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Wen B, Wu Y, Guo Y, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan SC, Íñiguez C, Ameling C, Valencia CDLC, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de'Donato F, Rao S, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca IH, Kyselý J, Madureira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Diaz MH, Ragettli MS, Hashizume M, Pascal M, Coélho MDSZS, Ortega NV, Ryti N, Scovronick N, Michelozzi P, Matus Correa P, Goodman P, Saldiva PHN, Raz R, Abrutzky R, Osorio S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Kim Y, Guo YL, Bell ML, Li S. Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study. ENVIRONMENT INTERNATIONAL 2024; 187:108712. [PMID: 38714028 DOI: 10.1016/j.envint.2024.108712] [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: 11/23/2023] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects. OBJECTIVES We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality. METHODS We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates. RESULTS Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV0-7 (0.9 °C). An IQR increase in inter-day TV0-7 (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV0-7 and inter-day TV0-7 was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type. CONCLUSIONS Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.
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Affiliation(s)
- Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Republic of Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Ariana Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | | | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Dominic Royé
- CIBER of Epidemiology and Public Health, Madrid, Spain; Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | | | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Gabriel Carrasco-Escobar
- Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Joana Madureira
- Environmental Health Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 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
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France
| | | | | | - Niilo Ryti
- 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
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Patrick Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | | | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - Veronika Huber
- IBE-Chair of Epidemiology, LMU Munich, Munich, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA; Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yue Leon Guo
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Zhang T, Ni M, Jia J, Deng Y, Sun X, Wang X, Chen Y, Fang L, Zhao H, Xu S, Ma Y, Zhu J, Pan F. Research on the relationship between common metabolic syndrome and meteorological factors in Wuhu, a subtropical humid city of China. BMC Public Health 2023; 23:2363. [PMID: 38031031 PMCID: PMC10685562 DOI: 10.1186/s12889-023-17299-8] [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: 06/25/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
As climate conditions deteriorate, human health faces a broader range of threats. This study aimed to determine the risk of death from metabolic syndrome (MetS) due to meteorological factors. We collected daily data from 2014 to 2020 in Wuhu City, including meteorological factors, environmental pollutants and death data of common MetS (hypertension, hyperlipidemia and diabetes), as well as a total number of 15,272 MetS deaths. To examine the relationship between meteorological factors, air pollutants, and MetS mortality, we used a generalized additive model (GAM) combined with a distributed delay nonlinear model (DLNM) for time series analysis. The relationship between the above factors and death outcomes was preliminarily evaluated using Spearman analysis and structural equation modeling (SEM). As per out discovery, diurnal temperature range (DTR) and daily mean temperature (T mean) increased the MetS mortality risk notably. The ultra low DTR raised the MetS mortality risk upon the general people, with the highest RR value of 1.033 (95% CI: 1.002, 1.065) at lag day 14. In addition, T mean was also significantly associated with MetS death. The highest risk of ultra low and ultra high T mean occured on the same day (lag 14), RR values were 1.043 (95% CI: 1.010, 1.077) and 1.032 (95% CI: 1.003, 1.061) respectively. Stratified analysis's result showed lower DTR had a more pronounced effect on women and the elderly, and ultra low and high T mean was a risk factor for MetS mortality in women and men. The elderly need to take extra note of temperature changes, and different levels of T mean will increase the risk of death. In warm seasons, ultra high RH and T mean can increase the mortality rate of MetS patients.
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Affiliation(s)
- Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Man Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Juan Jia
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yujie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Xiaoya Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Xinqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Lanlan Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Hui Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Shanshan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Jiansheng Zhu
- Wuhu center for disease control and prevention, Wuhu, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
- The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
- Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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Liu J, Du X, Yin P, Kan H, Zhou M, Chen R. Cause-specific mortality and burden attributable to temperature variability in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 896:165267. [PMID: 37406687 DOI: 10.1016/j.scitotenv.2023.165267] [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: 02/01/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Few large-scale, nationwide studies have assessed cause-specific mortality risks and burdens associated with temperature variability (TV). OBJECTIVE To estimate associations between TV and cause-specific mortality and quantify the mortality burden in China. METHODS Data on daily total and cause-specific mortality in 272 Chinese cities between 2013 and 2015 were recorded. TVs were computed as the standard deviations of daily minimum and maximum temperatures over a duration of 2 to 7 days. The time-series quasi-Poisson regression model with adjustment of the cumulative effects of daily mean temperature over the same duration was applied to evaluate the city-specific associations of TV and mortality. Then, we pooled the effect estimates using a random-effects meta-analysis and calculated the mortality burdens. RESULTS Overall, TV showed significant and positive associations with total and cause-specific mortality. The TV-mortality associations were generally stronger when using longer durations. A 1 °C increase in TV at 0-7 days (TV0-7) was associated with a 0.79 % [95 % confidence interval (CI): 0.55 %, 0.96 %] increase in total mortality. Mortality fractions attributable to TV0-7 were 4.37 % for total causes, 4.75 % for overall cardiovascular disease, 4.37 % for coronary heart disease, 5.05 % for stroke, 8.28 % for ischaemic stroke, 1.08 % for haemorrhagic stroke, 6.93 % for respiratory disease, and 6.81 % for COPD, respectively. The mortality risk and burden were generally higher in the temperate monsoon zone, females, and elders. CONCLUSION This nationwide study indicated that TV was an independent risk factor of mortality, and could result in significant burden for main cardiorespiratory diseases.
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Affiliation(s)
- Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xihao Du
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
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Liu Y, Guo Y, Liu Z, Feng X, Zhou R, He Y, Zhou H, Peng H, Huang Y. Augmented temperature fluctuation aggravates muscular atrophy through the gut microbiota. Nat Commun 2023; 14:3494. [PMID: 37311782 DOI: 10.1038/s41467-023-39171-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/01/2023] [Indexed: 06/15/2023] Open
Abstract
Large temperature difference is reported to be a risk factor for human health. However, little evidence has reported the effects of temperature fluctuation on sarcopenia, a senile disease characterized by loss of muscle mass and function. Here, we demonstrate that higher diurnal temperature range in humans has a positive correlation with the prevalence of sarcopenia. Fluctuated temperature exposure (10-25 °C) accelerates muscle atrophy and dampens exercise performance in mid-aged male mice. Interestingly, fluctuated temperature alters the microbiota composition with increased levels of Parabacteroides_distasonis, Duncaniella_dubosii and decreased levels of Candidatus_Amulumruptor, Roseburia, Eubacterium. Transplantation of fluctuated temperature-shaped microbiota replays the adverse effects on muscle function. Mechanically, we find that altered microbiota increases circulating aminoadipic acid, a lysine degradation product. Aminoadipic acid damages mitochondrial function through inhibiting mitophagy in vitro. And Eubacterium supplementation alleviates muscle atrophy and dysfunction induced by fluctuated temperature. Our results uncover the detrimental impact of fluctuated temperature on muscle function and provide a new clue for gut-muscle axis.
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Affiliation(s)
- Ya Liu
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yifan Guo
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zheyu Liu
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xu Feng
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Rui Zhou
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yue He
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Haiyan Zhou
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Peng
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yan Huang
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Qi J, Chen L, Yin P, Zhou M, Peng S, Liu G, Wang L, Noman M, Xie Y, Dong Z, Guo Y. Projecting the excess mortality related to diurnal temperature range: A nationwide analysis in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:160971. [PMID: 36535487 DOI: 10.1016/j.scitotenv.2022.160971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/24/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The projection of excess mortality due to diurnal temperature range (DTR) in future has not been evaluated yet in China. Based on daily cause-specific mortality data from 266 cities in China, this study aimed to examine the association between DTR and mortality, which help project the future mortality burden attributable to DTR by considering the modification effects of altitude and population migration. We first found that every 10 °C increase in the DTR would result in a 3.3 % (95 % confidence interval: 2.6 %-4.1 %) excess risk of non-accidental mortality. The unit risk of DTR-associated cause-specific mortality at moderate or high altitudes was significantly lower than at lower altitudes, especially for cardiovascular disease. Subsequently, DTR-associated excess mortality in 2017 in China was 233,154 deaths (with a population-weighted attributable fraction of 2.9 %). Furthermore, we projected DTR-attributable additional mortality in the future, with the associated mortalities to be 221,860 deaths in 2050-2059 (2050s) and 132,305 deaths in 2090-2099 (2090s), under the SSP1-2.6 scenario. Meanwhile, the regional inequalities were exacerbated by 18 % in 2050s and 13 % in 2090s when considering the modification effects of city altitude. Future population migration would increase excess mortality in most areas in central and southern China, and reduce the disease burden in most areas in eastern, western, and northern China. Our findings underpinned that regional strategies should be adopted to mitigate excess mortality attributable to global climate change.
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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, Beijing, China
| | - Lili Chen
- Beijing Academy of Blockchain and Edge Computing, Beijing, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shushi Peng
- College of Urban and Environmental Sciences, Peking University, China
| | - Gang Liu
- College of Urban and Environmental Sciences, Peking University, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Muhammad Noman
- School of Space and Environment, Beihang University, Beijing, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China; Laboratory for Low-carbon Intelligent Governance, Beihang University, Beijing, China.
| | - Zhaomin Dong
- School of Space and Environment, Beihang University, Beijing, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Tian Y, Wu J, Liu H, Wu Y, Si Y, Wang X, Wang M, Wu Y, Wang L, Li D, Wang W, Chen L, Wei C, Wu T, Gao P, Hu Y. Ambient temperature variability and hospital admissions for pneumonia: A nationwide study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159294. [PMID: 36209884 DOI: 10.1016/j.scitotenv.2022.159294] [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: 08/22/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Few investigations have assessed the impact of short-term ambient temperature change on pneumonia risk. We aimed to study the relation of temperature variability (TV) with daily hospitalizations for pneumonia in China. We conducted a time-series study in 184 major cities by extracting daily hospital data between 2014 and 2017 from a medical insurance claims database of 0.28 billion beneficiaries. TV was calculated as standard deviation of daily minimum and maximum temperatures over exposure days. We estimated associations of pneumonia admissions with TV for each city using over-dispersed generalized linear models controlling for weather conditions and ambient air pollution, and pooled city-specific estimates using random effects meta-analyses. We also investigated exposure-response relationship curve and potential effect modifiers. We identified 4.2 million pneumonia hospitalizations during the study period. TV was positively related to daily pneumonia admissions. At the national-average level, each 1-°C increase in TV at 0-6 days' exposure corresponded to a 0.65 % (95 % CI: 0.34 %-0.96 %) increase in pneumonia admissions. An approximately linear exposure-response curve for the relation of TV with pneumonia admission was noted. The relations were more evident in cities with larger average age (P = 0.038). As the first study in China to assess the impact of temperature change on pneumonia on a national scale, our results indicated that acute TV exposure was related to higher admissions for pneumonia. Our findings should provide new insight into the health impacts associated with climate change.
