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Hu K, Wang S, Fei F, Song J, Chen F, Zhao Q, Shen Y, Fu J, Zhang Y, Cheng J, Zhong J, Yang X, Wu J. Modifying temperature-related cardiovascular mortality through green-blue space exposure. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2024; 20:100408. [PMID: 38560758 PMCID: PMC10979139 DOI: 10.1016/j.ese.2024.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Green-blue spaces (GBS) are pivotal in mitigating thermal discomfort. However, their management lacks guidelines rooted in epidemiological evidence for specific planning and design. Here we show how various GBS types modify the link between non-optimal temperatures and cardiovascular mortality across different thermal extremes. We merged fine-scale population density and GBS data to create novel GBS exposure index. A case time series approach was employed to analyse temperature-cardiovascular mortality association and the effect modifications of type-specific GBSs across 1085 subdistricts in south-eastern China. Our findings indicate that both green and blue spaces may significantly reduce high-temperature-related cardiovascular mortality risks (e.g., for low (5%) vs. high (95%) level of overall green spaces at 99th vs. minimum mortality temperature (MMT), Ratio of relative risk (RRR) = 1.14 (95% CI: 1.07, 1.21); for overall blue spaces, RRR = 1.20 (95% CI: 1.12, 1.29)), while specific blue space types offer protection against cold temperatures (e.g., for the rivers at 1st vs MMT, RRR = 1.17 (95% CI: 1.07, 1.28)). Notably, forests, parks, nature reserves, street greenery, and lakes are linked with lower heat-related cardiovascular mortality, whereas rivers and coasts mitigate cold-related cardiovascular mortality. Blue spaces provide greater benefits than green spaces. The severity of temperature extremes further amplifies GBS's protective effects. This study enhances our understanding of how type-specific GBS influences health risks associated with non-optimal temperatures, offering valuable insights for integrating GBS into climate adaptation strategies for maximal health benefits.
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Affiliation(s)
- Kejia Hu
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
- Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, 310058, China
| | - Shiyi Wang
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Jinglu Song
- Department of Urban Planning and Design, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, China
| | - Feng Chen
- Zhejiang Institute of Meteorological Sciences, Hangzhou, 310008, China
| | - Qi Zhao
- School of Public Health, Shandong University, Jinan, 250012, China
| | - Yujie Shen
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Jingqiao Fu
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Jian Cheng
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xuchao Yang
- Ocean College, Zhejiang University, Zhoushan, 316021, China
| | - Jiayu Wu
- College of Agriculture and Biotechnology, Zhejiang University, Hangzhou, 310058, China
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Montoro-Ramírez EM, Parra-Anguita L, Álvarez-Nieto C, Parra G, López-Medina IM. Climate change effects in older people's health: A scoping review. J Adv Nurs 2024. [PMID: 38895960 DOI: 10.1111/jan.16270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/01/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Climate change has serious consequences for the morbidity and mortality of older adults. OBJECTIVE To identify the effects of climate change on older people's health. METHODS A scoping review was conducted following the Joanna Briggs Institute guidelines and the PRISMA-ScR checklist. Quantitative research and reports from organizations describing the effects of climate change on older people were selected. RESULTS Sixty-three full-text documents were selected. Heat and air pollution were the two factors that had the most negative effects on cardiovascular and respiratory morbidity and mortality in older people. Mental health and cognitive function were also affected. CONCLUSIONS Climate change affects several health problems in older individuals, especially high temperatures and air pollution. Nursing professionals must have the necessary skills to respond to the climate risks in older adults. More instruments are required to determine nursing competencies on climate change and the health of this population group. PATIENT OF PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
| | - Laura Parra-Anguita
- Department of Nursing, Faculty of Health Sciences, University of Jaen, Jaen, Spain
| | - Carmen Álvarez-Nieto
- Department of Nursing, Faculty of Health Sciences, University of Jaen, Jaen, Spain
| | - Gema Parra
- Animal Biology, Plant Biology and Ecology Department, University of Jaen, Jaen, Spain
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Singh N, Areal AT, Breitner S, Zhang S, Agewall S, Schikowski T, Schneider A. Heat and Cardiovascular Mortality: An Epidemiological Perspective. Circ Res 2024; 134:1098-1112. [PMID: 38662866 PMCID: PMC11042530 DOI: 10.1161/circresaha.123.323615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
As global temperatures rise, extreme heat events are projected to become more frequent and intense. Extreme heat causes a wide range of health effects, including an overall increase in morbidity and mortality. It is important to note that while there is sufficient epidemiological evidence for heat-related increases in all-cause mortality, evidence on the association between heat and cause-specific deaths such as cardiovascular disease (CVD) mortality (and its more specific causes) is limited, with inconsistent findings. Existing systematic reviews and meta-analyses of epidemiological studies on heat and CVD mortality have summarized the available evidence. However, the target audience of such reviews is mainly limited to the specific field of environmental epidemiology. This overarching perspective aims to provide health professionals with a comprehensive overview of recent epidemiological evidence of how extreme heat is associated with CVD mortality. The rationale behind this broad perspective is that a better understanding of the effect of extreme heat on CVD mortality will help CVD health professionals optimize their plans to adapt to the changes brought about by climate change and heat events. To policymakers, this perspective would help formulate targeted mitigation, strengthen early warning systems, and develop better adaptation strategies. Despite the heterogeneity in evidence worldwide, due in part to different climatic conditions and population dynamics, there is a clear link between heat and CVD mortality. The risk has often been found to be higher in vulnerable subgroups, including older people, people with preexisting conditions, and the socioeconomically deprived. This perspective also highlights the lack of evidence from low- and middle-income countries and focuses on cause-specific CVD deaths. In addition, the perspective highlights the temporal changes in heat-related CVD deaths as well as the interactive effect of heat with other environmental factors and the potential biological pathways. Importantly, these various aspects of epidemiological studies have never been fully investigated and, therefore, the true extent of the impact of heat on CVD deaths remains largely unknown. Furthermore, this perspective also highlights the research gaps in epidemiological studies and the potential solutions to generate more robust evidence on the future consequences of heat on CVD deaths.
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Affiliation(s)
- Nidhi Singh
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Ashtyn Tracy Areal
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
| | - Siqi Zhang
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
- Medical Research School, Heinrich Heine University Düsseldorf, Germany (A.T.A.)
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
- IBE-Chair of Epidemiology, Faculty of Medicine, LMU Munich, Neuherberg, Germany (S.B.)
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Stefan Agewall
- Institute of Clinical Medicine, University of Oslo, Norway (S.A.)
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden (S.A.)
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany (N.S., A.T.A., T.S.)
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany (S.B., A.S.)
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Rezaee R, Fathi S, Maleki A, Aboubakri O, Li G, Safari M, Sharafkhani R, Zarei M. Summer heat waves and their mortality risk over a 14-year period in a western region of Iran. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2081-2091. [PMID: 37845501 DOI: 10.1007/s00484-023-02564-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
Compared to previous decade, impact of heat waves (HWs) on mortality in recent years needs to be discussed in Iran. We investigated temporal change in added impact of summer HWs on mortality in eight cities of Iran. The pooled length of HWs was compared between 2015-2022 and 2008-2014 using random and fixed-effects of meta-analysis regression model. The temporal change in impact of HWs was evaluated through interaction effect between crossbasis function of HW and year in a two-stage time varying model. In order to pool the reduced coefficients of each period, multivariate meta-regression model, including city-specific temperature and temperature range as heterogenicity factors, was used. In addition to relative risk (RR), attributable fraction (AF) of HW in the two periods was also estimated in each city. In the last years, the frequency of all HWs was higher and the weak HWs were significantly longer. The only significant RR was related to the lowest and low severe HWs which was observed in the second period. In terms of AF, compared to the strong HWs, all weak HWs caused a considerable excess mortality in all cities and second period. The subgroup analysis revealed that the significant impact in the second period was mainly related to females and elderlies. The increased risk and AF due to more frequent and longer HWs (weak HWs) in the last years highlights the need for mitigation strategies in the region. Because of uncertainty in the results of severe HWs, further elaborately investigation of the HWs is need.
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Affiliation(s)
- Reza Rezaee
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Serveh Fathi
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Afshin Maleki
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Omid Aboubakri
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University, School of Public Health, Beijing, China
| | - Mahdi Safari
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Rahim Sharafkhani
- School of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| | - Mozhdeh Zarei
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Deputy of Research and Technology, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Vanos J, Guzman-Echavarria G, Baldwin JW, Bongers C, Ebi KL, Jay O. A physiological approach for assessing human survivability and liveability to heat in a changing climate. Nat Commun 2023; 14:7653. [PMID: 38030628 PMCID: PMC10687011 DOI: 10.1038/s41467-023-43121-5] [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: 03/14/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Most studies projecting human survivability limits to extreme heat with climate change use a 35 °C wet-bulb temperature (Tw) threshold without integrating variations in human physiology. This study applies physiological and biophysical principles for young and older adults, in sun or shade, to improve current estimates of survivability and introduce liveability (maximum safe, sustained activity) under current and future climates. Our physiology-based survival limits show a vast underestimation of risks by the 35 °C Tw model in hot-dry conditions. Updated survivability limits correspond to Tw~25.8-34.1 °C (young) and ~21.9-33.7 °C (old)-0.9-13.1 °C lower than Tw = 35 °C. For older female adults, estimates are ~7.2-13.1 °C lower than 35 °C in dry conditions. Liveability declines with sun exposure and humidity, yet most dramatically with age (2.5-3.0 METs lower for older adults). Reductions in safe activity for younger and older adults between the present and future indicate a stronger impact from aging than warming.
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Affiliation(s)
- Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA.
| | - Gisel Guzman-Echavarria
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - Jane W Baldwin
- Department of Earth System Science, University of California Irvine, Irvine, CA, USA
- Lamont-Doherty Earth Observatory, Palisades, NY, USA
| | - Coen Bongers
- Department of Medical Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, NSW, Australia
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Li Z, Li X, Yan F, Liu L, Bai T, Jiang W, Dong R. Remodeling of the cardiovascular hemodynamic environment by lower limb heat exposure: A computational fluid dynamic study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 238:107626. [PMID: 37263116 DOI: 10.1016/j.cmpb.2023.107626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/15/2023] [Accepted: 05/27/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Lower limb heat exposure (LLHE) is a promising strategy for the daily management of cardiovascular health because of its non-pharmaceutical advantages. To support the application of this strategy in cardiovascular protection, we examined its impact on the global hemodynamic environment. METHODS Skin blood flow (SBF) of eight locations on the lower limbs was measured before and after LLHE (40 °C and 44 °C) in ten healthy subjects by using a laser Doppler flowmeter. A closed-loop model of circulation uses changes in SBF to quantify the influence of LLHE on the blood flow of the arterial trunk (from ascending aorta to the femoral artery) and visceral branches (coronary, celiac, renal, and mesenteric arteries). RESULTS The SBF in all locations tested on the lower limbs increased significantly (p<0.001) with LLHE and a 3.39-fold and 7.40-fold increase in mean SBF were observed under 40 °C and 44 °C conditions, respectively. In the model, the peak (3.9-25.1%), end-diastolic (13.7-107.3%), and mean blood flow (8.5-86.5%) in the arterial trunk increased with the increase in temperature, but the retrograde flow in the thoracic aorta and abdominal aorta Ⅰ increased at least twice in the diastolic period. Furthermore, LLHE also increased the blood flow of the visceral branches (2.5-20.7%). CONCLUSION These findings suggest that LLHE is expected to be a daily strategy for enhancing the functions of both the arterial trunk and visceral arteries, but the increased blood flow reversal in the thoracic and abdominal aortas warrants further investigation.
