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Zhao C, Huang Y, Cheng Y, Zhang R, Wang Y, Tong S, He J, Guo J, Xia F, Li Y, Yao X. Association between heatwaves and risk and economic burden of injury related hospitalizations in China. ENVIRONMENTAL RESEARCH 2024; 259:119509. [PMID: 38945512 DOI: 10.1016/j.envres.2024.119509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Public health is greatly affected by heatwaves, especially as a result of climate change. It is unclear whether heatwaves affect injury hospitalization, especially as developing countries facing the impact of climate change. OBJECTIVES To assess the impact of heatwaves on injury-related hospitalization and the economic burden. METHODS The daily hospitalizations and meteorological data from 2014 to 2019 were collected from 23 study sites in 11 meteorological geographic zones in China. We conducted a two-stage time series analysis based on a time-stratified case-crossover design, combined with DLNM to assess the association between heatwaves and daily injury hospitalization, and to further assess the regional and national economic losses resulting from hospitalization by calculating excess hospitalization costs (direct economic losses) and labor losses (indirect economic losses). To determine the vulnerable groups and areas, we also carried out stratified analyses by age, sex, and region. RESULTS We found that 6.542% (95%CI: 3.939%, 9.008 %) of injury hospitalization were attributable to heatwaves during warm season (May to September) from 2014 to 2019. Approximately 361,447 injury hospitalizations were attributed to heatwaves each year in China, leading to an excess economic loss of 5.173 (95%CI: 3.104, 7.196) billion CNY, of which 3.114 (95%CI: 1.454, 4.720) billion CNY for males and 4.785 (95%CI: 3.203, 6.321) billion CNY for people aged 15-64 years. The attributable fraction (AF) of injury hospitalizations due to heatwaves was the highest in the plateau mountain climate zone, followed by the subtropical monsoon climate zone and the temperate monsoon climate zone. CONCLUSIONS Heatwaves significantly increase the disease and economic burden of injury hospitalizations, and vary across populations and regions. Our findings implicate the necessity for targeted measures, including raising public awareness, improving healthcare infrastructure, and developing climate resilience policies, to reduce the threat of heatwaves to vulnerable populations and the associated disease and economic burden.
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Affiliation(s)
- Cheng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yu Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Shilu Tong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, 230032, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jiang He
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jia Guo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Fan Xia
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
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Li F, Liu X, Niu Y, Gao J, Li M, Zhao Y, Ji C, Pan G, Zhao M, Wu B, Tang X, Wu G, Tian J, Chen J, Yan S, Tan J, Li Y, Zhao W, Li L, Qiu Y, Yao W, Zhu L. The impact of apparent temperature on the emergency visits for traumatic fractures in Hangzhou, China. BMC Public Health 2024; 24:1681. [PMID: 38914979 PMCID: PMC11197263 DOI: 10.1186/s12889-024-19119-z] [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: 01/04/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Traumatic fractures occur frequently worldwide. However, research remains limited on the association between short-term exposure to temperature and traumatic fractures. This study aims to explore the impact of apparent temperature (AT) on emergency visits (EVs) due to traumatic fractures. METHODS Based on EVs data for traumatic fractures and the contemporary meteorological data, a generalized Poisson regression model along with a distributed lag nonlinear model (DLNM) were undertaken to determine the impact of AT on traumatic fracture EVs. Subgroup analysis by gender and age and sensitivity analysis were also performed. RESULTS A total of 25,094 EVs for traumatic fractures were included in the study. We observed a wide "J"-shaped relationship between AT and risk of traumatic fractures, with AT above 9.5 °C positively associated with EVs due to traumatic fractures. The heat effects became significant at cumulative lag 0-11 days, and the relative risk (RR) for moderate heat (95th percentile, 35.7 °C) and extreme heat (99.5th percentile, 38.8 °C) effect was 1.311 (95% CI: 1.132-1.518) and 1.418 (95% CI: 1.191-1.688) at cumulative lag 0-14 days, respectively. The cold effects were consistently non-significant on single or cumulative lag days across 0-14 days. The heat effects were higher among male and those aged 18-65 years old. The sensitivity analysis results remained robust. CONCLUSION Higher AT is associated with cumulative and delayed higher traumatic fracture EVs. The male and those aged 18-65 years are more susceptible to higher AT.
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Affiliation(s)
- Feng Li
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Xuejiao Liu
- Department of Medical Record Management and Statistics, Beijing Jishuitan Hospital, Capital Medical Univisity, Beijing, 100035, China
| | - Yanlin Niu
- Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing, 100035, China
| | - Jinghong Gao
- Institute for Hospital Management of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450000, China
| | - Maoqiang Li
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Yipin Zhao
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Cheng Ji
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Guobiao Pan
- Department of Orthopedics, Third People's Hospital of Hangzhou, Hangzhou, 310009, China
| | - Mingxing Zhao
- Department of orthopedics, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, 311199, China
| | - Boliang Wu
- Department of orthopedics, The First People's Hospital of Yuhang District, Hangzhou, Hangzhou, 311199, China
| | - Xiaoxiang Tang
- Department of Orthopedics, The Second People's Hospital of Jiande, Hangzhou, 311600, China
| | - Gang Wu
- Department of Orthopedics, The Second People's Hospital of Fuyang District, Hangzhou, Hangzhou, 311400, China
| | - Jun Tian
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Jianwei Chen
- Department of Orthopedics, The Second People's Hospital of Fuyang District, Hangzhou, Hangzhou, 311400, China
| | - Shiyu Yan
- Department of Orthopedics, The Second People's Hospital of Jiande, Hangzhou, 311600, China
| | - Jianlu Tan
- Department of orthopedics, Affiliated Hospital of Jining Medical University, Jining, 272007, China
| | - Yunqing Li
- Nanjing University of Chinese Medicine, Nangjing, 210023, China
| | - Wentao Zhao
- Department of orthopedics, Beijing Shunyi Hospital, Beijing, 101300, China
| | - Lingyun Li
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Yinmiao Qiu
- Department of Orthopedics, The Third People's Hospital of Xiaoshan Hangzhou, Hangzhou, 311251, China
| | - Wangxiang Yao
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Liulong Zhu
- Department of Orthopedics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
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Chevance G, Minor K, Vielma C, Campi E, O'Callaghan-Gordo C, Basagaña X, Ballester J, Bernard P. A systematic review of ambient heat and sleep in a warming climate. Sleep Med Rev 2024; 75:101915. [PMID: 38598988 DOI: 10.1016/j.smrv.2024.101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/31/2024] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
Climate change is elevating nighttime and daytime temperatures worldwide, affecting a broad continuum of behavioral and health outcomes. Disturbed sleep is a plausible pathway linking rising ambient temperatures with several observed adverse human responses shown to increase during hot weather. This systematic review aims to provide a comprehensive overview of the literature investigating the relationship between ambient temperature and valid sleep outcomes measured in real-world settings, globally. We show that higher outdoor or indoor temperatures are generally associated with degraded sleep quality and quantity worldwide. The negative effect of heat persists across sleep measures, and is stronger during the hottest months and days, in vulnerable populations, and the warmest regions. Although we identify opportunities to strengthen the state of the science, limited evidence of fast sleep adaptation to heat suggests rising temperatures induced by climate change and urbanization pose a planetary threat to human sleep, and therefore health, performance, and wellbeing.
