon climate, data on ACS emergency hospitalizations were collected from two highest-ranking hospitals in the central urban area of Yancheng, China, from January 1, 2013, to December 31, 2018. We applied the time-series method to investigate the potentially lagged and non-linear effects of ambient temperature on ACS using the generalized linear model combined with the distributed lag non-linear model after adjusting for time trend, day of the week, holiday, and relative humidity. We identified a total of 5303 cases of ACS emergency hospitalizations during the study period. The exposure-response curves between ambient temperature and ACS hospitalizations were inverse "J-shaped." The effects of extreme low temperature on ACS hospitalizations occurred on the present day and lasted for 3 days, followed by the harvesting effect. The effects of extreme high temperature occurred on the present day and lasted for 5 days. The cumulative relative risks of ACS were 2.14 [95% confident interval (CI): 1.32 to 3.47] for extremely low temperature and 1.66 (95% CI: 1.33 to 2.06) for extremely high temperature over the lag of 0-5 days, compared with the reference temperature (25.0 °C). Both low and high temperatures were significantly associated with higher risks of emergency hospital admissions for ACS in Yancheng, China.
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Affiliation(s)
- Shumei Guo
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Yuexin Cheng
- Department of Hematology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Julia Kan
- University of Bristol Medical School, Bristol, BS8 1QU, UK
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Xu Li
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Jiading Li
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Jingyan Cao
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China.
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Silveira IH, Oliveira BFA, Cortes TR, Junger WL. The effect of ambient temperature on cardiovascular mortality in 27 Brazilian cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 691:996-1004. [PMID: 31326821 DOI: 10.1016/j.scitotenv.2019.06.493] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is limited evidence on the relationship between temperature and cardiovascular mortality in middle and low-income countries, particularly in Latin America. In this study, we investigated the total effect of temperature on cardiovascular mortality in 27 Brazilian cities, and the effect modification by geographic, socioeconomic, demographic and infrastructure characteristics within cities. METHODS In the city-specific analysis, we used time-series analyses to estimate the relationship between mean temperature and daily cardiovascular mortality using quasi-Poisson generalized linear models combined with distributed lag non-linear models. In the second stage, a meta-analysis was used to pool the effects of temperature on cardiovascular mortality for Brazil and its five regions (Central-West, North, Northeast, South, and Southeast). We used a meta-regression to examine the effect modification of city-specific geographic, socioeconomic, demographic and infrastructure-related variables. RESULTS The risks associated with temperature varied across the locations. Higher cardiovascular mortality was associated with low and high temperatures in most of the cities, Brazil and the Central-West, North, South, and Southeast regions. The overall relative risk (RR) for Brazil was 1.26 (95% confidence interval [CI]: 1.17-1.35) for the 1st percentile of temperature and 1.07 (95% CI: 1.01-1.13) for the 99th percentile of temperature versus the 79th percentile (27.7 °C), where RR was lowest. The temperature range was the variable that best explained the variation in effects among the cities, with greater effects in locations having a broader range. CONCLUSIONS The results indicate effects of low and high temperatures on the risk of cardiovascular mortality in most of Brazil's capital cities, besides a pooled effect for Brazil and the Central-West, North, South, and Southeast regions. These findings can help inform public policies addressing the health impact of temperature extremes, especially in the context of climate change.
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Affiliation(s)
- Ismael Henrique Silveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil.