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Affiliation(s)
- Zhongyou Li
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China
| | - Xiao Li
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China
| | - Fei Yan
- Chongqing University Three Gorges Hospital, Chongqing University, Chongqing, China
| | - Lingjun Liu
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Taoping Bai
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China
| | - Wentao Jiang
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China.
| | - Ruiqi Dong
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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Liu J, Dong H, Li M, Wu Y, Zhang C, Chen J, Yang Z, Lin G, Liu DL, Yang J. Projecting the excess mortality due to heatwave and its characteristics under climate change, population and adaptation scenarios. Int J Hyg Environ Health 2023; 250:114157. [PMID: 36989996 DOI: 10.1016/j.ijheh.2023.114157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Heatwaves have significant adverse effects on human health. The frequency, duration, and intensity of heatwaves are projected to increase dramatically, in the context of global warming. However, there are few comprehensive assessments of the health impact of heatwaves considering different definitions, and their characteristics under climate change scenarios. OBJECTIVE We aimed to compare future excess mortality related to heatwaves among different definitions under climate change, population, and adaptation scenarios in China and further explore the mortality burden associated with heatwave characteristics. METHODS Daily data during 2010-2019 were collected in Guangzhou, China. We adopted nine common heatwave definitions and applied quasi-Poisson models to estimate the effects of heatwaves and their characteristics' impact on mortality. We then projected the excess mortality associated with heatwaves and their characteristics concerning climate change, population, and adaptation scenarios. RESULTS The relative risks of the nine common heatwave definitions ranged from 1.05 (95% CI: 1.01, 1.10) to 1.24 (95% CI: 1.13, 1.35). Heatwave-related excess mortality will consistently increase in the future decades considering multiple heatwave definitions, with more rapidly increasing rates under the Shared Socioeconomic Path5-8.5 and non-adaptability scenarios. Regarding heatwave characteristics, the intensity is the main factor involved in the threat of heatwaves. The increasing trend of characteristic-related mortality burden is similar to that of heatwaves, and the mortality burden caused by the duration of the heatwaves was the largest among all characteristics. CONCLUSIONS This study provides a comprehensive picture of the impact of heatwaves and their characteristics on public health under various climate change scenarios, population changes, and adaptive assumptions. The results may provide important public health implications for policymakers in planning climate change adaptation and mitigation policies, and implementing specific plans.
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Rai M, Breitner S, Huber V, Zhang S, Peters A, Schneider A. Temporal variation in the association between temperature and cause-specific mortality in 15 German cities. ENVIRONMENTAL RESEARCH 2023; 229:115668. [PMID: 36958378 DOI: 10.1016/j.envres.2023.115668] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND There is limited evidence of temporal changes in the association between air temperature and the risk of cause-specific cardiovascular [CVD] and respiratory [RD] mortality. METHOD We explored temporal variations in the association between short-term exposures to air temperature and non-accidental and cause-specific CVD and RD mortality in the 15 largest German cities over 24 years (1993-2016) using time-stratified time series analysis. We applied location-specific confounder-adjusted Poisson regression with distributed lag non-linear models with a lag period of 14 days to estimate the temperature-mortality associations. We then pooled the estimates by a multivariate meta-analytical model. We analysed the whole study period and the periods 1993-2004 and 2005-16, separately. We also carried out age- and sex-stratified analysis. Cold and heat effects are reported as relative risk [RR] at the 1st and the 99th temperature percentile, relative to the 25th and the 75th percentile, respectively. RESULT We analysed a total of 3,159,292 non-accidental, 1,063,198 CVD and 183,027 RD deaths. Cold-related RR for CVD mortality was seen to rise consistently over time from 1.04 (95% confidence interval [95% CI] 1.02, 1.06) in the period 1993-2004 to 1.10 (95% CI 1.09, 1.11) in the period 2005-16. A similar increase in cold-related RR was also observed for RD mortality with risk increasing from 0.99 (95% CI 0.96, 1.03) to 1.07 (95% CI 1.03, 1.10). Cold-related ischemic, cerebrovascular, and heart failure mortality risk were seen to be increasing over time. Similarly, COPD, the commonly speculated driver of heat-related RD mortality was found to have a constant heat-related risk over time. Males were increasingly vulnerable to cold with time for all causes of death. Females showed increasing sensitivity to cold for CVD mortality. Our results indicated a significant increased cold and heat vulnerability of the youngest age-groups (<64) to non-accidental and RD mortality, respectively. Similarly, the older age group (>65) were found to have significantly increased susceptibility to cold for CVD mortality. CONCLUSION We found evidence of rising population susceptibility to both heat- and cold-related CVD and RD mortality risk from 1993 to 2016. Climate change mitigation and targeted adaptation strategies might help to reduce the number of temperature-related deaths in the future.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Aguilar M, Muñoz-Aguirre P, Cortés-Valencia A, Flores-Torres MH, Catzin-Kuhlmann A, López-Ridaura R, Lajous M, Rodriguez BL, Cantú-Brito C, Denova-Gutiérrez E. Sun Exposure and Intima-Media Thickness in the Mexican Teachers' Cohort Study. J Womens Health (Larchmt) 2023; 32:366-374. [PMID: 36795998 DOI: 10.1089/jwh.2022.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Objective: To determine whether long-term sun exposure has a protective role in subclinical cardiovascular disease in adult Mexican women. Materials and Methods: We conducted a cross-sectional analysis of a sample of women from the Mexican Teachers' Cohort (MTC) study. Sun exposure was assessed in the MTC 2008 baseline questionnaire, in which women were asked about their sun-related behavior. Vascular neurologists measured carotid intima-media thickness (IMT) using standard techniques. Multivariate linear regression models were used to estimate the difference in mean IMT and 95% confidence intervals (95% CIs), according to categories of sun exposure and multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% CIs for carotid atherosclerosis. Results: The mean age of participants was 49.6 ± 5.5 years, the mean IMT was 0.678 ± 0.097 mm, and the mean accumulated hours of weekly sun exposure were 2.9 ± 1.9. Prevalence of carotid atherosclerosis was 20.9%. Compared with women in the lowest quartile of sun exposure, women in the highest quartile had lower mean IMT, but this was not significant in the multivariable adjusted analysis. (Adjusted mean % difference: -0.8; 95% CI: -2.3 to 0.8). The multivariate adjusted ORs of carotid atherosclerosis were 0.54 (95% CI: 0.24-1.18) for women who were exposed 9 hours. For women who denied regular sunscreen use, those in the higher exposure category (9 hours) had lower mean IMT compared with those in the lower category (multivariable-adjusted mean % difference = -2.67; 95% CI: -6.9 to -1.5). Conclusions: We observed that cumulative sun exposure was inversely associated with IMT and subclinical carotid atherosclerosis. If these findings are further replicated and seen for other cardiovascular outcomes, sun exposure could be an easy, affordable strategy to lower overall cardiovascular risk.
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Affiliation(s)
- Mercedes Aguilar
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Paloma Muñoz-Aguirre
- CONACYT-Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Adrian Cortés-Valencia
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Mario H Flores-Torres
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Andrés Catzin-Kuhlmann
- Department of Medicine, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Ruy López-Ridaura
- Dirección General, Centro Nacional de Programas Preventivos y Control de Enfermedades, Mexico City, Mexico
| | - Martin Lajous
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Beatriz L Rodriguez
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.,Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, Mexico
| | - Carlos Cantú-Brito
- Department of Neurology, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Edgar Denova-Gutiérrez
- Department of Healthy Environments and Chronic Disease Prevention, Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
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Shivarov V, Shivarov H, Yordanov A. Seasonality of Deaths Due to Heart Diseases among Cancer Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1651. [PMID: 36422190 PMCID: PMC9693160 DOI: 10.3390/medicina58111651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/20/2022] [Accepted: 11/11/2022] [Indexed: 08/30/2023]
Abstract
Background and Objectives: Cancer patients are at increased short- and long-term risk of cardiac toxicity and mortality. It is well-known that cardiac morbidity and mortality follows a seasonal pattern. Here we address the question of whether heart disease-related fatalities among cancer patients also follow a seasonal pattern. Materials and Methods: We performed a retrospective analysis of seasonality of deaths due to heart diseases (n = 503,243) in patients with newly diagnosed cancer reported during the period from 1975 to 2016 in the US's largest cancer registry-the Surveillance, Epidemiology, and End Results (SEER) database. Seasonality was assessed through a classical cosinor model assuming a single annual peak. Results: We identified a significant seasonal peak in the first half of November. A peak with identical features was for all subgroups of patients defined based on demographic characteristics. This was also the case when analysis was performed on subgroups defined by the type of malignancy. Only patients with acute leukemias, pancreatic cancer and nervous system malignancies did not have a seasonal pattern in heart disease-related fatalities. Conclusion: the rate of heart disease-related fatalities after cancer diagnosis follows a seasonal pattern similar to that observed for the general population, albeit with an earlier peak in November. This suggests that close monitoring of the cardiovascular system in cancer survivors must be particularly active from late autumn and during the entire winter period.
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Affiliation(s)
- Velizar Shivarov
- Department of Experimental Research, Medical University Pleven, 5800 Pleven, Bulgaria
| | | | - Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria
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11
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Wan K, Feng Z, Hajat S, Doherty RM. Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets. Environ Health 2022; 21:99. [PMID: 36284320 PMCID: PMC9594922 DOI: 10.1186/s12940-022-00912-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adverse health impacts have been found under extreme temperatures in many parts of the world. The majority of such research to date for the UK has been conducted on populations in England, whilst the impacts of ambient temperature on health outcomes in Scottish populations remain largely unknown. METHODS This study uses time-series regression analysis with distributed lag non-linear models to characterise acute relationships between daily mean ambient temperature and mortality in Scotland including the four largest cities (Aberdeen, Dundee, Edinburgh and Glasgow) and three regions during 1974-2018. Increases in mortality risk under extreme cold and heat in individual cities and regions were aggregated using multivariate meta-analysis. Cold results are summarised by comparing the relative risk (RR) of death at the 1st percentile of localised temperature distributions compared to the 10th percentile, and heat effects as the RR at the 99th compared to the 90th percentile. RESULTS Adverse cold effects were observed in all cities and regions, and heat effects were apparent in all cities and regions except northern Scotland. Aggregate all-cause mortality risk in Scotland was estimated to increase by 10% (95% confidence interval, CI: 7%, 13%) under extreme cold and 4% (CI: 2%, 5%) under extreme heat. People in urban areas experienced higher mortality risk under extreme cold and heat than those in rural regions. The elderly had the highest RR under both extreme cold and heat. Males experienced greater cold effects than females, whereas the reverse was true with heat effects, particularly among the elderly. Those who were unmarried had higher RR than those married under extreme heat, and the effect remained after controlling for age. The younger population living in the most deprived areas experienced higher cold and heat effects than in less deprived areas. Deaths from respiratory diseases were most sensitive to both cold and heat exposures, although mortality risk for cardiovascular diseases was also heightened, particularly in the elderly. Cold effects were lower in the most recent 15 years, which may be linked to policies and actions in preventing the vulnerable population from cold impacts. No temporal trend was found with the heat effect. CONCLUSIONS This study assesses mortality risk associated with extreme temperatures in Scotland and identifies those groups who would benefit most from targeted actions to reduce cold- and heat-related mortalities.
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Affiliation(s)
- Kai Wan
- School of GeoSciences, University of Edinburgh, Edinburgh, UK.
| | - Zhiqiang Feng
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
- Scottish Centre for Administrative Data Research, School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre On Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth M Doherty
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
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12
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Park C, Yang J, Lee W, Kang C, Song IK, Kim H. Excess out-of-hospital cardiac arrests due to ambient temperatures in South Korea from 2008 to 2018. ENVIRONMENTAL RESEARCH 2022; 212:113130. [PMID: 35339469 DOI: 10.1016/j.envres.2022.113130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/05/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
Out-of-hospital cardiac arrest (OHCA) is a notable public health issue with negative outcomes, such as high mortality and aftereffects. Additionally, the adverse effects of extreme temperatures on health have become more important under climate change; however, few studies have investigated the relationship between temperature and OHCA. In this study, we examined the association between temperature and OHCA and its underlying risk factors. We conducted a two-stage time-series analysis using a Poisson regression model with a distributed lag non-linear model (DLNM) and meta-analysis, based on a nationwide dataset from South Korea (2008-2018). We found that 17.4% of excess OHCA was attributed to cold, while 0.9% was attributed to heat. Based on central estimates, excess OHCA attributed to cold were more prominent in the population with hypertension comorbidity (31.0%) than the populations with diabetes (24.3%) and heart disease (17.4%). Excess OHCA attributed to heat were larger in the populations with diabetes (2.7%) and heart disease comorbidity (2.7%) than the population with hypertension (1.2%) based on central estimates. Furthermore, the time-varying excess OHCA attributed to cold have decreased over time, and although those of heat did not show a certain pattern during the study period, there was a weak increasing tendency since 2011. In conclusion, we found that OHCAs were associated with temperature, and cold temperatures showed a greater impact than that of hot temperatures. The effects of cold and hot temperatures on OHCA were more evident in the populations with hypertension, diabetes, and heart diseases, compared to the general population. In addition, the impacts of heat on OHCA increased in recent years, while those of cold temperatures decreased. Our results provide scientific evidence for policymakers to mitigate the OHCA burden attributed to temperature.