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Affiliation(s)
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, United States.
| | | | | | - Cristina O'Callaghan-Gordo
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Québec, Canada
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Zhou L, Liu C, He C, Lei J, Zhu Y, Gao Y, Xuan J, Kan H, Chen R. Quantification of the Heat-Related Risk and Burden of Hospitalizations for Cause-Specific Injuries and Contribution of Human-Induced Climate Change: A Time-Stratified Case-Crossover Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57005. [PMID: 38752990 PMCID: PMC11098006 DOI: 10.1289/ehp14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000-2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (- 12.1 ° C ), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (< 18 years of age) or middle-aged (45-64 years of age) individuals, and those living in the North. The heat-related attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of human-induced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with human-induced change accounting for 6.7% to 10.6% of the burden. DISCUSSION This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. https://doi.org/10.1289/EHP14057.
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Affiliation(s)
- Lu Zhou
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cheng He
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jian Lei
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Sen University, Guangzhou, China
| | - Haidong Kan
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- National Center for Children’s Health, Children’s Hospital of Fudan University, Shanghai, China
| | - Renjie Chen
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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Guo Y, Gao Y, He C, Zhu Y, Zhou L, Kan H, Chen R. Short-term high temperature may increase the incidence risk of collective conflicts: A case-crossover study in the Greater Middle East. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170105. [PMID: 38232834 DOI: 10.1016/j.scitotenv.2024.170105] [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: 07/08/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Violent conflict is a formidable global challenge, with long-lasting impacts on individual health and society security. There has been compelling evidence that heat can increase aggression intention on the individual level. However, little is known about the short-term relationship between ambient temperature and collective violent conflicts, especially in less developed regions. METHOD We conducted a time-stratified case-crossover study combined with the distributed lag nonlinear model (DLNM) among 247,773 violent conflicts from 29 countries or regions in the Greater Middle East, between 1997 and 2021. Potential modification effects of economic status and climate conditions were explored by stratified analyses. Negative control and sensitivity analyses were also performed to test the robustness of our model. RESULTS We observed significant associations between higher temperature and the onset of five categories of violent conflicts. The effects generally occurred within the first several days after exposure. The incidence risks of battles, violence against civilians, explosions/remote violence, protests and riots were 1.60 [95 % confidence interval (CI): 1.31-1.95], 1.82 (95 % CI: 1.37-2.42), 1.24 (95 % CI: 1.08-1.41), 1.16 (95 % CI: 1.09-1.24) and 1.54 (95 % CI: 1.22-1.95) when comparing extreme high temperatures to minimum-risk temperatures. The associations were generally more prominent in areas with lower economic levels and associations in regions of the continental climate are also stronger. CONCLUSIONS Our finding reveals novel and concrete evidence that short-term high temperature could increase the risk of multiple forms of violent conflict in the Greater Middle East and provides new insights into the potential short-term mechanisms under the heat-collective violence association.
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Affiliation(s)
- Yichen Guo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lu Zhou
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
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Jung J, Kim G, Kang SW, Jeong S, Kang Y, Lee JY, Myung W, Kim H, Lee H. Short-term exposure to ambient air pollution and injuries due to external causes according to intentions and mechanisms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169202. [PMID: 38097073 DOI: 10.1016/j.scitotenv.2023.169202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023]
Abstract
Although injuries are a leading cause of death and affect the life expectancy of individuals who live with disabilities globally, the potential role of air pollution exposure on injuries due to external causes has received little scientific attention, especially compared with that given to the association of air pollution and non-external causes of morbidity and mortality. We investigated the association between emergency department visits for externally caused injuries and short-term exposure to major ambient air pollutants, with focus on the intentions and mechanisms of injuries. We identified 2,049,855 injured patients in Seoul, South Korea between 2008 and 2016 using the National Emergency Database. Daily short-term exposure to air pollution including particles <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) was estimated based on hourly concentrations. We employed a time-stratified case-crossover study design using a conditional Poisson regression model adjusted for meteorological variables, influenza epidemics, and holidays. Immediate exposure (lag 0) to most pollutants significantly increased the risk of total injuries (PM2.5, 0.42 %; NO2, 0.68 %; SO2, 1.05 %; CO, 0.57 %; O3, 1.86 % per interquartile range increment), and the associations differed according to the intention and mechanism of injury. Unintentional and assault injuries were significantly associated with air pollution exposure, whereas self-harm injuries showed no association. In mechanism-specific analyses, injuries caused by falls, blunt objects, penetration, traffic accidents, machinery, and slips were associated with specific air pollutants, even in the co-pollutant models. The associations were stronger in injured patients aged <15 years, and in males than in their counterparts. Our results suggest that short-term air pollution exposure might play a role in the risk of externally caused injuries and the association may differ depending on the intention and mechanism of injury, which provide important evidence for injury prevention and air quality strategies.
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Affiliation(s)
- Jiyun Jung
- Clinical Trial Center, Dongguk University Ilsan Hospital, Goyang, South Korea; Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, South Korea
| | - Gyeongchan Kim
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Sun-Woo Kang
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Subin Jeong
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Yoonjung Kang
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ho Kim
- Department of Public Health Science, School of Public Health, Seoul National University, Seoul, South Korea
| | - Hyewon Lee
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea; Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, South Korea; Department of Software Convergence, Soonchunhyang University Graduate School, Asan, South Korea.
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Lee H, Yoon HY. Impact of ambient temperature on respiratory disease: a case-crossover study in Seoul. Respir Res 2024; 25:73. [PMID: 38317208 PMCID: PMC10845516 DOI: 10.1186/s12931-024-02699-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Respiratory diseases contribute to global morbidity and mortality, and temperature is a significant factor. We investigated the association between ambient temperature and emergency department (ED) visits for various respiratory diseases in Seoul, South Korea. METHODS Using data from the National Emergency Department Information System (2008-2017), we analysed 1,616,644 ED visits for respiratory diseases, categorised according to the Korean Standard Classification of Diseases 7th revision codes (J00-J99). Using a time-stratified case-crossover design and a distributed lag nonlinear model, we investigated the effect of temperature exposure on ED visits for respiratory diseases, calculating the relative risk (RR) for the maximum risk temperature (MaxRT) of both cold and hot extremes compared to the minimum risk temperature (MinRT). RESULTS Cold temperatures (MaxRT: -9.0 °C) resulted in a 2.68-fold increase (RR = 2.68, 95% CI = 2.26-3.14) in ED visits for total respiratory diseases, while hot temperatures (MaxRT: 29.4 °C) led to a 1.26-fold increase (RR = 1.26, 95% CI = 1.11-1.42) compared to the MinRT (24.8 °C). Cold temperatures increased the risk of most respiratory diseases, except interstitial lung disease, whereas hot temperatures increased ED visits for acute upper respiratory infections and influenza. Cold temperatures increased ED visits for all age groups, especially those aged 18-64 (RR = 3.54, 95% CI = 2.90-4.33), while hot temperatures significantly affected those < 18 (RR = 1.45, 95% CI = 1.27-1.66). The risk levels were similar in both males and females, regardless of hot and cold temperatures. CONCLUSION Our findings underscore the significant impact of both cold and heat exposure on ED visits for respiratory diseases, with varying intensities and risk profiles across different population groups.