| | - Beatriz Fátima Alves Oliveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Washington Leite Junger
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
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Luo Q, Li S, Guo Y, Han X, Jaakkola JJK. A systematic review and meta-analysis of the association between daily mean temperature and mortality in China. ENVIRONMENTAL RESEARCH 2019; 173:281-299. [PMID: 30928859 DOI: 10.1016/j.envres.2019.03.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/17/2019] [Indexed: 05/15/2023]
Abstract
PURPOSE We summarized the evidence on the effects of heat and cold exposures on mortality in China. We included studies published on this topic in both Chinese and English, thereby filling a gap in knowledge using data from a country that consists of one-fifth of the world's population. METHODS We conducted a systematic search of peer-reviewed studies on the association between daily mean temperature and mortality published from 2001 up to July 2018. We searched one Chinese database (China National Knowledge infrastructure, http://www.cnki.net) and three English databases (PubMed, Scopus, Web of Science). We converted the effect estimates of heat/cold to rate ratios (RRs) associated with 1° increase/decrease beyond the heat/cold reference temperatures. For studies that provided lag-specific estimates, we used both the maximum and minimum of RR estimates. We calculated summary effect estimates for all-cause and cause-specific mortalities, as well as RRs stratified by sex, age, and socioeconomic status. We also investigated patterns of heat and cold adaptation at different latitudes, and at different reference temperatures. RESULTS In total, 45 articles were included in this systematic review. For every 1° temperature increase/decrease beyond reference points, the rate of non-accidental mortality increased by 2% (RR, 1.02; 95% confidence interval (95% CI [1.01-1.02]) for heat and 4% (RR, 1.04; 95% CI [1.03-1.04]) for cold, respectively; the rate of cardiovascular mortality increased 3% (RR, 1.03; 95% CI [1.03-1.04]) for heat and 6% (RR, 1.06; 95% CI [1.04-1.07]) for cold; the rate of respiratory mortality increased 2% (RR, 1.02; 95% CI [1.01-1.03]) for heat and 2% (RR, 1.02; 95% CI [1.00-1.04]) for cold; the rate of cerebrovascular mortality increased 2% (RR, 1.02; 95% CI [1.02-1.03]) for heat and 3% (RR, 1.03; 95% CI [1.02-1.04]) for cold. We identified a variation in optimal temperature range related to latitude of the residential area, and differences in people's capability to adapt to heat versus cold. CONCLUSION We found consistent evidence of the association between temperature and mortality, as well as evidence of patterns in human adaptation, and we discussed the implications of our findings.
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Affiliation(s)
- Qianlai Luo
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Shanshan Li
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Yuming Guo
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Xuemei Han
- NatureServe, 4600 North Fairfax Drive, Arlington, Virginia, 22203, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
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Liang F, Yang X, Liu F, Li J, Xiao Q, Chen J, Liu X, Cao J, Shen C, Yu L, Lu F, Wu X, Zhao L, Wu X, Li Y, Hu D, Huang J, Liu Y, Lu X, Gu D. Long-term exposure to ambient fine particulate matter and incidence of diabetes in China: A cohort study. ENVIRONMENT INTERNATIONAL 2019; 126:568-575. [PMID: 30852444 DOI: 10.1016/j.envint.2019.02.069] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Diabetes caused substantial economic and health burden worldwide. However, the associations between air pollution and diabetes incidence were rarely reported in the developing countries, especially in China with relatively high PM2.5 concentrations. OBJECTIVES A cohort-based study was conducted to assess the diabetes incidence associated with long-term exposure to ambient PM2.5. METHODS We collected individual health data and risk factors from the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR Project) from 15 provinces over China. Diabetes was defined as fasting glucose levels ≥7.0 mmol/L at the follow-ups and/or the use of insulin or oral hypoglycemic agents and/or diagnosed medical history of diabetes during 2004 to 2015. Individual-level PM2.5 exposures were estimated from satellite-based PM2.5 concentrations (10 km spatial resolution) during the study period. Cox proportional hazards models with random intercepts of each cohort and region were employed to estimate the diabetes incidence attributable to PM2.5, after the adjustment for age, gender, body mass index, smoking status, education, work-related physical activity level, hypertension, urbanicity, county-level averaged years of education, and long-term levels of temperature and relative humidity. RESULTS A total of 88,397 subjects were analyzed with 580,928 person-years of follow-up after 2004, among which 6439 new cases of diabetes were observed. The mean age of the subjects was 51.7 years at baseline. For an increase of 10 μg/m3 in long-term PM2.5 exposure, the multivariable-adjusted percent increase in the diabetes incidence was estimated to be 15.66% (95% confidence interval: 6.42%, 25.70%). The adverse effects of PM2.5 were larger among females, rural subjects, non-smokers, normotensives, subjects younger than 65 years and subjects with body mass index <25 kg/m2. CONCLUSIONS Our findings provided evidence for the association of long-term exposure to PM2.5 with diabetes incidence in China. A sustained improvement of air quality will benefit the reduction for diabetes epidemic in China.
