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Chang CJ, Chi CY, Yang HY. Heat exposure and chronic kidney disease: a temporal link in a Taiwanese agricultural county. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1511-1524. [PMID: 37319425 DOI: 10.1080/09603123.2023.2223514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
Heat stress-related kidney injury has drawn public health attention. This study explored the temporal relationships between impaired kidney function and preceding outdoor heat exposure Taiwan. Data of participants collected through a health screening program was used to assess the association between chronic kidney disease (CKD) and average ambient temperature with various time lag structures. A total of 1,243 CKD cases and 38,831 non-CKD participants were included in the study. After adjusting for demographic, socioeconomic, lifestyle factors, and comorbidities, CKD was positively associated with the ambient temperature within 1-9 months. The 9-month average ambient temperature yielded the highest odds ratio of CKD (OR = 1.22; 95% CI = 1.09-1.37). Furthermore, females and farmers were found to be more vulnerable to CKD risk after outdoor heat exposure. These findings suggest that the prevention of heat stress-related kidney injury should consider relevant time frames and focus on vulnerable populations.
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Affiliation(s)
- Che-Jui Chang
- Institute of Occupational and Environmental Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chun-Yi Chi
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
| | - Hsiao-Yu Yang
- Institute of Occupational and Environmental Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Population Health and Welfare Research Center, National Taiwan University College of Public Health, Taipei, Taiwan
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2
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Heo S, Choi HM, Lee JT, Bell ML. A nationwide time-series analysis for short-term effects of ambient temperature on violent crime in South Korea. Sci Rep 2024; 14:3210. [PMID: 38331944 PMCID: PMC10853231 DOI: 10.1038/s41598-024-53547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024] Open
Abstract
Psychological theories on heat-aggression relationship have existed for decades and recent models suggest climate change will increase violence through varying pathways. Although observational studies have examined the impact of temperature on violent crime, the evidence for associations is primarily limited to coarse temporal resolution of weather and crime (e.g., yearly/monthly) and results from a few Western communities, warranting studies based on higher temporal resolution data of modern systemic crime statistics for various regions. This observational study examined short-term temperature impacts on violent crime using national crime data for the warm months (Jun.-Sep.) across South Korea (2016-2020). Distributed lag non-linear models assessed relative risks (RRs) of daily violent crime counts at the 70th, 90th, and 99th summer temperature percentiles compared to the reference temperature (10th percentile), with adjustments for long-term trends, seasonality, weather, and air pollution. Results indicate potentially non-linear relationships between daily summer temperature (lag0-lag10) and violent crime counts. Violent crimes consistently increased from the lowest temperature and showed the highest risk at the 70th temperature (~ 28.0 °C). The RR at the 70th and 90th percentiles of daily mean temperature (lag0-lag10), compared to the reference, was 1.11 (95% CI 1.09, 1.15) and 1.04 (95% CI 1.01, 1.07), indicating significant associations. Stratified analysis showed significant increases in assault and domestic violence for increases in temperature. The lagged effects, the influences of heat on subsequent crime incidence, did not persist 21 days after the exposure, possibly due to the displacement phenomenon. We found curvilinear exposure-response relationships, which provide empirical evidence to support the psychological theories for heat and violence. Lower public safety through increased violent crime may be an additional public health harm of climate change.
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Affiliation(s)
- Seulkee Heo
- School of the Environment, Yale University, 195 Prospect St, New Haven, CT, 06511, USA.
| | - Hayon Michelle Choi
- School of the Environment, Yale University, 195 Prospect St, New Haven, CT, 06511, USA
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Michelle L Bell
- School of the Environment, Yale University, 195 Prospect St, New Haven, CT, 06511, USA
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
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3
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Walkowiak MP, Walkowiak D, Walkowiak J. Exploring the paradoxical nature of cold temperature mortality in Europe. Sci Rep 2024; 14:3181. [PMID: 38326605 PMCID: PMC10850168 DOI: 10.1038/s41598-024-53675-z] [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: 10/03/2023] [Accepted: 02/03/2024] [Indexed: 02/09/2024] Open
Abstract
While low winter temperatures are associated with increased mortality, this phenomenon has been suggested to be most severe in regions with seemingly mild winters. The study aimed to establish a temperature-based formula that could elucidate the previously ambiguous regional differences in vulnerability to low temperature. European weekly mortality data (2000-2019) were matched with meteorological data to determine for each region vulnerability to temperature decrease and the optimal temperature with lowest mortality. Regression models were developed to generalize and explain these findings considering regional temperature characteristics. Optimal temperature could be predicted based on local average summer temperature (R2 = 85.6%). Regional vulnerability to temperature decrease could be explained by combination of winter and summer temperatures (R2 = 86.1%). Regions with warm winters and cold summers showed the highest vulnerability to decrease of temperature during winter. Contrary to theories about economic disparities Eastern Europe exhibited resistance comparable to Scandinavia. The southern edges of Europe demonstrated serious low temperature vulnerability to decreased temperatures, even if temperature was relatively high around 20 °C. This suggests that the observed connection primarily reflects the modulation of the length of respiratory virus infection seasons by climate conditions, counterbalanced by varying levels of acquired immunity and the presence of heatwaves eliminating the most frail individuals. Thus, relatively low vulnerability and a flat mortality cycle in countries with harsh climates paradoxically imply the presence of threats throughout the whole year.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Święcickiego 6, 60-781, Poznań, Poland.
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland
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4
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Stone B, Gronlund CJ, Mallen E, Hondula D, O’Neill MS, Rajput M, Grijalva S, Lanza K, Harlan S, Larsen L, Augenbroe G, Krayenhoff ES, Broadbent A, Georgescu M. How Blackouts during Heat Waves Amplify Mortality and Morbidity Risk. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:8245-8255. [PMID: 37219950 PMCID: PMC10249403 DOI: 10.1021/acs.est.2c09588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023]
Abstract
The recent concurrence of electrical grid failure events in time with extreme temperatures is compounding the population health risks of extreme weather episodes. Here, we combine simulated heat exposure data during historical heat wave events in three large U.S. cities to assess the degree to which heat-related mortality and morbidity change in response to a concurrent electrical grid failure event. We develop a novel approach to estimating individually experienced temperature to approximate how personal-level heat exposure changes on an hourly basis, accounting for both outdoor and building-interior exposures. We find the concurrence of a multiday blackout event with heat wave conditions to more than double the estimated rate of heat-related mortality across all three cities, and to require medical attention for between 3% (Atlanta) and more than 50% (Phoenix) of the total urban population in present and future time periods. Our results highlight the need for enhanced electrical grid resilience and support a more spatially expansive use of tree canopy and high albedo roofing materials to lessen heat exposures during compound climate and infrastructure failure events.
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Affiliation(s)
- Brian Stone
- School
of City & Regional Planning, Georgia
Institute of Technology, Atlanta, Georgia 30332, United States
| | - Carina J. Gronlund
- University
of Michigan Institute for Social Research, Ann Arbor, Michigan 48106, United States
- University
of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Evan Mallen
- School
of City & Regional Planning, Georgia
Institute of Technology, Atlanta, Georgia 30332, United States
| | - David Hondula
- School
of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona 85281, United States
| | - Marie S. O’Neill
- University
of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Mayuri Rajput
- School
of Architecture, Georgia Institute of Technology, Atlanta, Georgia 30332 United States
| | - Santiago Grijalva
- School
of
Electrical and Computing Engineering, Georgia
Institute of Technology, Atlanta, Georgia 30332, United States
| | - Kevin Lanza
- University
of Texas Health Science Center at Houston School of Public Health, Austin, Texas 78701, United States
| | - Sharon Harlan
- Department
of Health Sciences, Northeastern University, Boston, Massachusetts 02115, United States
- School
of Human Evolution and Social Change, Arizona
State University, Tempe, Arizona 85281, United States
| | - Larissa Larsen
- Taubman
College of Architecture and Urban Planning, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Godfried Augenbroe
- School
of Architecture, Georgia Institute of Technology, Atlanta, Georgia 30332 United States
| | - E. Scott Krayenhoff
- School of
Environmental Sciences, University
of Guelph, Guelph N1G2W1, Canada
| | - Ashley Broadbent
- School
of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona 85281, United States
| | - Matei Georgescu
- School
of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona 85281, United States
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5
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The contribution of population age-sex structure to the excess mortality estimates of 2020-2021 in Denmark, Finland, Iceland, Norway, and Sweden. SSM Popul Health 2023; 22:101377. [PMID: 36919136 PMCID: PMC9998239 DOI: 10.1016/j.ssmph.2023.101377] [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: 12/06/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/07/2023] Open
Abstract
The Nordic countries offer an ideal case study of the COVID-19 pandemic due to their comparability, high data quality, and variable mitigations. We investigated the age- and sex-specific mortality patterns during 2020-2021 for the five Nordic countries and analysed the total age- and sex-adjusted excess deaths, ratios of actual to expected death rates, and age-standardized excess death estimates. We assessed excess deaths using several time periods and sensitivity tests, and 42 sex and age groups. Declining pre-pandemic age-specific death rates reflected improving health demographics. These affect the expected death estimates and should be accounted for in excess mortality models. Denmark had the highest death rates both before and during the pandemic, whereas in 2020 Sweden had the largest mortality increase. The age-standardized mortality of Denmark, Iceland and Norway was lowest in 2020. 2021 was one of the lowest mortality years for all Nordic countries. The total excess deaths in 2020-2021 were dominated by 70-89-year-olds, were not identified in children, and were more pronounced among men than women. Sweden had more excess deaths in 2020 than in 2021, whereas Finland, Norway and Denmark had the opposite. Our study provides new details on Nordic sex- and age-specific mortality during the first two years of the pandemic and shows that several metrics are important to enable a full understanding and comparison of the pandemic mortality.
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6
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Fu J, Fei F, Wang S, Zhao Q, Yang X, Zhong J, Hu K. Short-term effects of fine particulate matter constituents on mortality considering the mortality displacement in Zhejiang province, China. JOURNAL OF HAZARDOUS MATERIALS 2023; 457:131723. [PMID: 37257377 DOI: 10.1016/j.jhazmat.2023.131723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/10/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Evidence linking mortality and short-term exposure to particulate matter (PM2.5) constituents was sparse. The mortality displacement was often unconsidered and may induce incorrect risk estimation. OBJECTIVES To assess the short-term effects of PM2.5 constituents on all-cause mortality considering the mortality displacement. METHODS Daily data on all-cause mortality and PM2.5 constituents, including sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matters (OM), and black carbon (BC), were collected from 2009 to 2020. The mortality effect of PM2.5 and its constituents was estimated using a distributed lag non-linear model. Stratified analyses were performed by age, sex, and season. RESULTS Per interquartile range increases in SO42-, NO3-, NH4+, OM, and BC were associated with the 1.42% (95%CI: 0.98, 1.87), 3.76% (3.34, 4.16), 2.26% (1.70, 2.83), 2.36% (2.02, 2.70), and 1.26% (0.91, 1.61) increases in all-cause mortality, respectively. Mortality displacements were observed for PM2.5, SO42-, NH4+, OM, and BC, with their overall effects lasting for 7-15 days. Stratified analyses revealed a higher risk for old adults (>65 years) and females, with stronger effects in the cold season. CONCLUSIONS Short-term exposures to PM2.5 constituents were positively associated with increased risks of mortality. The mortality displacement should be considered in future epidemiological studies on PM constituents. DATA AVAILABILITY Data will be made available on request.
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Affiliation(s)
- Jingqiao Fu
- Ocean College, Zhejiang University, Zhoushan 316021, China; Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Hangzhou 310015, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Shiyi Wang
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou 310058, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan 316021, China.
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Kejia Hu
- Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province, Hangzhou 310015, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China.
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7
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Liao H, Zhang C, Burke PJ, Li R, Wei YM. Extreme temperatures, mortality, and adaptation: Evidence from the county level in China. HEALTH ECONOMICS 2023; 32:953-969. [PMID: 36639879 DOI: 10.1002/hec.4649] [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: 02/08/2021] [Revised: 10/11/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Extreme temperatures are known to cause adverse health outcomes. Yet knowledge on the magnitude of this effect in developing countries is limited due to data availability and reliability issues. Collecting data for 2872 counties in China, we estimate the effects of daily temperatures on the monthly mortality rate. The results indicate that an additional day for which the maximum temperature is 38°C or above on average increases the monthly mortality rate by about 1.7% relative to if that day's maximum temperature had been in the range 16-21°C. This is after deducting deaths harvested from the subsequent month. Higher gross domestic product per capita at the county level is associated with lower mortality effects of hot and cold days. Improved dwelling conditions are found to be associated with a lower mortality effect of hot days and improved local healthcare infrastructure to be associated with a lower mortality effect of cold days. In the absence of strong adaptation efforts, the estimates suggest net upward pressure on annual mortality rates over coming decades in many populous counties, especially under more extreme climate change scenarios.