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Affiliation(s)
- Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
- Department of Software Convergence, Soonchunhyang University Graduate School, Asan, Republic of Korea
| | - Hee-Young Yoon
- Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwanro, Yongsan-gu, Seoul, 04401, Republic of Korea.
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Pflaum-Carlson J. Commentary on "Drop of Blood". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:163. [PMID: 38294425 DOI: 10.1097/01.acm.0001006616.72921.3c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Jacqueline Pflaum-Carlson
- J. Pflaum-Carlson is clinical assistant professor, Division of Pulmonary and Critical Care Medicine, Department of Emergency Medicine, Wayne State University School of Medicine, Henry Ford Health System, Detroit, Michigan; ; Twitter: @CritCraftingMD; ORCID: http://orcid.org/0000-0002-0502-1826
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Le VTH, Berman JD, Wattenberg EV, Ngo TV, Tran QA, Alexander BH. Temperature-related emergency injury visits in Hanoi, Vietnam. Inj Prev 2024; 30:33-38. [PMID: 37863513 PMCID: PMC10850667 DOI: 10.1136/ip-2023-044946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/29/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND The short-term association between increasing temperatures and injury has been described in high-income countries, but less is known for low-income and-middle-income countries, including Vietnam. METHODS We used emergency injury visits (EIV) data for 2017-2019 from 733 hospitals and clinics in Hanoi, Vietnam to examine the effects of daily temperature on EIV. Time-series analysis with quasi-Poisson models was used to estimate a linear relative risk increase (RRI) for overall populations and ones stratified by age and sex. Exposure-response curves estimated non-linear associations as an RR between daily temperature and injury. Models were adjusted for the day of week, holidays, daily relative humidity, daily particulate matter, and long-term and seasonal trends. RESULTS AND CONCLUSIONS A total of 39 313 EIV were recorded averaging 36 injuries daily. Injuries more likely occurred in males and those aged 15-44, and aged 44-60. For linear effects, a 5°C increase in same day mean temperature was associated with an overall increased EIV (RRI 4.8; 95% CI 2.3 to 7.3) with males (RRI 5.9; 95% CI 3.0 to 8.9) experiencing a greater effect than females (RRI 3.0; 95% CI -0.5 to 6.5). Non-linear effects showed an increase in EIV at higher temperatures compared with the threshold temperature of 15°C, with the greatest effect at 33°C (RR 1.3; 95% CI 1.2 to 1.6). Further research to investigate temperature-injury among different populations and by the cause of injury is warranted.
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Affiliation(s)
- Vu Thuy Huong Le
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Jesse D Berman
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Elizabeth V Wattenberg
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Toan Van Ngo
- Environmental Health Department, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Quynh Anh Tran
- Environmental Health Department, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Du R, Jiao W, Ma J, Zhou Q, Liang ZS, Sun S, Ahmed OG, Rowan NR, Pinto JM, Ramanathan M, Zhang Z. Association between ambient temperature and chronic rhinosinusitis. Int Forum Allergy Rhinol 2023; 13:1906-1914. [PMID: 36897288 DOI: 10.1002/alr.23152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Chronic exposure to particulate matter air pollution (PM2.5 ) is associated with chronic rhinosinusitis (CRS). Elevated ambient temperature may increase PM2.5 levels and thereby exacerbate sinonasal symptoms. This study investigates the association between high ambient temperature and the risk of CRS diagnosis. METHODS Patients with CRS were diagnosed at Johns Hopkins hospitals from May to October 2013-2022, and controls were matched patients without CRS meanwhile. A total of 4752 patients (2376 cases and 2376 controls) were identified with a mean (SD) age of 51.8 (16.8) years. The effect of maximum ambient temperature on symptoms was estimated with a distributed lag nonlinear model (DLNM). Extreme heat was defined as 35.0°C (95th percentile of the maximum temperature distribution). Conditional logistic regression models estimated the association between extreme heat and the risk of CRS diagnosis. RESULTS Exposure to extreme heat was associated with increased odds of exacerbation of CRS symptoms (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03-1.19). The cumulative effect of extreme heat during 0-21 lag days was significant (OR 2.37, 95% CI 1.60-3.50) compared with the minimum morbidity temperature (MMT) at 25.3°C. Associations were more pronounced among young and middle-aged patients and patients with abnormal weight. CONCLUSIONS We found that short-term exposure to high ambient temperature is associated with increased CRS diagnosis, suggesting a cascading effect of meteorological phenomena. These results highlight climate change's potentially deleterious health effects on upper airway diseases, which could have a significant public health impact.
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Affiliation(s)
- Runming Du
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Wangteng Jiao
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Qinfeng Zhou
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Zhi-Sheng Liang
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, China
| | - Omar G Ahmed
- Division of Rhinology, Sinus, Sleep & Skull Base Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, Illinois, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Zhenyu Zhang
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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11
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Liu Y, Dong X, Li Z, Zhu S, Lin Z, He G, Gong W, Hu J, Hou Z, Meng R, Zhou C, Yu M, Huang B, Lin L, Xiao J, Zhong J, Jin D, Xu Y, Lv L, Huang C, Liu T, Ma W. The Combined Effects of Short-Term Exposure to Multiple Meteorological Factors on Unintentional Drowning Mortality: Large Case-Crossover Study. JMIR Public Health Surveill 2023; 9:e46792. [PMID: 37471118 PMCID: PMC10401198 DOI: 10.2196/46792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/05/2023] [Accepted: 06/15/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Drowning is a serious public health problem worldwide. Previous epidemiological studies on the association between meteorological factors and drowning mainly focused on individual weather factors, and the combined effect of mixed exposure to multiple meteorological factors on drowning is unclear. OBJECTIVE We aimed to investigate the combined effects of multiple meteorological factors on unintentional drowning mortality in China and to identify the important meteorological factors contributing to drowning mortality. METHODS Unintentional drowning death data (based on International Classification of Diseases, 10th Edition, codes W65-74) from January 1, 2013, to December 31, 2018, were collected from the Disease Surveillance Points System for Guangdong, Hunan, Zhejiang, Yunnan, and Jilin Provinces, China. Daily meteorological data, including daily mean temperature, relative humidity, sunlight duration, and rainfall in the same period were obtained from the Chinese Academy of Meteorological Science Data Center. We constructed a time-stratified case-crossover design and applied a generalized additive model to examine the effect of individual weather factors on drowning mortality, and then used quantile g-computation to estimate the joint effect of the mixed exposure to meteorological factors. RESULTS A total of 46,179 drowning deaths were reported in the 5 provinces in China from 2013 to 2018. In an effect analysis of individual exposure, we observed a positive effect for sunlight duration, a negative effect for relative humidity, and U-shaped associations for temperature and rainfall with drowning mortality. In a joint effect analysis of the above 4 meteorological factors, a 2.99% (95% CI 0.26%-5.80%) increase in drowning mortality was observed per quartile rise in exposure mixture. For the total population, sunlight duration was the most important weather factor for drowning mortality, with a 93.1% positive contribution to the overall effects, while rainfall was mainly a negative factor for drowning deaths (90.5%) and temperature and relative humidity contributed 6.9% and -9.5% to the overall effects, respectively. CONCLUSIONS This study found that mixed exposure to temperature, relative humidity, sunlight duration, and rainfall was positively associated with drowning mortality and that sunlight duration, rather than temperature, may be the most important meteorological factor for drowning mortality. These findings imply that it is necessary to incorporate sunshine hours and temperature into early warning systems for drowning prevention in the future.