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Affiliation(s)
- Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yaqin Si
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Lulin Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China; Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China
| | - Dan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Weixuan Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Libo Chen
- Beijing HealthCom Data Technology Co. Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071 Beijing, China
| | - Chen Wei
- Beijing HealthCom Data Technology Co. Ltd, No. 18 Fengtai North Road, 10/F Hengtai Plaza Block C, 100071 Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; Key Laboratory of Molecular Cardiovascular (Peking University), Ministry of Education, Beijing
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
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7
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Makunyane MS, Rautenbach H, Sweijd N, Botai J, Wichmann J. Health Risks of Temperature Variability on Hospital Admissions in Cape Town, 2011-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1159. [PMID: 36673914 PMCID: PMC9859170 DOI: 10.3390/ijerph20021159] [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: 12/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Epidemiological studies have provided compelling evidence of associations between temperature variability (TV) and health outcomes. However, such studies are limited in developing countries. This study aimed to investigate the relationship between TV and hospital admissions for cause-specific diseases in South Africa. Hospital admission data for cardiovascular diseases (CVD) and respiratory diseases (RD) were obtained from seven private hospitals in Cape Town from 1 January 2011 to 31 October 2016. Meteorological data were obtained from the South African Weather Service (SAWS). A quasi-Poisson regression model was used to investigate the association between TV and health outcomes after controlling for potential effect modifiers. A positive and statistically significant association between TV and hospital admissions for both diseases was observed, even after controlling for the non-linear and delayed effects of daily mean temperature and relative humidity. TV showed the greatest effect on the entire study group when using short lags, 0-2 days for CVD and 0-1 days for RD hospitalisations. However, the elderly were more sensitive to RD hospitalisation and the 15-64 year age group was more sensitive to CVD hospitalisations. Men were more susceptible to hospitalisation than females. The results indicate that more attention should be paid to the effects of temperature variability and change on human health. Furthermore, different weather and climate metrics, such as TV, should be considered in understanding the climate component of the epidemiology of these (and other diseases), especially in light of climate change, where a wider range and extreme climate events are expected to occur in future.
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Affiliation(s)
- Malebo Sephule Makunyane
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
- South African Weather Service, Pretoria 0001, South Africa
| | - Hannes Rautenbach
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
- Faculty of Natural Sciences, Akademia, Pretoria 0002, South Africa
| | - Neville Sweijd
- Applied Centre for Climate and Earth Systems Science, Council for Scientific and Industrial Research, Cape Town 7700, South Africa
| | - Joel Botai
- South African Weather Service, Pretoria 0001, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
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8
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Long-Term Impacts of Diurnal Temperature Range on Mortality and Cardiovascular Disease: A Nationwide Prospective Cohort Study. Metabolites 2022; 12:metabo12121287. [PMID: 36557325 PMCID: PMC9784544 DOI: 10.3390/metabo12121287] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/01/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Previous studies have documented the associations between short-term diurnal temperature range (DTR) exposure and cardiovascular disease (CVD) via time-series analyses. However, the long-term impacts of DTR through a population-based prospective cohort have not been elucidated thoroughly. This study aimed to quantify the longitudinal association of DTR exposure with all-cause mortality and CVD in a nationwide prospective cohort and, by extension, project future DTR changes across China under climate change. We included 22,702 adults (median age 56.1 years, 53.7% women) free of CVD at baseline from a nationwide cross-sectional study in China during 2012-2015, and examined three health outcomes during a follow-up survey in 2018-2019. We estimated the chronic DTR exposure as baseline annual mean daily maximum minus minimum temperature. The Cox proportional hazards regression was adopted to assess the multivariable-adjusted hazard ratio and its corresponding 95% confidence interval (95% CI). We employed 31 downscaled global climate models under two shared socioeconomic pathways for future projection. During the median follow-up period of ~5 years, 1096 subjects died due to all causes while 993 and 597 individuals developed fatal or nonfatal CVD and fatal or nonfatal stroke, respectively. The cumulative incidence rates of all-cause mortality, CVD, and stroke were 10.49, 9.45, and 5.64 per 1000 person-years, respectively. In the fully adjusted models, the risks for all-cause mortality, CVD, and stroke would increase by 13% (95% CI: 8-18%), 12% (95% CI: 7-18%), and 9% (95% CI: 2-16%) per 1 °C increment in DTR, respectively. Moreover, linear positive associations for the concentration-response curves between DTR and mortality and CVD were observed. We also found significantly greater DTR-related mortality risks among rural residents than their urban counterparts. The DTR changes featured a dipole pattern across China under a warming climate. The southern (northern) China would experience increased (decreased) DTR exposure by the end of 21st century. The present study indicates that chronic DTR exposure can exert long-term impacts on mortality and CVD risks, which may inform future public health policies on DTR-related susceptible population and regions.
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9
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Kapwata T, Gebreslasie MT, Wright CY. An analysis of past and future heatwaves based on a heat-associated mortality threshold: towards a heat health warning system. Environ Health 2022; 21:112. [PMID: 36401226 PMCID: PMC9675182 DOI: 10.1186/s12940-022-00921-4] [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: 06/20/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Heatwaves can have severe impacts on human health extending from illness to mortality. These health effects are related to not only the physical phenomenon of heat itself but other characteristics such as frequency, intensity, and duration of heatwaves. Therefore, understanding heatwave characteristics is a crucial step in the development of heat-health warning systems (HHWS) that could prevent or reduce negative heat-related health outcomes. However, there are no South African studies that have quantified heatwaves with a threshold that incorporated a temperature metric based on a health outcome. To fill this gap, this study aimed to assess the spatial and temporal distribution and frequency of past (2014 - 2019) and future (period 2020 - 2039) heatwaves across South Africa. Heatwaves were defined using a threshold for diurnal temperature range (DTR) that was found to have measurable impacts on mortality. In the current climate, inland provinces experienced fewer heatwaves of longer duration and greater intensity compared to coastal provinces that experienced heatwaves of lower intensity. The highest frequency of heatwaves occurred during the austral summer accounting for a total of 150 events out of 270 from 2014 to 2019. The heatwave definition applied in this study also identified severe heatwaves across the country during late 2015 to early 2016 which was during the strongest El Niño event ever recorded to date. Record-breaking global temperatures were reported during this period; the North West province in South Africa was the worst affected experiencing heatwaves ranging from 12 to 77 days. Future climate analysis showed increasing trends in heatwave events with the greatest increases (80%-87%) expected to occur during summer months. The number of heatwaves occurring in cooler seasons is expected to increase with more events projected from the winter months of July and August, onwards. The findings of this study show that the identification of provinces and towns that experience intense, long-lasting heatwaves is crucial to inform development and implementation of targeted heat-health adaptation strategies. These findings could also guide authorities to prioritise vulnerable population groups such as the elderly and children living in high-risk areas likely to be affected by heatwaves.
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Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2028, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa.
| | - Michael T Gebreslasie
- School of Agriculture, Earth, and Environmental Sciences, University of KwaZulu-Natal, Durban, 3629, South Africa
| | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0084, South Africa
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10
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Zhang Z, Xu D, Chen J, Meng Q, Liang Z, Zhang X. Daily diurnal temperature range associated with outpatient visits of acute lower respiratory infection in children: A time-series study in Guangzhou, China. Front Public Health 2022; 10:951590. [PMID: 36339182 PMCID: PMC9632279 DOI: 10.3389/fpubh.2022.951590] [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] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023] Open
Abstract
Background Diurnal temperature range (DTR) has been increasingly recognized as a risk factor for mortality and morbidity, but the association between DTR and acute lower respiratory infection (ALRI) outpatient visits has not been examined among children in China. Methods A total of 79,416 ALRI outpatient visits among children were obtained from the Guangdong Second Provincial General Hospital between 2013 and 2019. DTR was calculated by taking the difference between the maximum and the minimum temperatures. Generalized additive models using a quasi-Poisson distribution were used to model the relationship between DTR and ALRI outpatient visits. Results Diurnal temperature range was significantly associated with elevated risks of ALRI outpatient visits: the excess risks (ERs) and 95% confidence intervals (CIs) were 2.31% (1.26, 3.36%) for ALRI, 3.19% (1.86, 4.54%) for pneumonia, and 1.79% (0.59, 3.01%) for bronchiolitis, respectively. Subgroup analyses suggested that the associations were significantly stronger during rainy seasons (ER for ALRI: 3.02%, 95% CI: 1.43, 4.64%) than those in dry seasons (ER for ALRI: 2.21%, 95% CI: 0.65, 3.81%), while no significant effect modifications were found in sex and age groups. Conclusion Diurnal temperature range may elevate the risk of ALRI outpatient visits among children in China, especially during rainy seasons. Public health policies are needed to mitigate the adverse health impacts of DTR on children.
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Affiliation(s)
| | | | | | | | - Zhenyu Liang
- Department of Pediatrics, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xiao Zhang
- Department of Pediatrics, Guangdong Second Provincial General Hospital, Guangzhou, China
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11
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Gu S, Wang X, Mao G, Huang X, Wang Y, Xu P, Wu L, Lou X, Chen Z, Mo Z. The effects of temperature variability on mortality in patients with chronic obstructive pulmonary disease: a time-series analysis in Hangzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:71502-71510. [PMID: 35597825 DOI: 10.1007/s11356-022-20588-1] [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: 02/16/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a leading cause of death in people aged over 60 years old. Research has been reported that ambient temperature and diurnal temperature range (DTR), as representative indices of temperature variability, are contributors to the development and exacerbation of COPD. However, few studies are available in Chinese population. In this study, we aimed to assess the associations of temperature variability on COPD mortality in a fast developing city in China. Using the mortality surveillance system, we obtained a total of 7,863 deaths attributed to COPD from 2014 to 2016. Quasi-Poisson generalized linear regression with distributed lag non-linear model was applied to explore the associations between temperature variability and COPD deaths, after controlling for the potential confounders, including relative humidity, day of week, public holiday, and long-term trend. A J-shaped association of DTR and a reversely J-shaped association of temperature for COPD mortality were observed. Risk estimates showed that the relative risks (RRs) of COPD mortality with extreme high DTR at lag 0 and 0-7 days were 1.045 (95% CI: 0.949-1.151) and 1.460 (95% CI: 1.118-1.908), and the extreme high temperature at lag 0 and 0-7 days were 1.090 (95% CI: 0.945-1.256) and 1.352 (95% CI: 1.163-1.572). Our findings suggest that short-term exposure to extreme temperature was associated with mortality for COPD in Hangzhou. The evidence has implications for policy decision-making and targeted interventions.
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Affiliation(s)
- Simeng Gu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Xiaofeng Wang
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Guangming Mao
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Xuemin Huang
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Yuanyang Wang
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Peiwei Xu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Lizhi Wu
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Xiaoming Lou
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Zhijian Chen
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China
| | - Zhe Mo
- Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, China.