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Affiliation(s)
- Fengchao Liang
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xueli Yang
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qingyang Xiao
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Jichun Chen
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial People's Hospital, Fuzhou 350014, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Liancheng Zhao
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xigui Wu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Li
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Prevention Medicine, Shenzhen University School of Medicine, Shenzhen 518060, China
| | - Jianfeng Huang
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
| | - Dongfeng Gu
- Key Laboratory of Cardiovascular Epidemiology & Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. ENVIRONMENTAL RESEARCH 2019; 171:80-91. [PMID: 30660921 DOI: 10.1016/j.envres.2019.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 05/13/2023]
Abstract
Heat waves and high air temperature are associated with increased morbidity and mortality. However, the majority of research conducted on this topic is focused on high income areas of the world. Although heat waves have the most severe impacts on vulnerable populations, relatively few studies have studied their impacts in low and middle income countries (LMICs). The aim of this paper is to review the existing evidence in the literature on the impact of heat on human health in LMICs. We identified peer-reviewed epidemiologic studies published in English between January 1980 and August 2018 investigating potential associations between high ambient temperature or heat waves and mortality or morbidity. We selected studies according to the following criteria: quantitative studies that used primary and/or secondary data and report effect estimates where ambient temperature or heat waves are the main exposure of interest in relation to human morbidity or mortality within LMICs. Of the total 146 studies selected, eighty-two were conducted in China, nine in other countries of East Asia and the Pacific, twelve in South Asia, ten in Sub-Saharan Africa, eight in the Middle East and North Africa, and seven in each of Latin America and Europe. The majority of studies (92.9%) found positive associations between heat and human morbidity/mortality. Additionally, while outcome variables and study design differed greatly, most utilized a time-series study design and examined overall heath related morbidity/mortality impacts in an entire population, although it is notable that the selected studies generally found that the elderly, women, and individuals within the low socioeconomic brackets were the most vulnerable to the effects of high temperature. By highlighting the existing evidence on the impact of extreme heat on health in LMICs, we hope to determine data needs and help direct future studies in addressing this knowledge gap. The focus on LMICs is justified by the lack of studies and data studying the health burden of higher temperatures in these regions even though LMICs have a lower capacity to adapt to high temperatures and thus an increased risk.
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Affiliation(s)
- Hunter Green
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA
| | - Jennifer Bailey
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jennifer Vanos
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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Yin Q, Wang J, Su J, Wei Z. A new method to estimate the temperature-CVD mortality relationship. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:8895-8901. [PMID: 30715716 DOI: 10.1007/s11356-019-04247-6] [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: 09/11/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
Few detailed, individual-focused studies have researched the added effect of temperature on cardiovascular disease (CVD), particularly in China. Moreover, no prior studies have explored the exposure-response relationship among all populations and different sub-sociodemographic groups. A distributed lag nonlinear model (DLNM) was applied to evaluate the adverse health effects of temperature on CVD mortality for all populations and different sub-sociodemographic groups (by age, sex, educational level, living arrangement, and occupation) in Beijing. Based on the exposure-response relationships, firstly, we proposed a new model (COCKTAIL, Code Of Climate Key To An Ill) for revealing the split-and-merge relationships of the temperature-CVD mortality curve. This method could be used to apply the CVD deaths in a studied area to forecast the exposure-response relationships in the same area in the future. Secondly, this is the most detailed study to analyze the relationship between temperature and CVD mortality for different subgroups among the existing researches for developed and developing countries. We found that the cold temperature (at - 14 °C) was the risk factor for people with low socioeconomic status, especially for single people (including unmarried, divorced, and widowed), for indoor workers, and for people with low education, compared with the minimum mortality temperature, with a cumulative increase of 3.9 (80%CI, 2.9-5.4), 3.8 (80%CI, 2.8-5.1), and 4.5 (80%CI, 3.1-6.3) times respectively. Meanwhile, the hot temperature (at 35 °C) was the risk factor for CVD death, with a cumulative increase of 2.6 (80%CI, 2.0-3.4) for females, and 3.1 (80%CI, 2.4-4.2) for single people. The varying CVD vulnerability in terms of CVD mortality among various groups may assist governments in preparing health resources and taking measures to prevent or reduce temperature-related deaths.