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Affiliation(s)
- Hua Liao
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Center for Energy and Environmental Policy Research, Beijing Institute of Technology, Beijing, China
- Beijing Key Laboratory of Energy Economics and Environmental Management, Beijing, China
| | - Chen Zhang
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Center for Energy and Environmental Policy Research, Beijing Institute of Technology, Beijing, China
- Chengdu Library and Information Center, Chinese Academy of Science, Chengdu, China
| | - Paul J Burke
- Crawford School of Public Policy, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ru Li
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Center for Energy and Environmental Policy Research, Beijing Institute of Technology, Beijing, China
- Business School, Chengdu University of Technology, Chengdu, China
| | - Yi-Ming Wei
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Center for Energy and Environmental Policy Research, Beijing Institute of Technology, Beijing, China
- Beijing Key Laboratory of Energy Economics and Environmental Management, Beijing, China
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8
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Feng J, Cao D, Zheng D, Qian ZM, Huang C, Shen H, Liu Y, Liu Q, Sun J, Jiao G, Yang X, McMillin SE, Wang C, Lin H, Zhang X, Zhang S. Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160726. [PMID: 36502973 DOI: 10.1016/j.scitotenv.2022.160726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.
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Affiliation(s)
- Jin Feng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dawei Cao
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Dashan Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 102200, China; Institute of Healthy China, Tsinghua University, Beijing 102200, China
| | - Huiqing Shen
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Yi Liu
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, Zhejiang, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing 102200, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing 102200, China
| | - Stephen Edward McMillin
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xinri Zhang
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China.
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
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Lee WE, Woo Park S, Weinberger DM, Olson D, Simonsen L, Grenfell BT, Viboud C. Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022. eLife 2023; 12:77562. [PMID: 36811598 PMCID: PMC9946455 DOI: 10.7554/elife.77562] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 01/15/2023] [Indexed: 02/24/2023] Open
Abstract
Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we use time series approaches to separate the direct contribution of SARS-CoV-2 infection on mortality from the indirect consequences of the pandemic in the United States. We estimate excess deaths occurring above a seasonal baseline from March 1, 2020 to January 1, 2022, stratified by week, state, age, and underlying mortality condition (including COVID-19 and respiratory diseases; Alzheimer's disease; cancer; cerebrovascular diseases; diabetes; heart diseases; and external causes, which include suicides, opioid overdoses, and accidents). Over the study period, we estimate an excess of 1,065,200 (95% Confidence Interval (CI) 909,800-1,218,000) all-cause deaths, of which 80% are reflected in official COVID-19 statistics. State-specific excess death estimates are highly correlated with SARS-CoV-2 serology, lending support to our approach. Mortality from 7 of the 8 studied conditions rose during the pandemic, with the exception of cancer. To separate the direct mortality consequences of SARS-CoV-2 infection from the indirect effects of the pandemic, we fit generalized additive models (GAM) to age- state- and cause-specific weekly excess mortality, using covariates representing direct (COVID-19 intensity) and indirect pandemic effects (hospital intensive care unit (ICU) occupancy and measures of interventions stringency). We find that 84% (95% CI 65-94%) of all-cause excess mortality can be statistically attributed to the direct impact of SARS-CoV-2 infection. We also estimate a large direct contribution of SARS-CoV-2 infection (≥67%) on mortality from diabetes, Alzheimer's, heart diseases, and in all-cause mortality among individuals over 65 years. In contrast, indirect effects predominate in mortality from external causes and all-cause mortality among individuals under 44 years, with periods of stricter interventions associated with greater rises in mortality. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups and in mortality from external causes. Further research on the drivers of indirect mortality is warranted as more detailed mortality data from this pandemic becomes available.
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Affiliation(s)
- Wha-Eum Lee
- Department of Ecology and Evolutionary Biology, Princeton UniversityPrincetonUnited States
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton UniversityPrincetonUnited States
| | | | - Donald Olson
- New York City Department of Health and Mental HygieneNew YorkUnited States
| | - Lone Simonsen
- Department of Science and Environment, Roskilde UniversityRoskildeDenmark
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton UniversityPrincetonUnited States
- Princeton School of Public Affairs, Princeton UniversityPrincetonUnited States
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of HealthBethesdaUnited States
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10
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Kepp KP, Björk J, Kontis V, Parks RM, Bæk KT, Emilsson L, Lallukka T. Estimates of excess mortality for the five Nordic countries during the COVID-19 pandemic 2020-2021. Int J Epidemiol 2022; 51:1722-1732. [PMID: 36331437 PMCID: PMC9960481 DOI: 10.1093/ije/dyac204] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Excess mortality during the COVID-19 pandemic is of major scientific and political interest. METHODS We critically reviewed different estimates of all-cause excess mortality for the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), which have been much studied during the COVID-19 pandemic, using the latest register data to discuss uncertainties and implications. RESULTS We show using back-calculation of expected deaths from Nordic all-cause deaths that the Institute for Health Metrics and Evaluation model is a clear outlier in the compared estimates and likely substantially overestimates excess mortality of Finland and Denmark, and probably Sweden. Our review suggests a range of total Nordic excess deaths of perhaps 15 000-20 000, but results are sensitive to assumptions in the models as shown. CONCLUSIONS We document substantial heterogeneity and uncertainty in estimates of excess mortality. All estimates should be taken with caution in their interpretation as they miss detailed account of demographics, such as changes in the age group populations over the study period.
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Affiliation(s)
- Kasper P Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Jonas Björk
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Vasilis Kontis
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Robbie M Parks
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA
| | - Kristoffer T Bæk
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Louise Emilsson
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Vårdcentralen Värmlands Nysäter and Centre for Clinical Research, County Council of Värmland, Värmlands Nysäter, Sweden
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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11
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Schöley J, Aburto JM, Kashnitsky I, Kniffka MS, Zhang L, Jaadla H, Dowd JB, Kashyap R. Life expectancy changes since COVID-19. Nat Hum Behav 2022; 6:1649-1659. [PMID: 36253520 PMCID: PMC9755047 DOI: 10.1038/s41562-022-01450-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/17/2022] [Indexed: 01/14/2023]
Abstract
The COVID-19 pandemic triggered an unprecedented rise in mortality that translated into life expectancy losses around the world, with only a few exceptions. We estimate life expectancy changes in 29 countries since 2020 (including most of Europe, the United States and Chile), attribute them to mortality changes by age group and compare them with historic life expectancy shocks. Our results show divergence in mortality impacts of the pandemic in 2021. While countries in western Europe experienced bounce backs from life expectancy losses of 2020, eastern Europe and the United States witnessed sustained and substantial life expectancy deficits. Life expectancy deficits during fall/winter 2021 among people ages 60+ and <60 were negatively correlated with measures of vaccination uptake across countries (r60+ = -0.86; two-tailed P < 0.001; 95% confidence interval, -0.94 to -0.69; r<60 = -0.74; two-tailed P < 0.001; 95% confidence interval, -0.88 to -0.46). In contrast to 2020, the age profile of excess mortality in 2021 was younger, with those in under-80 age groups contributing more to life expectancy losses. However, even in 2021, registered COVID-19 deaths continued to account for most life expectancy losses.
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Affiliation(s)
- Jonas Schöley
- Max Planck Institute for Demographic Research, Rostock, Germany.
| | - José Manuel Aburto
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK.
- Nuffield College, University of Oxford, Oxford, UK.
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark.
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Ilya Kashnitsky
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Maxi S Kniffka
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Luyin Zhang
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
| | - Hannaliis Jaadla
- Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia
- Cambridge Group for the History of Population and Social Structure, Department of Geography, University of Cambridge, Cambridge, UK
| | - Jennifer B Dowd
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- Nuffield College, University of Oxford, Oxford, UK
| | - Ridhi Kashyap
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK.
- Nuffield College, University of Oxford, Oxford, UK.
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12
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Yang HY, Lee JKW, Chio CP. Extreme temperature increases the risk of stillbirth in the third trimester of pregnancy. Sci Rep 2022; 12:18474. [PMID: 36323816 PMCID: PMC9630541 DOI: 10.1038/s41598-022-23155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies have reported the association between extreme temperatures and adverse reproductive effects. However, the susceptible period of exposure during pregnancy remains unclear. This study aimed to assess the impact of extreme temperature on the stillbirth rate. We performed a time-series analysis to explore the associations between temperature and stillbirth with a distributed lag nonlinear model. A total of 22,769 stillbirths in Taiwan between 2009 and 2018 were enrolled. The mean stillbirth rate was 11.3 ± 1.4 per 1000 births. The relative risk of stillbirth due to exposure to extreme heat temperature (> 29 °C) was 1.18 (95% CI 1.11, 1.25). Pregnant women in the third trimester were most susceptible to the effects of extreme cold and heat temperatures. At lag of 0-3 months, the cumulative relative risk (CRR) of stillbirth for exposure to extreme heat temperature (29.8 °C, 97.5th percentile of temperature) relative to the optimal temperature (21 °C) was 2.49 (95% CI: 1.24, 5.03), and the CRR of stillbirth for exposure to extreme low temperature (16.5 °C, 1st percentile) was 1.29 (95% CI: 0.93, 1.80). The stillbirth rate in Taiwan is on the rise. Our findings inform public health interventions to manage the health impacts of climate change.
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Affiliation(s)
- Hsiao-Yu Yang
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,grid.19188.390000 0004 0546 0241Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jason Kai Wei Lee
- grid.4280.e0000 0001 2180 6431Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Global Asia Institute, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431N.1 Institute for Health, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Institute for Digital Medicine, National University of Singapore, Singapore, Singapore ,grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Chia-Pin Chio
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,Department of Medical Research, Tung’ Taichung Metro Harbor Hospital, Taichung, Taiwan
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13
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Lee WE, Park SW, Weinberger DM, Olson D, Simonsen L, Grenfell BT, Viboud C. Direct and indirect mortality impacts of the COVID-19 pandemic in the US, March 2020-April 2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.02.10.22270721. [PMID: 35194617 PMCID: PMC8863161 DOI: 10.1101/2022.02.10.22270721] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Excess mortality studies provide crucial information regarding the health burden of pandemics and other large-scale events. Here, we used time series approaches to separate the direct contribution of SARS-CoV-2 infections on mortality from the indirect consequences of pandemic interventions and behavior changes in the United States. We estimated deaths occurring in excess of seasonal baselines stratified by state, age, week and cause (all causes, COVID-19 and respiratory diseases, Alzheimer's disease, cancer, cerebrovascular disease, diabetes, heart disease, and external causes, including suicides, opioids, accidents) from March 1, 2020 to April 30, 2021. Our estimates of COVID-19 excess deaths were highly correlated with SARS-CoV-2 serology, lending support to our approach. Over the study period, we estimate an excess of 666,000 (95% Confidence Interval (CI) 556000, 774000) all-cause deaths, of which 90% could be attributed to the direct impact of SARS-CoV-2 infection, and 78% were reflected in official COVID-19 statistics. Mortality from all disease conditions rose during the pandemic, except for cancer. The largest direct impacts of the pandemic were seen in mortality from diabetes, Alzheimer's, and heart diseases, and in age groups over 65 years. In contrast, the largest indirect consequences of the pandemic were seen in deaths from external causes, which increased by 45,300 (95% CI 30,800, 59,500) and were statistically linked to the intensity of non-pharmaceutical interventions. Within this category, increases were most pronounced in mortality from accidents and injuries, drug overdoses, and assaults and homicides, while the rate of death from suicides remained stable. Younger age groups suffered the brunt of these indirect effects. Overall, on a national scale, the largest consequences of the COVID-19 pandemic are attributable to the direct impact of SARS-CoV-2 infections; yet, the secondary impacts dominate among younger age groups, in periods of stricter interventions, and in mortality from external causes. Further research on the drivers of indirect mortality is warranted to optimize interventions in future pandemics.