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12
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Impact of diurnal temperature range on hospital admissions for cerebrovascular disease among farmers in Northwest China. Sci Rep 2022; 12:15368. [PMID: 36100648 PMCID: PMC9470672 DOI: 10.1038/s41598-022-19507-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022] Open
Abstract
Diurnal temperature range (DTR) is an appropriate indicator for reflecting climate change. Many previous studies have examined the relationship between DTR and mortality. Cerebrovascular disease (CVD) have a higher mortality than other diseases, with mortality from CVD higher in rural areas than in urban areas. A distributed lag non-linear model (DLNM) was used to analyze the exposure-effect relationship between DTR and hospital admissions for CVD from 2018 to 2020 in the population living in rural areas of Tianshui, Gansu Province, China. We investigated the effects of extreme DTR in groups stratified according to gender and age. A U-shape relationship was observed between DTR and hospital admissions for CVD. Both high DTR (19 °C) and low DTR (3 °C) were significantly associated significantly with CVD hospital admissions. When the lag period was 0-21 days, the impact of high DTR (1.595 [95% CI 1.301-1.957]) was slightly more significant than that of a low DTR (1.579 [95% CI - 1.202 to 2.075]). The effect of DTR on CVD varied in different populations. Males and adults were more sensitive to DTR than females and elderly people. It is necessary to make preventive measures to protect vulnerable populations from the adverse effects of extreme DTR.
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13
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Zhou CL, Lv LS, Jin DH, Xie YJ, Ma WJ, Hu JX, Wang CE, Xu YQ, Zhang XE, Lu C. Temperature Change between Neighboring Days Contributes to Years of Life Lost per Death from Respiratory Disease: A Multicounty Analysis in Central China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105871. [PMID: 35627408 PMCID: PMC9141323 DOI: 10.3390/ijerph19105871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many epidemiological studies have recently assessed respiratory mortality attributable to ambient temperatures. However, the associations between temperature change between neighboring days and years of life lost are insufficiently studied. Therefore, we assessed the attributable risk of temperature change between neighboring days on life loss due to respiratory disease. METHODS We obtained daily mortality and weather data and calculated crude rates of years of life lost for 70 counties in Hunan Province, Central China, from 2013 to 2017. A time-series design with distributed lag nonlinear model and multivariate meta-regression was used to pool the relationships between temperature change between neighboring days and rates of years of life lost. Then, we calculated the temperature change between neighboring days related to average life loss per death from respiratory disease. RESULTS The total respiratory disease death was 173,252 during the study period. The association between temperature change and years of life lost rates showed a w-shape. The life loss per death attributable to temperature change between neighboring days was 2.29 (95% CI: 0.46-4.11) years, out of which 1.16 (95% CI: 0.31-2.01) years were attributable to moderately high-temperature change between neighboring days, and 0.99 (95% CI: 0.19-1.79) years were attributable to moderately low-temperature change between neighboring days. The temperature change between neighboring days related to life loss per respiratory disease death for females (2.58 years, 95% CI: 0.22-4.93) and the younger group (2.97 years, 95% CI: -1.51-7.44) was higher than that for males (2.21 years, 95% CI: 0.26-4.16) and the elderly group (1.96 years, 95% CI: 0.85-3.08). An average of 1.79 (95% CI: 0.18-3.41) life loss per respiratory disease death was related to non-optimal ambient temperature. CONCLUSIONS The results indicated that more attention should be given to temperature change, and more public health policies should be implemented to protect public health.
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Affiliation(s)
- Chun-Liang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China; (C.-L.Z.); (D.-H.J.); (C.-E.W.); (Y.-Q.X.); (X.-E.Z.)
| | - Ling-Shuang Lv
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China; (C.-L.Z.); (D.-H.J.); (C.-E.W.); (Y.-Q.X.); (X.-E.Z.)
- Correspondence: (L.-S.L.); (C.L.)
| | - Dong-Hui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China; (C.-L.Z.); (D.-H.J.); (C.-E.W.); (Y.-Q.X.); (X.-E.Z.)
| | - Yi-Jun Xie
- Hunan Provincial Climate Center, Changsha 410007, China;
| | - Wen-Jun Ma
- School of Medicine, Jinan University, Guangzhou 510632, China;
| | - Jian-Xiong Hu
- Guangdong Provincial Institute of Public Health, Guangzhou 511430, China;
| | - Chun-E Wang
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China; (C.-L.Z.); (D.-H.J.); (C.-E.W.); (Y.-Q.X.); (X.-E.Z.)
| | - Yi-Qing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China; (C.-L.Z.); (D.-H.J.); (C.-E.W.); (Y.-Q.X.); (X.-E.Z.)
| | - Xing-E Zhang
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China; (C.-L.Z.); (D.-H.J.); (C.-E.W.); (Y.-Q.X.); (X.-E.Z.)
| | - Chan Lu
- XiangYa School of Public Health, Central South University, Changsha 410078, China
- Correspondence: (L.-S.L.); (C.L.)
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14
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/07/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ‘‘U’’ shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth’s climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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15
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Wu Y, Wen B, Li S, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Analitis A, Zeka A, Tobias A, Alahmad B, Armstrong B, Forsberg B, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de’Donato F, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca IH, Kyselý J, Madureira J, Schwartz J, Katsouyanni K, Hurtado-Diaz M, Ragettli MS, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Scovronick N, Michelozzi P, Goodman P, Nascimento Saldiva PH, Abrutzky R, Osorio S, Dang TN, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Bell ML, Guo Y. Fluctuating temperature modifies heat-mortality association in the globe. Innovation (N Y) 2022; 3:100225. [PMID: 35340394 PMCID: PMC8942841 DOI: 10.1016/j.xinn.2022.100225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/02/2022] [Indexed: 11/30/2022] Open
Abstract
Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: −0.33 to 1.69), 1.34% (95% CI: −0.14 to 2.73), 1.99% (95% CI: 0.29–3.57), and 2.73% (95% CI: 0.76–4.50) of total deaths for Q1–Q4 (first quartile–fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25–9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: −0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health. Increased temperature variability (TV) poses a greater mortality risk due to heat TV has a more profound modification effect on extreme heat-mortality association Strategies against heat and TV simultaneously would benefit public health
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Affiliation(s)
- Yao Wu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Bo Wen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Corresponding author
| | - Antonio Gasparrini
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Shilu Tong
- Shanghai Children’s Medical Centre, Shanghai Jiao Tong University, Shanghai 200025, China
- School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei 230032, China
- Center for Global Health, Nanjing Medical University, Nanjing 211166, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane 4000, Australia
| | - Ala Overcenco
- National Agency for Public Health of the Ministry of Health, Labour, and Social Protection of the Republic of Moldova, Chisinau MD-2009, Republic of Moldova
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague 141 00, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague 165 00, Czech Republic
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg 85747, Germany
| | - Alireza Entezari
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617976487, Iran
| | - Ana Maria Vicedo-Cabrera
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Institute of Social and Preventive Medicine, University of Bern, Bern 3012, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern 3012, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Ariana Zeka
- Institute for Environment, Health, and Societies, Brunel University London, London UB8 3PN, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona 08034, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8521, Japan
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Ben Armstrong
- Department of Public Health, Environments, and Society, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València 46003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Caroline Ameling
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven 3720 BA, Netherlands
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos 62100, Mexico
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå 901 87, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven 3720 BA, Netherlands
| | - Do Van Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 17000, Vietnam
| | - Dominic Royé
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela 15705, Spain
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu 50090, Estonia
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Air Health Science Division, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617976487, Iran
| | | | - Francesca de’Donato
- Department of Epidemiology, Lazio Regional Health Service, Rome 00147, Italy
| | - Francesco Sera
- Department of Statistics, Computer Science, and Applications “G. Parenti”, University of Florence, Florence 50121, Italy
| | - Gabriel Carrasco-Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA 92093, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu 50090, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague 141 00, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague 165 00, Czech Republic
| | - Joana Madureira
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto 4050-600, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto 4050-600, Portugal
- Environmental Health Department, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto 4000-055, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens 11527, Greece
- School of Population Health and Environmental Sciences, King’s College London, London WC2R 2LS, UK
| | - Magali Hurtado-Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos 62100, Mexico
| | - Martina S. Ragettli
- Swiss Tropical and Public Health Institute, Basel 4051, Switzerland
- University of Basel, Basel 4001, Switzerland
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice 94 410, France
| | | | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome 00147, Italy
| | | | | | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires C1053ABH, Argentina
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 17000, Vietnam
| | - Valentina Colistro
- Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo 11200, Uruguay
| | - Veronika Huber
- IBE-Chair of Epidemiology, Ludwig Maximilian University Munich, Munich 81377, Germany
- Department of Physical, Chemical, and Natural Systems, Universidad Pablo de Olavide, Sevilla 41013, Spain
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT 06511, USA
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul 03760, South Korea
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8521, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki 305-8506, Japan
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, CT 06511, USA
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Corresponding author
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16
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Huang LJ, Zha JJ, Cao NW, Zhou HY, Chu XJ, Wang H, Li XB, Li BZ. Temperature might increase the hospital admission risk for rheumatoid arthritis patients in Anqing, China: a time-series study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:201-211. [PMID: 34718869 PMCID: PMC8557265 DOI: 10.1007/s00484-021-02207-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 05/20/2023]
Abstract
Temperature has been studied in relation to many health outcomes. However, few studies have explored its effect on the risk of hospital admission for rheumatoid arthritis (RA). A distributed lag non-linear model (DLNM) was used to analyze associations between mean temperature, diurnal temperature range (DTR), temperature change between neighboring days (TCN), and daily admissions for RA from 2015 to 2019 in Anqing, China. Subgroup analyses based on age, gender, rheumatoid factors, and admission route were performed. In total, 1456 patients with RA were hospitalized. Regarding the cumulative-lag effects of extreme cold temperature (5th percentile = 3℃), the risks of admissions for RA were increased and highest at lag 0-11 (RR = 2.68, 95% CI: 1.23-5.86). Exposing to low (5th percentile = 1.9℃) and high (95th percentile = 14.2℃) DTRs both had increased risks of RA admission, with highest RRs of 1.40 (95% CI: 1.03-1.91) and 1.24 (95% CI: 1.0-1.53) at lag 0 day, respectively. As for TCN, the marginal risk of admission in RA patients was found when exposed to high TCN (95th percentile = 2.9℃) with the largest single-day effect at lag 10 (RR = 1.11, 95% CI: 1.01-1.23). In subgroup analyses, females were more susceptible to extreme cold temperature, low and high DTRs, and high TCN. In regard to extreme cold temperature, significant risk of hospital admission in females only appeared at lag 2 (RR = 1.48, 95% CI: 1.02-2.15) and lag 0-2 (RR = 2.35, 95% CI: 1.11-4.95). It is clear that RA patients exposed to changing temperature may increase risks of admission.