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Affiliation(s)
- Chaerin Park
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Juyeon Yang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, United States
| | - Cinoo Kang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - In-Kyung Song
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
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13
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Semiparametric Permutation-Based Change Point Detection with an Application on Chicago Cardiovascular Mortality Data. MATHEMATICS 2022. [DOI: 10.3390/math10060857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Climate change has several negative effects on health, including cardiovascular disease. Many studies have considered the effect of temperature on cardiovascular disease and found that there is an association between extreme levels of temperature, cold and hot, and cardiovascular disease. However, the number of articles that have studied the change point or the threshold in temperature is very limited. To the best of our knowledge, there have been no studies focusing on detecting and testing the significance of the change point in the temperature–cardiovascular relationship. Identifying the change point in cities may help to design better adaptive strategies in view of predicted weather changes in the future. Knowing the change points of temperature may prevent further mortality associated with the weather changes. Therefore, in this paper, we propose a unified approach that simultaneously estimates the semiparametric relationship and detects the significant point. A semiparametric generalized change point single index model is introduced as our unified approach by adjusting for several weather variables. A permutation-based testing procedure to detect the change point is introduced as well. A simulation study is conducted to evaluate the proposed algorithm. The advantage of our proposed approach is demonstrated using the cardiovascular mortality data of the city of Chicago, USA.
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14
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Constantinou A, Oikonomou S, Konstantinou C, Makris KC. A randomized cross-over trial investigating differences in 24-h personal air and skin temperatures using wearable sensors between two climatologically contrasting settings. Sci Rep 2021; 11:22020. [PMID: 34759278 PMCID: PMC8580978 DOI: 10.1038/s41598-021-01180-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/25/2021] [Indexed: 11/08/2022] Open
Abstract
The influence of elevated air temperatures recorded in various urban microenvironments in adversely impacting biologically relevant disease end points has not yet been extensively tackled. This study is a post hoc analysis of the TEMP pilot trial, a randomized 2 × 2 cross-over trial that examined changes in metabolic and stress hormonal profiles of healthy adults in two settings (urban vs. rural) with distinctly different climatological characteristics during the Mediterranean summer. This analysis aimed to study the association between the 24-h personal air or skin temperature sensor measurements and the diary-based location type (indoors vs. outdoors) in urban (seaside) vs. rural (higher in altitude) microenvironments. Out of 41 eligible participants, a total of 37 participants were included in this post-hoc TEMP trial analysis. Wearable sensors recorded personal air temperature, skin temperature, and activity (as a surrogate marker of physical activity) in each setting, while a time-stamped personal diary recorded the types of indoor or outdoor activities. Temperature peaks during the 24-h sampling period were detected using a peak finding algorithm. Mixed effect logistic regression models were fitted for the odds of participant location (being indoors vs. outdoors) as a function of setting (urban vs. rural) and sensor-based personal temperature data (either raw temperature values or number of temperature peaks). During the study period (July-end of September), median [interquartile range, IQR] personal air temperature in the rural (higher altitude) settings was 1.5 °C lower than that in the urban settings (27.1 °C [25.4, 29.2] vs. 28.6 °C [27.1, 30.5], p < 0.001), being consistent with the Mediterranean climate. Median [IQR] personal air temperature in indoor (micro)environments was lower than those in outdoors (28.0 °C [26.4, 30.3] vs 28.5 °C [26.8, 30.7], p < 0.001). However, median [IQR] skin temperature was higher in indoor (micro)environments vs. outdoors (34.8 °C [34.0, 35.6] and 33.9 °C [32.9, 34.8], p < 0.001) and the number of both personal air and skin temperature peaks was higher indoors compared to outdoors (median [IQR] 3.0 [2.0,4.0] vs 1.0 [1.0,1.3], p < 0.007, for the skin sensors). A significant association between the number of temperature peaks and indoor location types was observed with either the personal air sensor (OR 3.1; 95% CI 1.2-8.2; p = 0.02) or the skin sensor (OR 3.7; 95% CI 1.4-9.9; p = 0.01), suggesting higher number of indoor air temperature fluctuations. Amidst the global climate crisis, more population health studies or personalized medicine approaches that utilize continuous tracking of individual-level air/skin temperatures in both indoor/outdoor locations would be warranted, if we were to better characterize the disease phenotype in response to climate change manifestations.
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Affiliation(s)
- Andria Constantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Stavros Oikonomou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
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Dastoorpoor M, Khodadadi N, Khanjani N, Borsi SH. Physiological Equivalent Temperature (PET) index and cardiovascular hospital admissions in Ahvaz, southwest of Iran. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:653-661. [PMID: 34665079 DOI: 10.1080/19338244.2021.1990830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Evidence shows that climate change may have adverse effects on human health. The purpose of this study was to investigate the relation between Physiologically Equivalent Temperature (PET) and cardiovascular hospital admissions in Ahvaz. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression models were used to investigate the effect of PET on hospital admissions. Low PET values (6.4 °C, 9.9 °C and 16.9 °C) in all lags, except lag 0-30, significantly decreased the risk of hospital admissions for total cardiovascular diseases, hypertension, ischemic heart diseases, and cardiovascular admissions in men, women and ≤65 years. But, low PET (6.4 °C) in lags 0 and 0-2 significantly increased the risk of hospital admissions for cerebrovascular diseases; and high PET values increased the risk of ischemic heart diseases and in men. Both cold and hot stress are involved in cardiovascular hospital admissions.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Hamid Borsi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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16
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Tsoutsoubi L, Ioannou LG, Flouris AD. Mortality due to circulatory causes in hot and cold environments in Greece. SCAND CARDIOVASC J 2021; 55:333-335. [PMID: 34494493 DOI: 10.1080/14017431.2021.1970801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Ambient temperature can affect the survival rate of humans. Studies have shown a relationship between ambient temperature and mortality rate in hot and cold environments. This effect of ambient temperature on mortality seems to be more pronounced in older people. The aim of this study is to examine the effects of thermal stress on cardiovascular mortality and the associated relative risk per degree Celsius in Greek individuals ≥70 years old. Mortality data 1999-2012 were matched with the midday temperature. The present study found a higher circulatory mortality when ambient temperature is below or above the temperature range 6 to 39 °C.
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Affiliation(s)
- Lydia Tsoutsoubi
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Leonidas G Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Andreas D Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
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17
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He F, Su W, Wu R, Li H, Lou L, Wu A, Xie L, Du Y, Wu S. The effect of cold exposure on serum cholesterol is dependent upon ApoE. J Therm Biol 2021; 99:102972. [PMID: 34420615 DOI: 10.1016/j.jtherbio.2021.102972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Several lines of evidence indicate that cold stimulation may not only activate brown adipose tissue (BAT) and the white adipose tissue (WAT), but also regulate the lipid metabolism and influence the development of atherosclerosis. However, the study of cold exposure affecting cholesterol metabolism have opposite results in different experiments, and Apolipoprotein E (ApoE) may play an important role. There is still a lack of complete research to illustrate this problem. METHODS In this study, we first analyzed and discussed the activation of interscapular brown adipose tissue (iBAT), inguinal white adipose tissue (iWAT) and epididymal white adipose tissue (eWAT) under cold exposure (4 °C) in male wild-type C57BL/6 J (WT) and ApoE-deficient mice (ApoE-/-) fed high-fat diet (HFD) for 4 weeks. Subsequently, we investigated the effect of cold exposure on blood lipid profiles in both models. We further explored whether cold exposure can reduce serum cholesterol. RESULTS In both WT and ApoE-/- mice, cold exposure activates iBAT and iWAT, as well as hardly affects eWAT. In WT mice,4 weeks cold exposure (4 °C) reduces serum triglyceride by 28%, cholesterol by 30% and LDL-cholesterol by 63%. In ApoE-/- mice, cold stimulation decreases serum triglyceride by 59%, but increases cholesterol by 20% and LDL-cholesterol by 25%. CONCLUSIONS Based on these findings, we conclude that cold exposure decreases serum cholesterol is dependent upon the existence of ApoE.
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Affiliation(s)
- Fang He
- National Drug Clinical Trial Institution, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Wenquan Su
- National Drug Clinical Trial Institution, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Rongrong Wu
- National Drug Clinical Trial Institution, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - He Li
- National Drug Clinical Trial Institution, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Lixia Lou
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Aiming Wu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Lifang Xie
- Susan Samueli Integrative Health Institute, School of Medicine, University of California Irvine, USA
| | - Yawei Du
- National Drug Clinical Trial Institution, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Shengxian Wu
- National Drug Clinical Trial Institution, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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18
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Min JY, Lee HS, Choi YS, Min KB. Association between income levels and prevalence of heat- and cold-related illnesses in Korean adults. BMC Public Health 2021; 21:1264. [PMID: 34187422 PMCID: PMC8243613 DOI: 10.1186/s12889-021-11227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Given that low income worsens health outcomes, income differences may affect health disparities in weather-related illnesses. The aim of this study was to investigate the association between income levels and prevalence of heat- and cold-related illnesses among Korean adults. METHODS The current study comprised 535,186 participants with all variables on income and health behaviors. Patients with temperature-related illnesses were defined as individuals with outpatient medical code of heat- and cold-related illnesses. We categorized individual income into three levels: "low" for the fourth quartile (0-25%), "middle" for the second and the third quartiles (25-75%), and "high" for the first quartile (75-100%). To examine income-related health disparities, Cox proportional hazard regression was performed. Hazard ratios (HRs) and 95% CI (confidence interval) for heat- and cold-related illnesses were provided. The model adjusted for age, sex, smoking status, alcohol drinking, exercise, body mass index, hypertension, hyperglycemia, and local income per capita. RESULTS A total of 5066 (0.95%) and 3302 (0.62%) cases identified patients with heat- and cold-related illnesses, respectively. Compared with high income patients, the adjusted HR for heat-related illnesses was significantly increased in the low income (adjusted HR = 1.103; 95% CI: 1.022-1.191). For cold-related illnesses, participants with low income were likely to have 1.217 times greater likelihood than those with high income (95% CI: 1.107-1.338), after adjusting for other covariates. In the stratified analysis of age (20-64 years and over 65 years) and sex, there was no difference in the likelihood of heat-related illnesses according to income levels. On the other hand, an HR for cold-related illnesses was higher in patients aged 20 to 64 years than in those aged over 65 years. Male with low income had also a higher HR for cold-related illnesses than female with low income. CONCLUSIONS Our results showed that heat- or cold-related illnesses were more prevalent in Koreans with low income than those with high income. Strategies for low-income subgroups were needed to reduce greater damage due to the influence of extreme temperature events and to implement effective adaptation.
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Affiliation(s)
- Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Hyeong-Seong Lee
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Yeon-Soo Choi
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Wang C, Solís P, Villa L, Khare N, Wentz EA, Gettel A. Spatial Modeling and Analysis of Heat-Related Morbidity in Maricopa County, Arizona. J Urban Health 2021; 98:344-361. [PMID: 33768466 PMCID: PMC8190233 DOI: 10.1007/s11524-021-00520-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 11/28/2022]
Abstract
The objective of the present study was to examine the effects of a confluence of demographic, socioeconomic, housing, and environmental factors that systematically contribute to heat-related morbidity in Maricopa County, Arizona, from theoretical, empirical, and spatial perspectives. The present study utilized ordinary least squares (OLS) regression and multiscale geographically weighted regression (MGWR) to analyze health data, U.S. census data, and remotely sensed data. The results suggested that the MGWR model showed a significant improvement in goodness of fit over the OLS regression model, which implies that spatial heterogeneity is an essential factor that influences the relationship between these factors. Populations of people aged 65+, Hispanic people, disabled people, people who do not own vehicles, and housing occupancy rate have much stronger local effects than other variables. These findings can be used to inform and educate local residents, communities, stakeholders, city managers, and urban planners in their ongoing and extensive efforts to mitigate the negative impacts of extreme heat on human health in Maricopa County.