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Affiliation(s)
- Yingyin Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zhixing Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Department of Nosocomial Infection Management, Affiliated Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Lingshuang Lv
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Tao Liu
- Disease Control and Prevention Institute of Jinan University, School of Medicine, Jinan University, Guangzhou, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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12
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Zheng H, Cheng J, Ho HC, Zhu B, Ding Z, Du W, Wang X, Yu Y, Fei J, Xu Z, Zhou J, Yang J. Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study. FRONTIERS OF ENVIRONMENTAL SCIENCE & ENGINEERING 2023; 17:105. [PMID: 37033401 PMCID: PMC10067518 DOI: 10.1007/s11783-023-1705-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
UNLABELLED Although studies have suggested that non-optimal temperatures may increase the risk of injury, epidemiological studies focusing on the association between temperature and non-fatal injury among children and adolescents are limited. Therefore, we investigated the short-term effect of ambient temperature on non-fatal falls and road traffic injuries (RTIs) among students across Jiangsu Province, China. Meteorological data and records of non-fatal outdoor injuries due to falls and RTIs among students aged 6-17 were collected during 2018-2020. We performed a time-stratified case-crossover analysis with a distributed lag nonlinear model to examine the effect of ambient temperature on the risk of injury. Individual meteorological exposure was estimated based on the address of the selected school. We also performed stratified analyses by sex, age, and area. A total of 57322 and 5455 cases of falls and RTIs were collected, respectively. We observed inverted U-shaped curves for temperature-injury associations, with maximum risk temperatures at 18 °C (48th of daily mean temperature distribution) for falls and 22 °C (67th of daily mean temperature distribution) for RTIs. The corresponding odds ratios (95% confidence intervals) were 2.193 (2.011, 2.391) and 3.038 (1.988, 4.644) for falls and RTIs, respectively. Notably, there was a significant age-dependent trend in which the temperature effect on falls was greater in older students (P-trend < 0.05). This study suggests a significant association between ambient temperature and students' outdoor falls and RTIs. Our findings may help advance tailored strategies to reduce the incidence of outdoor falls and RTIs in children and adolescents. ELECTRONIC SUPPLEMENTARY MATERIAL Supplementary material is available in the online version of this article at 10.1007/s11783-023-1705-1 and is accessible for authorized users.
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Affiliation(s)
- Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032 China
- Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, 230032 China
| | - Hung Chak Ho
- Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong, 999077 China
| | - Baoli Zhu
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Zhen Ding
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Wencong Du
- Department of Noncommunicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Xin Wang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Yang Yu
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Juan Fei
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Zhiwei Xu
- School of Public Health, University of Queensland, Queensland, 4006 Australia
| | - Jinyi Zhou
- Department of Noncommunicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
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13
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Xia Y, Shi C, Li Y, Jiang X, Ruan S, Gao X, Chen Y, Huang W, Li M, Xue R, Wen X, Peng X, Chen J, Zhang L. Effects of ambient temperature on mortality among elderly residents of Chengdu city in Southwest China, 2016-2020: a distributed-lag non-linear time series analysis. BMC Public Health 2023; 23:149. [PMID: 36681785 PMCID: PMC9863161 DOI: 10.1186/s12889-022-14931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With complex changes in the global climate, it is critical to understand how ambient temperature affects health, especially in China. We aimed to assess the effects of temperature on daily mortality, including total non-accidental, cardiovascular disease (CVD), respiratory disease, cerebrovascular disease, and ischemic heart disease (IHD) mortality between 2016 and 2020 in Chengdu, China. METHODS We obtained daily temperature and mortality data for the period 2016-2020. A Poisson regression model combined with a distributed-lag nonlinear model was used to examine the association between temperature and daily mortality. We investigated the effects of individual characteristics by sex, age, education level, and marital status. RESULTS We found significant non-linear effects of temperature on total non-accidental, CVD, respiratory, cerebrovascular, and IHD mortality. Heat effects were immediate and lasted for 0-3 days, whereas cold effects persisted for 7-10 days. The relative risks associated with extreme high temperatures (99th percentile of temperature, 28 °C) over lags of 0-3 days were 1.22 (95% confidence interval [CI]: 1.17, 1.28) for total non-accidental mortality, 1.40 (95% CI: 1.30, 1.50) for CVD morality, 1.34 (95% CI: 1.24, 1.46) for respiratory morality, 1.33 (95% CI: 1.20, 1.47) for cerebrovascular mortality, and 1.38 (95% CI: 1.20, 1.58) for IHD mortality. The relative risks associated with extreme cold temperature (1st percentile of temperature, 3.0 °C) over lags of 0-14 days were 1.32 (95% CI: 1.19, 1.46) for total mortality, 1.45 (95% CI: 1.24, 1.68) for CVD morality, 1.28 (95% CI: 1.09, 1.50) for respiratory morality, 1.36 (95% CI: 1.09, 1.70) for cerebrovascular mortality, and 1.26 (95% CI: 0.95, 1.68) for IHD morality. We found that hot and cold affects were greater in those over 85 years of age, and that women, individuals with low education levels, and those who were widowed, divorced, or never married, were more vulnerable. CONCLUSIONS This study showed that exposure to hot and cold temperatures in Chengdu was associated with increased mortality, with people over 85 years old, women, those with low education levels, and unmarried individuals being more affected by hot and cold temperatures.