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Affiliation(s)
- Li-Juan Huang
- Medical Department, The Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui, China
| | - Jun-Jing Zha
- Medical Department, The Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui, China
| | - Nv-Wei Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hao-Yue Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xiu-Jie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xian-Bao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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17
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Wang Y, Chen Y, Chen J, Wu R, Guo P, Zha S, Zhang Q. Mortality risk attributable to diurnal temperature range: a multicity study in Yunnan of southwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:60597-60608. [PMID: 34160766 DOI: 10.1007/s11356-021-14981-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023]
Abstract
We aimed to estimate the non-accidental and cause-specific mortality burden attributed to diurnal temperature range (DTR) and the relative contributions of low, high, and extremely low and extremely high DTR in Yunnan, southwest China. Furthermore, we explored the possible effect modification of the DTR-mortality association by season, sex, age, ethnicity, marital status, and occupation. A standard time-series quasi-Poisson regression model combined with a distributed lag nonlinear model was used to derive estimates of city-specific DTR-mortality associations, then random effects meta-analysis was used to pool the estimated city-specific overall cumulative DTR-mortality association, estimating empirical confidence intervals (eCIs). The overall fraction of non-accidental mortality caused by DTR was 11.00% (95% eCI 3.40-17.28): high DTR accounted for most of burden (total estimate 10.03%, 95% eCI 2.59-16.32). The estimated mortality risk attributable to DTR was significantly associated with cardiovascular and respiratory mortality, with attributable fractions of 13.61% (95% eCI 3.91-21.13) and 14.32% (95% eCI 0.47-21.44), respectively. The estimated risk attributable to DTR was slightly greater for males, people ≥75 years old, married people, and non-farmers than their corresponding categories. Most of the DTR-related mortality burden was attributable to high DTR, and the mortality risk attributable to DTR might be modified by specific causes, sex, age, marital status, and occupation.
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Affiliation(s)
- Yujin Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yang Chen
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, Yunnan, China
| | - Jiaqi Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Rong Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Shun Zha
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, Yunnan, China.
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China.
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China.
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18
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Xiao Y, Meng C, Huang S, Duan Y, Liu G, Yu S, Peng J, Cheng J, Yin P. Short-Term Effect of Temperature Change on Non-Accidental Mortality in Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168760. [PMID: 34444520 PMCID: PMC8392083 DOI: 10.3390/ijerph18168760] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
Temperature change is an important meteorological indicator reflecting weather stability. This study aimed to examine the effects of ambient temperature change on non-accidental mortality using diurnal temperature change (DTR) and temperature change between neighboring days (TCN) from two perspectives, intra-day and inter-day temperature change, and further, to explore seasonal variations of mortality, identify the susceptible population and investigate the interaction between temperature change and apparent temperature (AT). We collected daily data on cause-specific mortality, air pollutants and meteorological indicators in Shenzhen, China, from 1 January 2013 to 29 December 2017. A Quasi-Poisson generalized linear regression combined with distributed lag non-linear models (DLNMs) were conducted to estimate the effects of season on temperature change-related mortality. In addition, a non-parametric bivariate response surface model was used to explore the interaction between temperature change and AT. The cumulative effect of DTR was a U-shaped curve for non-accidental mortality, whereas the curve for TCN was nearly monotonic. The overall relative risks (RRs) of non-accidental, cardiovascular and respiratory mortality were 1.407 (95% CI: 1.233-1.606), 1.470 (95% CI: 1.220-1.771) and 1.741 (95% CI: 1.157-2.620) from exposure to extreme large DTR (99th) in cold seasons. However, no statistically significant effects were observed in warm seasons. As for TCN, the effects were higher in cold seasons than warm seasons, with the largest RR of 1.611 (95% CI: 1.384-1.876). The elderly and females were more sensitive, and low apparent temperature had a higher effect on temperature change-related non-accidental mortality. Temperature change was positively correlated with an increased risk of non-accidental mortality in Shenzhen. Both female and elderly people are more vulnerable to the potential adverse effects, especially in cold seasons. Low AT may enhance the effects of temperature change.
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Affiliation(s)
- Yao Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (Y.X.); (C.M.); (Y.D.)
| | - Chengzhen Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (Y.X.); (C.M.); (Y.D.)
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China; (S.H.); (G.L.); (S.Y.)
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China; (Y.X.); (C.M.); (Y.D.)
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China; (S.H.); (G.L.); (S.Y.)
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China; (S.H.); (G.L.); (S.Y.)
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen 518020, China
- Correspondence: (J.P.); (J.C.); (P.Y.)
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China; (S.H.); (G.L.); (S.Y.)
- Correspondence: (J.P.); (J.C.); (P.Y.)
| | - 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, China; (Y.X.); (C.M.); (Y.D.)
- Correspondence: (J.P.); (J.C.); (P.Y.)
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19
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Yi W, Cheng J, Wei Q, Pan R, Song S, He Y, Tang C, Liu X, Zhou Y, Su H. Disparities of weather type and geographical location in the impacts of temperature variability on cancer mortality: A multicity case-crossover study in Jiangsu Province, China. ENVIRONMENTAL RESEARCH 2021; 197:110985. [PMID: 33744269 DOI: 10.1016/j.envres.2021.110985] [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: 09/04/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Considering the serious health burden caused by adverse weather events, increasing researches focused on the relationship between temperature variability (TV) and cause-specific mortality, but its association with cancer was not well explored. We aimed to investigate the impacts of TV on cancer mortality and examine the modifying effects of weather type and geographical location as well as other characteristics. MATERIALS AND METHODS Daily city-specific data of cancer deaths, mean temperature (Tmean), maximum and minimum temperatures (Tmax and Tmin), relative humidity (RH), rainfall, and air pollutants were collected during 2016-2017 in 13 cities in Jiangsu Province, China. TV0-t was defined as the standard deviation of the daily Tmax and Tmin on the exposure 0-t days. A two-stage analysis was applied. First, a time-stratified case-crossover design was used to examine the odds ratio (OR) and attributable fraction of cancer mortality per 1 °C increase in TV by adjusting for potential confounders. Random effect meta-analysis was used to summarize the pooled ORs. Second, stratified analysis was performed for weather type, geographical location, demographics, and other city-level characteristics. The weather was defined as four types according to days during warm or cold season combined with high or low RH. RESULTS A total of 303670 cases were included in our study. Meta-analysis showed that the ORs of cancer mortality per 1 °C increase in TV0-t significantly increased and peaked in TV0-2 (OR=1.0098, 95% CI: 1.0039-1.0157). The attributable fraction of TV0-2 on cancer mortality was 4.74%, accounting for 14395 deaths in the study period. Significant ORs of TV-related cancer mortality were found during the warm season combined with high RH and in the northern region of Jiangsu. Susceptible groups of TV-related cancer mortality were identified as female patients, patients aged 45-65 years, and those living in cities with lower per capita green area. CONCLUSIONS TV can significantly increase the risk of cancer mortality, especially during warm and humid days and in the northern region of Jiangsu. Findings are of great significance to formulate urban planning, resource allocation, and health intervention to prolong the life of cancer patients.
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Affiliation(s)
- Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yu Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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20
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Guo F, Do V, Cooper R, Huang Y, Zhang P, Ran J, Zhang Q, Tian L, Fu Z. Trends of temperature variability: Which variability and what health implications? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 768:144487. [PMID: 33444866 DOI: 10.1016/j.scitotenv.2020.144487] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/16/2020] [Accepted: 12/09/2020] [Indexed: 05/28/2023]
Abstract
A large majority of climate change studies carried out to date are on changes in mean climate, which have comparatively downplayed variability. In terms of trend analysis or forecast, the scientific output and common knowledge for global warming are much more robust than for changes in temperature variability. Quantification of temperature variability adds another dimension of temporal scale, requiring immense labor and presenting great uncertainty. Regardless, this endeavor is necessary since changes in ambient temperature variabilities could also contribute to current and future human health burden besides changes in mean quantities. Here, we review the current literature on trends of surface air temperature variability defined at a range of timescales, aiming to tease out the welter of evidence and thus improving the scientific recognition of changes in air temperature variability in the context of climate change. The findings of reviewed studies from numerous regions differ substantially over various temporal scales. In general, the ambient temperature variability on short time scales (e.g., diurnal or inter-day) shows a downward trend, while it is increasing on longer time scales (e.g., inter-annual). We then move beyond the review and deliver an extended discussion of potential implications for future research related to ambient temperature variability. We highlight the need to consider the methodological choices, especially timescales of interest, in the trend analysis as well as health impact studies. Continued research focusing on temperature variability at multiple timescales, with concerted efforts from scientists of all relevant stripes, is meaningful in synthesizing knowledge and reducing uncertainties surrounding air temperature variability.
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Affiliation(s)
- Fang Guo
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Vivian Do
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China; Mailman School of Public Health, Columbia University, New York, USA
| | - Rachel Cooper
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MA, USA
| | - Yu Huang
- School of Physics, Peking University, Beijing, China
| | - Pei Zhang
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Jinjun Ran
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Qiang Zhang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
| | - Zuntao Fu
- School of Physics, Peking University, Beijing, China
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21
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Li H, Yao Y, Duan Y, Liao Y, Yan S, Liu X, Zhao Z, Fu Y, Yin P, Cheng J, Jiang H. Years of life lost and mortality risk attributable to non-optimum temperature in Shenzhen: a time-series study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:187-196. [PMID: 32054993 DOI: 10.1038/s41370-020-0202-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/15/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
To assess YLL and mortality burden attributable to non-optimum ambient temperature, we collected mortality and environmental data from June 1, 2012 to December 30, 2017 in Shenzhen. We applied distributed lag nonlinear models with 21 days of lag to examine temperature-YLL and temperature-mortality associations, and calculated the attributable fractions of YLL and deaths for non-optimum temperature, including four subranges, mild cold, mild heat, extreme cold, and extreme heat. Cold and heat were distinguished by the optimum temperature, and each was separated into extreme and mild by cutoffs at 2.5th (12.2 °C) and 97.5th (30.4 °C) temperature percentile further. The optimum temperature was defined as the temperature that had minimum effect on YLL or mortality risk. The optimum temperature for non-accidental YLL was 24.5 °C, and for mortality it was 25.4 °C. Except for the population older than 65 years, the optimum temperature was generally lower in the YLL model than the mortality model. Of the total 61,576 non-accidental deaths and 1,350,835.7 YLL within the study period, 17.28% (95% empirical CI 9.42-25.14%) of YLL and 17.27% (12.70-21.34%) of mortality were attributable to non-optimum temperature. More YLL was caused by cold (10.14%, 3.94-16.36%) than by heat (7.14%, 0.47-13.88%). Mild cold (12.2-24.5 °C) was responsible for far more YLL (8.78%, 3.00-14.61%) than extreme cold (3.5-12.2 °C). As for cardiovascular deaths, only the fractions attributable to overall and cold temperature were significant, with mild cold contributing the largest fraction to YLL (16.31%, 6.85-25.82%) and mortality (16.08%, 9.77-21.22%). Most of the temperature-related YLL and mortality was attributable to mild but non-optimum weather, especially mild cold, while the YLL model implied a more prominent heat effect on premature death. Our findings can supply additional evidence from multiperspectives for health planners to define priorities and make targeted policies for mitigating the burden of adverse temperatures.
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Affiliation(s)
- Hongyan Li
- 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
| | - Yao Yao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Yanran Duan
- 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
| | - Yi Liao
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyu Yan
- 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
| | - Xuehan Liu
- 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
| | - Zhiguang Zhao
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, 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.