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Affiliation(s)
- Wha-Eum Lee
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, USA, 08544
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, USA, 08544
| | | | - Donald Olson
- Department of Health and Mental Hygiene, New York, New York
| | - Lone Simonsen
- Department of Science and Environment, Roskilde University, Denmark
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, USA, 08544
- Princeton School of Public Affairs, Princeton University, Princeton, USA, 08544
| | - Cécile Viboud
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA. 20892
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14
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Su X, Song H, Cheng Y, Yao X, Li Y. The mortality burden of nervous system diseases attributed to ambient temperature: A multi-city study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 800:149548. [PMID: 34388642 DOI: 10.1016/j.scitotenv.2021.149548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUNDS Studies on the association between ambient temperature and human mortality have been widely reported, focusing on common diseases such as cardiopulmonary diseases. However, multi-city studies on the association between both high and low temperatures and mortality of nervous system diseases were scarce, especially on the evidence of vulnerable populations. METHODS Weekly meteorological data, air pollution data and mortality data of nervous system were collected in 5 cities in China. A quasi-Poisson regression with distributed lag non-linear model (DLNM) was applied to quantify the association between extreme temperatures and mortality of nervous system diseases. Multivariate meta-analysis was applied to estimate the pooled effects at the overall levels. The attributable fractions (AFs) were calculated to assess the mortality burden attributable to both high and low temperatures. Stratified analyses were also performed by gender and age-groups through the above steps. RESULTS A total of 12,132 deaths of nervous system diseases were collected in our study. The overall minimum mortality temperature was 23.9 °C (61.9th), the cumulative relative risks of extreme heat and cold for nervous system diseases were 1.33(95%CI: 1.10, 1.61) and 1.47(95%CI: 1.27, 1.71). The mortality burden attributed to non-optimal temperatures accounted for 29.54% (95%eCI: 13.45%, 40.52%), of which the mortality burden caused by low temperature and high temperature accounted for 25.89% (95%eCI: 13.03%, 34.36%) and 3.65% (95%eCI: 0.42%, 6.17%), respectively. The mortality burden attributable to ambient temperature was higher in both males and the elderly (>74 years old), with the AF of 31.85% (95%eCI: 20.68%, 39.88%) and 31.14% (95%eCI: -6.83%, 49.51%), respectively. CONCLUSIONS The non-optimal temperature can increase the mortality of nervous system diseases and the males and the elderly over 74 years have the highest attributable burden. The findings add the evidence of vulnerable populations of nervous system diseases against ambient temperatures.
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Affiliation(s)
- Xuemei Su
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Daxing District Center for Disease Control and Prevention, Beijing 102600, China
| | - Hejia Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, 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
| | - 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
| | - 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.
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15
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Ueno S, Hayano D, Noguchi E, Aruga T. Investigating age and regional effects on the relation between the incidence of heat-related ambulance transport and daily maximum temperature or WBGT. Environ Health Prev Med 2021; 26:116. [PMID: 34893022 PMCID: PMC8903699 DOI: 10.1186/s12199-021-01034-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background Although age and regional climate are considered to have effects on the incidence ratio of heat-related illness, quantitative estimation of age or region on the effect of occurring temperature for heat stroke is limited. Methods By utilizing data on the number of daily heat-related ambulance transport (HAT) in each of three age groups (7–17, 18–64, 65 years old, or older) and 47 prefectures in Japan, and daily maximum temperature (DMT) or Wet Bulb Globe Temperature (DMW) of each prefecture for the summer season, the effects of age and region on heat-related illness were studied. Two-way ANOVA was used to analyze the significance of the effect of age and 10 regions in Japan on HAT. The population-weighted average of DMT or DMW measured at weather stations in each prefecture was used as DMT or DMW for each prefecture. DMT or DMW when HAT is one in 100,000 people (T1 and W1, respectively) was calculated for each age category and prefecture as an indicator of heat acclimatization. The relation between T1 or W1 and average DMT or DMW of each age category and prefecture were also analyzed. Results HAT of each age category and prefecture was plotted nearly on the exponential function of corresponding DMT or DMW. Average R2 of the regression function in 47 prefectures in terms of DMW was 0.86, 0.93, and 0.94 for juveniles, adults, and elderly, respectively. The largest regional difference of W1 in 47 prefectures was 4.5 and 4.8 °C for juveniles and adults, respectively between Hokkaido and Tokyo, 3.9 °C for elderly between Hokkaido and Okinawa. Estimated W1 and average DMT or DMW during the summer season for 47 prefectures was linearly related. Regarding age difference, the regression line showed that W1 of the prefecture for DMW at 30 °C of WBGT was 31.1 °C, 32.4 °C, and 29.8 °C for juveniles, adults, and elderly, respectively. Conclusions Age and regional differences affected the incidence of HAT. Thus, it is recommended that public prevention measures for heat-related disorders take into consideration age and regional variability.
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Affiliation(s)
- Satoru Ueno
- Work Environment Research Group, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki, Japan.
| | - Daisuke Hayano
- Department of Emergency and Critical Care Medicine, Kanto Rosai Hospital, Japan Organization of Occupational Health and Safety, Kawasaki, Japan
| | - Eiichi Noguchi
- Yokohama Branch, General Incorporated Association Toda Medical Group Headquarters, Yokohama, Japan
| | - Tohru Aruga
- Japan Organization of Occuational Health and Safety, Kawasaki, Japan
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16
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Gahide G, Phaneuf SC, Cossette M, Banine A, Budimir M, Maghsoudloo K, Fei P, Dou BY, Bouthillier M, Alain C, Bradette S, Noel-Lamy M, Belzile F, Bui BT, Despatis MA, Vendrell JF. Paclitaxel and mortality in patients with claudication and de novo femoropopliteal lesions: a historical cohort study. CVIR Endovasc 2021; 4:65. [PMID: 34424424 PMCID: PMC8382808 DOI: 10.1186/s42155-021-00255-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To compare the mortality rates of patients with claudication and de novo femoropopliteal lesions treated with and without paclitaxel coated devices (PCD). Background A recent meta-analysis, mostly including patients with claudication and de novo femoropopliteal lesions but also with recurrent stenoses and critical limb ischemia, has shown a significant excess mortality in patients treated with PCD. Methods Comparison of two historical cohorts of patients presenting with claudication and de novo femoropopliteal lesions treated with and without PCD between 2008 and 2018. Results After review of 5219 arteriograms in patients presenting with peripheral artery disease, 700 consecutive patients were included consisting in 72.6% of male (n = 508). Mean age was 68.1 ± 8.5 years. 45.7% of the patients (n = 320) had a treatment including a PCD. Mean femoropopliteal lesion length was 123 ± 91 mm including 44.6% of occlusions. Patients of the control group were censored at crossover to paclitaxel when applicable. Mortality rates at 1, 2 and 5 years were 4.6%, 7.5%, 19.4% and 1.6%, 6.2%, 16.6% in the non-PCD and PCD groups respectively. The relative risks of death when using PCD were 0.35 (p = 0.03), 0.83 (p = NS) and 0.86 (p = NS) at 1, 2 and 5 years respectively. Conclusion There was no excess mortality in patients with claudication and de novo femoropopliteal lesions treated with paclitaxel coated devices at 1, 2 and 5 years of follow-up in this cohort. The current study suggests that additional prospective randomized studies properly powered to study mortality are necessary.
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Affiliation(s)
- Gérald Gahide
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada. .,Centre de Recherche du CHUS, Etienne Le Bel, Université de Sherbrooke, 12e Avenue Nord Porte 6, Sherbrooke, Québec, J1H 5N4, Canada. .,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada.
| | - Samuel C Phaneuf
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Mathilde Cossette
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Amine Banine
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Martina Budimir
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Kourosh Maghsoudloo
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Phillip Fei
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Bo Yi Dou
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Maxime Bouthillier
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Charles Alain
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Simon Bradette
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Maxime Noel-Lamy
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Francois Belzile
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Bao The Bui
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
| | - Marc Antoine Despatis
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada.,Service de Chirurgie Vasculaire, Département de Chirurgie, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada
| | - Jean Francois Vendrell
- Service de Radiologie Interventionnelle. Département d'Imagerie Médicale, Centre Hospitalier Universitaire de Sherbrooke, 3001, 12ème Avenue Nord, Sherbrooke, Québec, J1H 5H3, Canada.,Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001 12 ème Avenue Nord Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada
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17
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Bravo JM. Pricing participating longevity-linked life annuities: a Bayesian Model Ensemble approach. EUROPEAN ACTUARIAL JOURNAL 2021; 12:125-159. [PMID: 34002122 PMCID: PMC8117133 DOI: 10.1007/s13385-021-00279-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 10/14/2020] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
Participating longevity-linked life annuities (PLLA) in which benefits are updated periodically based on the observed survival experience of a given underlying population and the performance of the investment portfolio are an alternative insurance product offering consumers individual longevity risk protection and the chance to profit from the upside potential of financial market developments. This paper builds on previous research on the design and pricing of PLLAs by considering a Bayesian Model Ensemble of single population generalised age-period-cohort stochastic mortality models in which individual forecasts are weighted by their posterior model probabilities. For the valuation, we adopt a longevity option decomposition approach with risk-neutral simulation and investigate the sensitivity of results to changes in the asset allocation by considering a more aggressive lifecycle strategy. We calibrate models using Taiwanese (mortality, yield curve and stock market) data from 1980 to 2019. The empirical results provide significant valuation and policy insights for the provision of a cost effective and efficient risk pooling mechanism that addresses the individual uncertainty of death, while providing appropriate retirement income and longevity protection.
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18
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Andreeva GF, Gorbunov VM. Basic Aspects of Seasonal Cardiovascular Mortality. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-02-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The review demonstrates the main aspects of seasonal cardiovascular mortality. Climatic factors, including seasonal weather changes, have a significant impact on the biosphere. People are also characterized by the seasonal dynamics of the activity of many organs and systems, biochemical parameters, and mortality. Cardiovascular mortality is also characterized by seasonal fluctuations: in winter it is maximum, in summer it is minimal. The same patterns are characteristic of mortality from cardiovascular diseases (myocardial infarction, stroke, cardiac arrhythmias, etc.). The article presents the basic patterns of seasonal cardiovascular mortality in various climatic zones, the cardiovascular mortality of countries located in the equatorial and subequatorial climatic region. In addition, the mortality displacement phenomenon, the paradox of winter mortality. The main trends in changes in cardiovascular mortality over a long period of time are demonstrated. The paper discusses some of the mechanisms that underlie the dynamics of cardiovascular mortality during the year: seasonal fluctuations in the level of vitamin D, lipids in the blood plasma, changes in hemodynamic parameters, the effects of microbial and viral infections in the cold season, etc. In addition, data on seasonal the dynamics of risk factors for cardiovascular diseases is considered: an increase in body weight, a physical activity decrease, a change in the nutrition structure in the winter, the seasonal dynamics of depression, anxiety, hostility, the relationship of seasonal cardiovascular mortality with socio-economic, demographic and other factors. In conclusion, the main ways of development and prevention of seasonal CV cardiovascular mortality M, taking into account modern technologies at the international level, for state health departments, for specific patients, are demonstrated.
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Affiliation(s)
- G. F. Andreeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. M. Gorbunov
- National Medical Research Center for Therapy and Preventive Medicine
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19
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Dimitrova A, Ingole V, Basagaña X, Ranzani O, Milà C, Ballester J, Tonne C. Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 146:106170. [PMID: 33395923 DOI: 10.1016/j.envint.2020.106170] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/16/2020] [Accepted: 09/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND South Asia is highly vulnerable to climate change and is projected to experience some of the highest increases in average annual temperatures throughout the century. Although the adverse impacts of ambient temperature on human health have been extensively documented in the literature, only a limited number of studies have focused on populations in this region. OBJECTIVES Our aim was to systematically review the current state and quality of available evidence on the direct relationship between ambient temperature and heat waves and all-cause mortality in South Asia. METHODS The databases Pubmed, Web of Science, Scopus and Embase were searched from 1990 to 2020 for relevant observational quantitative studies. We applied the Navigation Guide methodology to assess the strength of the evidence and performed a meta-analysis based on a novel approach that allows for combining nonlinear exposure-response associations without access to data from individual studies. RESULTS From the 6,759 screened papers, 27 were included in the qualitative synthesis and five in a meta-analysis. Studies reported an association of all-cause mortality with heat wave episodes and both high and low daily temperatures. The meta-analysis showed a U-shaped pattern, with increasing mortality for both high and low temperatures, but a statistically significant association was found only at higher temperatures - above 31° C for lag 0-1 days and above 34° C for lag 0-13 days. Effects were found to vary with cause of death, age, sex, location (urban vs. rural), level of education and socio-economic status, but the profile of vulnerabilities was somewhat inconsistent and based on a limited number of studies. Overall, the strength of the evidence for ambient temperature as a risk factor for all-cause mortality was judged as limited and for heat wave episodes as inadequate. CONCLUSIONS The evidence base on temperature impacts on mortality in South Asia is limited due to the small number of studies, their skewed geographical distribution and methodological weaknesses. Understanding the main determinants of the temperature-mortality association as well as how these may evolve in the future in a dynamic region such as South Asia will be an important area for future research. Studies on viable adaptation options to high temperatures for a region that is a hotspot for climate vulnerability, urbanisation and population growth are also needed.