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Affiliation(s)
- Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No.6, Longxiang Road, Wuhou District, Chengdu, 610041 China
| | - Yu Chen
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500 China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No.826, Huichuan Road, Ziliujing District, Zigong, 643000 China
| | - Mingjiang Li
- Panzhi Hua Center for Disease Control and Prevention, Dong District, No.996, Jichang Road617067, Panzhi Hua, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No.996, Binhebei RoadLizhou District, Guangyuan, 628017 China
| | - Xianying Wen
- Mianyang Center for Disease Control and Prevention, Gaoxin District, No.50, Mianxingdong Road, Mianyang, 621000 China
| | - Xiaojuan Peng
- Yaan Center for Disease Control and Prevention, No.9, Fangcao Road, Yucheng District, Yaan, 625000 China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041 China
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14
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Hu J, He G, Meng R, Gong W, Ren Z, Shi H, Lin Z, Liu T, Zeng F, Yin P, Bai G, Qin M, Hou Z, Dong X, Zhou C, Pingcuo Z, Xiao Y, Yu M, Huang B, Xu X, Lin L, Xiao J, Zhong J, Jin D, Zhao Q, Li Y, Gama C, Xu Y, Lv L, Zeng W, Li X, Luo L, Zhou M, Huang C, Ma W. Temperature-related mortality in China from specific injury. Nat Commun 2023; 14:37. [PMID: 36596791 PMCID: PMC9810693 DOI: 10.1038/s41467-022-35462-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 12/05/2022] [Indexed: 01/04/2023] Open
Abstract
Injury poses heavy burden on public health, accounting for nearly 8% of all deaths globally, but little evidence on the role of climate change on injury exists. We collect data during 2013-2019 in six provinces of China to examine the effects of temperature on injury mortality, and to project future mortality burden attributable to temperature change driven by climate change based on the assumption of constant injury mortality and population scenario. The results show that a 0.50% (95% confident interval (CI): 0.13%-0.88%) increase of injury mortality risk for each 1 °C rise in daily temperature, with higher risk for intentional injury (1.13%, 0.55%-1.71%) than that for unintentional injury (0.40%, 0.04%-0.77%). Compared to the 2010s, total injury deaths attributable to temperature change in China would increase 156,586 (37,654-272,316) in the 2090 s under representative concentration pathways 8.5 scenario with the highest for transport injury (64,764, 8,517-115,743). Populations living in Western China, people aged 15-69 years, and male may suffer more injury mortality burden from increased temperature caused by climate change. Our findings may be informative for public health policy development to effectively adapt to climate change.
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Affiliation(s)
- Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 511443, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310009, China
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Heng Shi
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, 850002, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 511443, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 511443, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 511443, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Guoxia Bai
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, 850002, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, 650034, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 511443, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Zhuoma Pingcuo
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, 850002, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming, 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310009, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China
| | - Yajie Li
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, 850002, China
| | - Cangjue Gama
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa, 850002, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Lingshuang Lv
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Liying Luo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 511443, China.
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15
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Basagaña X, de la Peña-Ramirez C. Ambient temperature and risk of motor vehicle crashes: A countrywide analysis in Spain. ENVIRONMENTAL RESEARCH 2023; 216:114599. [PMID: 36270536 DOI: 10.1016/j.envres.2022.114599] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Some studies have documented that cold or hot ambient temperatures increase the risk of motor vehicle crashes. However, the number of existing studies is still limited, especially for the effects of cold. OBJECTIVES To estimate the relationship between ambient temperatures and risk of motor vehicle crashes in Spain, and to estimate the same association when restricting to those crashes with driver performance-associated factors (namely distraction, fatigue, sleepiness or disease). METHODS We used data for the period 1993-2013. We conducted a time series analysis controlling for seasonality and trends and using the distributed lag nonlinear model framework to estimate nonlinear and delayed effects of up to 7 days. Analyses were conducted at the province level and combined using multivariate meta-analysis. RESULTS The study included 1,908,460 motor vehicle crashes, 37% of them with associated driver performance factors. The overall analysis showed that the risk of crashes increased almost linearly with temperature. The estimates of the cumulative effect of lags 0-7 when comparing the 99th percentile and the first percentile of temperature produced a relative risk (RR) of 1.15 (95% confidence interval (CI): 1.11, 1.20). The estimates were slightly higher when analyses were restricted to crashes with driver performance-associated factors (RR: 1.23, 95% CI: 1.17, 1.30). In some provinces that reached temperatures below 0 °C, an increased risk with cold temperatures was also observed. An added effect of both cold spell and heat wave periods was found only in the analysis of crashes with driver performance-associated factors (cold spells, RR: 1.029, 95% CI: 1.005, 1.053; heat waves, RR: 1.020, 95% CI: 1.002, 1.039). CONCLUSIONS The increase of temperature increased the risk of motor vehicle crashes in Spain. Measures aimed at reducing the influence of heat on the risk of motor vehicle crashes can have important benefits for public health.
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Affiliation(s)
- Xavier Basagaña
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
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16
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Luo L, Zeng F, Bai G, Gong W, Ren Z, Hu J, He G, Shi H, Lin Z, Liu T, Yin P, Qin M, Hou Z, Meng R, Zhou C, Dong X, Pingcuo Z, Xiao Y, Yu M, Huang B, Xu X, Lin L, Xiao J, Zhong J, Jin D, Li Y, Gama C, Xiong P, Xu Y, Lv L, Zeng W, Li X, Zhou M, Huang C, Ma W. Future injury mortality burden attributable to compound hot extremes will significantly increase in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 845:157019. [PMID: 35798110 DOI: 10.1016/j.scitotenv.2022.157019] [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: 02/22/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND As climate change, compound hot extremes (CHEs), daytime and nighttime persistent hot extremes, are projected to become much more frequent and intense, which may pose a serious threat to human health. However, evidence on the impact of CHEs on injury is rare. METHODS We collected injury death data and daily meteorological data from six Chinese provinces during 2013-2018. A time-stratified case-crossover design with two-stage analytic approach was applied to assess the associations of CHEs with injury mortality by intention, mechanism, age and gender. Using the projected daily temperatures of five General Circulation Models (GCMs), we projected the frequency of CHEs and CHEs-attributable mortality burden of injury under three Representative Concentration Pathway (RCP) scenarios. RESULTS CHEs were significantly associated with increased injury mortality risk (RR = 1.14, 95%CI: 1.09-1.19), with strong effects on unintentional injuries (RR = 1.16, 95%CI:1.11,1.22) and intentional injuries (RR = 1.11, 95%CI:0.99,1.25). Female (RR = 1.21,95%CI: 1.13-1.29) and the elderly (RR = 1.30, 95%CI: 1.22-1.39) were more susceptible to CHEs. Both the frequency and injury mortality burden of CHEs showed a steep rising trend under RCP8.5 scenario, with a 7.37-fold and 8.22-fold increase respectively, by the end of the century, especially in southern, eastern, central and northwestern China. CONCLUSION CHEs were associated with increased injury mortality risk, and the CHEs-attributable injury mortality burden was projected to aggravate substantially in the future as global warming. It is urgent to develop targeted adaptation policies to alleviate the health burden of CHEs.
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Affiliation(s)
- Liying Luo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 511443, China
| | - Guoxia Bai
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850002, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310009, China
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Heng Shi
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850002, China
| | - Ziqiang Lin
- Department of Psychiatry, New York University School of Medicine, One Park Ave, New York, NY 10016, United States
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 511443, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 511443, China
| | - Zhuoma Pingcuo
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850002, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310009, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yajie Li
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850002, China
| | - Cangjue Gama
- Tibet Autonomous Region Center for Disease Control and Prevention, Lhasa 850002, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 511443, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Lingshuang Lv
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 511443, China.