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
| | - Hongwei Jiang
- 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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22
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Vencloviene J, Radisauskas R, Kranciukaite-Butylkiniene D, Tamosiunas A, Vaiciulis V, Rastenyte D. Association between stroke occurrence and changes in atmospheric circulation. BMC Public Health 2021; 21:42. [PMID: 33407282 PMCID: PMC7789358 DOI: 10.1186/s12889-020-10052-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background The impact of weather on morbidity from stroke has been analysed in previous studies. As the risk of stroke was mostly associated with changing weather, the changes in the daily stroke occurrence may be associated with changes in atmospheric circulation. The aim of our study was to detect and evaluate the association between daily numbers of ischaemic strokes (ISs) and haemorrhagic strokes (HSs) and the teleconnection pattern. Methods The study was performed in Kaunas, Lithuania, from 2000 to 2010. The daily numbers of ISs, subarachnoid haemorrhages (SAHs), and intracerebral haemorrhages (ICHs) were obtained from the Kaunas Stroke Register. We evaluated the association between these types of stroke and the teleconnection pattern by applying Poisson regression and adjusting for the linear trend, month, and other weather variables. Results During the study period, we analysed 4038 cases (2226 men and 1812 women) of stroke. Of these, 3245 (80.4%) cases were ISs, 533 (13.2%) cases were ICHs, and 260 (6.4%) cases were SAHs. An increased risk of SAH was associated with a change in mean daily atmospheric pressure over 3.9 hPa (RR = 1.49, 95% CI 1.14–1.96), and a stronger El Niño event had a protective effect against SAHs (RR = 0.34, 95% CI 0.16–0.69). The risk of HS was positively associated with East Atlantic/West Russia indices (RR = 1.13, 95% CI 1.04–1.23). The risk of IS was negatively associated with the Arctic Oscillation index on the same day and on the previous day (RR = 0.97, p < 0.033). During November–March, the risk of HS was associated with a positive North Atlantic Oscillation (NAO) (RR = 1.29, 95% CI 1.03–1.62), and the risk of IS was negatively associated with the NAO index (RR = 0.92, 95% CI 0.85–0.99). Conclusions The results of our study provide new evidence that the North Atlantic Oscillation, Arctic Oscillation, East Atlantic/West Russia, and El Niño-Southern Oscillation pattern may affect the risk of stroke. The impact of these teleconnections is not identical for various types of stroke. Emergency services should be aware that specific weather conditions are more likely to prompt calls for more severe strokes.
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Affiliation(s)
- Jone Vencloviene
- Department of Environmental Sciences, Vytautas Magnus University, Donelaicio St. 58, LT-44248, Kaunas, Lithuania. .,Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania.
| | - Ricardas Radisauskas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania.,Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania
| | - Daina Kranciukaite-Butylkiniene
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania.,Department of Family Medicine, Lithuanian University of Health Sciences, Eiveniu St. 2, LT-50009, Kaunas, Lithuania
| | - Abdonas Tamosiunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu St. 15, LT-50103, Kaunas, Lithuania.,Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania
| | - Vidmantas Vaiciulis
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania.,Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, LT-47181, Kaunas, Lithuania
| | - Daiva Rastenyte
- Department of Neurology, Lithuanian University of Health Sciences, Eiveniu St. 2, LT-50009, Kaunas, Lithuania
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23
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Lei L, Bao J, Guo Y, Wang Q, Peng J, Huang C. Effects of diurnal temperature range on first-ever strokes in different seasons: a time-series study in Shenzhen, China. BMJ Open 2020; 10:e033571. [PMID: 33444167 PMCID: PMC7682471 DOI: 10.1136/bmjopen-2019-033571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Diurnal temperature range (DTR) is an important meteorological indicator of global climate change; high values of DTR may induce stroke morbidity, while the related high-risk periods and sensitive populations are not clear. This study aims to evaluate the effects of DTR on first-ever strokes in different seasons and in relation to sensitive populations. METHODS We collected data on 142 569 first-ever strokes during 2005-2016 in Shenzhen. We fitted a time-series Poisson model in our study, estimating the associations between DTR and first-ever strokes, with a distributed lag non-linear model. Then, we calculated strokes attributable to high DTR in different genders, age groups, education levels and stroke subtypes. RESULTS High DTR had a significant association with first-ever strokes, and the risk of stroke increased with the rise of DTR in the summer and winter. In total, 3.65% (95% empirical CI (eCI) 1.81% to 5.53%) of first-ever strokes were attributable to high DTR (5.5°C and higher) in the summer, while 2.42% (95% eCI 0.05% to 4.42%) were attributable to high DTR (8°C and higher) in the winter. In the summer, attributable fraction (AF) was significant in both genders, middle-aged and old patients, patients with different levels of education, as well as patients with cerebral infarction (CBI); in the winter, AF was significant in middle-aged patients, patients with primary and lower education level, as well as patients with CBI. CONCLUSIONS High DTR may trigger first-ever strokes in the summer and winter, and CBI is more sensitive than intracerebral haemorrhage to DTR. Most people are sensitive to high DTR in the summer, while middle-aged and low-education populations are sensitive in the winter. It is recommended that the DTR values be reported and emphasised in weather forecast services, together with the forecasts of heat and cold.
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Affiliation(s)
- Lin Lei
- Department of Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Junzhe Bao
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yanfang Guo
- Department of Non-Communicable Disease Control and Prevention, Bao'an District Hospital for Chronic Diseases Prevention and Cure, Shenzhen, Guangdong, China
| | - Qiong Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
| | - Ji Peng
- Department of Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Cunrui Huang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
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24
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Lee W, Kim Y, Sera F, Gasparrini A, Park R, Michelle Choi H, Prifti K, Bell ML, Abrutzky R, Guo Y, Tong S, de Sousa Zanotti Stagliorio Coelho M, Nascimento Saldiva PH, Lavigne E, Orru H, Indermitte E, Jaakkola JJK, Ryti NRI, Pascal M, Goodman P, Zeka A, Hashizume M, Honda Y, Hurtado Diaz M, César Cruz J, Overcenco A, Nunes B, Madureira J, Scovronick N, Acquaotta F, Tobias A, Vicedo-Cabrera AM, Ragettli MS, Guo YLL, Chen BY, Li S, Armstrong B, Zanobetti A, Schwartz J, Kim H. Projections of excess mortality related to diurnal temperature range under climate change scenarios: a multi-country modelling study. Lancet Planet Health 2020; 4:e512-e521. [PMID: 33159878 PMCID: PMC7869581 DOI: 10.1016/s2542-5196(20)30222-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Various retrospective studies have reported on the increase of mortality risk due to higher diurnal temperature range (DTR). This study projects the effect of DTR on future mortality across 445 communities in 20 countries and regions. METHODS DTR-related mortality risk was estimated on the basis of the historical daily time-series of mortality and weather factors from Jan 1, 1985, to Dec 31, 2015, with data for 445 communities across 20 countries and regions, from the Multi-Country Multi-City Collaborative Research Network. We obtained daily projected temperature series associated with four climate change scenarios, using the four representative concentration pathways (RCPs) described by the Intergovernmental Panel on Climate Change, from the lowest to the highest emission scenarios (RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5). Excess deaths attributable to the DTR during the current (1985-2015) and future (2020-99) periods were projected using daily DTR series under the four scenarios. Future excess deaths were calculated on the basis of assumptions that warmer long-term average temperatures affect or do not affect the DTR-related mortality risk. FINDINGS The time-series analyses results showed that DTR was associated with excess mortality. Under the unmitigated climate change scenario (RCP 8.5), the future average DTR is projected to increase in most countries and regions (by -0·4 to 1·6°C), particularly in the USA, south-central Europe, Mexico, and South Africa. The excess deaths currently attributable to DTR were estimated to be 0·2-7·4%. Furthermore, the DTR-related mortality risk increased as the long-term average temperature increased; in the linear mixed model with the assumption of an interactive effect with long-term average temperature, we estimated 0·05% additional DTR mortality risk per 1°C increase in average temperature. Based on the interaction with long-term average temperature, the DTR-related excess deaths are projected to increase in all countries or regions by 1·4-10·3% in 2090-99. INTERPRETATION This study suggests that globally, DTR-related excess mortality might increase under climate change, and this increasing pattern is likely to vary between countries and regions. Considering climatic changes, our findings could contribute to public health interventions aimed at reducing the impact of DTR on human health. FUNDING Korea Ministry of Environment.
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Affiliation(s)
- Whanhee Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rokjin Park
- School of Earth and Environmental Sciences, Seoul National University, Seoul, South Korea
| | | | - Kristi Prifti
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Rosana Abrutzky
- Faculty of Social Sciences, Research Institute Gino Germani, University of Buenos Aires, Buenos Aries, Argentina
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ene Indermitte
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Niilo R I Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Department of Environmental Health, French National Public Health Agency, Public Health France, Saint Maurice, France
| | - Patrick Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Julio César Cruz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ala Overcenco
- Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Republic of Moldova
| | - Baltazar Nunes
- Department of Epidemiology, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal
| | - Joana Madureira
- Department of Environmental Health, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; EPIUnit, Institute of Public Health, University of Porto, Lisbon, Portugal
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, IDAEA, Spanish Council for Scientific Research, CSIC, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Bing-Yu Chen
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea.
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25
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Abed Al Ahad M, Sullivan F, Demšar U, Melhem M, Kulu H. The effect of air-pollution and weather exposure on mortality and hospital admission and implications for further research: A systematic scoping review. PLoS One 2020; 15:e0241415. [PMID: 33119678 PMCID: PMC7595412 DOI: 10.1371/journal.pone.0241415] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Air-pollution and weather exposure beyond certain thresholds have serious effects on public health. Yet, there is lack of information on wider aspects including the role of some effect modifiers and the interaction between air-pollution and weather. This article aims at a comprehensive review and narrative summary of literature on the association of air-pollution and weather with mortality and hospital admissions; and to highlight literature gaps that require further research. METHODS We conducted a scoping literature review. The search on two databases (PubMed and Web-of-Science) from 2012 to 2020 using three conceptual categories of "environmental factors", "health outcomes", and "Geographical region" revealed a total of 951 records. The narrative synthesis included all original studies with time-series, cohort, or case cross-over design; with ambient air-pollution and/or weather exposure; and mortality and/or hospital admission outcomes. RESULTS The final review included 112 articles from which 70 involved mortality, 30 hospital admission, and 12 studies included both outcomes. Air-pollution was shown to act consistently as risk factor for all-causes, cardiovascular, respiratory, cerebrovascular and cancer mortality and hospital admissions. Hot and cold temperature was a risk factor for wide range of cardiovascular, respiratory, and psychiatric illness; yet, in few studies, the increase in temperature reduced the risk of hospital admissions for pulmonary embolism, angina pectoris, chest, and ischemic heart diseases. The role of effect modification in the included studies was investigated in terms of gender, age, and season but not in terms of ethnicity. CONCLUSION Air-pollution and weather exposure beyond certain thresholds affect human health negatively. Effect modification of important socio-demographics such as ethnicity and the interaction between air-pollution and weather is often missed in the literature. Our findings highlight the need of further research in the area of health behaviour and mortality in relation to air-pollution and weather, to guide effective environmental health precautionary measures planning.