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Affiliation(s)
- Asya Dimitrova
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Vijendra Ingole
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Otavio Ranzani
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Carles Milà
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Joan Ballester
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain.
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Urban A, Kyselý J, Plavcová E, Hanzlíková H, Štěpánek P. Temporal changes in years of life lost associated with heat waves in the Czech Republic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:137093. [PMID: 32044496 DOI: 10.1016/j.scitotenv.2020.137093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/09/2020] [Accepted: 02/01/2020] [Indexed: 06/10/2023]
Abstract
Seniors constitute the population group generally most at risk of mortality due to heat stress. As life expectancy increases and health conditions of elderly people improve over time, vulnerability of the population to heat changes as well. We employed the years-of-life-lost (YLL) approach, considering life expectancy at the time of each death, to investigate how population ageing affects temporal changes in heat-related mortality in the Czech Republic. Using an updated gridded meteorological database, we identified heat waves during 1994-2017, and analysed temporal changes in their impacts on YLL and mortality. The mean impact of a heat-wave day on relative excess mortality and YLL had declined by approximately 2-3% per decade. That decline abated in the current decade, however, and the decreasing trend in mean excess mortality as well as YLL vanished when the short-term mortality displacement effect was considered. Moreover, the cumulative number of excess deaths and YLL during heat waves rose due to increasing frequency and intensity of heat waves during the examined period. The results show that in studies of temporal changes it is important to differentiate between mean effects of heat waves on mortality and the overall death burden associated with heat waves. Analysis of the average ratio of excess YLL/death per heat-wave day indicated that the major heat-vulnerable population group shifted towards older age (70+ years among males and 75+ years among females). Our findings highlight the importance of focusing heat-protection measures especially upon the elderly population, which is most heat-vulnerable and whose numbers are rising.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Jan Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Global Change Research Institute of the Czech Academy of Sciences, Brno, Czech Republic
| | - Eva Plavcová
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Hana Hanzlíková
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Geophysics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Petr Štěpánek
- Global Change Research Institute of the Czech Academy of Sciences, Brno, Czech Republic; Institute of Geophysics of the Czech Academy of Sciences, Prague, Czech Republic; Czech Hydrometeorological Institute, Regional Office Brno, Brno, Czech Republic
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Williams AA, Allen JG, Catalano PJ, Spengler JD. The Role of Individual and Small-Area Social and Environmental Factors on Heat Vulnerability to Mortality Within and Outside of the Home in Boston, MA. CLIMATE 2020; 8. [PMID: 35368800 PMCID: PMC8974638 DOI: 10.3390/cli8020029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Climate change is resulting in heatwaves that are more frequent, severe, and longer lasting, which is projected to double-to-triple the heat-related mortality in Boston, MA if adequate climate change mitigation and adaptation strategies are not implemented. A case-only analysis was used to examine subject and small-area neighborhood characteristics that modified the association between hot days and mortality. Deaths of Boston, Massachusetts residents that occurred from 2000–2015 were analyzed in relation to the daily temperature and heat index during the warm season as part of the case-only analysis. The modification by small-area (census tract, CT) social, and environmental (natural and built) factors was assessed. At-home mortality on hot days was driven by both social and environmental factors, differentially across the City of Boston census tracts, with a greater proportion of low-to-no income individuals or those with limited English proficiency being more highly represented among those who died during the study period; but small-area built environment features, like street trees and enhanced energy efficiency, were able to reduce the relative odds of death within and outside the home. At temperatures below current local thresholds used for heat warnings and advisories, there was increased relative odds of death from substance abuse and assault-related altercations. Geographic weighted regression analyses were used to examine these relationships spatially within a subset of at-home deaths with high-resolution temperature and humidity data. This revealed spatially heterogeneous associations between at-home mortality and social and environmental vulnerability factors.
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Affiliation(s)
- Augusta A. Williams
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Correspondence:
| | - Joseph G. Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Paul J. Catalano
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - John D. Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Lee H, Jung J, Myung W, Baek JH, Kang JM, Kim DK, Kim H. Association between dust storm occurrence and risk of suicide: Case-crossover analysis of the Korean national death database. ENVIRONMENT INTERNATIONAL 2019; 133:105146. [PMID: 31630066 DOI: 10.1016/j.envint.2019.105146] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 08/30/2019] [Accepted: 08/31/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Asian dust storms (ADSs) have been associated with adverse health outcomes, including respiratory and cardiovascular diseases. Considering the increasing global desertification driven by climate change, it is necessary to assess dust storm-related adverse health effects for establishing appropriate public health interventions. Recent studies have found that ambient air pollution has negative effects on mental health including cognitive disorders, depression, and suicide. However, these studies mostly focused on traditional anthropogenic pollutants from traffic exhaust or fossil fuel power plants; the association between dust storms and suicidal death is yet to be determined. OBJECTIVE To assess the association between ADSs and suicide risk in Seoul, South Korea from 2002 to 2015. METHODS To determine whether increased risk of suicide is associated with occurrence of ADSs, we performed a time-stratified case-crossover study that linked the national death statistics database with ADS occurrence data from the Korea Meteorology Administration. Exposure to ADSs was compared between the day of suicide and control days, matched to the day of the week, month, and year. We further examined whether the effect of ADSs on suicide risk differed according to ADS duration and intensity. RESULTS Over the 14-year period, 30,704 people died by suicide and 133 ADSs were reported. Of these, 55 ADSs lasted over 2 days (long-duration ADSs), and 67 ADSs had higher levels of particulate matter < 10 μm in diameter (PM10) that exceeded the 50th percentile value over the total 133 ADS days (high-intensity ADSs). Exposure to ADS was associated with a 13.1% (95% confidence interval [CI], 4.5-22.4; P = .002) increase in suicide risk on the day of ADS occurrence. Long-duration and high-intensity ADSs were associated with a 19.8% (95% CI, 6.5-34.7; P = .003) and 17.0% (95% CI, 5.2-30.0; P = .004) increase in suicide risk, respectively. These associations remained robust after adjusting for local air pollution levels and meteorological factors. However, this association was not replicated in the unconstrained distributed lag model which revealed inferior goodness-of-fit to our data. CONCLUSIONS Exposure to ADSs was associated with an increased risk of suicide, especially on the same day. This study provides novel evidence of a relationship between ADSs and suicide. These findings could help in establishing public health interventions for suicide prevention as well as in establishing dust storm warning systems. Future studies are warranted to confirm if our findings are replicable and to elucidate the underlying mechanisms.
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Affiliation(s)
- Hyewon Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Institute of Health and Environment, Seoul National University, South Korea
| | - Jiyun Jung
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Doh Kwan Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, South Korea; Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, South Korea.
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Heo S, Bell ML. Heat waves in South Korea: differences of heat wave characteristics by thermal indices. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:790-805. [PMID: 30283069 DOI: 10.1038/s41370-018-0076-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 07/25/2018] [Accepted: 09/06/2018] [Indexed: 06/08/2023]
Abstract
Heat wave warning systems and related research define heat waves using various indices and there exists no standard definition for a heat wave. Despite various weather forecast services for heat stress in South Korea, it is unclear how different thermal indices affect the designation of heat waves and health effect estimates. We aimed to analyze trends of heat wave characteristics and mortality associations using various criteria for the warm season (June-September) in 2011-5 for the most populated two cities in South Korea, Seoul and Busan. Hourly weather monitoring data and daily mortality data in each city were obtained. The following indices were estimated to define heat waves: air temperature, heat index (HI), humidex, apparent temperature (AT), effective temperature (ET), and wet-bulb globe temperature (WBGT). The thresholds of each index for heat wave definitions were obtained by statistical distribution (95th percentiles) and minimum mortality temperature (MMT). Thermal indices showed clustering of accumulation of excess heat above thresholds for northeast regions in the cities while air temperature showed it for central regions. Compared to 95th percentiles, the MMTs resulted 14 times longer heat wave days for thermal indices except for air temperature. When MMTs were used, nine times larger excess mortality from heat waves occurred for all indices compared to that from heat waves defined by the 95th percentiles. The thermal indices with the highest association between heat and mortality varied between the two cities: air temperature for Seoul and WBGT for Busan. Heat wave warnings should be based on a thorough comparison of how different heat wave criteria will affect the public health impact of heat wave warnings in terms of identifying a heat wave and degree of health impacts due to it.
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Affiliation(s)
- Seulkee Heo
- School of Forestry and Environmental Studies, Yale University, New Haven, United States.
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, United States
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Lin Q, Lin H, Liu T, Lin Z, Lawrence WR, Zeng W, Xiao J, Li X, Zhang B, Lin S, Ma W. The effects of excess degree-hours on mortality in Guangzhou, China. ENVIRONMENTAL RESEARCH 2019; 176:108510. [PMID: 31207409 DOI: 10.1016/j.envres.2019.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prior studies that examined the association between temperature and mortality relied on mean temperature, maximum temperature, minimum temperature, humidex, and daily temperature variability, not accounting for variations in hourly temperature throughout the day. We proposed an indicator, excess degree-hours, to examine the association between temperature and mortality. METHODS A distributed lag non-linear model (DLNM) was used to determine the hot (27.8 °C) and cold (24.3 °C) threshold. Hourly temperature in Guangzhou, China were summarized with extreme heat expressed as sum of degree-hours >27.8 °C and extreme cold as sum of degree-hours <24.3 °C within one day from January 1, 2012 to December 31, 2015. We then estimated the associations of daily mortality with hot and cold degree-hours in both hot and cold season. We also calculated the mortality burden of excess degree-hours. RESULTS An interquartile range (IQR) increase of hot degree-hours was associated with 2.11% (95% confidence interval [95% CI]: 1.25%, 2.98%), 3.74% (95% CI: 0.71%, 6.86%), and 2.63% (95% CI: 0.70%, 4.59%) increments in non-injury related death, respiratory mortality, and cardiovascular mortality, respectively. While the corresponding excess risk for an IQR increase of cold degree-hours was 2.42% (95% CI: 1.97%, 2.88%), 3.16% (95% CI: 2.57%, 3.76%), and 2.93% (95% CI: 1.98%, 3.88%). The estimated mortality burdens for hot and cold degree-hours were 1366,2465, respectively. CONCLUSION The excess degree-hours reduced to a single indication in duration and intensity is an approach and shows a different perspective and significant extreme weather effects on human health.
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Affiliation(s)
- Qiaoxuan Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China; Department of Health Resource, Guangzhou Center of Health Information, Guangzhou, Guangdong, China
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Ziqiang Lin
- Department of Psychiatry, New York University Langone School of Medicine, New York, NY, USA
| | - Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Bing Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Shao Lin
- Department of Environmental Health Science, School of Public Health, University at Albany, State University of New York, NY, USA
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
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Luy M, Di Giulio P, Di Lego V, Lazarevič P, Sauerberg M. Life Expectancy: Frequently Used, but Hardly Understood. Gerontology 2019; 66:95-104. [PMID: 31390630 DOI: 10.1159/000500955] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 05/14/2019] [Indexed: 11/19/2022] Open
Abstract
Period life expectancy is one of the most used summary indicators for the overall health of a population. Its levels and trends direct health policies, and researchers try to identify the determining risk factors to assess and forecast future developments. The use of period life expectancy is often based on the assumption that it directly reflects the mortality conditions of a certain year. Accordingly, the explanation for changes in life expectancy are typically sought in factors that have an immediate impact on current mortality conditions. It is frequently overlooked, however, that this indicator can also be affected by at least three kinds of effects, in particular in the situation of short-term fluctuations: cohort effects, heterogeneity effects, and tempo effects. We demonstrate their possible impact with the example of the almost Europe-wide decrease in life expectancy in 2015, which caused a series of reports about an upsurge of a health crisis, and we show that the consideration of these effects can lead to different conclusions. Therefore, we want to raise an awareness concerning the sensitivity of life expectancy to sudden changes and the menaces a misled interpretation of this indicator can cause.