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Affiliation(s)
- Qian Yin
- State Key Laboratory of Resources and Environmental Information System, Chinese Academy of Sciences, Institute of Geographic Sciences and Nature Resources Research, A11, Datun Road, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Chinese Academy of Sciences, Institute of Geographic Sciences and Nature Resources Research, A11, Datun Road, Beijing, China.
- The University of Chinese Academy of Sciences, Beijing, China.
| | - Jianting Su
- Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Beijing Research Center for Preventive Medicine, Beijing, China
| | - Zaihua Wei
- Beijing Municipal Center for Disease Prevention and Control, Beijing, China
- Beijing Research Center for Preventive Medicine, Beijing, China
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Liu T, Ren Z, Zhang Y, Feng B, Lin H, Xiao J, Zeng W, Li X, Li Z, Rutherford S, Xu Y, Lin S, Nasca PC, Du Y, Wang J, Huang C, Jia P, Ma W. Modification Effects of Population Expansion, Ageing, and Adaptation on Heat-Related Mortality Risks Under Different Climate Change Scenarios in Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030376. [PMID: 30699991 PMCID: PMC6388188 DOI: 10.3390/ijerph16030376] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 12/24/2022]
Abstract
(1) Background: Although the health effects of future climate change have been examined in previous studies, few have considered additive impacts of population expansion, ageing, and adaptation. We aimed to quantify the future heat-related years of life lost (YLLs) under different Representative Concentration Pathways (RCP) scenarios and global-scale General Circulation Models (GCMs), and further to examine relative contributions of population expansion, ageing, and adaptation on these projections. (2) Methods: We used downscaled and bias-corrected projections of daily temperature from 27 GCMs under RCP2.6, 4.5, and 8.5 scenarios to quantify the potential annual heat-related YLLs in Guangzhou, China in the 2030s, 2060s, and 2090s, compared to those in the 1980s as a baseline. We also explored the modification effects of a range of population expansion, ageing, and adaptation scenarios on the heat-related YLLs. (3) Results: Global warming, particularly under the RCP8.5 scenario, would lead to a substantial increase in the heat-related YLLs in the 2030s, 2060s, and 2090s for the majority of the GCMs. For the total population, the annual heat-related YLLs under the RCP8.5 in the 2030s, 2060s, and 2090s were 2.2, 7.0, and 11.4 thousand, respectively. The heat effects would be significantly exacerbated by rapid population expansion and ageing. However, substantial heat-related YLLs could be counteracted by the increased adaptation (75% for the total population and 20% for the elderly). (4) Conclusions: The rapid population expansion and ageing coinciding with climate change may present an important health challenge in China, which, however, could be partially counteracted by the increased adaptation of individuals.
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Affiliation(s)
- Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Baixiang Feng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Hualiang Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Zhihao Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | | | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Pl, Rensselaer, NY 12148, USA.
| | - Philip C Nasca
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Pl, Rensselaer, NY 12148, USA.
| | - Yaodong Du
- Guangdong Provincial Climate Center, Guangzhou 510080, China.
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Peng Jia
- Department of Earth Observation Science, Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, 7500 Enschede, The Netherlands.
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), 7500 Enschede, The Netherlands.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
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Temporal Trends in Heat-Related Mortality: Implications for Future Projections. ATMOSPHERE 2018. [DOI: 10.3390/atmos9100409] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
High temperatures have large impacts on premature mortality risks across the world, and there is concern that warming temperatures associated with climate change, and in particular larger-than-expected increases in the proportion of days with extremely high temperatures, may lead to increasing mortality risks. Comparisons of heat-related mortality exposure-response functions across different cities show that the effects of heat on mortality risk vary by latitude, with more pronounced heat effects in more northerly climates. Evidence has also emerged in recent years of trends over time in heat-related mortality, suggesting that in many locations, the risk per unit increase in temperature has been declining. Here, I review the emerging literature on these trends, and draw conclusions for studies that seek to project future impacts of heat on mortality. I also make reference to the more general heat-mortality literature, including studies comparing effects across locations. I conclude that climate change projection studies will need to take into account trends over time (and possibly space) in the exposure response function for heat-related mortality. Several potential methods are discussed.