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Affiliation(s)
- Mary Abed Al Ahad
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
| | - Frank Sullivan
- School of Medicine, University of St Andrews, Scotland, United Kingdom
| | - Urška Demšar
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
| | - Maya Melhem
- Department of Landscape Design and Ecosystem Management, American University of Beirut, Beirut, Lebanon
| | - Hill Kulu
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
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26
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Huang K, Yang XJ, Hu CY, Ding K, Jiang W, Hua XG, Liu J, Cao JY, Sun CY, Zhang T, Kan XH, Zhang XJ. Short-term effect of ambient temperature change on the risk of tuberculosis admissions: Assessments of two exposure metrics. ENVIRONMENTAL RESEARCH 2020; 189:109900. [PMID: 32980000 DOI: 10.1016/j.envres.2020.109900] [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: 04/25/2020] [Revised: 06/20/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although the effects of seasonal variations and ambient temperature on the incidence of tuberculosis (TB) have been well documented, it is still unknown whether ambient temperature change is an independent risk factor for TB. The aim of this study was to assess the association between ambient temperature change and the risk of TB admissions. METHOD A distributed lag non-linear model (DLNM) combined with Poisson generalized linear regression model was performed to assess the association between ambient temperature change and the risk of TB admissions from 2014 to 2018 in Hefei, China. Two temperature change metrics including temperature change between neighboring days (TCN) and diurnal temperature range (DTR) were used to assess the effects of temperature change exposure. Subgroup analyses were performed by gender, age and season. Besides, the attributable risk was calculated to evaluated the public health significance. RESULTS The overall exposure-response curves suggested that there were statistically significant associations between two temperature change metrics and the risk of TB admissions. The maximum lag-specific relative risk (RR) of TB admissions was 1.088 (95%CI: 1.012-1.171, lag 4 day) for exposing to large temperature drop (TCN= -4 °C) in winter. Besides, the overall cumulative risk of TB admissions increased continuously and peaked at a lag of 7 days (RR=1.350, 95%CI: 1.120-1.628). Subgroup analysis suggested that exposure to large temperature drop had an adverse effect on TB admissions among males, females and adults. Similarly, large level of DTR exposure (DTR=15 °C) in spring also increased the risk of TB admissions on lag 0 day (RR=1.039, 95%CI: 1.016-1.063), and the cumulative RRs peaked at a lag of 1 days (RR=1.029, 95%CI: 1.012-1.047). We also found that females and elderly people were more vulnerable to the large level of DTR exposure. Additionally, the assessment of attributable risk suggested that taking target measures for the upcoming large temperature drop (b-AF = 4.17%, 95% eCI: 1.24%, 7.22%, b-AN = 1195) may achieve great public health benefits for TB prevention. CONCLUSION This study suggests that ambient temperature change is associated with the risk of TB admissions. Besides, TCN may be a better predictor for the TB prevention and public health.
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Affiliation(s)
- Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Wen Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Guo Hua
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jie Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ji-Yu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chen-Yu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, 60657, Illinois, USA
| | - Tao Zhang
- Anhui Chest Hospital, 397 Jixi Road, Hefei, 230022, China
| | - Xiao-Hong Kan
- Anhui Chest Hospital, 397 Jixi Road, Hefei, 230022, China; Anhui Medical University Clinical College of Chest, 397 Jixi Road, Hefei, 230022, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Zheng S, Zhu W, Wang M, Shi Q, Luo Y, Miao Q, Nie Y, Kang F, Mi X, Bai Y. The effect of diurnal temperature range on blood pressure among 46,609 people in Northwestern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 730:138987. [PMID: 32428804 DOI: 10.1016/j.scitotenv.2020.138987] [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: 01/18/2020] [Revised: 04/08/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND A large number of studies have found a positive association between diurnal temperature range (DTR) and cardiovascular diseases (CVDs) incidence and mortality. Few studies regarding the effects of DTR on blood pressure (BP) are available. OBJECTIVE To investigate the effects of DTR on BP in Jinchang, northwestern China. METHODS Based on a prospective cohort research, a total of 46,609 baseline survey data were collected from 2011 to 2015. The meteorological observation data and environmental monitoring data were collected in the same period. The generalized additive model (GAM) was used to estimate the relationship between DTR and BP after adjusting for confounding variables. RESULTS Our study found that there was a positive linear correlation between DTR and systolic blood pressure (SBP) and plus pressure (PP), and a negative linear correlation between DTR and diastolic blood pressure (DBP). With a 1 °C increase of DTR, SBP and PP increased 0.058 mmHg (95%CI: 0.018-0.097) and 0.114 mmHg (95%CI: 0.059-0.168) respectively, and DBP decreased 0.039 mmHg (95%CI:-0.065 ~ -0.014). There was a significant interaction between season and DTR on SBP and PP. DTR had the greatest impact on SBP and PP in hot season. The association between DTR and BP varied significantly by education level. CONCLUSION There was a significant association between DTR and BP in Jinchang, an area with large temperature change at high altitudes in northwestern China. These results provide new evidence that DTR is an independent risk factor for BP changes among general population. Therefore, effective control and management of BP in the face of temperature changes can help prevent CVDs.
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Affiliation(s)
- Shan Zheng
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China.
| | - Wenzhi Zhu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Minzhen Wang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Qin Shi
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Yan Luo
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Qian Miao
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Yonghong Nie
- Jinchang Center for Disease Prevention and Control, Jinchang 737100, China
| | - Feng Kang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang 737103, China
| | - Xiuying Mi
- Jinchang Meteorological Service, Jinchang 737100, China
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
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Phosri A, Sihabut T, Jaikanlaya C. Short-term effects of diurnal temperature range on hospital admission in Bangkok, Thailand. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 717:137202. [PMID: 32062282 DOI: 10.1016/j.scitotenv.2020.137202] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/28/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Diurnal temperature range (DTR) is a key indicator reflecting climate stability. Many previous studies have examined the effects of ambient temperature, both hot and cold, on human morbidity and mortality, but few studies have evaluated health effects of DTR, especially those in developing countries. This study aimed to investigate the association between short-term exposure to DTR and hospital admissions for cardiovascular and respiratory diseases in Bangkok, Thailand. We obtained daily meteorological variables from the Thai Meteorological Department from January 2006 through December 2014 and daily hospital admissions from the National Health Security Office during the same period. Quasi-Poisson generalized linear regression model combined with distributed lag non-linear model was used to examine the association between DTR and cardiovascular and respiratory hospital admissions controlling for daily average temperature, relative humidity, day of the week, public holiday, and seasonal and long-term trend. A J-shape relationship between DTR and hospital admissions was observed. With 7.8 °C DTR as a reference value, the relative risks for cardiovascular and respiratory hospital admission associated with extremely high DTR (11.6 °C) at cumulative lag 0-21 (21-day cumulative effects) were 1.206 (95% CI: 1.002-1.452) and 1.021 (95% CI: 0.856-1.218), respectively. The effects of extremely high DTR relative to a reference value did not significantly differ between males and females, as well as between young people (<65 years) and the elderly (≥65 years) for both cardiovascular and respiratory admission. When stratifying the effects by season, the effect of extremely high DTR in winter was greater than that in summer and rainy season. This study showed that short-term exposure to extremely high DTR was significantly associated with increased risk of hospital admissions for cardiovascular disease in Bangkok, especially during winter. Results from this study could provide important scientific evidence for policy decision making to protect populations from adverse health effects of DTR.
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Affiliation(s)
- Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
| | - Tanasri Sihabut
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Chate Jaikanlaya
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
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Tian Q, Li M, Montgomery S, Fang B, Wang C, Xia T, Cao Y. Short-Term Associations of Fine Particulate Matter and Synoptic Weather Types with Cardiovascular Mortality: An Ecological Time-Series Study in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031111. [PMID: 32050549 PMCID: PMC7038017 DOI: 10.3390/ijerph17031111] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/05/2020] [Accepted: 02/09/2020] [Indexed: 12/23/2022]
Abstract
Background: Exposures to both ambient fine particulate matter (PM2.5) and extreme weather conditions have been associated with cardiovascular disease (CVD) deaths in numerous epidemiologic studies. However, evidence on the associations with CVD deaths for interaction effects between PM2.5 and weather conditions is still limited. This study aimed to investigate associations of exposures to PM2.5 and weather conditions with cardiovascular mortality, and further to investigate the synergistic or antagonistic effects of ambient air pollutants and synoptic weather types (SWTs). Methods: Information on daily CVD deaths, air pollution, and meteorological conditions between 1 January 2012 and 31 December 2014 was obtained in Shanghai, China. Generalized additive models were used to assess the associations of daily PM2.5 concentrations and meteorological factors with CVD deaths. A 15-day lag analysis was conducted using a polynomial distributed lag model to access the lag patterns for associations with PM2.5. Results: During the study period, the total number of CVD deaths in Shanghai was 59,486, with a daily mean of 54.3 deaths. The average daily PM2.5 concentration was 55.0 µg/m3. Each 10 µg/m3 increase in PM2.5 concentration was associated with a 1.26% (95% confidence interval (CI): 0.40%, 2.12%) increase in CVD mortality. No SWT was statistically significantly associated with CVD deaths. For the interaction between PM2.5 and SWT, statistically significant interactions were found between PM2.5 and cold weather, with risk for PM2.5 in cold dry SWT decreasing by 1.47% (95% CI: 0.54%, 2.39%), and in cold humid SWT the risk decreased by 1.45% (95% CI: 0.52%, 2.36%). In the lag effect analysis, statistically significant positive associations were found for PM2.5 in the 1-3 lag days, while no statistically significant effects were found for other lag day periods. Conclusions: Exposure to PM2.5 was associated with short-term increased risk of cardiovascular deaths with some lag effects, while the cold weather may have an antagonistic effect with PM2.5. However, the ecological study design limited the possibility to identify a causal relationship, so prospective studies with individual level data are warranted.
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Affiliation(s)
- Qing Tian
- Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Mei Li
- Center for Assessment of Medical Technology, Örebro University Hospital, Örebro University, 70182 Örebro, Sweden;
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Bo Fang
- Division of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China; (B.F.); (C.W.)
| | - Chunfang Wang
- Division of Vital Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China; (B.F.); (C.W.)
| | - Tian Xia
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
- Correspondence: (T.X.); (Y.C.); Tel.: +46-19-602-6236 (Y.C.)
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
- Correspondence: (T.X.); (Y.C.); Tel.: +46-19-602-6236 (Y.C.)
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Deng J, Hu X, Xiao C, Xu S, Gao X, Ma Y, Yang J, Wu M, Liu X, Ni J, Pan F. Ambient temperature and non-accidental mortality: a time series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:4190-4196. [PMID: 31828703 DOI: 10.1007/s11356-019-07015-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
Under the background of global climate change, the present study aimed to evaluate the effects of daily mean temperature and diurnal temperature range (DTR) on the non-accidental mortality. Poisson generalized linear model (PGLM) combined with distributed lag non-linear model (DLNM) was used to evaluate these effects after adjusting the relative humidity and major air pollutants. All effects were presented as relative risk (RR), with 75th percentiles of daily mean temperature and DTR compare with their lowest RRs corresponding values. Daily mean temperature was associated with the non-accidental mortality with a U-shaped curve, and the non-accidental mortality increased by 1.8% (95% CI: 0.7~3.0%) when the temperature was 24.4 °C (20 °C as the reference). Additionally, the non-accidental mortality increased by 1.4% (95% CI: 0.1~2.7%) on lag6 day when DTR was 11.3 °C (7 °C as the reference). The elderly (≥ 65 years) were more susceptible to daily mean temperature and DTR, and females were more susceptible to high DTR effect than males. Our study provides evidence that daily mean temperature and DTR are significantly associated with non-accidental mortality and have delayed effects. Both females and elderly people are vulnerable to the potential adverse effects.