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Affiliation(s)
- Chuyuan Wang
- Department of Geography and Environmental Planning, Towson University, 8000 York Road, Towson, MD, 21252, USA. .,Knowledge Exchange for Resilience, Arizona State University, Tempe, AZ, 85287, USA.
| | - Patricia Solís
- Knowledge Exchange for Resilience, Arizona State University, Tempe, AZ, 85287, USA.,School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, 85287, USA
| | - Lily Villa
- Knowledge Exchange for Resilience, Arizona State University, Tempe, AZ, 85287, USA.,School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, 85287, USA
| | - Nayan Khare
- Knowledge Exchange for Resilience, Arizona State University, Tempe, AZ, 85287, USA
| | - Elizabeth A Wentz
- Knowledge Exchange for Resilience, Arizona State University, Tempe, AZ, 85287, USA.,School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, 85287, USA
| | - Aaron Gettel
- Office of Epidemiology, Maricopa County Department of Public Health, Phoenix, AZ, 85012, USA
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20
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Abstract
BACKGROUND Air conditioning has been proposed as one of the key factors explaining reductions of heat-related mortality risks observed in the last decades. However, direct evidence is still limited. METHODS We used a multi-country, multi-city, longitudinal design to quantify the independent role of air conditioning in reported attenuation in risk. We collected daily time series of mortality, mean temperature, and yearly air conditioning prevalence for 311 locations in Canada, Japan, Spain, and the USA between 1972 and 2009. For each city and sub-period, we fitted a quasi-Poisson regression combined with distributed lag non-linear models to estimate summer-only temperature-mortality associations. At the second stage, we used a novel multilevel, multivariate spatio-temporal meta-regression model to evaluate effect modification of air conditioning on heat-mortality associations. We computed relative risks and fractions of heat-attributable excess deaths under observed and fixed air conditioning prevalences. RESULTS Results show an independent association between increased air conditioning prevalence and lower heat-related mortality risk. Excess deaths due to heat decreased during the study periods from 1.40% to 0.80% in Canada, 3.57% to 1.10% in Japan, 3.54% to 2.78% in Spain, and 1.70% to 0.53% in the USA. However, increased air conditioning explains only part of the observed attenuation, corresponding to 16.7% in Canada, 20.0% in Japan, 14.3% in Spain, and 16.7% in the USA. CONCLUSIONS Our findings are consistent with the hypothesis that air conditioning represents an effective heat adaptation strategy, but suggests that other factors have played an equal or more important role in increasing the resilience of populations.
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da Silva PE, Spyrides MHC, de Melo Barbosa Andrade L, Santos E Silva CM, Mutti PR, Lucio PS. An epidemiological index for drought vulnerability in the Rio Grande do Norte State, Brazil. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:325-335. [PMID: 33125535 DOI: 10.1007/s00484-020-02034-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 07/13/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
In the Northeast Brazil (NEB), the impacts of climate extreme events such as severe droughts are aggravated by poverty and poor socioeconomic conditions. In this region, such events usually result in the spread of endemic diseases, problems in water distribution, and agricultural losses, often leading to an increase in the population's vulnerability. Thus, this study aims to evaluate the microregions of the Rio Grande do Norte (RN) state, in the NEB, according to the Epidemiological Index for Drought Vulnerability (EIDV). We mapped and classified the microregions according to three dimensions of vulnerability: risk, susceptibility, and adaptive capacity. We also verified potential associations between drought risk and epidemiological vulnerability. The EIDV was calculated by considering the three dimensions of vulnerability as mutually exclusive events and applying the third axiom of probability. Then we carried out a cluster analysis in order to classify the microregions according to similarities in the EIDV. Odds ratio were also calculated in order to evaluate the odds of microregions having a high susceptibility to diseases and high vulnerability given the drought risk. Results showed that the Pau dos Ferros, Seridó Ocidental, Seridó Oriental, and Umarizal microregions were the most vulnerable, while Natal and Litoral Sul were the least vulnerable. Regarding the dimensions of vulnerability, we observed that almost the entire RN state exhibited high drought risk. Pau dos Ferros and Umarizal had the highest susceptibility and Litoral Nordeste presented the worst adaptive capacity to the effects of drought on health. The EIDV revealed that the population of the RN state needs improvements in living conditions and health, since socioeconomic status is one of the factors that most influence the vulnerability of microregions, which in turn is aggravated by drought risk.
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Affiliation(s)
| | | | - Lara de Melo Barbosa Andrade
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Cláudio Moisés Santos E Silva
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Pedro Rodrigues Mutti
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Paulo Sérgio Lucio
- Departamento de Ciências Atmosféricas e Climáticas, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Ma Y, Jiao H, Zhang Y, Feng F, Cheng B, Ma B, Yu Z. Short-term effect of extreme air temperature on hospital emergency room visits for cardiovascular diseases from 2009 to 2012 in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:38029-38037. [PMID: 32621192 DOI: 10.1007/s11356-020-09814-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
Extreme air temperature directly affected human health. However, the short-term effect of extreme air temperature on the incidence of cardiovascular diseases has rarely been reported in China. In this study, we focused on Beijing, China, and assessed the effects of cold/warm days and nights on the number of hospital emergency room (ER) visits for cardiovascular diseases from 2009 to 2012. We used a generalized additive model (GAM) to estimate the association between extreme air temperature and the number of hospital ER visits for cardiovascular diseases. We divided the entire study group into two gender subgroups and three age subgroups. The results showed that the short-term effect of extreme air temperature on hospital ER visits for cardiovascular diseases was more profound in females and the elderly (aged ≥ 75 years). Among all the study subgroups, the highest relative risk (RR) of cardiovascular diseases associated with extremely cold days, warm days, cold nights, and warm nights was 3.0% (95% CI, 1.6%-4.4%), 0.8% (95% CI, - 0.9%-2.6%), 2.8% (95% CI, 1.6%-4.2%), and 1.8% (95% CI, 0.6%-4.3%), respectively. Overall, the effect of extremely low air temperature (during both days and nights) on the incidence of cardiovascular diseases was stronger and more acute than that of extremely high air temperature.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bingji Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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Interactive Effect of Diurnal Temperature Range and Temperature on Mortality, Northeast Asia. Epidemiology 2020; 30 Suppl 1:S99-S106. [PMID: 31181012 DOI: 10.1097/ede.0000000000000997] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The diurnal temperature range (DTR) represents temperature variability within a day and has been reported as a potential risk factor for mortality. Previous studies attempted to identify the role of temperature in the DTR-mortality association, but results are inconclusive. The aim of this study was to investigate the interactive effect of temperature and DTR on mortality using a multicountry time series analysis. METHODS We collected time series data for mortality and weather variables for 57 communities of three countries (Taiwan, Korea, and Japan) in Northeast Asia (1972-2012). Two-stage time series regression with a distributed lag nonlinear model and meta-analysis was used to estimate the DTR-mortality association changing over temperature strata (six strata were defined based on community-specific temperature percentiles). We first investigated the whole population and then, the subpopulations defined by temperature distribution (cold and warm regions), sex, and age group (people <65 and ≥65 years of age), separately. RESULTS The DTR-mortality association changed over temperature strata. The relative risk (RR) of mortality for 10°C increase in DTR was larger for high-temperature strata compared with cold-temperature strata (e.g., = 1.050; 95% confidence interval [CI] = 1.040, 1.060 at extreme-hot stratum and RR = 1.040; 95% CI = 1.031, 1.050 at extreme-cold stratum); extreme-hot and -cold strata were defined as the days with daily mean temperature above 90th and below 10th percentiles each community's temperature distribution. Such increasing pattern was more pronounced in cold region and in people who were 65 years or older. CONCLUSIONS We found evidence that the DTR-related mortality may increase as temperature increases.
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Li C, Gu H. Climate change and mortality evolution in China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2020; 267:110622. [PMID: 32364132 DOI: 10.1016/j.jenvman.2020.110622] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
This paper explores the historical relationship between weather fluctuations and mortality evolution in China. Using panel data on the annual provincial mortality rate and daily weather variables for the 1964-2008 period, we applied a dynamic model structure with sufficient controls to estimate the short-term effects of temperature shocks on China's mortality rate. Our main results show that an additional 1 °C rise in average temperature in a given year increases the annual mortality rate by an average of 3.2%. In addition, days with daily average temperatures exceeding 27 °C (30 °C) are associated with an increase in the annual mortality rate of nearly 0.1% (0.2%) or approximately 9,520 (19,040) additional deaths. In contrast, extremely cold days do not have these effects. By applying a hybrid model structure (the long difference approach) to examine the medium-term effects of temperature changes, we find that there is little evidence of overall adaptation to high temperatures when moving from the short term to the medium term. In addition, by introducing interactions between temperatures and potential modifiers such as access to doctors, hospital beds, air conditioning and refrigerators, we determined that only residential air conditioning played an important role in mitigating the temperature-mortality relationship. However, the penetration of air conditioning in China is still relatively low. These findings indicate that climate change could partially explain the historical phenomenon of China's rising mortality rate during the unprecedented economic boom experienced since the 1980s.
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Affiliation(s)
- Chengzheng Li
- Institute for Economic and Social Research, Jinan University, Guangzhou, China.
| | - Haiying Gu
- Department of Applied Economics, Shanghai Jiao Tong University, Shanghai, China.
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Lu P, Xia G, Zhao Q, Xu R, Li S, Guo Y. Temporal trends of the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016: A time-stratified case-crossover study. PLoS Med 2020; 17:e1003176. [PMID: 32692738 PMCID: PMC7373260 DOI: 10.1371/journal.pmed.1003176] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 06/16/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In the context of global warming, studies have turned to assess the temporal trend of the association between temperature and health outcomes, which can be used to reflect whether human beings have adapted to the local temperature. However, most studies have only focused on hot temperature and mortality. We aim to investigate the temporal variations in the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016. METHODS AND FINDINGS We obtained data on 1,855,717 cardiovascular hospitalisations (mean age: 65.9 years, 42.7% female) from all 443 postal areas in Queensland, Australia between January 1, 1995 and December 31, 2016. Grid-level meteorological data were downloaded from scientific information for landowners. We used a time-stratified case-crossover design fitted with a conditional quasi-Poisson regression model and time-varying distributed lag nonlinear model (DLNM) to evaluate the association between temperature and cardiovascular hospitalisations and the temporal trends of the associations. Stratified analyses were performed in different age, sex, and climate zones. In all groups, relative risks (RRs) of cardiovascular hospitalisations associated with high temperatures (heat effects) increased, but cold effects showed a decreasing trend from 1995 to 2016. The increasing magnitude of heat effects was larger (p = 0.002) in men than in women and larger (p < 0.001) in people aged ≤69 years than in those aged ≥70 years. There was no apparent difference amongst different climate zones. The study was limited by the switch from ICD-9 to ICD-10 coding systems, by being unable to separate first-time hospitalisation from repeated hospitalisations, and possibly by confounding by air pollution or by influenza infections. CONCLUSION The impacts of cold temperatures on cardiovascular hospitalisations have decreased, but the impacts of high temperatures have increased in Queensland, Australia. The findings highlight that Queensland people have adapted to the impacts of cold temperatures, but not high temperatures. The burden of cardiovascular hospitalisations due to high temperatures is likely to increase in the context of global warming.
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Affiliation(s)
- Peng Lu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Guoxin Xia
- School of Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rongbin Xu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Shin HH, Parajuli RP, Maquiling A, Smith-Doiron M. Temporal trends in associations between ozone and circulatory mortality in age and sex in Canada during 1984-2012. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 724:137944. [PMID: 32408420 DOI: 10.1016/j.scitotenv.2020.137944] [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: 10/11/2019] [Revised: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Considerable research has been conducted on the association between ground-level ozone (ozone) and various causes of mortality, but the relationships by age and sex (biological) have been inconsistent, and temporal trends remain unexplored. OBJECTIVES The study goals are to investigate the adverse health effects of short-term exposure to ozone on circulatory mortality by age and sex, and to examine trends in annual health effects. METHODS Daily ozone, temperature, and circulatory mortality counts (ICD I00-I99) were collected for 24 urban cities for 29 years (1984-2012). Associations between ozone and circulatory mortality were estimated using generalized additive Poisson models for season (warm vs. cold), age [base (≥1) vs. seniors (>65)], and sex, accounting for confounders (calendar-time, temperature, day of the week). City-specific estimates were pooled to represent national associations through Bayesian hierarchical models. RESULTS While the cold season returned insignificant estimates, the warm season showed statistically significant associations: a 10 ppb increase in ozone was associated with 0.7% increase in circulatory mortality with a 95% posterior interval of 0.2%, 1.1%. One-day lagged ozone in the warm season showed little age differences [0.7% (0.23%, 1.12%) vs. 0.8% (0.22%, 1.27%)], but visible sex differences: females were at a higher circulatory mortality risk than males [1.1% (0.31%, 1.71%) vs. 0.3% (-0.46%, 0.98%)]. Annual estimates suggest overall up-down temporal changes; a slightly increasing trend until 2002-2004, and a generally decreasing trend thereafter. CONCLUSION This study found noticeable sex-related differences in circulatory mortality attributable to short-term exposure to ozone. Further research is warranted to understand whether sex alone, or unknown interactions with other factors derived the differences, and to clarify the specific biological mechanisms underlying differences in risk estimates between females and males.