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Affiliation(s)
- Marc Luy
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna, Austria, .,Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria,
| | - Paola Di Giulio
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna, Austria.,Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria
| | - Vanessa Di Lego
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna, Austria.,Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria
| | - Patrick Lazarevič
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna, Austria.,Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria
| | - Markus Sauerberg
- Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna, Austria.,Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria
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Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101696. [PMID: 31091805 PMCID: PMC6573000 DOI: 10.3390/ijerph16101696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/03/2019] [Accepted: 05/10/2019] [Indexed: 01/13/2023]
Abstract
Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.
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Sheridan SC, Lee CC, Allen MJ. The Mortality Response to Absolute and Relative Temperature Extremes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1493. [PMID: 31035559 PMCID: PMC6539858 DOI: 10.3390/ijerph16091493] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 12/16/2022]
Abstract
While the impact of absolute extreme temperatures on human health has been amply studied, far less attention has been given to relative temperature extremes, that is, events that are highly unusual for the time of year but not necessarily extreme relative to a location's overall climate. In this research, we use a recently defined extreme temperature event metric to define absolute extreme heat events (EHE) and extreme cold events (ECE) using absolute thresholds, and relative extreme heat events (REHE) and relative extreme cold events (RECE) using relative thresholds. All-cause mortality outcomes using a distributed lag nonlinear model are evaluated for the largest 51 metropolitan areas in the US for the period 1975-2010. Both the immediate impacts and the cumulative 20-day impacts are assessed for each of the extreme temperature event types. The 51 metropolitan areas were then grouped into 8 regions for meta-analysis. For heat events, the greatest mortality increases occur with a 0-day lag, with the subsequent days showing below-expected mortality (harvesting) that decreases the overall cumulative impact. For EHE, increases in mortality are still statistically significant when examined over 20 days. For REHE, it appears as though the day-0 increase in mortality is short-term displacement. For cold events, both relative and absolute, there is little mortality increase on day 0, but the impacts increase on subsequent days. Cumulative impacts are statistically significant at more than half of the stations for both ECE and RECE. The response to absolute ECE is strongest, but is also significant when using RECE across several southern locations, suggesting that there may be a lack of acclimatization, increasing mortality in relative cold events both early and late in winter.
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Affiliation(s)
- Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH 44242, USA.
| | - Cameron C Lee
- Department of Geography, Kent State University, Kent, OH 44242, USA.
| | - Michael J Allen
- Department of Political Science and Geography, Old Dominion University, Norfolk, VA 23529, USA.
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Urban A, Hondula DM, Hanzlíková H, Kyselý J. The predictability of heat-related mortality in Prague, Czech Republic, during summer 2015-a comparison of selected thermal indices. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:535-548. [PMID: 30739159 DOI: 10.1007/s00484-019-01684-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices-Universal Thermal Climate Index and Excess Heat Factor (EHF)-were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May-September) during 1994-2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, P.O. Box 875302, Tempe, AZ, 85287-5302, USA
| | - Hana Hanzlíková
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 165 21, Prague 6, Czech Republic
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 603 00, Brno, Czech Republic
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Borg M, Nitschke M, Williams S, McDonald S, Nairn J, Bi P. Using the excess heat factor to indicate heatwave-related urinary disease: a case study in Adelaide, South Australia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:435-447. [PMID: 30687904 DOI: 10.1007/s00484-019-01674-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
The excess heat factor (EHF) is being adopted nationally for heatwave forecasting in Australia, but there is limited research utilizing it as a predictor for heat-related morbidity from diseases of the urinary system (urinary diseases). In this study, the incidence of eight temperature-prone specific urinary disease categories was analyzed in relation to the EHF. Daily data for maximum and minimum temperature and data for metropolitan hospital emergency department presentations and inpatient admissions for urinary disease were acquired in Adelaide, South Australia, from 1 July 2003 to 31 March 2014. An increased incidence for urolithiasis, acute kidney injury (AKI), chronic kidney disease, and lower urinary tract infections was associated with the EHF. Using the Australian national heatwave definition with the EHF, emergency department presentations increased on heatwave days compared to non-heatwave days for total urinary disease (IRR 1.046, 95% CI 1.016-1.076), urolithiasis (IRR 1.106, 95% 1.046-1.169), and acute kidney injury (AKI) (IRR 1.416, 95% CI 1.258-1.594). Likewise, inpatient admissions increased for total urinary disease (IRR 1.090, 95% CI 1.048-1.133) and AKI (IRR 1.335, 95% CI 1.204-1.480). The EHF is a reliable metric for predicting heat-induced morbidity from urinary disease. Climate change-related elevations in temperature can increase morbidity from urinary disease, especially AKI and urolithiasis. Diseases of the urinary system should be highlighted when providing public health guidance during heatwaves indicated by the EHF.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia, Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - John Nairn
- South Australian State Office, Bureau of Meteorology, Adelaide, South Australia, Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, SA, 5005, Australia.
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Yin P, Chen R, Wang L, Liu C, Niu Y, Wang W, Jiang Y, Liu Y, Liu J, Qi J, You J, Zhou M, Kan H. The added effects of heatwaves on cause-specific mortality: A nationwide analysis in 272 Chinese cities. ENVIRONMENT INTERNATIONAL 2018; 121:898-905. [PMID: 30347372 DOI: 10.1016/j.envint.2018.10.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND The evidence was limited and inconclusive about the added effects of heatwaves, especially in developing countries. OBJECTIVE To evaluate the added effects of heatwaves on cause-specific mortality in China. METHODS We designed a nationwide time-series analysis based on daily data from 272 main Chinese cities to from 2013 to 2015. We adopted 12 definitions by combining 4 heat thresholds (90th, 92.5th, 95th, 97.5th percentile of city-specific daily mean temperature) and duration of ≥2, 3 and 4 days. We applied overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative effects of heatwaves over lags of 0-10 days after controlling for daily temperature. We then, used a meta-regression model to pool the effect estimates at national and regional levels. RESULTS Heatwaves could significantly increase risk for mortality from total and cardiopulmonary diseases, including coronary heart disease, ischemic stroke (rather than hemorrhagic stroke) and chronic obstructive pulmonary disease. The effects increased with higher thresholds, but were not appreciably influenced by the duration of heat. The risks generally occurred immediately and lasted for 3 to 5 days. The risks were much larger in the temperate continental zone and the temperate monsoon zones than in the subtropical monsoon zone where there was an evident mortality displacement. The elderly, females and less-educated people were more vulnerable. CONCLUSIONS This analysis provided ample evidence for the added mortality risk associated with heatwaves, which had important implications for designing heatwave-warning systems and predicting the disease burden of future heatwaves.
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Affiliation(s)
- Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Yunning Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jinling You
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproduction and Development, Fudan University, Shanghai 200032, China..
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Hoehne CG, Hondula DM, Chester MV, Eisenman DP, Middel A, Fraser AM, Watkins L, Gerster K. Heat exposure during outdoor activities in the US varies significantly by city, demography, and activity. Health Place 2018; 54:1-10. [PMID: 30199773 DOI: 10.1016/j.healthplace.2018.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/12/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
Environmental heat is a growing public health concern in cities. Urbanization and global climate change threaten to exacerbate heat as an already significant environmental cause of human morbidity and mortality. Despite increasing risk, very little is known regarding determinants of outdoor urban heat exposure. To provide additional evidence for building community and national-scale resilience to extreme heat, we assess how US outdoor urban heat exposure varies by city, demography, and activity. We estimate outdoor urban heat exposure by pairing individual-level data from the American Time Use Survey (2004-2015) with corresponding meteorological data for 50 of the largest metropolitan statistical areas in the US. We also assess the intersection of activity intensity and heat exposure by pairing metabolic intensities with individual-level time-use data. We model an empirical relationship between demographic indicators and daily heat exposure with controls for spatiotemporal factors. We find higher outdoor heat exposure among the elderly and low-income individuals, and lower outdoor heat exposure in females, young adults, and those identifying as Black race. Traveling, lawn and garden care, and recreation are the most common outdoor activities to contribute to heat exposure. We also find individuals in cities with the most extreme temperatures do not necessarily have the highest outdoor heat exposure. The findings reveal large contrasts in outdoor heat exposure between different cities, demographic groups, and activities. Resolving the interplay between exposure, sensitivity, adaptive capacity, and behavior as determinants of heat-health risk will require advances in observational and modeling tools, especially at the individual scale.
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Affiliation(s)
- Christopher G Hoehne
- Civil, Environmental, and Sustainable Engineering, Arizona State University, Tempe, AZ, USA.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA; Global Institute of Sustainability, Arizona State University, Tempe, AZ, USA
| | - Mikhail V Chester
- Civil, Environmental, and Sustainable Engineering, Arizona State University, Tempe, AZ, USA; Global Institute of Sustainability, Arizona State University, Tempe, AZ, USA
| | - David P Eisenman
- David Geffen School of Medicine at UCLA and the UCLA Center for Public Health and Disasters, Los Angeles, CA, USA
| | - Ariane Middel
- Geography and Urban Studies Department, Temple University, Philadelphia, PA, USA; Global Institute of Sustainability, Arizona State University, Tempe, AZ, USA; School of Arts, Media and Engineering and School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Andrew M Fraser
- Civil, Environmental, and Sustainable Engineering, Arizona State University, Tempe, AZ, USA
| | - Lance Watkins
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - Katrina Gerster
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
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Cedeño Laurent JG, Williams A, Oulhote Y, Zanobetti A, Allen JG, Spengler JD. Reduced cognitive function during a heat wave among residents of non-air-conditioned buildings: An observational study of young adults in the summer of 2016. PLoS Med 2018; 15:e1002605. [PMID: 29990359 PMCID: PMC6039003 DOI: 10.1371/journal.pmed.1002605] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/08/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In many regions globally, buildings designed for harnessing heat during the cold exacerbate thermal exposures during heat waves (HWs) by maintaining elevated indoor temperatures even when high ambient temperatures have subdued. While previous experimental studies have documented the effects of ambient temperatures on cognitive function, few have observed HW effects on indoor temperatures following subjects' habitual conditions. The objective was to evaluate the differential impact of having air conditioning (AC) on cognitive function during a HW among residents of AC and non-AC buildings using a prospective observational cohort study. METHODS We followed 44 students (mean age = 20.2 years; SD = 1.8 years) from a university in the Greater Boston area, Massachusetts in the United States living in AC (n = 24) and non-AC (n = 20) buildings before, during, and after a HW. Two cognition tests were self-administered daily for a period of 12 days (July 9-July 20, 2016), the Stroop color-word test (STROOP) to assess selective attention/processing speed and a 2-digit, visual addition/subtraction test (ADD) to evaluate cognitive speed and working memory. The effect of the HW on cognitive function was evaluated using difference-in-differences (DiD) modelling. FINDINGS Mean indoor temperatures in the non-AC group (mean = 26.3°C; SD = 2.5°C; range = 19.6-30.4°C) were significantly higher (p < 0.001) than in the AC group (mean = 21.4°C; SD = 1.9°C; range = 17.5-25.0°C). DiD estimates show an increase in reaction time (STROOP = 13.4%, p < 0001; ADD = 13.3%, p < 0.001) and reduction in throughput (STROOP = -9.9%, p < 0.001; ADD = -6.3%, p = 0.08) during HWs among non-AC residents relative to AC residents at baseline. While ADD showed a linear relationship with indoor temperatures, STROOP was described by a U-shaped curve with linear effects below and above an optimum range (indoor temperature = 22°C-23°C), with an increase in reaction time of 16 ms/°C and 24 ms/°C for STROOP and ADD, respectively. Cognitive tests occurred right after waking, so the study is limited in that it cannot assess whether the observed effects extended during the rest of the day. Although the range of students' ages also represents a limitation of the study, the consistent findings in this young, healthy population might indicate that greater portions of the population are susceptible to the effects of extreme heat. CONCLUSIONS Cognitive function deficits resulting from indoor thermal conditions during HWs extend beyond vulnerable populations. Our findings highlight the importance of incorporating sustainable adaptation measures in buildings to preserve educational attainment, economic productivity, and safety in light of a changing climate.