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17
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Liang M, Min M, Guo X, Song Q, Wang H, Li N, Su W, Liang Q, Ding X, Ye P, Duan L, Sun Y. The relationship between ambient temperatures and road traffic injuries: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:50647-50660. [PMID: 35235122 DOI: 10.1007/s11356-022-19437-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
Traffic accidents cause considerable economic losses and injuries. Although the adverse effects of a change in ambient temperatures on human health have been widely documented, its effects on road traffic safety are still debated. This systematic review and meta-analysis was performed to synthesize available data on the association between ambient temperature and the risks of road traffic accidents (RTAs) and traffic accident injuries (TAIs). We searched 7 different databases to locate studies. The subgroup analyses were stratified by temperature type, temperature exposure, region, mean temperature, mortality, study period, statistical model, and source of injury data. This study was registered with PROSPERO under the number CRD42021264660. This is the first meta-analysis to investigate the association between ambient temperature and road traffic safety. A total of 34 high-temperature effect estimates were reported, and two additional studies reported the relationship between low temperatures and TAI risk. The meta-analysis results found a significant association between the high temperature and RTAs, and the pooled RR was 1.025 (95%CI 1.014, 1.035). The risk of TAI was also significantly associated with temperature increases. Subgroup analyses found that using daily mean temperatures, the RR value of road traffic accidents was 1.024 (95%CI 0.939, 1.116), and the RR value of road traffic injuries was 1.052 (95%CI 1.024, 1.080). Hourly temperatures significantly increased the risk of RTA, while the risk of TAI was not significantly increased by hourly temperature. The sensitivity analysis indicated that the results were stable, and no obvious publication bias was detected. The results of this systematic review and meta-analysis suggest that increases in ambient temperature are associated with an increased risk of RTAs and TAIs. These findings add to the evidence of the impact of ambient temperature on road traffic safety.
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Affiliation(s)
- Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Min Min
- Anhui Institute of Medical Information (Anhui Medical Association), No.15 Gongwan Road, Hefei, 230061, Anhui, People's Republic of China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Pengpeng Ye
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Leilei Duan
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
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18
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Zhao Q, Yu P, Mahendran R, Huang W, Gao Y, Yang Z, Ye T, Wen B, Wu Y, Li S, Guo Y. Global climate change and human health: Pathways and possible solutions. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:53-62. [PMID: 38075529 PMCID: PMC10702927 DOI: 10.1016/j.eehl.2022.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/13/2022] [Accepted: 04/28/2022] [Indexed: 12/13/2023]
Abstract
Global warming has been changing the planet's climate pattern, leading to increasing frequency, intensity and duration of extreme weather events and natural disasters. These climate-changing events affect various health outcomes adversely through complicated pathways. This paper reviews the main signs of climate change so far, e.g., suboptimal ambient temperature, sea-level rise and other conditions, and depicts the interactive pathways between different climate-changing events such as suboptimal temperature, wildfires, and floods with a broad range of health outcomes. Meanwhile, the modifying effect of socioeconomic, demographic and environmental factors on the pathways is summarised, such that the youth, elderly, females, poor and those living in coastal regions are particularly susceptible to climate change. Although Earth as a whole is expected to suffer from climate change, this review article discusses some potential benefits for certain regions, e.g., a more liveable environment and sufficient food supply. Finally, we summarise certain mitigation and adaptation strategies against climate change and how these strategies may benefit human health in other ways. This review article provides a comprehensive and concise introduction of the pathways between climate change and human health and possible solutions, which may map directions for future research.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Pei Yu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Rahini Mahendran
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Wenzhong Huang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yuan Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Zhengyu Yang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Tingting Ye
- Department of Epidemiology and Preventive Medicine, 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
| | - Yao Wu
- Department of Epidemiology and Preventive Medicine, 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
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
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19
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Qin RX, Velin L, Yates EF, El Omrani O, McLeod E, Tudravu J, Samad L, Woodward A, McClain CD. Building sustainable and resilient surgical systems: A narrative review of opportunities to integrate climate change into national surgical planning in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 22:100407. [PMID: 35243461 PMCID: PMC8881731 DOI: 10.1016/j.lanwpc.2022.100407] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Five billion people lack access to surgical care worldwide; climate change is the biggest threat to human health in the 21st century. This review studies how climate change could be integrated into national surgical planning in the Western Pacific region. We searched databases (PubMed, Web of Science, and Global Health) for articles on climate change and surgical care. Findings were categorised using the modified World Health Organisation Health System Building Blocks Framework. 220 out of 2577 records were included. Infrastructure: Operating theatres are highly resource-intensive. Their carbon footprint could be reduced by maximising equipment longevity, improving energy efficiency, and renewable energy use. Service delivery Tele-medicine, outreaches, and avoiding desflurane could reduce emissions. Robust surgical systems are required to adapt to the increasing burden of surgically treated diseases, such as injuries from natural disasters. Finance: Climate change adaptation funds could be mobilised for surgical system strengthening. Information systems: Sustainability should be a key performance indicator for surgical systems. Workforce: Surgical providers could change clinical, institutional, and societal practices. Governance: Planning in surgical care and climate change should be aligned. Climate change mitigation is essential in the regional surgical care scale-up; surgical system strengthening is also necessary for adaptation to climate change.
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20
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Yue X, Yang X, Song D, Yuan Y. The interaction effect of severe weather and non-weather factors on freeway travel volume. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 808:152057. [PMID: 34883178 DOI: 10.1016/j.scitotenv.2021.152057] [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: 09/29/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 06/13/2023]
Abstract
The existing literature has confirmed that extreme weather such as wind, rain, and snow have a negative impact on cross-sectional traffic flow. However, travel activities with different destination regions, travel distances and vehicle types may have different responses to severe weather. We employ the multilevel mixed-effects negative binomial (MENB) model to explore the interaction effect of severe weather and non-weather factors on intercity origin-destination (OD) demand, based on the data from freeway toll stations in Shandong Province from March 2011 to February 2012. The MENB model is superior to the SNB model in that the former has both smaller AIC (456,645.4 < 4,586,877.2) and BIC (456,963.4 < 458,975.8) values and log-likelihood ratio tests. The results indicate that weather impact on freeway travel to the same metropolitan area is homogeneous, and the impact in different metropolitan areas is heterogeneous. Besides, there is an interaction effect between severe weather (strong wind, fog, heavy rain, snow) and travel distance on freeway OD volume. With increasing travel distance, the impact of both strong wind and heavy rain decreases gradually, while the impact of both fog and snow increases. In addition, heat (0.0351 > 0.0201), strong wind (0.0930 > 0.0454), and heavy rain (0.1245 > 0.1044) have a greater impact on passenger car volume than on truck volume, while fog (0.4340 < 0.4802) and snow (0.4383 < 0.4884) have a less significant impact on passenger car volume. The findings of this study provide some deep insights into the relationship between severe weather factors and intercity travel demand, which suggests that different strategies of travel demand management should be adopted for different travel distances and different vehicle types under various weather conditions.