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Affiliation(s)
- Hwashin Hyun Shin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada.
| | | | - Aubrey Maquiling
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Marc Smith-Doiron
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
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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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Wu C, Li J, Wang C, Song C, Chen Y, Finka M, La Rosa D. Understanding the relationship between urban blue infrastructure and land surface temperature. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 694:133742. [PMID: 31756833 DOI: 10.1016/j.scitotenv.2019.133742] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/18/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
Urban heat island (UHI) effect has serious negative impacts on urban ecosystems and human well-being. Mitigation of UHI using nature-based solutions is highly desirable. It was well known that urban green infrastructure (UGI), i.e., urban vegetation, can effectively mitigate UHI effect. However, the potential of urban blue infrastructure (UBI), i.e., urban surface water, on UHI mitigation is not well understood, although its potential to lower UHI effect via evaporation is similar to the biophysical mechanism of evapotranspiration through vegetation. In this paper, we study the relationship between UBI and land surface temperature (LST) in Wuhan city in central China, using a normalized difference water index (NDWI), maximum local cool island intensity and the maximum cooling distance as indicators for the cooling effects of UBI, respectively. We found a significant negative linear relationship between mean LST and NDWI after NDWI passes a critical threshold value. NDWI is an effective biophysical parameter to delineate the spatial distribution of UBI. The cooling effects of UBI are influenced both by its size and shape. Water surface temperature decreased logarithmically with increasing UBI size, critical threshold values of UBI size corresponding to maximum cooling efficiency do exists. Maximum cooling distance and maximum local cool island intensity are also affected by the shape and size of UBI, and exhibit seasonal and spatial variations. These results provide insights for urban landscape planning regarding how to use UBI as a nature-based solution to improve urban thermal environment.
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Affiliation(s)
- Caiyan Wu
- School of Ecological and Environmental Sciences, East China Normal University, Shanghai 200241, PR China
| | - Junxiang Li
- School of Ecological and Environmental Sciences, East China Normal University, Shanghai 200241, PR China; Shanghai Key Laboratory of Urbanization Ecological Processes and Eco-restoration, East China Normal University, Shanghai 200241, PR China; Institute of Eco-Chongming, 3663 North Zhongshan Road, Shanghai 200062, PR China.
| | - Chunfang Wang
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai 200336, PR China.
| | - Conghe Song
- School of Ecological and Environmental Sciences, East China Normal University, Shanghai 200241, PR China; Shanghai Key Laboratory of Urbanization Ecological Processes and Eco-restoration, East China Normal University, Shanghai 200241, PR China; Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Yu Chen
- School of Ecological and Environmental Sciences, East China Normal University, Shanghai 200241, PR China
| | - Maroš Finka
- School of Ecological and Environmental Sciences, East China Normal University, Shanghai 200241, PR China; SPECTRA Centre of Excellence EU at Slovak University of Technology in Bratislava (STU), 81243 Bratislava, Vazovova 5, Slovak Republic
| | - Daniele La Rosa
- Dipartimento Ingegneria Civile e Architettura, Università di Catania, Viale A. Doria 6, 95126 Catania, Italy
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Hurtado-Díaz M, Cruz JC, Texcalac-Sangrador JL, Félix-Arellano EE, Gutiérrez-Ávila I, Briseño-Pérez AA, Saavedra-Lara N, Tobías A, Riojas-Rodríguez H. Short-term effects of ambient temperature on non-external and cardiovascular mortality among older adults of metropolitan areas of Mexico. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1641-1650. [PMID: 31407098 DOI: 10.1007/s00484-019-01778-y] [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: 11/16/2018] [Revised: 07/18/2019] [Accepted: 07/31/2019] [Indexed: 05/21/2023]
Abstract
Multi-city studies assessing the association between acute exposure to temperature and mortality in Latin American are limited. To analyze the short-term effect of changes in temperature (increase and decrease) on daily non-external and cardiovascular mortality from 1998 to 2014, in people 65 years old and over living in 10 metropolitan areas of Mexico. Analyses were performed through Poisson regression models with distributed lag non-linear models. Statistical comparison of minimum mortality temperature (MMT) and city-specific cutoffs of 24-h temperature mean values (5th/95th and 1st/99th percentiles) were used to obtain the mortality relative Risk (RR) for cold/hot and extreme cold/extreme hot, respectively, for the same day and lags of 0-3, 0-7, and 0-21 days. A meta-analysis was conducted to synthesize the estimates (RRpooled). Significant non-linear associations of temperature-mortality relation were found in U or inverted J shape. The best predictors of mortality associations with cold and heat were daily temperatures at lag 0-7 and lag 0-3, respectively. RRpooled of non-external causes was 6.3% (95%CI 2.7, 10.0) for cold and 10.2% (95%CI 4.4, 16.2) for hot temperatures. The RRpooled for cardiovascular mortality was 7.1% (95%CI 0.01, 14.7) for cold and 7.1% (95%CI 0.6, 14.0) for hot temperatures. Results suggest that, starting from the MMT, the changes in temperature are associated with an increased risk of non-external and specific causes of mortality in elderly people. Generally, heat effects on non-external and specific causes of mortality occur immediately, while cold effects occur within a few days and last longer.
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Affiliation(s)
- Magali Hurtado-Díaz
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Julio C Cruz
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - José L Texcalac-Sangrador
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Eunice E Félix-Arellano
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Iván Gutiérrez-Ávila
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Arely A Briseño-Pérez
- Fielding School of Public Health, Center for Health Sciences, University of California, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095-1772, USA
| | - Nenetzen Saavedra-Lara
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Aurelio Tobías
- Institute of Environmental Assessment and Water Research (IDAEA) - Spanish Council for Scientific Research (CSIC), C/Jordi Girona 18-26, 08034, Barcelona, Spain
| | - Horacio Riojas-Rodríguez
- National Institute of Public Health, Av. Universidad No. 655 Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
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Zilli Vieira CL, Alvares D, Blomberg A, Schwartz J, Coull B, Huang S, Koutrakis P. Geomagnetic disturbances driven by solar activity enhance total and cardiovascular mortality risk in 263 U.S. cities. Environ Health 2019; 18:83. [PMID: 31511079 PMCID: PMC6739933 DOI: 10.1186/s12940-019-0516-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/09/2019] [Indexed: 05/24/2023]
Abstract
BACKGROUND Short-term geomagnetic disturbances (GMD) driven by the quasi-periodic 11-year cycle of solar activity have been linked to a broad range of adverse health effects, including cardiovascular diseases (CVD) and total deaths. We conducted a large epidemiological study in 263 U.S. cities to assess the effects of GMD on daily deaths of total, CVD, myocardial infarction (MI), and stroke. METHODS We employed a two-step meta-analysis approach, in which we estimated city-specific and season-stratified mortality risk associated with a GMD parameter (Kp index) in 263 U.S. cities. In addition, sensitivity analysis was performed to assess whether effect modification of particulate matter (PM2.5) in the prior day changed Kp index effects on daily deaths after adjusting for confounders. RESULTS We found significant association between daily GMD and total, CVD, and MI deaths. The effects were even stronger when we adjusted the models for 24-h PM2.5 for different seasons. For example, in the winter and fall one standard deviation of z-score Kp index increase was associated with a 0.13 and 0.31% increase in total deaths, respectively (Winter: p = 0.01, 95% CI: 0.02 to 0.24; Fall: p = 0.00001; 95% CI: 0.23 to 0.4), without adjusting for PM2.5. The effects of GMD on total deaths were also observed in spring and summer in the models without PM2.5 (p = 0.00001). When the models were adjusted for PM2.5 the total deaths increased 0.47% in winter (p = 0.00001, 95% CI: 0.3 to 0.65) and by 0.23% in fall (p = 0.001, 95% CI: 0.09 to 0.37). The effects of GMD were also significant associated with MI deaths and CVD. No positive significant association were found between Kp and stroke. The GMD effects on deaths were higher than for 24 h-PM2.5 alone, especially in spring and fall. CONCLUSION Our results suggest that GMD is associated with total, CVD and MI deaths in 263 U. S cities. Increased mortality in the general population during GMD should be further investigated to determine whether those human physiological dynamics driven by variations in solar activity can be related to daily clinical cardiovascular observations.
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Affiliation(s)
- Carolina Leticia Zilli Vieira
- Department of Environmental Health at Harvard School of Public Health, 401 Park Drive, Landmark Center 4th floor West (HSPH), 420 room, Boston, MA, 02215, USA.
| | - Danilo Alvares
- Department of Statistics, Pontifical Catholic University of Chile, Santiago, Chile
| | - Annelise Blomberg
- Department of Environmental Health at Harvard School of Public Health, 401 Park Drive, Landmark Center 4th floor West (HSPH), 420 room, Boston, MA, 02215, USA
| | - Joel Schwartz
- Department of Environmental Health at Harvard School of Public Health, 401 Park Drive, Landmark Center 4th floor West (HSPH), 420 room, Boston, MA, 02215, USA
| | - Brent Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, USA
| | - Shaodan Huang
- Department of Environmental Health at Harvard School of Public Health, 401 Park Drive, Landmark Center 4th floor West (HSPH), 420 room, Boston, MA, 02215, USA
| | - Petros Koutrakis
- Department of Environmental Health at Harvard School of Public Health, 401 Park Drive, Landmark Center 4th floor West (HSPH), 420 room, Boston, MA, 02215, USA
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Achebak H, Devolder D, Ballester J. Trends in temperature-related age-specific and sex-specific mortality from cardiovascular diseases in Spain: a national time-series analysis. Lancet Planet Health 2019; 3:e297-e306. [PMID: 31230996 DOI: 10.1016/s2542-5196(19)30090-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/03/2019] [Accepted: 05/08/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Climate change driven by human activities has increased annual temperatures in Spain by around 1°C since 1980. However, little is known regarding the extent to which the association between temperature and mortality has changed among the most susceptible population groups as a result of the rapidly warming climate. We aimed to assess trends in temperature-related cardiovascular disease mortality in Spain by sex and age, and we investigated the association between climate warming and changes in the risk of mortality. METHODS We did a country-wide time-series analysis of 48 provinces in mainland Spain and the Balearic Islands between Jan 1, 1980, and Dec 31, 2016. We extracted daily cardiovascular disease mortality data disaggregated by sex, age, and province from the Spanish National Institute of Statistics database. We also extracted daily mean temperatures from the European Climate Assessment and Dataset project. We applied a quasi-Poisson regression model for each province, controlling for seasonal and long-term trends, to estimate the temporal changes in the province-specific temperature-mortality associations with distributed lag non-linear models. We did a multivariate random-effects meta-analysis to derive the best linear unbiased prediction of the temperature-mortality association and the minimum mortality temperature in each province. Heat-attributable and cold-attributable fractions of death were computed by separating the contributions from days with temperatures warmer and colder than the minimum mortality temperature, respectively. FINDINGS Between 1980 and 2016, 4 576 600 cardiovascular deaths were recorded. For warm temperatures, the increase in relative risk (RR) of death from cardiovascular diseases was higher for women than men and higher for older individuals (aged ≥90 years) than younger individuals (aged 60-74 years), whereas for cold temperatures, RRs were higher for men than women, with no clear pattern by age group. The heat-attributable fraction of cardiovascular deaths was higher for women in all age groups, and the cold-attributable fraction was larger in men. The heat-attributable fraction increased with age for both sexes, whereas the cold-attributable fraction increased with age for men and decreased for women. Overall minimum mortality temperature increased from 19·5°C between 1980 and 1994 to 20·2°C between 2002 and 2016, which is similar in magnitude to, and occurred in parallel with, the observed mean increase of 0·77°C that occurred in Spain between these two time periods. In general, between 1980 and 2016, the risk and attributable fraction of cardiovascular deaths due to warm and cold temperatures decreased for men and women across all age groups. For all the age groups combined, between 1980-94 and 2002-16, the heat-attributable fraction decreased by -42·06% (95% empirical CI -44·39 to -41·06) for men and -36·64% (-36·70 to -36·04) for women, whereas the cold-attributable fraction was reduced by -30·23% (-30·34 to -30·05) for men and -44·87% (-46·77 to -42·94) for women. INTERPRETATION In Spain, the observed warming of the climate has occurred in parallel with substantial adaptation to both high and low temperatures. The reduction in the RR and the attributable fraction associated with heat would be compatible with an adaptive response specifically addressing the negative consequences of climate change. Nevertheless, the simultaneous reduction in the RR and attributable fraction of cold temperatures also highlights the importance of more general factors such as socioeconomic development, increased life expectancy and quality, and improved health-care services in the country. FUNDING None.