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Masselot P, Chebana F, Ouarda TBMJ, Bélanger D, St-Hilaire A, Gosselin P. A new look at weather-related health impacts through functional regression. Sci Rep 2018; 8:15241. [PMID: 30323248 PMCID: PMC6189063 DOI: 10.1038/s41598-018-33626-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 08/17/2018] [Indexed: 12/13/2022] Open
Abstract
A major challenge of climate change adaptation is to assess the effect of changing weather on human health. In spite of an increasing literature on the weather-related health subject, many aspect of the relationship are not known, limiting the predictive power of epidemiologic models. The present paper proposes new models to improve the performances of the currently used ones. The proposed models are based on functional data analysis (FDA), a statistical framework dealing with continuous curves instead of scalar time series. The models are applied to the temperature-related cardiovascular mortality issue in Montreal. By making use of the whole information available, the proposed models improve the prediction of cardiovascular mortality according to temperature. In addition, results shed new lights on the relationship by quantifying physiological adaptation effects. These results, not found with classical model, illustrate the potential of FDA approaches.
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Affiliation(s)
- Pierre Masselot
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada.
| | - Fateh Chebana
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Taha B M J Ouarda
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Diane Bélanger
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
| | - Pierre Gosselin
- Canada Research Chair in Statistical Hydro-Climatology INRS-ETE, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
- Institut national de santé publique du Québec (INSPQ), Québec, Canada
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Chen R, Miao F, Zheng J, Wu Y, Li Y. Effects of Consecutive Moderately Cold Days on Cardiovascular Disease Mortality in Shenzhen, China: A Preliminary Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1148-1151. [PMID: 30440594 DOI: 10.1109/embc.2018.8513273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite traditional risk factors such as aging and hyperlipemia for cardiovascular disease (CVD) mortality, many studies have also confirmed that both hot and cold ambient temperatures are associated with CVD mortality. This paper aims to explore the effects of consecutive moderately cold days on CVD mortality in the warm city Shenzhen during relatively cold months from 2011 to 2015. In this study, totally there were 4589 CVD death cases among the residents during a total of 24 relatively cold months. Effects of consecutive cold days on CVD mortality was evaluated by the daily percent increase of CVD mortality. Three temperature thresholds were selected, which were 15°, 14°, and 13°, respectively. The results showed that when the cold weather lasted 5 days and onwards, CVD mortality showed a continuous increment. When the temperature thresholds were 15°, 14°, or 13°, percent increase of CVD mortality at the consecutive 6th cold day reached 22%, 21%, and 24% respectively, and 26%, 38%, 33% at the consecutive 10th cold day, respectively. Thus, the consecutive moderately cold days in warm regions had continuous and accumulative negative effects on CVD mortality. The study may help local government to take timely prevention measures for moderately cold temperatures and thus to protect the wellbeing for the public.