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Affiliation(s)
- Xianfei Yue
- MOT Key Laboratory of Transport Industry of Big Data Application Technologies for Comprehensive Transport, School of Traffic and Transportation, Beijing Jiaotong University, Beijing 100044, China
| | - Xiaobao Yang
- MOT Key Laboratory of Transport Industry of Big Data Application Technologies for Comprehensive Transport, School of Traffic and Transportation, Beijing Jiaotong University, Beijing 100044, China.
| | - Dongdong Song
- MOT Key Laboratory of Transport Industry of Big Data Application Technologies for Comprehensive Transport, School of Traffic and Transportation, Beijing Jiaotong University, Beijing 100044, China
| | - Yali Yuan
- MOT Key Laboratory of Transport Industry of Big Data Application Technologies for Comprehensive Transport, School of Traffic and Transportation, Beijing Jiaotong University, Beijing 100044, China
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21
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Liu Y, Han X, Cui X, Zhao X, Zhao X, Zheng H, Zhang B, Ren X. Association Between Air Pollutants and Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Time Stratified Case-Crossover Design With a Distributed Lag Nonlinear Model. GEOHEALTH 2022; 6:e2021GH000529. [PMID: 35128294 PMCID: PMC8802523 DOI: 10.1029/2021gh000529] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/13/2021] [Accepted: 12/30/2021] [Indexed: 06/02/2023]
Abstract
Acute exacerbation of chronic obstruction pulmonary disease (AECOPD) as a respiratory disease, is considered to be related to air pollution by more and more studies. However, the evidence on how air pollution affect the incidence of AECOPD and whether there are population differences is still insufficient. Therefore, we select PM10, PM2.5, SO2, NO2, CO, and O3 as representatives combined with daily AECOPD admission data from 1 January 2015 to 26 June 2016 in the rural areas of Qingyang, northwestern China to explore the associations of air pollution with AECOPD. Based on a time-stratified case-crossover design, we constructed a distributed lag nonlinear model to qualify the single and cumulative lagged effects of air pollution on AECOPD. Stratified related risks by sex and age were also reported. The cumulative exposure-response curves were approximately linear for PM2.5, "V"-shaped for PM10, "U"-shaped for NO2 and inverted-"V" for SO2, CO and O3. Exposure to high-PM2.5 (42 μg/m3), high-PM10 (91 μg/m3), high-SO2 (58 μg/m3), low-NO2 (12 μg/m3), and high-CO (1.55 mg/m3) increased the risk of AECOPD. Females aged 15-64 were more susceptible under extreme concentrations of PM2.5, SO2, CO, and low-PM10 than other subgroups. In addition, adults aged 15-64 were more sensitive to extreme concentrations of NO2 compared with the elderly ≥65 years old, while the latter were more sensitive to high-PM10. High-SO2, high-NO2, and extreme concentrations of PM2.5 had the greatest effects on the day of exposure, while low-SO2 and low-CO had lagged effects on AECOPD. Precautionary measures should be taken with a focus on vulnerable subgroups, to control hospitalization for AECOPD associated with air pollutants.
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Affiliation(s)
- Yanchen Liu
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
| | - Xiaoli Han
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
- Administration Department of Nosocomial InfectionAffiliated Hospital of Gansu Medical CollegePingliangChina
| | - Xudong Cui
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
| | - Xiangkai Zhao
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
| | - Xin Zhao
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
| | - Hongmiao Zheng
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
| | - Benzhong Zhang
- Institute of Occupational and Environmental HygieneSchool of Public HealthLanzhou UniversityLanzhouChina
| | - Xiaowei Ren
- Institute of Epidemiology and Health StatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
- Now at Department of Epidemiology and BiostatisticsSchool of Public HealthLanzhou UniversityLanzhouChina
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22
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Ghada W, Estrella N, Ankerst DP, Menzel A. Universal thermal climate index associations with mortality, hospital admissions, and road accidents in Bavaria. PLoS One 2021; 16:e0259086. [PMID: 34788302 PMCID: PMC8598056 DOI: 10.1371/journal.pone.0259086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
When meteorological conditions deviate from the optimal range for human well-being, the risks of illness, injury, and death increase, and such impacts are feared in particular with more frequent and intense extreme weather conditions resulting from climate change. Thermal indices, such as the universal thermal climate index (UTCI), can better assess human weather-related stresses by integrating multiple weather components. This paper quantifies and compares the seasonal and spatial association of UTCI with mortality, morbidity, and road accidents in the federal state of Bavaria, Germany. Linear regression was applied to seasonally associate daily 56 million hospital admissions and 2.5 million death counts (1995-2015) as well as approximately 930,000 road accidents and 1.7 million people injured (2002-2015) with spatially interpolated same day- and lagged- (up to 14 days) average UTCI values. Additional linear regressions were performed stratifying by age, gender, region, and district. UTCI effects were clear in all three health outcomes studied: Increased UTCI resulted in immediate (1-2 days) rises in morbidity and even more strongly in mortality in summer, and lagged (up to 14 days) decreases in fall, winter, and spring. The strongest UTCI effects were found for road accidents where increasing UTCI led to immediate decreases in daily road accidents in winter but pronounced increases in all other seasons. Differences in UTCI effects were observed e.g. between in warmer north-western regions (Franconia, more districts with heat stress-related mortality, but hospital admissions for lung, heart and external reasons decreasing with summer heat stress), the touristic alpine regions in the south (immediate effect of increasing UTCI on road accidents in summer), and the colder south-eastern regions (increasing hospital admissions for lung, heart and external reasons in winter with UTCI). Districts with high percentages of elderly suffered from higher morbidity and mortality, particularly in winter. The influences of UTCI as well as the spatial and temporal patterns of this influence call for improved infrastructure planning and resource allocation in the health sector.
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Affiliation(s)
- Wael Ghada
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
| | - Nicole Estrella
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
| | - Donna P. Ankerst
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
- Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Annette Menzel
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
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23
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Liang M, Ding X, Yao Z, Duan L, Xing X, Sun Y. Effects of ambient temperature and fall-related injuries in Ma'anshan, Anhui Province, China: a distributed lag nonlinear analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:58092-58103. [PMID: 34105075 DOI: 10.1007/s11356-021-14663-2] [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: 03/09/2021] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
Despite the significant economic cost of falls and injuries to individuals and communities, little is known about the impact of meteorological factors on the incidence of fall-related injuries (FRIs). Therefore, a time-series study was conducted to explore the effects of meteorological factors on FRIs in Ma'anshan City, East China. Injury data from 2011 to 2017 were collected from the National Injury Monitoring Station in Ma'anshan City. A distributed lag nonlinear model was used in this study to evaluate the correlation between ambient temperature and fall injuries. The results showed a significant exposure-response relationship between temperature and FRIs in Ma'anshan City. The high temperatures increased the risk of FRIs (RR = 1.110; 95% CI, 1.005-1.225; lag 0). The lag effect appeared at lag 10 (RR = 1.032; 95% CI, 1.003-1.063), and then gradually remained stable after lag 25 (RR = 1.077; 95% CI, 1.045-1.110). The effect of ambient temperature varied with age and gender. The lag effect of high temperature appeared in the male group after lag 15 (RR = 1.042; 95% CI, 1.006-1.079). In contrast, the effect of the female group appeared for the first time at lag 0 (RR = 1.187; 95% CI, 1.042-1.352). And the ≥ 60 years subgroup seemed to be more sensitive in low temperature (RR = 1.017; 95% CI, 1.004-1.031; lag 0; RR = 1.003; 95% CI, 1.000-1.007; lag 25). The cumulative result is similar to the single-day effect. From the results, this study would help the establishment of fall-related injury prediction and provide evidence for the formulation and implementation of preventive strategies and measures in the future.