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Affiliation(s)
- Hicham Achebak
- Centre for Demographic Studies, Autonomous University of Barcelona, Barcelona, Spain; Climate and Health Program, Barcelona Institute for Global Health, Barcelona, Spain
| | - Daniel Devolder
- Centre for Demographic Studies, Autonomous University of Barcelona, Barcelona, Spain
| | - Joan Ballester
- Climate and Health Program, Barcelona Institute for Global Health, Barcelona, Spain.
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Li M, Shaw BA, Zhang W, Vásquez E, Lin S. Impact of Extremely Hot Days on Emergency Department Visits for Cardiovascular Disease among Older Adults in New York State. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2119. [PMID: 31207990 PMCID: PMC6617208 DOI: 10.3390/ijerph16122119] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 12/02/2022]
Abstract
Prior studies have reported the impact of ambient heat exposure on heat-related illnesses and mortality in summer, but few have assessed its effect on cardiovascular diseases (CVD) morbidity, and the association difference by demographics and season. This study examined how extremely hot days affected CVD-related emergency department (ED) visits among older adults from 2005-2013 in New York State. A time-stratified case-crossover design was used to assess the heat-CVD association in summer and transitional months (April-May and September-October). Daily mean temperature >95th percentile of regional monthly mean temperature was defined as an extremely hot day. Extremely hot days were found to be significantly associated with increased risk of CVD-related ED visits at lag day 5 (OR: 1.02, 95% CI: 1.01-1.04) and lag day 6 (OR: 1.01, 95% CI: 1.00-1.03) among older adults in summer after controlling for PM2.5 concentration, relative humidity, and barometric pressure. Specifically, there was a 7% increased risk of ischemic heart disease on the day of extreme heat, and increased risks of hypertension (4%) and cardiac dysrhythmias (6%) occurred on lag days 5 and 6, respectively. We also observed large geographic variations in the heat-CVD associations.
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Affiliation(s)
- Mengxuan Li
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY 12144, USA.
| | - Benjamin A Shaw
- Department of Health Policy, Management and Behavior, University at Albany School of Public Health, Rensselaer, NY 12144, USA.
| | - Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany School of Public Health, Rensselaer, NY 12144, USA.
| | - Elizabeth Vásquez
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY 12144, USA.
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany School of Public Health, Rensselaer, NY 12144, USA.
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Sugg MM, Stevens S, Runkle JD. Estimating personal ambient temperature in moderately cold environments for occupationally exposed populations. ENVIRONMENTAL RESEARCH 2019; 173:497-507. [PMID: 30986652 DOI: 10.1016/j.envres.2019.03.066] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/05/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
Despite high mortality and morbidity rates in the winter season, few studies have investigated the health effects from working in moderately cold environments, especially among vulnerable outdoor worker populations in the southeastern US. Yet recent research has shown that the mortality risk from cold events is greatest in southern cities compared to other US locations. We performed repeated personal cold exposure measurements in outdoor grounds management workers in the southeastern US using consumer-based sensors. We recruited outdoor workers from two locations (Raleigh, NC and Boone, NC) each characterized by climatological differences in cold temperature to participate in a 3-week data collection period at the peak of the winter (Jan/Feb 2018). Lower personal ambient temperatures were observed among participants who worked in a warmer climate (Raleigh, NC). The relative risk for cold symptomatology was higher in moderately cold personal ambient temperatures (0 °C to 20 °C) than extremely cold personal ambient temperatures (less than 0 °C). A weak significant relationship was observed between personal ambient temperatures and weather station measurements highlighting that epidemiological researchers should be cautious when investigating the health effects of ambient temperatures based on fixed site measurements. As mobile technology progresses, real-time temperature health monitoring and analysis of environmental conditions at the individual level across multiple occupational-settings will become more feasible and ultimately, we believe, a digitally enhanced workforce will become standard practice in the field.
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Affiliation(s)
- Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32066, Boone, NC, 28608, USA.
| | - Scott Stevens
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC, 28801, USA.
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC, 28801, USA.
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Bladder drug mirabegron exacerbates atherosclerosis through activation of brown fat-mediated lipolysis. Proc Natl Acad Sci U S A 2019; 116:10937-10942. [PMID: 31085638 DOI: 10.1073/pnas.1901655116] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Mirabegron (Myrbetriq) is a β3-adrenoreceptor agonist approved for treating overactive bladder syndrome in human patients. This drug can activate brown adipose tissue (BAT) in adult humans and rodents through the β3-adrenoreceptor-mediated sympathetic activation. However, the effect of the mirabegron, approved by the US Food and Drug Administration, on atherosclerosis-related cardiovascular disease is unknown. Here, we show that the clinical dose of mirabegron-induced BAT activation and browning of white adipose tissue (WAT) exacerbate atherosclerotic plaque development. In apolipoprotein E-/- (ApoE -/-) and low-density lipoprotein (LDL) receptor-/- (Ldlr -/-) mice, oral administration of clinically relevant doses of mirabegron markedly accelerates atherosclerotic plaque growth and instability by a mechanism of increasing plasma levels of both LDL-cholesterol and very LDL-cholesterol remnants. Stimulation of atherosclerotic plaque development by mirabegron is dependent on thermogenesis-triggered lipolysis. Genetic deletion of the critical thermogenesis-dependent protein, uncoupling protein 1, completely abrogates the mirabegron-induced atherosclerosis. Together, our findings suggest that mirabegron may trigger cardiovascular and cerebrovascular diseases in patients who suffer from atherosclerosis.
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Wei Y, Wang Y, Lin CK, Yin K, Yang J, Shi L, Li L, Zanobetti A, Schwartz JD. Associations between seasonal temperature and dementia-associated hospitalizations in New England. ENVIRONMENT INTERNATIONAL 2019; 126:228-233. [PMID: 30822651 PMCID: PMC8491247 DOI: 10.1016/j.envint.2018.12.054] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/17/2018] [Accepted: 12/24/2018] [Indexed: 05/22/2023]
Abstract
Human-induced climate change has accelerated in recent decades, causing adverse health effects. However, the impact of the changing climate on neurological disorders in the older population is not well understood. We applied time-varying Cox proportional hazards models to estimate the associations between hospital admissions for dementia and the mean and variability of summer and winter temperatures in New England. We estimated seasonal temperatures for each New England zip code using a satellite-based prediction model. By characterizing spatial differences and temporal fluctuations in seasonal temperatures, we observed a lower risk of dementia-associated hospital admissions in years when local temperatures in either summer (hazard ration [HR] = 0.98; 95% confidence interval [CI]: 0.96, 1.00) or winter (HR = 0.97; 95% CI: 0.94, 0.99) were higher than average, and a greater risk of dementia-associated admissions for older adults living in zip codes with higher temperature variations. Effect modifications by sex, race, age, and dual eligibility were considered to examine vulnerability of population subgroups. Our results suggest that cooler-than-average temperatures and higher temperature variability increase the risk of dementia-associated hospital admissions. Thus, climate change may affect progression of dementia and associated hospitalization costs.
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Affiliation(s)
- Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America.
| | - Yan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America; Department of Biostatistics, Harvard T.H. Chan School of Public Health, United States of America
| | - Cheng-Kuan Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America
| | - Kanhua Yin
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, United States of America
| | - Jiabei Yang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, United States of America
| | - Liuhua Shi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America
| | - Longxiang Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, United States of America
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Geirinhas JL, Trigo RM, Libonati R, Castro LCO, Sousa PM, Coelho CAS, Peres LF, Magalhães MDAFM. Characterizing the atmospheric conditions during the 2010 heatwave in Rio de Janeiro marked by excessive mortality rates. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 650:796-808. [PMID: 30308855 DOI: 10.1016/j.scitotenv.2018.09.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 06/08/2023]
Abstract
Global temperatures have increased considerably over the last decades, directly impacting the number, intensity and duration of extreme events such as heat waves. Climate model projections accounting for anthropogenic factors indicate that deadly mega-heat waves are likely to become more frequent in the future. Although the atmospheric features and social-economic related impacts of heat waves have already been documented in various regions around the world, for other highly populated regions, such as the Metropolitan Region of Rio de Janeiro (MRRJ), a similar objective assessment is still needed. Heat waves directly impact the public health sector and particularly the less wealthy and elderly population groups. During February 2010, an elevated mortality peak occurred during a 8-day period (from 2 to 9 Feb 2010) characterized as a heat wave episode in MRRJ. A total excess of 737 deaths was recorded with the elderly group registering the highest mortality incidence. During this heat wave period, a quasi-stationary anticyclonic anomaly forced in altitude by a Rossby wave train was established over the south Brazilian coast. At the surface, the meteorological scenario from January 2010 to the heat wave period was marked by clear sky conditions, large precipitation deficits, and enhanced diabatic heating. During the heat wave period, warm and dry air masses were advected from interior regions towards the MRRJ, exacerbating temperature conditions by pronounced subsidence and adiabatic heating mechanisms. All these conditions contributed to pronounced positive temperature anomalies, reinforced by land-atmosphere feedbacks.
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Affiliation(s)
- João L Geirinhas
- Instituto Dom Luiz, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa, Portugal.
| | - Ricardo M Trigo
- Instituto Dom Luiz, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa, Portugal
| | - Renata Libonati
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Lisboa, Portugal
| | - Lucas C O Castro
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pedro M Sousa
- Instituto Dom Luiz, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, Lisboa, Portugal
| | - Caio A S Coelho
- Centro de Previsão de Tempo e Estudos Climáticos (CPTEC), Instituto Nacional de Pesquisas Espaciais (INPE), Cachoeira Paulista, SP, Brazil
| | - Leonardo F Peres
- Departamento de Meteorologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Instituto Português do Mar e da Atmosfera (IPMA), Lisboa, Portugal
| | - Mônica de Avelar F M Magalhães
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
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Guo W, Du M, Sun D, Zhao N, Hao Z, Wu R, Dong C, Sun X, Tian C, Gao L, Li H, Yu D, Niu M, Wu R, Sun J. The effect characteristics of temperature on stroke mortality in Inner Mongolia and globally. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:159-166. [PMID: 30565077 DOI: 10.1007/s00484-018-1647-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/24/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
The current study investigated the correlation between stroke mortality and temperature. Monthly and seasonal variations in stroke mortality were plotted and daily stroke-related deaths were calculated. The lag times were calculated using the time series analysis. The correlation between stroke incidence and the diurnal temperature range (DTR) was analyzed using case-crossover analysis. Global stroke mortality was described in five latitudes. In the eastern region of Inner Mongolia, the stroke mortality was 174.18/105, about twice of that of the midwestern regions (87.07/105), and temperature was negatively correlated with stroke mortality. Mortality peaked in the winter and troughed in the summer (χ2 = 13.634, P < 0.001). The days in which stroke-related deaths were greater than ten occurred between late October and early April. The effect of temperature on stroke incidence occurred during a lag time of 1 (P = 0.024) or 2 months (P = 0.039). A DTR over 13 °C was positively correlated (r = 0.95, P = 0.004) with stroke with a lag time of 1 day. The effect of temperature on stroke was shown to be the same for various populations. As the latitude increases, stroke mortality also increases with latitudes > 40°; the highest mortality was 188.05/105 at the highest latitude. Only in relatively cold regions as the temperature decreases does stroke mortality increase for various populations. Differences in the time lag as well as in the DTR lag and DTR critical point vary for both the temperature and region.