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Affiliation(s)
- Jixiang Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xingxing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Changchun Xiao
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui Province, China
| | - Shanshan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jiajia Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Meng Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui Province, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Xincheng Road, Guangdong Province, Dongguan, 523808, China.
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
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Zhang Y, Xiang Q, Yu C, Bao J, Ho HC, Sun S, Ding Z, Hu K, Zhang L. Mortality risk and burden associated with temperature variability in China, United Kingdom and United States: Comparative analysis of daily and hourly exposure metrics. ENVIRONMENTAL RESEARCH 2019; 179:108771. [PMID: 31574448 DOI: 10.1016/j.envres.2019.108771] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/12/2019] [Accepted: 09/22/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Temperature variability (TV) is closely associated with climate change, but there is no unified TV definition worldwide. Two novel composite TV indexes were developed recently by calculating the standard deviations of several days' daily maximum and minimum temperatures (TVdaily), or hourly mean temperatures (TVhourly). OBJECTIVES This study aimed to compare the mortality risks and burden associated with TVdaily and TVhourly using large time-series datasets collected from multiple locations in China, United Kingdom and United States. METHODS We collected daily mortality and hourly temperature data through 1987 to 2012 from 63 locations in China (8 communities, 2006-2012), United Kingdom (10 regions, 1990-2012), and USA (45 cities, 1987-2000). TV-mortality associations were investigated using a three-stage analytic approach separately for China, UK, and USA. First, we applied a time-series regression for each location to derive location-specific TV-mortality curves. A second-stage meta-analysis was then performed to pool these estimated associations for each country. Finally, we calculated mortality fraction attributable to TV based on above-described location-specific and pooled estimates. RESULTS Our dataset totally consisted of 23, 089, 328 all-cause death cases, including 93, 750 from China, 7,573,716 from UK and 15, 421, 862 from USA, respectively. In despite of a relatively wide uncertainty in China, approximately linear relationships were consistently identified for TVdaily and TVhourly. In the three countries, generally similar lag patterns of TV effects were consistently observed for TVdaily and TVhourly. A 1 °C rise in TVdaily and TVhourly at lag 0-7 days was associated with mortality increases of 0.93% (95% confidence interval [CI]: 0.12, 1.74) and 0.97% (0.18, 1.77) in China, 0.33% (0.15, 0.51) and 0.41% (0.21, 0.60) in UK, and 0.55% (0.41, 0.70) and 0.51% (0.35, 0.66) in USA, respectively. Larger attributable fractions were estimated using TVdaily than those using TVhourly, with estimates at 0-10 days of 3.69% (0.51, 6.75) vs. 2.59% (0.10, 5.01) in China, 1.14% (0.54, 1.74) vs. 0.98% (0.55, 1.42) in UK, and 2.57% (1.97, 3.16) vs. 1.67% (1.15, 2.18) in USA, respectively. Our meta-regression analyses indicated higher vulnerability to TV-induced mortality risks in warmer locations. CONCLUSIONS Our study added multi-country evidence for increased mortality risk associated with short-term exposure to large temperature variability. Daily and hourly TV exposure metrics produced generally comparable risk effects, but the attributable mortality burden tended to be higher using TVdaily instead of TVhourly.
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Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Junzhe Bao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
| | - Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China
| | - Kejia Hu
- Department of Precision Health and Data Science, School of Public Health, Zhejiang University, Hangzhou, 310003, China
| | - Ling Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China; Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China
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Xu X, Chen Z, Huo X, Wang C, Li N, Meng X, Wang Q, Liu Q, Bi P, Li J. The effects of temperature on human mortality in a Chinese city: burden of disease calculation, attributable risk exploration, and vulnerability identification. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1319-1329. [PMID: 31240387 DOI: 10.1007/s00484-019-01746-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 06/09/2023]
Abstract
Few studies have examined the attributable fraction (AF) of temperature to mortality and Years of Life Lost (YLL), especially in developing countries. This study aims to explore the short-term effect of the cold and hot temperatures on the cause-specific YLL and mortality, discover the attributable contributions from the temperature variations, and identify the vulnerable populations in Weifang, China. Daily registered death information and meteorological data over the period 2010-2016 were obtained in Weifang, a northern Chinese city. Generalized additive Poisson and Gaussian regression models were used to assess the impacts of temperatures on both mortality and YLL, explore the AF of the temperature variations on mortality, after adjusting for other covariates. Both hot and cold temperatures have had significant negative impacts on cause-specific mortality counts and YLL, with heat presented an acute and short effect and the cold temperatures had delayed effects and lasted for several days. In terms of the attributable fraction calculations, the contributions from cold effects was higher than that of hot effects on non-accidental, cardiovascular, and respiratory deaths (YLL 10.88 vs. 1.23%, 19.58 vs. 1.71%, and 14.47 vs. 3.05%; mortality 13.97 vs. 1.65%, 19.20 vs. 1.59%, and 14.89 vs. 3.09%), respectively. The elderly and women and people with low education level were the most vulnerable. The findings will provide important scientific evidences and policy implications for developing adaptation strategies to reduce the adverse effect of cold and hot exposure in Weifang, in terms of resource allocation, healthcare workforce capacity building, and community health education, especially for the vulnerable groups.
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Affiliation(s)
- Xin Xu
- Affiliated Hospital of Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Zuosen Chen
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Xiyuan Huo
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Chunping Wang
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Ning Li
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Xianfeng Meng
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Qiang Wang
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, Beijing, People's Republic of China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, 5005, SA, Australia
| | - Jing Li
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China.
- "Health Shandong" Major Social Risk Prediction and Governance Collaborative Innovation Center, Weifang, 261053, Shandong Province, People's Republic of China.
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Ma C, Yang J, Nakayama SF, Honda Y. The association between temperature variability and cause-specific mortality: Evidence from 47 Japanese prefectures during 1972-2015. ENVIRONMENT INTERNATIONAL 2019; 127:125-133. [PMID: 30913457 DOI: 10.1016/j.envint.2019.03.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/10/2019] [Accepted: 03/10/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND In the context of climate change, extreme temperature events are known to be associated with increased mortality risk. However, data about the mortality risk related to temperature variability (TV) accounting for both intra- and inter-day variations in temperature are limited. OBJECTIVES The present study aims to quantify the associations between TV and cause-specific mortality in Japan, evaluate whether the effects of TV are modified by prefecture-level characteristics and examine the temporal trend in mortality risk of TV. METHODS Data on daily all-cause and 11 cause-specific mortality and meteorological variables in 47 Japanese prefectures from 1972 to 2015 were collected. TV was defined as the standard deviation of daily minimum and maximum temperatures during exposure days. A quasi-Poisson regression model combined with a distributed lag non-linear model was firstly applied to assess the prefecture-specific mortality effects of TV, adjusting for potential confounders. The pooled effects of TV at the national level were then obtained via a meta-analysis through the restricted maximum-likelihood estimation. Potential effect modification by prefecture characteristics was firstly examined using a meta-regression analysis, and the joint modification of season and humidity was then evaluated after including product terms in two-stage analyses. Finally, the temporal trend in TV effects was evaluated by a random-effect meta regression model after obtaining the prefecture-year-specific effects. RESULTS TV had significant adverse effects on all-cause and cause-specific mortality. The effects of TV were more detrimental to those with asthma and senility. In general, the estimates of mortality risk increased with longer exposure days. A 1 °C increase in TV at 0-7 days of exposure was associated with a 0.9% (95% confidence intervals: 0.82%-0.98%) increase in all-cause mortality. All-cause mortality risk of TV showed a decreasing trend during our study period. TV effects were larger in densely populated prefectures and on warm and humid days. CONCLUSIONS TV-related death is a significant issue in Japan that requires effective interventions.
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Affiliation(s)
- Chaochen Ma
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Shoji F Nakayama
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
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Singh N, Mhawish A, Ghosh S, Banerjee T, Mall RK. Attributing mortality from temperature extremes: A time series analysis in Varanasi, India. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 665:453-464. [PMID: 30772576 DOI: 10.1016/j.scitotenv.2019.02.074] [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: 09/26/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 06/09/2023]
Abstract
Climate extremes are often associated with increased human mortality and such association varies considerably with space and time. We therefore, aimed to systematically investigate the effects of temperature extremes, daily means and diurnal temperature variations (DTV) on mortality in the city of Varanasi, India during 2009-2016. Time series data on daily mortality, air quality (SO2, NO2, O3 and PM10) and weather variables were obtained from the routinely collected secondary sources. A semiparametric quasi-Poisson regression model estimated the effects of temperature extremes on daily all-cause mortality adjusting nonlinear confounding effects of time trend, relative humidity and air pollution; stratified by seasons. An effect modification by age, gender and place of death as semi-economic indicator were also explored. Daily mean temperature was strongly associated with excess mortality, both during summer (5.61% with 95% CI: 4.69-6.53% per unit increase in mean temperature) and winter (1.53% with 95% CI: 0.88-2.18% per unit decrease in mean temperature). Daily mortality was found to be increased by 12.02% (with 95% CI: 4.21-19.84%) due to heat wave. The DTV has exhibited downward trend over the years and showed a negative association with all-cause mortality. Significant association of mortality and different metric of temperature extreme along with decreasing trend in DTV clearly indicate the potential impact of climate change on human health in the city of Varanasi. The finding may well be useful to prioritize the government policies to curb the factors that causes the climate change and for developing early warning system.
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Affiliation(s)
- Nidhi Singh
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India; Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India
| | - Alaa Mhawish
- Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India
| | - Santu Ghosh
- Department of Biostatistics, St Johns Medical College, Koramongala, Bangalore, India
| | - Tirthankar Banerjee
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India; Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India
| | - R K Mall
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India; Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India.
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Hu K, Guo Y, Yang X, Zhong J, Fei F, Chen F, Zhao Q, Zhang Y, Chen G, Chen Q, Ye T, Li S, Qi J. Temperature variability and mortality in rural and urban areas in Zhejiang province, China: An application of a spatiotemporal index. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 647:1044-1051. [PMID: 30180312 DOI: 10.1016/j.scitotenv.2018.08.095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/24/2018] [Accepted: 08/06/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND Temperature variability (TV) is a potential trigger for death in urban areas, but there is little evidence of this in rural areas. In addition, a typical TV index only considers the temporal variability of temperature and ignores its spatial variability, which should be considered due to the effects of human mobility. Here this study aimed to 1) develop a novel spatiotemporal TV index accounting for human mobility; and 2) based on this index, explore the urban-rural differences in TV-mortality associations in China. METHODS We collected daily data on fine-gridded hourly temperatures and >2 million deaths that occurred in Zhejiang province, China from 2009 to 2015. A spatiotemporal TV index was developed by calculating the standard deviation of the hourly temperatures from multi-site records over the course of several exposure days. A three-stage analysis was performed to estimate the mortality risks and mortality burdens of TV. Stratified analyses were performed by cause-specific mortality, urban/rural district, age and gender. RESULTS Significant associations were found between TV and all types of targeted diseases, age groups, and genders. Percentage increase in mortality associated with a 1 °C increase in TV at 0-7 exposure days were found to be higher for rural dwellers than urban dwellers in the warm season [for all-cause mortality, 2.07% (95% CI: 1.49%, 2.64%) vs. 1.16% (95%CI: 0.70%, 1.62%)]. An estimated all-cause mortality fraction of 5.33% was attributable to TV, with 4.99% in urban areas and 6.02% in rural areas. The elderly (aged 65+ years) and females were more sensitive to TV than young people and males, respectively. CONCLUSIONS A spatiotemporal TV index was developed, considering both the temporal and spatial variability of temperatures. TV is an independent health risk factor. In China, rural areas generally suffer greater TV-related mortality risks than urban areas in the warm season. Our findings have important implications for developing area-, cause-, and group-specific adaptation strategies and emergency planning to reduce TV-related mortality.