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Masselot P, Chebana F, Bélanger D, St-Hilaire A, Abdous B, Gosselin P, Ouarda TBMJ. Aggregating the response in time series regression models, applied to weather-related cardiovascular mortality. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 628-629:217-225. [PMID: 29438931 DOI: 10.1016/j.scitotenv.2018.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/04/2018] [Accepted: 02/02/2018] [Indexed: 06/08/2023]
Abstract
In environmental epidemiology studies, health response data (e.g. hospitalization or mortality) are often noisy because of hospital organization and other social factors. The noise in the data can hide the true signal related to the exposure. The signal can be unveiled by performing a temporal aggregation on health data and then using it as the response in regression analysis. From aggregated series, a general methodology is introduced to account for the particularities of an aggregated response in a regression setting. This methodology can be used with usually applied regression models in weather-related health studies, such as generalized additive models (GAM) and distributed lag nonlinear models (DLNM). In particular, the residuals are modelled using an autoregressive-moving average (ARMA) model to account for the temporal dependence. The proposed methodology is illustrated by modelling the influence of temperature on cardiovascular mortality in Canada. A comparison with classical DLNMs is provided and several aggregation methods are compared. Results show that there is an increase in the fit quality when the response is aggregated, and that the estimated relationship focuses more on the outcome over several days than the classical DLNM. More precisely, among various investigated aggregation schemes, it was found that an aggregation with an asymmetric Epanechnikov kernel is more suited for studying the temperature-mortality relationship.
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Affiliation(s)
- Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Diane Bélanger
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Belkacem Abdous
- Université Laval, Département de Médecine Sociale et Préventive, Québec, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada; Institut National de Santé Publique du Québec (INSPQ), Québec, Canada
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
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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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Masselot P, Chebana F, Bélanger D, St-Hilaire A, Abdous B, Gosselin P, Ouarda TBMJ. EMD-regression for modelling multi-scale relationships, and application to weather-related cardiovascular mortality. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 612:1018-1029. [PMID: 28892843 DOI: 10.1016/j.scitotenv.2017.08.276] [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: 05/25/2017] [Revised: 07/31/2017] [Accepted: 08/28/2017] [Indexed: 06/07/2023]
Abstract
In a number of environmental studies, relationships between nat4ural processes are often assessed through regression analyses, using time series data. Such data are often multi-scale and non-stationary, leading to a poor accuracy of the resulting regression models and therefore to results with moderate reliability. To deal with this issue, the present paper introduces the EMD-regression methodology consisting in applying the empirical mode decomposition (EMD) algorithm on data series and then using the resulting components in regression models. The proposed methodology presents a number of advantages. First, it accounts of the issues of non-stationarity associated to the data series. Second, this approach acts as a scan for the relationship between a response variable and the predictors at different time scales, providing new insights about this relationship. To illustrate the proposed methodology it is applied to study the relationship between weather and cardiovascular mortality in Montreal, Canada. The results shed new knowledge concerning the studied relationship. For instance, they show that the humidity can cause excess mortality at the monthly time scale, which is a scale not visible in classical models. A comparison is also conducted with state of the art methods which are the generalized additive models and distributed lag models, both widely used in weather-related health studies. The comparison shows that EMD-regression achieves better prediction performances and provides more details than classical models concerning the relationship.
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Affiliation(s)
- Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Diane Bélanger
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada
| | - André St-Hilaire
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
| | - Belkacem Abdous
- Université Laval, Département de médecine sociale et préventive, Québec, Canada
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada; Centre Hospitalier Universitaire de Québec, Centre de Recherche, Québec, Canada; Institut national de santé publique du Québec (INSPQ), Québec, Canada
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, Québec, Canada
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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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Seposo XT, Dang TN, Honda Y. How Does Ambient Air Temperature Affect Diabetes Mortality in Tropical Cities? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040385. [PMID: 28379204 PMCID: PMC5409586 DOI: 10.3390/ijerph14040385] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/16/2017] [Accepted: 03/28/2017] [Indexed: 12/20/2022]
Abstract
Diabetes is well-known as one of the many chronic diseases that affect different age groups. Currently, most studies that evaluated the effects of temperature on diabetes mortality focused on temperate and subtropical settings, but no study has been conducted to assess the relationship in a tropical setting. We conducted the first multi-city study carried out in tropical cities, which evaluated the temperature–diabetes relationship. We collected daily diabetes mortality (ICD E10–E14) of four Philippine cities from 2006 to 2011. Same period meteorological data were obtained from the National Oceanic and Atmospheric Administration. We used a generalized additive model coupled with a distributed lag non-linear model (DLNM) in determining the relative risks. Results showed that both low and high temperatures pose greater risks among diabetics. Likewise, the study was able to observe the: (1) high risk brought about by low temperature, aside from the largely observed high risks by high temperature; and (2) protective effects in low temperature percentile. These results provide significant policy implications with strategies related to diabetes risk groups in relation to health service and care strategies.