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Affiliation(s)
- Wenfang Guo
- Inner Mongolia Autonomous Region Academy of Chinese Medicine, Hohhot, China
| | - Maolin Du
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | - Dejun Sun
- Inner Mongolia People's Hospital, Hohhot, China
| | - Nengjun Zhao
- Affiliated People's Hospital Inner Mongolia Medical University, Hohhot, China
| | - Zhihui Hao
- Inner Mongolia People's Hospital, Hohhot, China
| | - Rina Wu
- Inner Mongolia People's Hospital, Hohhot, China
| | - Chao Dong
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | | | - Chunfang Tian
- Inner Mongolia Autonomous Region Academy of Chinese Medicine, Hohhot, China
| | - Liqun Gao
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | - Hongwei Li
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | - Di Yu
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | - Mingzhu Niu
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | - Ruijie Wu
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China
| | - Juan Sun
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, China.
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Yang J, Yin P, Sun J, Wang B, Zhou M, Li M, Tong S, Meng B, Guo Y, Liu Q. Heatwave and mortality in 31 major Chinese cities: Definition, vulnerability and implications. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 649:695-702. [PMID: 30176480 DOI: 10.1016/j.scitotenv.2018.08.332] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/01/2018] [Accepted: 08/24/2018] [Indexed: 05/21/2023]
Abstract
Few data are available on the health impacts of heatwaves in China, and in particular, the heatwave definition and vulnerable populations remain to be identified. We collected data on daily maximum temperature and mortality from 31 Chinese capital cities during 2007-2013. A Poisson regression model allowing for over-dispersion was applied to estimate the short-term effects of heatwaves on mortality in hot season (May-September). 15 heatwave definitions combining five heat thresholds (90.0th, 92.5th, 95th, 97.5th and 99th percentiles of daily maximum temperature) and three durations (≥2, ≥3 and ≥4 days) were compared. The pooled effects were then computed using random effect meta-analysis based on the residual maximum likelihood estimation. Effect modification of heatwave-mortality association by individual-level characteristics was tested using a stratified analysis. Potential effect modification by city-level characteristics was examined by meta-regression analysis. Totally, 259 million permanent residents were covered and 4,481,090 non-accidental deaths occurred during the study period. Generally, the magnitude of heatwave impacts increased by intensities and durations of the heatwaves. Heatwave definition using daily maximum temperature ≥ 92.5th percentile with duration ≥3 days produced the best model fit. The pooled relative risks of heatwaves on non-accidental mortality at lag 0, lag 0-2 and lag 0-10 days were 1.06 (95%CI: 1.03-1.09), 1.09 (1.05-1.13) and 1.10 (1.05-1.15), respectively. Compared with non-accidental mortality, higher effect estimates of heatwaves were observed among deaths from ischemic heart diseases, stroke and respiratory diseases, although the differences were not statistically significant. Females, those ≥75 years old and the illiterates were more vulnerable to heatwaves. Cities with higher concentrations of PM2.5, higher latitudes, and lower numbers of hospital beds per 10,000 populations had higher mortality risks during heatwaves. These findings may have important implications for developing heat alert systems and early response actions on protecting the vulnerable populations from adverse health effects of heatwave in China.
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Affiliation(s)
- Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Jimin Sun
- State 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 102206, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Mengmeng Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing 100005, China; School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China; School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Bohan Meng
- Department of Geography and Computer Science, University of Victoria, Victoria V8P5C2, Canada
| | - Yuming Guo
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Qiyong Liu
- State 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 102206, China.
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Liu Y, Hoppe BO, Convertino M. Threshold Evaluation of Emergency Risk Communication for Health Risks Related to Hazardous Ambient Temperature. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:2208-2221. [PMID: 29637591 DOI: 10.1111/risa.12998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/25/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
Emergency risk communication (ERC) programs that activate when the ambient temperature is expected to cross certain extreme thresholds are widely used to manage relevant public health risks. In practice, however, the effectiveness of these thresholds has rarely been examined. The goal of this study is to test if the activation criteria based on extreme temperature thresholds, both cold and heat, capture elevated health risks for all-cause and cause-specific mortality and morbidity in the Minneapolis-St. Paul Metropolitan Area. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear model is used to derive the exposure-response functions between daily maximum heat index and mortality (1998-2014) and morbidity (emergency department visits; 2007-2014). Specific causes considered include cardiovascular, respiratory, renal diseases, and diabetes. Six extreme temperature thresholds, corresponding to 1st-3rd and 97th-99th percentiles of local exposure history, are examined. All six extreme temperature thresholds capture significantly increased relative risks for all-cause mortality and morbidity. However, the cause-specific analyses reveal heterogeneity. Extreme cold thresholds capture increased mortality and morbidity risks for cardiovascular and respiratory diseases and extreme heat thresholds for renal disease. Percentile-based extreme temperature thresholds are appropriate for initiating ERC targeting the general population. Tailoring ERC by specific causes may protect some but not all individuals with health conditions exacerbated by hazardous ambient temperature exposure.
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Affiliation(s)
- Yang Liu
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Brenda O Hoppe
- Department of Health, Environmental Health Division, Minnesota, St. Paul, MN, USA
| | - Matteo Convertino
- Complexity Group, Division of Frontier Science & Media and Network Technologies, Laboratory of Information Communication Networks, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
- Global Station for Big Data and Cybersecurity, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
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Meteorological Factors and Air Pollutants Contributing to Seasonal Variation of Acute Exacerbation of Atrial Fibrillation: A Population-Based Study. J Occup Environ Med 2018; 60:1082-1086. [PMID: 30211757 DOI: 10.1097/jom.0000000000001449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We investigated seasonal variation of acute exacerbation of atrial fibrillation (AAF) and contributing environmental factors. METHODS AAF events, meteorological elements, and air pollutants in Seoul between 2013 and 2015 were obtained from the nationwide database. AAF was defined if a patient visited the emergency room due to any AF-relevant symptoms or signs. RESULTS AAF occurred less frequently in summer than in other seasons (6.71 vs 7.25 events/d, P = 0.005). AAF tended to decrease with an increase of air temperature (r = -0.058). Among air pollutants, NO2 was significantly lower in summer and positively correlated with AAF after adjusting for other variables (β = 3.197). CONCLUSIONS The rate of AAF events was the lowest in summer; air temperature and NO2 were contributing factors. The weather and environmental conditions should be considered as risk factors of AAF.
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Achebak H, Devolder D, Ballester J. Heat-related mortality trends under recent climate warming in Spain: A 36-year observational study. PLoS Med 2018; 15:e1002617. [PMID: 30040838 PMCID: PMC6057624 DOI: 10.1371/journal.pmed.1002617] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/20/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Anthropogenic greenhouse gas emissions have increased summer temperatures in Spain by nearly one degree Celsius on average between 1980 and 2015. However, little is known about the extent to which the association between heat and human mortality has been modified. We here investigate whether the observed warming has been associated with an upward trend in excess mortality attributable to heat or, on the contrary, a decrease in the vulnerability to heat has contributed to a reduction of the mortality burden. METHODS AND FINDINGS We analysed a dataset from 47 major cities in Spain for the summer months between 1980 and 2015, which included daily temperatures and 554,491 deaths from circulatory and respiratory causes, by sex. We applied standard quasi-Poisson regression models, controlling for seasonality and long-term trends, and estimated the temporal variation in heat-related mortality with time-varying distributed lag nonlinear models (DLNMs). Results pointed to a reduction in the relative risks of cause-specific and cause-sex mortality across the whole range of summer temperatures. These reductions in turn explained the observed downward trends in heat-attributable deaths, with the only exceptions of respiratory diseases for women and both sexes together. The heat-attributable deaths were consistently higher in women than in men for both circulatory and respiratory causes. The main limitation of our study is that we were not able to account for air pollution in the models because of data unavailability. CONCLUSIONS Despite the summer warming observed in Spain between 1980 and 2015, the decline in the vulnerability of the population has contributed to a general downward trend in overall heat-attributable mortality. This reduction occurred in parallel with a decline in the vulnerability difference between men and women for circulatory and cardiorespiratory mortality. Despite these advances, the risk of death remained high for respiratory diseases, and particularly in women.
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Affiliation(s)
- Hicham Achebak
- Center for Demographic Studies (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Daniel Devolder
- Center for Demographic Studies (CED), Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Joan Ballester
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
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Lee W, Choi HM, Lee JY, Kim DH, Honda Y, Kim H. Temporal changes in mortality impacts of heat wave and cold spell in Korea and Japan. ENVIRONMENT INTERNATIONAL 2018; 116:136-146. [PMID: 29679776 DOI: 10.1016/j.envint.2018.04.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 05/27/2023]
Abstract
Investigating how well people adapt to heat waves and cold spells has been an important issue under climate change. Also, most of previous studies focused only on the mortality risks for heat waves or cold spells for certain time period not considering its temporal changes and increasing frequencies. This study investigated the change in risks of mortality from heat waves and cold spells over time, and estimated the temporal changes in mortality burden attributed to heat waves and cold spells in Korea and Japan. We collected time-series data covering mortality and weather variables from 53 communities in the two countries from 1992 to 2015. Two-stage time-series regression with a time-varying distributed lag model and meta-analysis was used to assess the impacts of heat waves and cold spells by period (1990s, 2000s, and 2010s). In total population, the risks of heat waves have decreased over time; however their mortality burden increased in the 2010s compared to the 2000s with increasing frequency. On the other hand, the risk and health burden of cold spells have increased over the decades. Our findings showed that the future mortality burden of heat waves and cold spells might not decrease, when considering their changes in risks and frequencies.
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Affiliation(s)
- Whanhee Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hayon Michelle Choi
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jae Young Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Da Hye Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
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Abstract
PURPOSE OF REVIEW Our goal was to assess current literature and knowledge on associations between characteristics (mean, variability, extremes) of ambient temperatures and human health. We were motivated by concerns that climate change, which operates on a time frame of decades or longer, may influence not only shorter-term associations between weather and health (daily/weekly) but also have enduring implications for population health. We reviewed papers published between 2010 and 2017 on the health effects of longer-term (3 weeks to years) exposures to ambient temperature. We sought to answer: 'What health outcomes have been associated with longer-term exposures?' We included studies on a diverse range of health outcomes, with the exception of vector borne diseases such as malaria. Longer-term exposures were considered to be exposures to annual and seasonal temperatures and temperature variability. RECENT FINDINGS We found 26 papers meeting inclusion criteria, which addressed mortality, morbidity, respiratory disease, obesity, suicide, infectious diseases and allergies among various age groups. In general, most studies found associations between longer-term temperature metrics and health outcomes. Effects varied by population subgroup. For example, associations with suicide differed by sex and underlying chronic illness modified effects of heat on mortality among the elderly. SUMMARY We found that regional and local temperatures, and changing conditions in weather due to climate change, were associated with a diversity of health outcomes through multiple mechanisms. Future research should focus on evidence for particular mechanistic pathways in order to inform adaptation responses to climate change.