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Affiliation(s)
- Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Xuchao Yang
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Center for Global Change and Earth Observations, Michigan State University, East Lansing 48823, USA.
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Feng Chen
- Zhejiang Institute of Meteorological Sciences, Hangzhou 310008, China
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Qian Chen
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Tingting Ye
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Jiaguo Qi
- Center for Global Change and Earth Observations, Michigan State University, East Lansing 48823, USA
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Zhang Y, Xiang Q, Yu Y, Zhan Z, Hu K, Ding Z. Socio-geographic disparity in cardiorespiratory mortality burden attributable to ambient temperature in the United States. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:694-705. [PMID: 30414026 DOI: 10.1007/s11356-018-3653-z] [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: 08/10/2018] [Accepted: 10/31/2018] [Indexed: 05/13/2023]
Abstract
Compared with relative risk, attributable fraction (AF) is more informative when assessing the mortality burden due to some environmental exposures (e.g., ambient temperature). Up to date, however, available AF-based evidence linking temperature with mortality has been very sparse regionally and nationally, even for the leading mortality types such as cardiorespiratory deaths. This study aimed to quantify national and regional burden of cardiorespiratory mortality (CRM) attributable to ambient temperature in the USA, and to explore potential socioeconomic and demographic sources of spatial heterogeneity between communities. Daily CRM and weather data during 1987-2000 for 106 urban communities across the mainland of USA were acquired from the publicly available National Morbidity, Mortality and Air Pollution Study (NMMAPS). We did the data analysis using a three-stage analytic approach. We first applied quasi-Poisson regression incorporated with distributed lag nonlinear model to estimate community-specific temperature-CRM associations, then pooled these associations at the regional and national level through a multivariate meta-analysis, and finally estimated the temperature-AF of CRM and performed subgroup analyses stratified by community-level characteristics. Both low and high temperatures increased short-term CRM risk, while temperature-CRM associations varied by regions. Nationally, the fraction of cardiorespiratory deaths caused by the total non-optimum, low, and high temperatures was 7.58% (95% empirical confidence interval, 6.68-8.31%), 7.15% (6.31-7.85%), and 0.43% (0.37-0.46%), respectively. Greater temperature-AF was identified in two northern regions (i.e., Industrial Midwest and North East) and communities with lower temperature and longitude, higher latitude, and moderate humidity. Additionally, higher vulnerability appeared in locations with higher urbanization level, more aging population, less White race, and lower socioeconomic status. Ambient temperature may be responsible for a large fraction of cardiorespiratory deaths. Also, temperature-AF of CRM varied considerably by geographical and climatological factors, as well as community-level disparity in socioeconomic status.
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Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China.
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
- Hubei Provincial Institute for Food Supvision and Test, Wuhan, 430075, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, 442000, China
| | - Zhiying Zhan
- Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan, 316021, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, Shenzhen, 518102, China.
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Arbuthnott K, Hajat S, Heaviside C, Vardoulakis S. What is cold-related mortality? A multi-disciplinary perspective to inform climate change impact assessments. ENVIRONMENT INTERNATIONAL 2018; 121:119-129. [PMID: 30199667 DOI: 10.1016/j.envint.2018.08.053] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/02/2018] [Accepted: 08/24/2018] [Indexed: 05/16/2023]
Abstract
BACKGROUND There is a growing discussion regarding the mortality burdens of hot and cold weather and how the balance between these may alter as a result of climate change. Net effects of climate change are often presented, and in some settings these may suggest that reductions in cold-related mortality will outweigh increases in heat-related mortality. However, key to these discussions is that the magnitude of temperature-related mortality is wholly sensitive to the placement of the temperature threshold above or below which effects are modelled. For cold exposure especially, where threshold effects are often ill-defined, choices in threshold placement have varied widely between published studies, even within the same location. Despite this, there is little discussion around appropriate threshold selection and whether reported associations reflect true causal relationships - i.e. whether all deaths occurring below a given temperature threshold can be regarded as cold-related and are therefore likely to decrease as climate warms. OBJECTIVES Our objectives are to initiate a discussion around the importance of threshold placement and examine evidence for causality across the full range of temperatures used to quantify cold-related mortality. We examine whether understanding causal mechanisms can inform threshold selection, the interpretation of current and future cold-related health burdens and their use in policy formation. METHODS Using Greater London data as an example, we first illustrate the sensitivity of cold related mortality to threshold selection. Using the Bradford Hill criteria as a framework, we then integrate knowledge and evidence from multiple disciplines and areas- including animal and human physiology, epidemiology, biomarker studies and population level studies. This allows for discussion of several possible direct and indirect causal mechanisms operating across the range of 'cold' temperatures and lag periods used in health impact studies, and whether this in turn can inform appropriate threshold placement. RESULTS Evidence from a range of disciplines appears to support a causal relationship for cold across a range of temperatures and lag periods, although there is more consistent evidence for a causal effect at more extreme temperatures. It is plausible that 'direct' mechanisms for cold mortality are likely to occur at lower temperatures and 'indirect' mechanisms (e.g. via increased spread of infection) may occur at milder temperatures. CONCLUSIONS Separating the effects of 'extreme' and 'moderate' cold (e.g. temperatures between approximately 8-9 °C and 18 °C in the UK) could help the interpretation of studies quoting attributable mortality burdens. However there remains the general dilemma of whether it is better to use a lower cold threshold below which we are more certain of a causal relationship, but at the risk of under-estimating deaths attributable to cold.
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Affiliation(s)
- Katherine Arbuthnott
- The Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, WC1H 9SH, UK; Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK.
| | - Shakoor Hajat
- The Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, WC1H 9SH, UK
| | - Clare Heaviside
- The Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, WC1H 9SH, UK; Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Sotiris Vardoulakis
- The Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, WC1H 9SH, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK; Institute of Occupational Medicine, Edinburgh, EH14 4AP, UK
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Zhang Y, Yu Y, Peng M, Meng R, Hu K, Yu C. Temporal and seasonal variations of mortality burden associated with hourly temperature variability: A nationwide investigation in England and Wales. ENVIRONMENT INTERNATIONAL 2018; 115:325-333. [PMID: 29626694 DOI: 10.1016/j.envint.2018.03.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/24/2018] [Accepted: 03/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sudden temperature change may elevate short-term mortality and remains an important global health threat in the context of climate change. To date, however, little available temperature-mortality evidence has taken into account both intra- and inter-day temperature variability (TV), thus largely limiting the comprehensive understanding of mortality burden due to unstable weather. Moreover, seasonal and temporal patterns in TV-mortality associations were sparsely discussed, nationally and regionally. OBJECTIVES We aimed to assess the nationwide association of all-cause mortality with hourly temperature variability (HTV), quantify HTV-attributable mortality, and further explore the temporal and seasonal variations of mortality burden due to HTV in United Kingdom. METHODS Fourteen-year time-series data on temperature and mortality were collected from 10 regions in England and Wales during 1993-2006, totally including 7,573,716 all-cause deaths. HTV was calculated from the standard deviation of hourly temperature records within two neighboring days. A three-stage analytic approach was adopted to assess HTV-associated mortality burden. We first applied a time-series quasi-Poisson regression to estimate region-specific HTV-mortality associations, then pooled these associations at the national level using a multivariate meta-analysis, and finally estimated the HTV-attributable mortality fraction and illustrated its seasonal and temporal variations by conducting season- and period-specific analyses based on time-varying distributed lag models. RESULTS We found strong evidence that large HTV exposure elevated short-term mortality risk in England and Wales, with a pooled estimate of 1.13% (95% confidence interval (CI): 0.88, 1.39) associated with a 1-°C increase in HTV. During the whole study period, HTV accounted for a national average attributable fraction of 2.52% (95% empirical confidence interval (eCI): 2.27, 2.76) of the total deaths. This HTV-attributable mortality estimate showed a significant temporal decrease (p < 0.001) from 2.72% (95% eCI: 2.58, 2.87) in 1993-99 to 2.28% (95% eCI: 2.13, 2.43) in 2000-06. Additionally, clear seasonal variations were observed for HTV-attributable mortality burden, with the largest estimate of 3.08% (95% eCI: 2.80, 3.38) in summer, followed by 2.71% (95% eCI: 2.44, 2.98) in spring, 2.40% (95% eCI: 2.16, 2.63) in autumn, and 2.00% (95% eCI: 1.81, 2.20) in winter. CONCLUSIONS Despite clear evidence observed for the reduction, mortality burden caused by temperature variability remained a great public health threat, especially in warm seasons. It highlighted the importance of specific interventions targeted to unstable weather as well as temperature extremes, so as to reduce climate-related mortality burden.
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Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China.
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, China
| | - Minjin Peng
- Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Runtang Meng
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuhan 430072, China.
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Banwell N, Rutherford S, Mackey B, Street R, Chu C. Commonalities between Disaster and Climate Change Risks for Health: A Theoretical Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030538. [PMID: 29547592 PMCID: PMC5877083 DOI: 10.3390/ijerph15030538] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 12/11/2022]
Abstract
Disasters and climate change have significant implications for human health worldwide. Both climate change and the climate-sensitive hazards that result in disasters, are discussed in terms of direct and indirect impacts on health. A growing body of literature has argued for the need to link disaster risk reduction and climate change adaptation. However, there is limited articulation of the commonalities between these health impacts. Understanding the shared risk pathways is an important starting point for developing joint strategies for adapting to, and reducing, health risks. Therefore, this article discusses the common aspects of direct and indirect health risks of climate change and climate-sensitive disasters. Based on this discussion a theoretical framework is presented for understanding these commonalities. As such, this article hopes to extend the current health impact frameworks and provide a platform for further research exploring opportunities for linked adaptation and risk reduction strategies.
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Affiliation(s)
- Nicola Banwell
- Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane 4111, Australia.
| | - Shannon Rutherford
- Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane 4111, Australia.
| | - Brendan Mackey
- Griffith Climate Change Response Program, Griffith University, Gold Coast City 4222, Australia.
| | - Roger Street
- UK Climate Impacts Programme, Environmental Change Institute, University of Oxford, Oxford OX1 3QY, UK.
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane 4111, Australia.
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