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Affiliation(s)
- Jose Guillermo Cedeño Laurent
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Augusta Williams
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Youssef Oulhote
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Antonella Zanobetti
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Joseph G. Allen
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - John D. Spengler
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Anderson GB, Oleson KW, Jones B, Peng RD. Projected trends in high-mortality heatwaves under different scenarios of climate, population, and adaptation in 82 US communities. CLIMATIC CHANGE 2018; 146:455-470. [PMID: 29628541 PMCID: PMC5881935 DOI: 10.1007/s10584-016-1779-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 08/17/2016] [Indexed: 05/23/2023]
Abstract
Some rare heatwaves have extreme daily mortality impacts; moderate heatwaves have lower daily impacts but occur much more frequently at present and so account for large aggregated impacts. We applied health-based models to project trends in high-mortality heatwaves, including proportion of all heatwaves expected to be high-mortality, using the definition that a high-mortality heatwave increases mortality risk by ≥20 %. We projected these trends in 82 US communities in 2061-2080 under two scenarios of climate change (RCP4.5, RCP8.5), two scenarios of population change (SSP3, SSP5), and three scenarios of community adaptation to heat (none, lagged, on-pace) for large- and medium-ensemble versions of the National Center for Atmospheric Research's Community Earth System Model. More high-mortality heatwaves were expected compared to present under all scenarios except on-pace adaptation, and population exposure was expected to increase under all scenarios. At least seven more high-mortality heatwaves were expected in a twenty-year period in the 82 study communities under RCP8.5 than RCP4.5 when assuming no adaptation. However, high-mortality heatwaves were expected to remain <1 % of all heatwaves and heatwave exposure under all scenarios. Projections were most strongly influenced by the adaptation scenario- going from a scenario of on-pace to lagged adaptation or from lagged to no adaptation more than doubled the projected number of and exposure to high-mortality heatwaves. Based on our results, fewer high-mortality heatwaves are expected when following RCP4.5 versus RCP8.5 and under higher levels of adaptation, but high-mortality heatwaves are expected to remain a very small proportion of total heatwave exposure.
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Affiliation(s)
- G. Brooke Anderson
- Department of Environmental & Radiological Health Sciences, Colorado State University, Lake Street, Fort Collins, CO 80521, USA
| | | | - Bryan Jones
- CUNY Institute for Demographic Research, New York, NY, USA
| | - Roger D. Peng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Allen MJ, Sheridan SC. Mortality risks during extreme temperature events (ETEs) using a distributed lag non-linear model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:57-67. [PMID: 26646668 DOI: 10.1007/s00484-015-1117-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 10/21/2015] [Accepted: 11/22/2015] [Indexed: 06/05/2023]
Abstract
This study investigates the relationship between all-cause mortality and extreme temperature events (ETEs) from 1975 to 2004. For 50 U.S. locations, these heat and cold events were defined based on location-specific thresholds of daily mean apparent temperature. Heat days were defined by a 3-day mean apparent temperature greater than the 95th percentile while extreme heat days were greater than the 97.5th percentile. Similarly, calculations for cold and extreme cold days relied upon the 5th and 2.5th percentiles. A distributed lag non-linear model assessed the relationship between mortality and ETEs for a cumulative 14-day period following exposure. Subsets for season and duration effect denote the differences between early- and late-season as well as short and long ETEs. While longer-lasting heat days resulted in elevated mortality, early season events also impacted mortality outcomes. Over the course of the summer season, heat-related risk decreased, though prolonged heat days still had a greater influence on mortality. Unlike heat, cold-related risk was greatest in more southerly locations. Risk was highest for early season cold events and decreased over the course of the winter season. Statistically, short episodes of cold showed the highest relative risk, suggesting unsettled weather conditions may have some relationship to cold-related mortality. For both heat and cold, results indicate higher risk to the more extreme thresholds. Risk values provide further insight into the role of adaptation, geographical variability, and acclimatization with respect to ETEs.
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Affiliation(s)
- Michael J Allen
- Department of Political Science and Geography, Old Dominion University, 7042 Batten Arts and Letters, Norfolk, VA, 23529, USA.
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Chiabai A, Spadaro JV, Neumann MB. Valuing deaths or years of life lost? Economic benefits of avoided mortality from early heat warning systems. MITIGATION AND ADAPTATION STRATEGIES FOR GLOBAL CHANGE 2018; 23:1159-1176. [PMID: 30174541 PMCID: PMC6105260 DOI: 10.1007/s11027-017-9778-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 12/14/2017] [Indexed: 05/03/2023]
Abstract
The study aims to explore the main drivers influencing the economic appraisal of heat warning systems by integrating epidemiological modelling and benefit-cost analysis. To shed insights on heat wave mortality valuation, we consider three valuation schemes: (i) a traditional one, where the value of a statistical life (VSL) is applied to both displaced and premature mortality; (ii) an intermediate one, with VSL applied for premature mortality and value of a life year (VOLY) for displaced mortality; and (iii) a conservative one, where both premature and displaced mortality are quantified in terms of loss of life expectancy, and then valued using the VOLY approach. When applying these three schemes to Madrid (Spain), we obtain a benefit-cost ratio varying from 12 to 3700. We find that the choice of the valuation scheme has the largest influence, whereas other parameters such as attributable risk, displaced mortality ratio, or the comprehensiveness and effectiveness of the heat warning system are less influential. The results raise the question of which is the most appropriate approach to value mortality in the context of heat waves, given that the lower bound estimate for the benefit-cost ratio (option iii using VOLY) is up to two orders of magnitude lower than the value based on the traditional VSL approach (option i). The choice of the valuation methodology has significant implications for public health authorities at the local and regional scale, which becomes highly relevant for locations where the application of the VOLY approach could lead to benefit-cost ratios significantly lower than 1. We propose that specific metrics for premature and displaced VOLYs should be developed for the context of heat waves. Until such values are available, we suggest testing the economic viability of heat warning systems under the three proposed valuation schemes (i-iii) and using values for VOLY commonly applied in air pollution as the health end points are similar. Lastly, periodical reassessment of heat alert plans should be performed by public health authorities to monitor their long-term viability and cost-effectiveness.
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Affiliation(s)
- Aline Chiabai
- Basque Centre for Climate Change BC3, Building 1, 1st floor, Barrio Sarriena, s/n, 48940 Leioa, Bizkaia Spain
| | - Joseph V. Spadaro
- Basque Centre for Climate Change BC3, Building 1, 1st floor, Barrio Sarriena, s/n, 48940 Leioa, Bizkaia Spain
- SERC, Hillsborough, NJ 08844 USA
| | - Marc B. Neumann
- Basque Centre for Climate Change BC3, Building 1, 1st floor, Barrio Sarriena, s/n, 48940 Leioa, Bizkaia Spain
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao, Bizkaia Spain
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Impacts of the 2015 Heat Waves on Mortality in the Czech Republic-A Comparison with Previous Heat Waves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121562. [PMID: 29236040 PMCID: PMC5750980 DOI: 10.3390/ijerph14121562] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/10/2017] [Accepted: 12/08/2017] [Indexed: 11/17/2022]
Abstract
This study aimed to assess the impacts of heat waves during the summer of 2015 on mortality in the Czech Republic and to compare them with those of heat waves back to the previous record-breaking summer of 1994. We analyzed daily natural-cause mortality across the country’s entire population. A mortality baseline was determined using generalized additive models adjusted for long-term trends, seasonal and weekly cycles, and identified heat waves. Mortality deviations from the baseline were calculated to quantify excess mortality during heat waves, defined as periods of at least three consecutive days with mean daily temperature higher than the 95th percentile of annual distribution. The summer of 2015 was record-breaking in the total duration of heat waves as well as their total heat load. Consequently, the impact of the major heat wave in 2015 on the increase in excess mortality relative to the baseline was greater than during the previous record-breaking heat wave in 1994 (265% vs. 240%). Excess mortality was comparable among the younger age group (0–64 years) and the elderly (65+ years) in the 1994 major heat wave while it was significantly larger among the elderly in 2015. The results suggest that the total heat load of a heat wave needs to be considered when assessing its impact on mortality, as the cumulative excess heat factor explains the magnitude of excess mortality during a heat wave better than other characteristics such as duration or average daily mean temperature during the heat wave. Comparison of the mortality impacts of the 2015 and 1994 major heat waves suggests that the recently reported decline in overall heat-related mortality in Central Europe has abated and simple extrapolation of the trend would lead to biased conclusions even for the near future. Further research is needed toward understanding the additional mitigation measures required to prevent heat-related mortality in the Czech Republic and elsewhere.
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Borg M, Bi P, Nitschke M, Williams S, McDonald S. The impact of daily temperature on renal disease incidence: an ecological study. Environ Health 2017; 16:114. [PMID: 29078794 PMCID: PMC5659014 DOI: 10.1186/s12940-017-0331-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/12/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Extremely high temperatures over many consecutive days have been linked to an increase in renal disease in several cities. This is becoming increasingly relevant with heatwaves becoming longer, more intense, and more frequent with climate change. This study aimed to extend the known relationship between daily temperature and kidney disease to include the incidence of eight temperature-prone specific renal disease categories - total renal disease, urolithiasis, renal failure, acute kidney injury (AKI), chronic kidney disease (CKD), urinary tract infections (UTIs), lower urinary tract infections (LUTIs) and pyelonephritis. METHODS Daily data was acquired for maximum, minimum and average temperature over the period of 1 July 2003 to 31 March 2014 during the warm season (October to March) in Adelaide, South Australia. Data for daily admissions to all metropolitan hospitals for renal disease, including 83,519 emergency department admissions and 42,957 inpatient admissions, was also obtained. Renal outcomes were analyzed using time-stratified negative binomial regression models, with the results aggregated by day. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated for associations between the number of admissions and daily temperature. RESULTS Increases in daily temperature per 1 °C were associated with an increased incidence for all renal disease categories except for pyelonephritis. Minimum temperature was associated with the greatest increase in renal disease followed by average temperature and then maximum temperature. A 1°C increase in daily minimum temperature was associated with an increase in daily emergency department admissions for AKI (IRR 1.037, 95% CI: 1.026-1.048), renal failure (IRR 1.030, 95% CI: 1.022-1.039), CKD (IRR 1.017, 95% CI: 1.001-1.033) urolithiasis (IRR 1.015, 95% CI: 1.010-1.020), total renal disease (IRR 1.009, 95% CI: 1.006-1.011), UTIs (IRR 1.004, 95% CI: 1.000-1.007) and LUTIs (IRR 1.003, 95% CI: 1.000-1.006). CONCLUSIONS An increased frequency of renal disease, including urolithiasis, acute kidney injury and urinary tract infections, is predicted with increasing temperatures from climate change. These results have clinical and public health implications for the management of renal diseases and demand tailored health services. Future research is warranted to analyze individual renal diseases with more comprehensive information regarding renal risk factors, and studies examining mortality for specific renal diseases.
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Affiliation(s)
- Matthew Borg
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Peng Bi
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Monika Nitschke
- SA Health, Government of South Australia, Adelaide, South Australia Australia
| | - Susan Williams
- School of Public Health, University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Stephen McDonald
- The Central Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia Australia
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Guo Y, Gasparrini A, Armstrong BG, Tawatsupa B, Tobias A, Lavigne E, Coelho MDSZS, Pan X, Kim H, Hashizume M, Honda Y, Guo YLL, Wu CF, Zanobetti A, Schwartz JD, Bell ML, Scortichini M, Michelozzi P, Punnasiri K, Li S, Tian L, Garcia SDO, Seposo X, Overcenco A, Zeka A, Goodman P, Dang TN, Dung DV, Mayvaneh F, Saldiva PHN, Williams G, Tong S. Heat Wave and Mortality: A Multicountry, Multicommunity Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:087006. [PMID: 28886602 PMCID: PMC5783630 DOI: 10.1289/ehp1026] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/20/2017] [Accepted: 03/31/2017] [Indexed: 05/02/2023]
Abstract
BACKGROUND Few studies have examined variation in the associations between heat waves and mortality in an international context. OBJECTIVES We aimed to systematically examine the impacts of heat waves on mortality with lag effects internationally. METHODS We collected daily data of temperature and mortality from 400 communities in 18 countries/regions and defined 12 types of heat waves by combining community-specific daily mean temperature ≥90th, 92.5th, 95th, and 97.5th percentiles of temperature with duration ≥2, 3, and 4 d. We used time-series analyses to estimate the community-specific heat wave-mortality relation over lags of 0-10 d. Then, we applied meta-analysis to pool heat wave effects at the country level for cumulative and lag effects for each type of heat wave definition. RESULTS Heat waves of all definitions had significant cumulative associations with mortality in all countries, but varied by community. The higher the temperature threshold used to define heat waves, the higher heat wave associations on mortality. However, heat wave duration did not modify the impacts. The association between heat waves and mortality appeared acutely and lasted for 3 and 4 d. Heat waves had higher associations with mortality in moderate cold and moderate hot areas than cold and hot areas. There were no added effects of heat waves on mortality in all countries/regions, except for Brazil, Moldova, and Taiwan. Heat waves defined by daily mean and maximum temperatures produced similar heat wave-mortality associations, but not daily minimum temperature. CONCLUSIONS Results indicate that high temperatures create a substantial health burden, and effects of high temperatures over consecutive days are similar to what would be experienced if high temperature days occurred independently. People living in moderate cold and moderate hot areas are more sensitive to heat waves than those living in cold and hot areas. Daily mean and maximum temperatures had similar ability to define heat waves rather than minimum temperature. https://doi.org/10.1289/EHP1026.