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Affiliation(s)
- Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health
| | - Marie S. O’Neill
- Departments of Epidemiology and Environmental Health Sciences, University of Michigan School of Public Health
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Chung Y, Yang D, Gasparrini A, Vicedo-Cabrera AM, Fook Sheng Ng C, Kim Y, Honda Y, Hashizume M. Changing Susceptibility to Non-Optimum Temperatures in Japan, 1972-2012: The Role of Climate, Demographic, and Socioeconomic Factors. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:057002. [PMID: 29727132 PMCID: PMC6071988 DOI: 10.1289/ehp2546] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 05/13/2023]
Abstract
BACKGROUND Previous studies have shown that population susceptibility to non-optimum temperatures has changed over time, but little is known about the related time-varying factors that underlie the changes. OBJECTIVE Our objective was to investigate the changing population susceptibility to non-optimum temperatures in 47 prefectures of Japan over four decades from 1972 to 2012, addressing three aspects: minimum mortality temperature (MMT) and heat- and cold-related mortality risks. In addition, we aimed to examine how these aspects of susceptibility were associated with climate, demographic, and socioeconomic variables. METHODS We first used a two-stage time-series design with a time-varying distributed lag nonlinear model and multivariate meta-analysis to estimate the time-varying MMT, heat- and cold-related mortality risks. We then applied linear mixed effects models to investigate the association between each of the three time-varying aspects of susceptibility and various time-varying factors. RESULTS MMT increased from 23.2 [95% confidence interval (CI): 23, 23.6] to 28.7 (27.0, 29.7) °C. Heat-related mortality risk [relative risk (RR) for the 99th percentile of temperature vs. the MMT] decreased from 1.18 (1.15, 1.21) to 1.01 (0.98, 1.04). Cold-related mortality risk (RR for the first percentile vs. the MMT) generally decreased from 1.48 (1.41, 1.54) to 1.35 (1.32, 1.40), with the exception of a few eastern prefectures that showed increased risk. The changing patterns in all three aspects differed by region, sex, and causes of death. Higher mean temperature was associated (p<0.01) with lower heat risk, whereas higher humidity was associated with higher cold risk. A higher percentage of elderly people was associated with a higher cold risk, whereas higher economic strength of the prefecture was related to lower cold risk. CONCLUSIONS Population susceptibility to heat has decreased over the last four decades in Japan. Susceptibility to cold has decreased overall except for several eastern prefectures where it has either increased or remained unchanged. Certain climate, demographic, and socioeconomic factors explored in the current study might underlie this changing susceptibility. https://doi.org/10.1289/EHP2546.
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Affiliation(s)
- Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Daewon Yang
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Antonio Gasparrini
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ana M Vicedo-Cabrera
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Fook Sheng Ng
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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Lee W, Choi HM, Kim D, Honda Y, Guo YLL, Kim H. Temporal changes in morality attributed to heat extremes for 57 cities in Northeast Asia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 616-617:703-709. [PMID: 29103641 DOI: 10.1016/j.scitotenv.2017.10.258] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 06/07/2023]
Abstract
Recent studies have reported that heat-related mortality decreased by adaptation during decades. However, since the frequency of extreme heat events is increasing, it is difficult to conclude with certainty that the heat mortality burden is decreasing. To examine temporal changes in mortality attributed to heat extremes in Northeast Asia, we collected temperature and mortality data covering the years 1972-2012 from 57 cities of 3 countries (Taiwan, Korea, and Japan) in Northeast Asia. Poisson regression curves were fitted to the data from each city. The temporal changes in heat-mortality association were estimated with a time-varying distributed lag non-linear model. Heat extremes were defined as temperatures greater than the 97.5th percentiles of city-specific average temperatures. Attributable deaths were calculated considering temporal variations in exposure and relative risk. The estimates were then pooled through meta-analysis. The results show that the mortality risk on extreme heat days declined during the study period in all countries. However, as summer temperatures in Japan have shown more heat extremes over time, the mortality risk attributed to heat increased during 2003-2012 (0.32%) compared with 1972-1981 (0.19%). Thus, to assess the total health burden due to heat extremes related to climate change, public health strategies should focus on the temporal variation in heat-mortality association as well as changes in the distribution of heat extremes overtime.
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Affiliation(s)
- Whanhee Lee
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hayon Michelle Choi
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Dahye Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University, Taipei, Taiwan
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
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Lundgren-Kownacki K, Hornyanszky ED, Chu TA, Olsson JA, Becker P. Challenges of using air conditioning in an increasingly hot climate. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:401-412. [PMID: 29289994 PMCID: PMC5854721 DOI: 10.1007/s00484-017-1493-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/17/2017] [Accepted: 12/11/2017] [Indexed: 05/14/2023]
Abstract
At present, air conditioning (AC) is the most effective means for the cooling of indoor space. However, its increased global use is problematic for various reasons. This paper explores the challenges linked to increased AC use and discusses more sustainable alternatives. A literature review was conducted applying a transdisciplinary approach. It was further complemented by examples from cities in hot climates. To analyse the findings, an analytical framework was developed which considers four societal levels-individual, community, city, and national. The main challenges identified from the literature review are as follows: environmental, organisational, socio-economical, biophysical and behavioural. The paper also identifies several measures that could be taken to reduce the fast growth of AC use. However, due to the complex nature of the problem, there is no single solution to provide sustainable cooling. Alternative solutions were categorised in three broad categories: climate-sensitive urban planning and building design, alternative cooling technologies, and climate-sensitive attitudes and behaviour. The main findings concern the problems arising from leaving the responsibility to come up with cooling solutions entirely to the individual, and how different societal levels can work towards more sustainable cooling options. It is concluded that there is a need for a more holistic view both when it comes to combining various solutions as well as involving various levels in society.
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Affiliation(s)
| | | | - Tuan Anh Chu
- Department of Architecture, Lund University, Lund, Sweden
| | | | - Per Becker
- Division of Risk Management and Societal Safety, Lund University, Lund, Sweden
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Tian L, Liang F, Guo Q, Chen S, Xiao S, Wu Z, Jin X, Pan X. The effects of interaction between particulate matter and temperature on mortality in Beijing, China. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2018; 20:395-405. [PMID: 29337319 DOI: 10.1039/c7em00414a] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND the effects of interaction between temperature and inhalable particulate matter (aerodynamic diameter < 10 μm, PM10) on mortality have been examined in some previous studies, but the results were inconsistent. This study aims to explore whether the effects of PM10 on daily non-accidental, cardiovascular and respiratory mortality were modified by temperature levels in Beijing from 2006 to 2009. METHODS we applied a bivariate response surface model and temperature-stratified model based on time-series Poisson generalized additive models (GAMs) to examine the interactive effects in single- and two-pollutant models. The modification of age and gender was examined in subgroup analyses. RESULTS the median of temperature (15.9 °C) and visualized turning point (20 °C) were chosen as cut-offs to define the temperature strata as two levels (low and high). Results showed that the effect estimates of PM10 were stronger at the high temperature level for non-accidental, cardiovascular and respiratory mortality than at the low temperature level. When controlling the moving average lag of temperature for 14 days, the effect estimates per 10 μg m-3 increase in PM10 for non-accidental, cardiovascular and respiratory mortality increased 0.14% (95% CI: 0.05, 0.22), 0.12% (95% CI: 0.02, 0.23) and 0.14% (95% CI: -0.06, 0.34) when the temperature was low and 0.24% (95% CI: 0.12, 0.35), 0.17% (95% CI: 0.01, 0.34) and 0.45% (95% CI: 0.13, 0.78) at the high temperature level, respectively. In the two-pollutant model, the effects of PM10 were attenuated at both high and low temperatures at all lags after adjusting SO2 and NO2. The PM10 effects were stronger at the high temperature level for females and elderly people (≥65 years old). CONCLUSION the findings suggest that daily mortality attributed to PM10 might be modified by temperature. The interaction between air pollution and global climate change has potential strategy and policy implications.
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Affiliation(s)
- Lin Tian
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
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Guo T, Wang Y, Zhang H, Zhang Y, Zhao J, Wang Y, Xie X, Wang L, Zhang Q, Liu D, He Y, Yang Y, Xu J, Peng Z, Ma X. The association between ambient temperature and the risk of preterm birth in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 613-614:439-446. [PMID: 28918275 DOI: 10.1016/j.scitotenv.2017.09.104] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND With the gradual increase of global warming, the impact of extreme temperatures on health has become a focus of attention, however, its relationship with preterm birth remains unclear. OBJECTIVES To investigate the association between exposure to extreme temperatures and preterm birth. METHODS Temperature exposures and birth outcomes of 1,020,471 pregnant women from 132 cities in China were investigated. The pregnancy process was divided into different pregnancy periods. Study areas were divided into three categories (cold, medium, and hot areas) according to the local average temperature by cluster analysis. Average temperature data for each province used in the cluster analysis came from the China Statistical Yearbook 2013. Logistic regression was used to compare the effects of exposure to hot and cold conditions on the outcomes of pregnancy in different periods and regions. RESULTS A total of 1,020,471 singleton births were included, of which 73,240(7.2%) were preterm births. Compared with moderate temperatures (5th to 95th percentile), heat exposure (>95th percentile) in different periods of pregnancy increased the risk of preterm birth in hot areas. The most obvious increase was during the 3 months before pregnancy (odds ratio (OR)=1.229, 95% confidence interval (CI): 1.166-1.295). In contrast to heat exposure, cold exposure (<5th percentile) in hot areas reduced the risk of preterm birth; the protective effect was most pronounced in the 3 months before pregnancy (OR=0.784, 95% CI: 0.734-0.832). In medium and cold areas cold exposure also reduced the risk of preterm birth. The effect of exposure to extreme ambient temperatures throughout the entire pregnancy on preterm birth was similar to those of the periods above. CONCLUSIONS Acute and chronic exposure to extreme temperatures may affect the risk of preterm birth. Extreme heat is a risk factor for preterm birth and extreme cold is a protective factor.
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Affiliation(s)
- Tongjun Guo
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China; Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, 100081, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, 100081, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, 100081, China
| | - Jun Zhao
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Yan Wang
- National Research Institute for Family Planning, Beijing, 100081, China
| | - Xiaoxu Xie
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Long Wang
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Qian Zhang
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Dujia Liu
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China
| | - Jihong Xu
- National Research Institute for Family Planning, Beijing, 100081, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, 100081, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, 100081, China; Graduate School of Peking Union Medical College, Beijing, 100730, China; Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, 100081, China.
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Vicedo-Cabrera AM, Sera F, Guo Y, Chung Y, Arbuthnott K, Tong S, Tobias A, Lavigne E, de Sousa Zanotti Stagliorio Coelho M, Hilario Nascimento Saldiva P, Goodman PG, Zeka A, Hashizume M, Honda Y, Kim H, Ragettli MS, Röösli M, Zanobetti A, Schwartz J, Armstrong B, Gasparrini A. A multi-country analysis on potential adaptive mechanisms to cold and heat in a changing climate. ENVIRONMENT INTERNATIONAL 2018; 111:239-246. [PMID: 29272855 DOI: 10.1016/j.envint.2017.11.006] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Temporal variation of temperature-health associations depends on the combination of two pathways: pure adaptation to increasingly warmer temperatures due to climate change, and other attenuation mechanisms due to non-climate factors such as infrastructural changes and improved health care. Disentangling these pathways is critical for assessing climate change impacts and for planning public health and climate policies. We present evidence on this topic by assessing temporal trends in cold- and heat-attributable mortality risks in a multi-country investigation. METHODS Trends in country-specific attributable mortality fractions (AFs) for cold and heat (defined as below/above minimum mortality temperature, respectively) in 305 locations within 10 countries (1985-2012) were estimated using a two-stage time-series design with time-varying distributed lag non-linear models. To separate the contribution of pure adaptation to increasing temperatures and active changes in susceptibility (non-climate driven mechanisms) to heat and cold, we compared observed yearly-AFs with those predicted in two counterfactual scenarios: trends driven by either (1) changes in exposure-response function (assuming a constant temperature distribution), (2) or changes in temperature distribution (assuming constant exposure-response relationships). This comparison provides insights about the potential mechanisms and pace of adaptation in each population. RESULTS Heat-related AFs decreased in all countries (ranging from 0.45-1.66% to 0.15-0.93%, in the first and last 5-year periods, respectively) except in Australia, Ireland and UK. Different patterns were found for cold (where AFs ranged from 5.57-15.43% to 2.16-8.91%), showing either decreasing (Brazil, Japan, Spain, Australia and Ireland), increasing (USA), or stable trends (Canada, South Korea and UK). Heat-AF trends were mostly driven by changes in exposure-response associations due to modified susceptibility to temperature, whereas no clear patterns were observed for cold. CONCLUSIONS Our findings suggest a decrease in heat-mortality impacts over the past decades, well beyond those expected from a pure adaptation to changes in temperature due to the observed warming. This indicates that there is scope for the development of public health strategies to mitigate heat-related climate change impacts. In contrast, no clear conclusions were found for cold. Further investigations should focus on identification of factors defining these changes in susceptibility.
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Affiliation(s)
- Ana M Vicedo-Cabrera
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Francesco Sera
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Katherine Arbuthnott
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Children's Medical Center, Shanghai Jiao-Tong University, Shanghai, China; School of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Eric Lavigne
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Ariana Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, United Kingdom
| | - 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
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ben Armstrong
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
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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: 39] [Impact Index Per Article: 6.5] [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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