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Affiliation(s)
- Xerxes T Seposo
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City 305-8577, Japan.
| | - Tran Ngoc Dang
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City 305-8577, Japan.
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City 70000, Vietnam.
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba City 305-8577, Japan.
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Ha S, Liu D, Zhu Y, Kim SS, Sherman S, Mendola P. Ambient Temperature and Early Delivery of Singleton Pregnancies. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:453-459. [PMID: 27580125 PMCID: PMC5332199 DOI: 10.1289/ehp97] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND Extreme temperature is associated with adverse birth outcomes but it is unclear whether it increases early delivery risk. OBJECTIVES We aimed to determine the association between ambient temperature and early delivery. METHODS Medical records from 223,375 singleton deliveries from 12 U.S. sites were linked to local ambient temperature. Exposure to hot (> 90th percentile) or cold (< 10th percentile) using site-specific and window-specific temperature distributions were defined for 3-months preconception, 7-week periods during the first two trimesters, 1 week preceding delivery, and whole pregnancy. Poisson regression with generalized estimating equations calculated the relative risk (RR) and 95% confidence interval for early deliveries associated with hot/cold exposures, adjusting for conception month, humidity, site, sex, maternal demographics, parity, insurance, prepregnancy body mass index, pregnancy complications, and smoking or drinking during pregnancy. Acute temperature associations were estimated separately for warm (May-September) and cold season (October-April) in a case-crossover analysis using conditional logistic regression. RESULTS Compared with mild temperature (10-90th percentile), exposure to hot or cold during weeks 1-7 increased risk for early preterm (< 34 weeks) [RRhot: 1.11 (95% CI: 1.01, 1.21); RRcold: 1.20 (95% CI: 1.11, 1.30)], late preterm (34-36 weeks) [RRcold: 1.09 (95% CI: 1.04, 1.15)], and early term (37-38 weeks) [RRhot: 1.04 (95% CI: 1.02, 1.07); RRcold: 1.03 (95% CI: 1.00, 1.05)] delivery. Findings were similar for hot exposures during weeks 15-21. Examining deliveries at each week from 23 through 38, whole-pregnancy hot exposures increased delivery risk by 6-21% at weeks 34 and 36-38. In the case-crossover analysis, a 5°F increase during the week preceding delivery was associated with 12-16% higher and 4-5% lower early delivery risk during warm and cold season, respectively. CONCLUSIONS Both acute and chronic ambient temperature extremes may affect early delivery risk. Citation: Ha S, Liu D, Zhu Y, Kim SS, Sherman S, Mendola P. 2017. Ambient temperature and early delivery of singleton pregnancies. Environ Health Perspect 125:453-459; http://dx.doi.org/10.1289/EHP97.
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Affiliation(s)
| | - Danping Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland, USA
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Temperature and Cardiovascular Mortality Associations in Four Southern Chinese Cities: A Time-Series Study Using a Distributed Lag Non-Linear Model. SUSTAINABILITY 2017. [DOI: 10.3390/su9030321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chen F, Qiao Z, Fan Z, Zheng Q, Wu Y, Zhang M, Cui Y, Deng Y, Luo B, Zhang W, Ji K, Qiao X, Zhao X, Li X. The effects of Sulphur dioxide on acute mortality and years of life lost are modified by temperature in Chengdu, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 576:775-784. [PMID: 27810762 DOI: 10.1016/j.scitotenv.2016.10.161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/20/2016] [Accepted: 10/20/2016] [Indexed: 06/06/2023]
Abstract
The effect modification of meteorological factors on the association between ambient Sulphur dioxide (SO2) and mortality is critical for designing intervention policy. Existing studies did not result in consistent conclusions on the effect modification, and Years of life lost (YLLs) was rarely used as a health impact indicator to examine the modifying effect. This study aims to estimate the mean air temperature and relative humidity modification effects on the impact of SO2 on daily mortality and YLLs in Chengdu, China. Mortality, YLLs, air pollution and meteorological data were collected for 2011-2014. Three analytical approaches based on generalized additive models (GAMs) were used, including bivariate response surface model, product term model, and stratification model. We found that the effects of SO2 on mortality and YLLs depended on temperature at various lags, but did not depend on relative humidity. SO2 exhibited larger adverse effects on mortality in high temperature level (22.8-29.4°C) days than in low temperature level (-0.3-9.3°C) days, with a 10μg/m3 increment in SO2, non-accidental death increased by 0.8% (0.001, 0.015)at low temperature level, but increased by 1.4% (0.005, 0.024) at high temperature level. On the contrary, SO2 showed greater adverse effects on YLLs in low temperature days than in high temperature days, with a 10μg/m3 increment in SO2, non-accidental YLL increased by 40.580 (31.478, 49.682) at high temperature level, but increased by -2.703 (-14.668, 9.261) at low temperature level. We concluded that the effect of SO2 on mortality and YLLs may depend on temperature in Chengdu, China. Our results highlight the importance of considering the interaction between SO2 and temperature on health outcomes in future research. Also, policy makers should enhance the emission control of SO2 in extreme temperature days in Chengdu.