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Affiliation(s)
- Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland , Brisbane, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University , Melbourne, Australia
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine , London, UK
| | - Ben G Armstrong
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine , London, UK
| | - Benjawan Tawatsupa
- Health Impact Assessment Division, Department of Health, Ministry of Public Heath , Thailand
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research , Barcelona, Spain
| | - Eric Lavigne
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa , Ottawa, Canada
- Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | | | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University , Beijing, China
| | - Ho Kim
- Graduate School of Public Health, Seoul National University , Seoul, Republic of Korea
| | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University , Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba , Tsukuba, Japan
| | - Yue-Liang Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institutes , Zhunan, Taiwan
| | - Chang-Fu Wu
- Department of Public Health, National Taiwan University , Taipei, Taiwan
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University , New Haven, Connecticut, USA
| | - Matteo Scortichini
- Department of Epidemiology of the Lazio Regional Health Service, Rome, Italy
| | - Paola Michelozzi
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong , Hong Kong, China
| | - Kornwipa Punnasiri
- Health Impact Assessment Division, Department of Health, Ministry of Public Heath , Thailand
| | - Shanshan Li
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland , Brisbane, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University , Melbourne, Australia
| | - Linwei Tian
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong , Hong Kong, China
| | | | - Xerxes Seposo
- Graduate School of Comprehensive Human Sciences, University of Tsukuba , Tsukuba City, Japan
| | - Ala Overcenco
- Laboratory of Management in Public Health, Chisinau, Republic of Moldova
| | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London , London, UK
| | - Patrick Goodman
- Environmental Health Sciences Institute, Dublin Institute of Technology , Dublin, Ireland
| | - Tran Ngoc Dang
- Graduate School of Comprehensive Human Sciences, University of Tsukuba , Tsukuba City, Japan
- Institute of Research and Development, Duy Tan University , Da Nang, Vietnam
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City, Vietnam
| | - Do Van Dung
- Department of Medical Statistics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City, Vietnam
| | - Fatemeh Mayvaneh
- School of Geography and Environmental Sciences, University of Hakim Sabzevari , Iran
| | - Paulo Hilario Nascimento Saldiva
- Laboratory of Experimental Air Pollution, Department of Pathology, School of Medicine, University of São Paulo , São Paulo, Brazil
| | - Gail Williams
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland , Brisbane, Australia
| | - Shilu Tong
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, Australia
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University , Shanghai, China
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Garcia F, Shendell DG, Madrigano J. Relationship among environmental quality variables, housing variables, and residential needs: a secondary analysis of the relationship among indoor, outdoor, and personal air (RIOPA) concentrations database. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:513-525. [PMID: 27572236 DOI: 10.1007/s00484-016-1229-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 03/11/2016] [Accepted: 08/01/2016] [Indexed: 06/06/2023]
Abstract
Retrospective descriptive secondary analyses of data from relationships of indoor, outdoor, and personal air (RIOPA) study homes (in Houston, Texas; Los Angeles County, California; and, Elizabeth, New Jersey May 1999-February 2001) were conducted. Data included air exchange rates, associations between indoor and outdoor temperature and humidity, and calculated apparent temperature and humidex. Analyses examined if study homes provided optimum thermal comfort for residents during both heating and cooling seasons when compared to current American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standards 62/62.1 and 55. Results suggested outdoor temperature, humidex, and apparent temperature during the cooling season potentially served as indicators of indoor personal exposure to parameters of thermal comfort. Outdoor temperatures, humidex, and apparent temperature during the cooling season had statistically significant predictive abilities in predicting indoor temperature. During the heating season, only humidex in Texas and combined data across study states were statistically significant, but with weaker to moderate predicative ability. The high degree of correlation between outdoor and indoor environmental variables provided support for the validity of epidemiologic studies of weather relying on temporal comparisons. Results indicated most RIOPA study residents experienced thermal comfort; however, many values indicated how several residents may have experienced some discomfort depending on clothing and indoor activities. With climate change, increases in temperature are expected, with more days of extreme heat and humidity and, potentially harsher, longer winters. Homes being built or modernized should be created with the appropriate guidelines to provide comfort for residents daily and in extreme weather events.
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Affiliation(s)
- Fausto Garcia
- Center for School and Community-Based Research and Education (CSCBRE), Rutgers School of Public Health (SPH), 335 George Street, Suite 2200, New Brunswick, NJ, 08903-2688, USA
- Teaneck (NJ) Health Department, Teaneck, NJ, USA
| | - Derek G Shendell
- Center for School and Community-Based Research and Education (CSCBRE), Rutgers School of Public Health (SPH), 335 George Street, Suite 2200, New Brunswick, NJ, 08903-2688, USA.
- Department of Environmental and Occupational Health (ENOH), SPH, 3rd Fl. SPH Bldg, Piscataway, NJ, 08854, USA.
- Environmental and Occupational Health Science Institute (EOHSI), Exposure Measurement and Assessment Division, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
- Department of Environmental and Occupational HealthRutgers School of Public Health, 683 Hoes Lane West, 3rd Floor, Piscataway, NJ, 08854, USA.
| | - Jaime Madrigano
- Center for School and Community-Based Research and Education (CSCBRE), Rutgers School of Public Health (SPH), 335 George Street, Suite 2200, New Brunswick, NJ, 08903-2688, USA
- Department of Environmental and Occupational Health (ENOH), SPH, 3rd Fl. SPH Bldg, Piscataway, NJ, 08854, USA
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40
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Urban Heat Island Intensification during Hot Spells—The Case of Paris during the Summer of 2003. URBAN SCIENCE 2016. [DOI: 10.3390/urbansci1010003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Benmarhnia T, Bailey Z, Kaiser D, Auger N, King N, Kaufman JS. A Difference-in-Differences Approach to Assess the Effect of a Heat Action Plan on Heat-Related Mortality, and Differences in Effectiveness According to Sex, Age, and Socioeconomic Status (Montreal, Quebec). ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1694-1699. [PMID: 27203433 PMCID: PMC5089885 DOI: 10.1289/ehp203] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/14/2015] [Accepted: 05/04/2016] [Indexed: 05/10/2023]
Abstract
BACKGROUND The impact of heat waves on mortality and health inequalities is well documented. Very few studies have assessed the effectiveness of heat action plans (HAPs) on health, and none has used quasi-experimental methods to estimate causal effects of such programs. OBJECTIVES We developed a quasi-experimental method to estimate the causal effects associated with HAPs that allows the identification of heterogeneity across subpopulations, and to apply this method specifically to the case of the Montreal (Quebec, Canada) HAP. METHODS A difference-in-differences approach was undertaken using Montreal death registry data for the summers of 2000-2007 to assess the effectiveness of the Montreal HAP, implemented in 2004, on mortality. To study equity in the effect of HAP implementation, we assessed whether the program effects were heterogeneous across sex (male vs. female), age (≥ 65 years vs. < 65 years), and neighborhood education levels (first vs. third tertile). We conducted sensitivity analyses to assess the validity of the estimated causal effect of the HAP program. RESULTS We found evidence that the HAP contributed to reducing mortality on hot days, and that the mortality reduction attributable to the program was greater for elderly people and people living in low-education neighborhoods. CONCLUSION These findings show promise for programs aimed at reducing the impact of extreme temperatures and health inequities. We propose a new quasi-experimental approach that can be easily applied to evaluate the impact of any program or intervention triggered when daily thresholds are reached. Citation: Benmarhnia T, Bailey Z, Kaiser D, Auger N, King N, Kaufman J. 2016. A difference-in-differences approach to assess the effect of a heat action plan on heat-related mortality, and differences in effectiveness according to sex, age, and socioeconomic status (Montreal, Quebec). Environ Health Perspect 124:1694-1699; http://dx.doi.org/10.1289/EHP203.
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Affiliation(s)
- Tarik Benmarhnia
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
- Address correspondence to T. Benmarhnia, Institute for Health and Social Policy, McGill University, Meredith, Charles, House, 1130 Pine Ave. West, Montreal, Quebec H3A 1A3 Canada. Telephone: 15146384393. E-mail:
| | - Zinzi Bailey
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | - David Kaiser
- Direction de santé publique de l’Agence de la santé et des services sociaux de Montréal, Montréal, Québec, Canada
| | - Nathalie Auger
- Institut National de Santé Publique du Québec, Montréal, Québec, Canada
| | - Nicholas King
- Biomedical Ethics Unit, and
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Jay S. Kaufman
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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42
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Fuhrmann CM, Sugg MM, Konrad CE, Waller A. Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007-2011). J Community Health 2016; 41:146-56. [PMID: 26289379 DOI: 10.1007/s10900-015-0080-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Extreme heat is the leading cause of weather-related mortality in the U.S. Extreme heat also affects human health through heat stress and can exacerbate underlying medical conditions that lead to increased morbidity and mortality. In this study, data on emergency department (ED) visits for heat-related illness (HRI) and other selected diseases were analyzed during three heat events across North Carolina from 2007 to 2011. These heat events were identified based on the issuance and verification of heat products from local National Weather Service forecast offices (i.e. Heat Advisory, Heat Watch, and Excessive Heat Warning). The observed number of ED visits during these events were compared to the expected number of ED visits during several control periods to determine excess morbidity resulting from extreme heat. All recorded diagnoses were analyzed for each ED visit, thereby providing insight into the specific pathophysiological mechanisms and underlying health conditions associated with exposure to extreme heat. The most common form of HRI was heat exhaustion, while the percentage of visits with heat stroke was relatively low (<10%). The elderly (>65 years of age) were at greatest risk for HRI during the early summer heat event (8.9 visits per 100,000), while young and middle age adults (18-44 years of age) were at greatest risk during the mid-summer event (6.3 visits per 100,000). Many of these visits were likely due to work-related exposure. The most vulnerable demographic during the late summer heat event was adolescents (15-17 years of age), which may relate to the timing of organized sports. This demographic also exhibited the highest visit rate for HRI among all three heat events (10.5 visits per 100,000). Significant increases (p < 0.05) in visits with cardiovascular and cerebrovascular diseases were noted during the three heat events (3-8%). The greatest increases were found in visits with hypotension during the late summer event (23%) and sequelae during the early summer event (30%), while decreases were noted for visits with hemorrhagic stroke during the middle and late summer events (13-24%) and for visits with aneurysm during the early summer event (15%). Significant increases were also noted in visits with respiratory diseases (5-7%). The greatest increases in this category were found in visits with pneumonia and influenza (16%), bronchitis and emphysema (12%), and COPD (14%) during the early summer event. Significant increases in visits with nervous system disorders were also found during the early summer event (16%), while increases in visits with diabetes were noted during the mid-summer event (10%).
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Affiliation(s)
- Christopher M Fuhrmann
- Department of Geosciences, Mississippi State University, P.O. Box 5448, Mississippi State, MS, 39762, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA
| | - Charles E Konrad
- Southeast Regional Climate Center, Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna Waller
- Carolina Center for Health Informatics, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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The Short-Term Effect of Ambient Temperature on Mortality in Wuhan, China: A Time-Series Study Using a Distributed Lag Non-Linear Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070722. [PMID: 27438847 PMCID: PMC4962263 DOI: 10.3390/ijerph13070722] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/06/2016] [Accepted: 07/14/2016] [Indexed: 01/03/2023]
Abstract
Less evidence concerning the association between ambient temperature and mortality is available in developing countries/regions, especially inland areas of China, and few previous studies have compared the predictive ability of different temperature indictors (minimum, mean, and maximum temperature) on mortality. We assessed the effects of temperature on daily mortality from 2003 to 2010 in Jiang'an District of Wuhan, the largest city in central China. Quasi-Poisson generalized linear models combined with both non-threshold and double-threshold distributed lag non-linear models (DLNM) were used to examine the associations between different temperature indictors and cause-specific mortality. We found a U-shaped relationship between temperature and mortality in Wuhan. Double-threshold DLNM with mean temperature performed best in predicting temperature-mortality relationship. Cold effect was delayed, whereas hot effect was acute, both of which lasted for several days. For cold effects over lag 0-21 days, a 1 °C decrease in mean temperature below the cold thresholds was associated with a 2.39% (95% CI: 1.71, 3.08) increase in non-accidental mortality, 3.65% (95% CI: 2.62, 4.69) increase in cardiovascular mortality, 3.87% (95% CI: 1.57, 6.22) increase in respiratory mortality, 3.13% (95% CI: 1.88, 4.38) increase in stroke mortality, and 21.57% (95% CI: 12.59, 31.26) increase in ischemic heart disease (IHD) mortality. For hot effects over lag 0-7 days, a 1 °C increase in mean temperature above the hot thresholds was associated with a 25.18% (95% CI: 18.74, 31.96) increase in non-accidental mortality, 34.10% (95% CI: 25.63, 43.16) increase in cardiovascular mortality, 24.27% (95% CI: 7.55, 43.59) increase in respiratory mortality, 59.1% (95% CI: 41.81, 78.5) increase in stroke mortality, and 17.00% (95% CI: 7.91, 26.87) increase in IHD mortality. This study suggested that both low and high temperature were associated with increased mortality in Wuhan, and that mean temperature had better predictive ability than minimum and maximum temperature in the association between temperature and mortality.