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Affiliation(s)
- Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhenhai Yao
- Anhui Meteorological Service Center, Anhui Meteorological Bureau, Hefei, 230000, Anhui, China
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Xiuya Xing
- Department of Chronic Noncommunicable Disease Control and Prevention, Anhui Provincial Center for Disease Control and Prevention, No. 12560, Fanhua Road, Hefei, 230601, Anhui, China.
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Center for Injury Control and Prevention, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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24
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Suicide and Associations with Air Pollution and Ambient Temperature: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147699. [PMID: 34300149 PMCID: PMC8303705 DOI: 10.3390/ijerph18147699] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/17/2021] [Accepted: 07/19/2021] [Indexed: 12/22/2022]
Abstract
Given health threats of climate change, a comprehensive review of the impacts of ambient temperature and ar pollution on suicide is needed. We performed systematic literature review and meta-analysis of suicide risks associated with short-term exposure to ambient temperature and air pollution. Pubmed, Scopus, and Web of Science were searched for English-language publications using relevant keywords. Observational studies assessing risks of daily suicide and suicide attempts associated with temperature, particulate matter with aerodynamic diameter ≤10 μm (PM10) and ≤2.5 mm (PM2.5), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were included. Data extraction was independently performed in duplicate. Random-effect meta-analysis was applied to pool risk ratios (RRs) for increases in daily suicide per interquartile range (IQR) increase in exposure. Meta-regression analysis was applied to examine effect modification by income level based on gross national income (GNI) per capita, national suicide rates, and average level of exposure factors. In total 2274 articles were screened, with 18 studies meeting inclusion criteria for air pollution and 32 studies for temperature. RRs of suicide per 7.1 °C temperature was 1.09 (95% CI: 1.06, 1.13). RRs of suicide per IQR increase in PM2.5, PM10, and NO2 were 1.02 (95% CI: 1.00, 1.05), 1.01 (95% CI: 1.00, 1.03), and 1.03 (95% CI: 1.00, 1.07). O3, SO2, and CO were not associated with suicide. RR of suicide was significantly higher in higher-income than lower-income countries (1.09, 95% CI: 1.07, 1.11 and 1.20, 95% CI: 1.14, 1.26 per 7.1 °C increased temperature, respectively). Suicide risks associated with air pollution did not significantly differ by income level, national suicide rates, or average exposure levels. Research gaps were found for interactions between air pollution and temperature on suicide risks.
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25
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Nagai K, Suzuki H, Ueda A, Agar JWM, Itsubo N. Assessment of environmental sustainability in renal healthcare. J Rural Med 2021; 16:132-138. [PMID: 34239623 PMCID: PMC8249367 DOI: 10.2185/jrm.2020-049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/12/2021] [Indexed: 11/27/2022] Open
Abstract
The health effects of climate change are becoming increasingly important; there are direct effects from heatwaves and floods, and indirect effects from the altered distribution of infectious diseases and changes in crop yield. Ironically, the healthcare system itself carries an environmental burden, contributing to environmental health impacts. Life cycle assessment is a widely accepted and well-established method that quantitatively evaluates environmental impact. Given that monetary evaluations have the potential to motivate private companies and societies to reduce greenhouse gas emissions using market mechanisms, instead of assessing the carbon footprint alone, we previously developed a life cycle impact assessment method based on an endpoint that integrates comprehensive environmental burdens into a single index-the monetary cost. Previous investigations estimated that therapy for chronic kidney disease had a significant carbon footprint in the healthcare sector. We have been aiming to investigate on the environmental impact of chronic kidney disease based on field surveys from the renal department in a hospital and several health clinics in Japan. To live sustainably, it is necessary to establish cultures, practices, and research that aims to conserve resources to provide environmentally friendly healthcare in Japan.
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Affiliation(s)
- Kei Nagai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiroaki Suzuki
- Faculty of Environmental and Information Studies, Tokyo City University, Japan
| | - Atsushi Ueda
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan.,Department of Nephrology, Hitachi General Hospital, Japan
| | - John W M Agar
- Department of Renal Medicine, University Hospital Geelong, Australia
| | - Norihiro Itsubo
- Faculty of Environmental and Information Studies, Tokyo City University, Japan
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Liang M, Zhao D, Wu Y, Ye P, Wang Y, Yao Z, Bi P, Duan L, Sun Y. Short-term effects of ambient temperature and road traffic accident injuries in Dalian, Northern China: A distributed lag non-linear analysis. ACCIDENT; ANALYSIS AND PREVENTION 2021; 153:106057. [PMID: 33647596 DOI: 10.1016/j.aap.2021.106057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/30/2020] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although traffic accidents cause considerable economic losses and injuries to individuals, families, and communities, little is known about the impact of meteorological factors on the incidence of traffic accident injuries (TAIs). Therefore, a time-series study was conducted to explore the effect of meteorological variables on TAIs in Dalian, Northern China. METHODS Poisson generalized linear models (PGLM) combined with distributed lag nonlinear models (DLNM) were used to estimate the association between daily TAIs and ambient temperature in Dalian, China, 2015-2017. The injury data collected by Dalian national injury surveillance hospitals, and meteorological data were extracted and accumulated from the National Meteorological Information Center. Modified the model with variables such as pressure, humidity, precipitation, PM2.5, SO2, O3, day of the week, seasonality, and time trend. In the subgroup analysis, the modification effects of gender and age were also examined. RESULTS Both high temperatures (RR = 1.198, 95%CI:1.017-1.411) and low temperatures (RR = 1.017, 95%CI:1.001-1.035) increased the risk of TAIs. The cumulative lag effect would last until after the 7th day. While the 40-59 years subgroup seemed to be more vulnerable in high temperature environments, those who are more than 60 years showed higher TAIs in low temperatures for both single-day and cumulative TAI risks. CONCLUSIONS Identifying the association between ambient temperature and traffic injuries could provide needed scientific evidence for relevant public health actions.
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Affiliation(s)
- Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dongdong Zhao
- The First Affiliated Hospital of Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Pengpeng Ye
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yuan Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Zhenhai Yao
- Anhui Meteorological Service Center, Anhui Meteorological Bureau, No. 16 Shihe Road, Hefei, 230000, Anhui, China
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Injury Control and Prevention, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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