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Affiliation(s)
- Fei Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Zhijiao Qiao
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Zhiwei Fan
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Qulu Zheng
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yunyun Wu
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Meixia Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yan Cui
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China
| | - Ying Deng
- Sichuan Centre for Disease Control and Prevention, Chengdu 610041, Sichuan, China
| | - Bin Luo
- Sichuan Environmental Monitoring Centre, Chengdu 610041, Sichuan, China
| | - Wei Zhang
- Sichuan Environmental Monitoring Centre, Chengdu 610041, Sichuan, China
| | - Kui Ji
- Sichuan Centre for Disease Control and Prevention, Chengdu 610041, Sichuan, China
| | - Xue Qiao
- Institute of New Energy and Low-Carbon Technology, Sichuan University, Chengdu, Sichuan, China
| | - Xing Zhao
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xiaosong Li
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan, China.
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Niu Y, Chen R, Liu C, Ran P, Chen A, Chen X, Kan H. The association between ambient temperature and out-of-hospital cardiac arrest in Guangzhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 572:114-118. [PMID: 27497032 DOI: 10.1016/j.scitotenv.2016.07.205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 07/08/2016] [Accepted: 07/29/2016] [Indexed: 06/06/2023]
Abstract
Out-of-hospital cardiac arrest (OHCA) is becoming a considerable public health burden worldwide. The seasonal variation of OHCA has been observed, but the potential effects of ambient temperature on OHCA were rarely investigated. We, therefore, aimed to evaluate the association between ambient temperature and OHCA in Guangzhou, China. We collected daily emergency ambulance dispatches for OHCA from the Guangzhou Emergency Center from January 1, 2008 to December 31, 2012. We analyzed the associations using the time-series method. We applied the generalized linear model combined with the distributed lag non-linear model to estimate the potentially non-linear and lagged effects of temperature on OHCA. Time trends, day of the week, and air pollutants were controlled as covariates. We identified a total of 4369 cases of OHCD. The associations between daily mean temperature and OHCA were generally J-shaped. Both low and high temperatures could increase the risk of OHCA. The effects were strongest on the concurrent day (lag 0) and lasted for 6 or 7days. The cumulative risks of extreme cold (1st percentile of temperature) and extreme heat (99th percentile of temperature) over lags 0-21days were 3.75 (95% confidence interval [CI]: 1.63, 8.63) and 2.45 (95%CI: 1.15, 5.33), respectively, compared with the referent temperature (28°C)·This study suggested that both cold and hot temperatures could significantly increase the risk of OHCA in Guangzhou, China. Our results might have important public health implications for the prevention of OHCA.
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Affiliation(s)
- Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Ailan Chen
- Department of Cardiology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China
| | - Xinyu Chen
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China; Department of Pathogenic Biology, Guangzhou Hoffmann Institute of Immunology, Guangzhou Medical University, Guangzhou 511436, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai 200032, China.
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