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Davis RE, Hondula DM, Patel AP. Temperature Observation Time and Type Influence Estimates of Heat-Related Mortality in Seven U.S. Cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:795-804. [PMID: 26636734 PMCID: PMC4892923 DOI: 10.1289/ehp.1509946] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 11/18/2015] [Indexed: 05/03/2023]
Abstract
BACKGROUND Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat-mortality relationships. OBJECTIVES We examined how the strength of the relationship between daily heat-related mortality and temperature varies as a function of temperature observation time, lag, and calculation method. METHODS Long time series of daily mortality counts and hourly temperature for seven U.S. cities with different climates were examined using a generalized additive model. The temperature effect was modeled separately for each hour of the day (with up to 3-day lags) along with different methods of calculating daily maximum, minimum, and mean temperature. We estimated the temperature effect on mortality for each variable by comparing the 99th versus 85th temperature percentiles, as determined from the annual time series. RESULTS In three northern cities (Boston, MA; Philadelphia, PA; and Seattle, WA) that appeared to have the greatest sensitivity to heat, hourly estimates were consistent with a diurnal pattern in the heat-mortality response, with strongest associations for afternoon or maximum temperature at lag 0 (day of death) or afternoon and evening of lag 1 (day before death). In warmer, southern cities, stronger associations were found with morning temperatures, but overall the relationships were weaker. The strongest temperature-mortality relationships were associated with maximum temperature, although mean temperature results were comparable. CONCLUSIONS There were systematic and substantial differences in the association between temperature and mortality based on the time and type of temperature observation. Because the strongest hourly temperature-mortality relationships were not always found at times typically associated with daily maximum temperatures, temperature variables should be selected independently for each study location. In general, heat-mortality was more closely coupled to afternoon and maximum temperatures in most cities we examined, particularly those typically prone to heat-related mortality. CITATION Davis RE, Hondula DM, Patel AP. 2016. Temperature observation time and type influence estimates of heat-related mortality in seven U.S. cities. Environ Health Perspect 124:795-804; http://dx.doi.org/10.1289/ehp.1509946.
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Affiliation(s)
- Robert E. Davis
- Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, USA
- Address correspondence to R.E. Davis, 291 McCormick Rd., Charlottesville, VA 22904-4123 USA. Telephone: (434) 924-0579. E-mail:
| | - David M. Hondula
- Center for Policy Informatics, and School of Geographical Sciences and Urban Planning, Arizona State University, Phoenix, Arizona, USA
| | - Anjali P. Patel
- Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, USA
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Oudin Åström D, Åström C, Rekker K, Indermitte E, Orru H. High Summer Temperatures and Mortality in Estonia. PLoS One 2016; 11:e0155045. [PMID: 27167851 PMCID: PMC4864204 DOI: 10.1371/journal.pone.0155045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/22/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND On-going climate change is predicted to result in a growing number of extreme weather events-such as heat waves-throughout Europe. The effect of high temperatures and heat waves are already having an important impact on public health in terms of increased mortality, but studies from an Estonian setting are almost entirely missing. We investigated mortality in relation to high summer temperatures and the time course of mortality in a coastal and inland region of Estonia. METHODS We collected daily mortality data and daily maximum temperature for a coastal and an inland region of Estonia. We applied a distributed lag non-linear model to investigate heat related mortality and the time course of mortality in Estonia. RESULTS We found an immediate increase in mortality associated with temperatures exceeding the 75th percentile of summer maximum temperatures, corresponding to approximately 23°C. This increase lasted for a couple of days in both regions. The total effect of elevated temperatures was not lessened by significant mortality displacement. DISCUSSION We observed significantly increased mortality in Estonia, both on a country level as well as for a coastal region and an inland region with a more continental climate. Heat related mortality was higher in the inland region as compared to the coastal region, however, no statistically significant differences were observed. The lower risks in coastal areas could be due to lower maximum temperatures and cooling effects of the sea, but also better socioeconomic condition. Our results suggest that region specific estimates of the impacts of temperature extremes on mortality are needed.
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Affiliation(s)
- Daniel Oudin Åström
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
- Centre for Primary Health Care Research, Department of Clinical Science, Malmö, Lund University, Lund, Sweden
| | - Christofer Åström
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Kaidi Rekker
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Tartu Health Care College, Tartu, Estonia
| | - Ene Indermitte
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
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Urban A, Burkart K, Kyselý J, Schuster C, Plavcová E, Hanzlíková H, Štěpánek P, Lakes T. Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030284. [PMID: 26959044 PMCID: PMC4808947 DOI: 10.3390/ijerph13030284] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/31/2016] [Accepted: 02/23/2016] [Indexed: 01/28/2023]
Abstract
The study examines spatial patterns of effects of high temperature extremes on cardiovascular mortality in the Czech Republic at a district level during 1994–2009. Daily baseline mortality for each district was determined using a single location-stratified generalized additive model. Mean relative deviations of mortality from the baseline were calculated on days exceeding the 90th percentile of mean daily temperature in summer, and they were correlated with selected demographic, socioeconomic, and physical-environmental variables for the districts. Groups of districts with similar characteristics were identified according to socioeconomic status and urbanization level in order to provide a more general picture than possible on the district level. We evaluated lagged patterns of excess mortality after hot spell occurrences in: (i) urban areas vs. predominantly rural areas; and (ii) regions with different overall socioeconomic level. Our findings suggest that climatic conditions, altitude, and urbanization generally affect the spatial distribution of districts with the highest excess cardiovascular mortality, while socioeconomic status did not show a significant effect in the analysis across the Czech Republic as a whole. Only within deprived populations, socioeconomic status played a relevant role as well. After taking into account lagged effects of temperature on excess mortality, we found that the effect of hot spells was significant in highly urbanized regions, while most excess deaths in rural districts may be attributed to harvesting effects.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
- Faculty of Science, Charles University, Albertov 6, 12843 Prague 2, Czech Republic.
| | - Katrin Burkart
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY 10032, USA.
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 16521 Prague 6, Czech Republic.
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 60300 Brno, Czech Republic.
| | - Christian Schuster
- Department of Geography, Geoinformation Science Lab, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| | - Eva Plavcová
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
| | - Hana Hanzlíková
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
- Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic.
| | - Petr Štěpánek
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 60300 Brno, Czech Republic.
- Czech Hydrometeorological Institute, Regional Office Brno, Kroftova 2578, 61667 Brno, Czech Republic.
| | - Tobia Lakes
- Department of Geography, Geoinformation Science Lab, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
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Tian L, Qiu H, Sun S, Lin H. Emergency Cardiovascular Hospitalization Risk Attributable to Cold Temperatures in Hong Kong. Circ Cardiovasc Qual Outcomes 2016; 9:135-42. [DOI: 10.1161/circoutcomes.115.002410] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 01/27/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Linwei Tian
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Hong Qiu
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Shengzhi Sun
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Hualiang Lin
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
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Witt C, Schubert AJ, Jehn M, Holzgreve A, Liebers U, Endlicher W, Scherer D. The Effects of Climate Change on Patients With Chronic Lung Disease. A Systematic Literature Review. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 112:878-83. [PMID: 26900154 PMCID: PMC4736555 DOI: 10.3238/arztebl.2015.0878] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ever since higher overall mortality rates due to heat stress were reported during the European heat waves of 2003 and 2006, the relation between heat waves and disease-specific events has been an object of scientific study. The effects of heat waves on the morbidity and mortality of persons with chronic lung disease remain unclear. METHODS We conducted a systematic search using PubMed, the Cochrane Library, and Google Advanced Search to identify relevant studies published between 1990 and 2015. The reference lists of the primarily included articles were searched for further pertinent articles. All articles were selected according to the PRISMA guidelines. The heat-wave-related relative excess mortality was descriptively expressed as a mean daily rate ratio ([incidence 1]/[incidence 2]), and the cumulative excess risk (CER) was expressed in percent. RESULTS 33 studies with evaluable raw data concerning the effect of heat waves on patients with chronic lung disease (chronic obstructive pulmonary disease, bronchial asthma, pulmonary arterial hypertension, and idiopathic pulmonary fibrosis) were analyzed in this review. By deriving statistics from the overall data set, we arrived at the conclusion that future heat waves will-with at least 90% probability-result in a mean daily excess mortality (expressed as a rate ratio) of at least 1.018, and-with 50% probability-in a mean daily excess mortality of at least 1.028. These figures correspond, respectively, to 1.8% and 2.8% rises in the daily risk of death. CONCLUSION Heat waves significantly increase morbidity and mortality in patients with chronic lung disease. The argument that the excess mortality during heat waves is compensated for by a decrease in mortality in the subsequent weeks/months (mortality displacement) should not be used as an excuse for delay in implementing adaptive strategies to protect lung patients from this risk to their health.
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Affiliation(s)
- Christian Witt
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
- These authors share first authorship
| | - André Jean Schubert
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
- These authors share first authorship
| | - Melissa Jehn
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
| | | | - Uta Liebers
- Pneumological Oncology and Transplantology, Charité Universitätsmedizin Berlin
| | - Wilfried Endlicher
- Geography Department, Humboldt-Universität zu Berlin; on behalf of the KLIMZUG Research Group, Berlin
| | - Dieter Scherer
- Department of Ecology, Technische Universität Berlin; on behalf of the UCaSH Research Unit, Berlin
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Hanzlíková H, Plavcová E, Kynčl J, Kříž B, Kyselý J. Contrasting patterns of hot spell effects on morbidity and mortality for cardiovascular diseases in the Czech Republic, 1994-2009. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1673-1684. [PMID: 25744153 DOI: 10.1007/s00484-015-0974-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 02/11/2015] [Accepted: 02/11/2015] [Indexed: 06/04/2023]
Abstract
The study examines effects of hot spells on cardiovascular disease (CVD) morbidity and mortality in the population of the Czech Republic, with emphasis on differences between ischaemic heart disease (IHD) and cerebrovascular disease (CD) and between morbidity and mortality. Daily data on CVD morbidity (hospital admissions) and mortality over 1994-2009 were obtained from national hospitalization and mortality registers and standardized to account for long-term changes as well as seasonal and weekly cycles. Hot spells were defined as periods of at least two consecutive days with average daily air temperature anomalies above the 95% quantile during June to August. Relative deviations of mortality and morbidity from the baseline were evaluated. Hot spells were associated with excess mortality for all examined cardiovascular causes (CVD, IHD and CD). The increases were more pronounced for CD than IHD mortality in most population groups, mainly in males. In the younger population (0-64 years), however, significant excess mortality was observed for IHD while there was no excess mortality for CD. A short-term displacement effect was found to be much larger for mortality due to CD than IHD. Excess CVD mortality was not accompanied by increases in hospital admissions and below-expected-levels of morbidity prevailed during hot spells, particularly for IHD in the elderly. This suggests that out-of-hospital deaths represent a major part of excess CVD mortality during heat and that for in-hospital excess deaths CVD is a masked comorbid condition rather than the primary diagnosis responsible for hospitalization.
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Affiliation(s)
- Hana Hanzlíková
- Institute of Atmospheric Physics, The Czech Academy of Sciences, Boční II 1401, 141 31, Prague, Czech Republic.
- Faculty of Science, Charles University, Prague, Czech Republic.
- Institute of Geophysics, The Czech Academy of Sciences, Prague, Czech Republic.
| | - Eva Plavcová
- Institute of Atmospheric Physics, The Czech Academy of Sciences, Boční II 1401, 141 31, Prague, Czech Republic
| | - Jan Kynčl
- Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Bohumír Kříž
- Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, The Czech Academy of Sciences, Boční II 1401, 141 31, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
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