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Ren N, Huang H, Liu B, Wu C, Xiang J, Zhou Q, Kang S, Zhang X, Jiang Y. Interactive effects of atmospheric oxidising pollutants and heat waves on the risk of residential mortality. Glob Health Action 2024; 17:2313340. [PMID: 38381455 PMCID: PMC10883108 DOI: 10.1080/16549716.2024.2313340] [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: 06/08/2023] [Accepted: 01/29/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND The impact of heat waves and atmospheric oxidising pollutants on residential mortality within the framework of global climate change has become increasingly important. OBJECTIVE In this research, the interactive effects of heat waves and oxidising pollutants on the risk of residential mortality in Fuzhou were examined. Methods We collected environmental, meteorological, and residential mortality data in Fuzhou from 1 January 2016, to 31 December 2021. We then applied a generalised additive model, distributed lagged nonlinear model, and bivariate three-dimensional model to investigate the effects and interactions of various atmospheric oxidising pollutants and heat waves on the risk of residential mortality. RESULTS Atmospheric oxidising pollutants increased the risk of residential mortality at lower concentrations, and O3 and Ox were positively associated with a maximum risk of 2.19% (95% CI: 0.74-3.66) and 1.29% (95% CI: 0.51-2.08). The risk of residential mortality increased with increasing temperature, with a strong and long-lasting effect and a maximum cumulative lagged effect of 1.11% (95% CI: 1.01, 1.23). Furthermore, an interaction between atmospheric oxidising pollutants and heat waves may have occurred: the larger effects in the longest cumulative lag time on residential mortality per 10 µg/m3 increase in O3, NO2 and Ox during heat waves compared to non-heat waves were [-3.81% (95% CI: -14.82, 8.63)]; [-0.45% (95% CI: -2.67, 1.81)]; [67.90% (95% CI: 11.55, 152.71)]; 16.37% (95% CI: 2.43, 32.20)]; [-3.00% (95% CI: -20.80, 18.79)]; [-0.30% (95% CI: -3.53, 3.04)]. The risk on heat wave days was significantly higher than that on non-heat wave days and higher than the separate effects of oxidising pollutants and heat waves. CONCLUSIONS Overall, we found some evidence suggesting that heat waves increase the impact of oxidising atmospheric pollutants on residential mortality to some extent.
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Affiliation(s)
- Nan Ren
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Huimin Huang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Baoying Liu
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Chuancheng Wu
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jianjun Xiang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Quan Zhou
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Shuling Kang
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Xiaoyang Zhang
- Department of Public Health, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Yu Jiang
- Department of Preventive Medicine, Fujian Provincial Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
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Zhao C, Huang Y, Cheng Y, Zhang R, Wang Y, Tong S, He J, Guo J, Xia F, Li Y, Yao X. Association between heatwaves and risk and economic burden of injury related hospitalizations in China. ENVIRONMENTAL RESEARCH 2024; 259:119509. [PMID: 38945512 DOI: 10.1016/j.envres.2024.119509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Public health is greatly affected by heatwaves, especially as a result of climate change. It is unclear whether heatwaves affect injury hospitalization, especially as developing countries facing the impact of climate change. OBJECTIVES To assess the impact of heatwaves on injury-related hospitalization and the economic burden. METHODS The daily hospitalizations and meteorological data from 2014 to 2019 were collected from 23 study sites in 11 meteorological geographic zones in China. We conducted a two-stage time series analysis based on a time-stratified case-crossover design, combined with DLNM to assess the association between heatwaves and daily injury hospitalization, and to further assess the regional and national economic losses resulting from hospitalization by calculating excess hospitalization costs (direct economic losses) and labor losses (indirect economic losses). To determine the vulnerable groups and areas, we also carried out stratified analyses by age, sex, and region. RESULTS We found that 6.542% (95%CI: 3.939%, 9.008 %) of injury hospitalization were attributable to heatwaves during warm season (May to September) from 2014 to 2019. Approximately 361,447 injury hospitalizations were attributed to heatwaves each year in China, leading to an excess economic loss of 5.173 (95%CI: 3.104, 7.196) billion CNY, of which 3.114 (95%CI: 1.454, 4.720) billion CNY for males and 4.785 (95%CI: 3.203, 6.321) billion CNY for people aged 15-64 years. The attributable fraction (AF) of injury hospitalizations due to heatwaves was the highest in the plateau mountain climate zone, followed by the subtropical monsoon climate zone and the temperate monsoon climate zone. CONCLUSIONS Heatwaves significantly increase the disease and economic burden of injury hospitalizations, and vary across populations and regions. Our findings implicate the necessity for targeted measures, including raising public awareness, improving healthcare infrastructure, and developing climate resilience policies, to reduce the threat of heatwaves to vulnerable populations and the associated disease and economic burden.
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Affiliation(s)
- Cheng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yu Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Shilu Tong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, 230032, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jiang He
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Jia Guo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Fan Xia
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
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Hanson C, de Bont J, Annerstedt KS, Alsina MDR, Nobile F, Roos N, Waiswa P, Pembe A, Dossou JP, Chipeta E, Benova L, Kidanto H, Part C, Stafoggia M, Filippi V, Ljungman P. A time-stratified, case-crossover study of heat exposure and perinatal mortality from 16 hospitals in sub-Saharan Africa. Nat Med 2024:10.1038/s41591-024-03245-7. [PMID: 39227446 DOI: 10.1038/s41591-024-03245-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 08/09/2024] [Indexed: 09/05/2024]
Abstract
Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case-crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0-6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.34 (95% confidence interval (CI) 1.01-1.78)). The estimates for stillbirths were similarly positive, but CIs included unity: OR = 1.29 (95% CI 0.95-1.77) for all stillbirths, OR = 1.18 (95% CI 0.71-1.95) for antepartum stillbirths and OR = 1.64 (95% CI 0.74-3.63) for intrapartum stillbirths. The cumulative exposure-response curve suggested that the steepest slopes for heat for intrapartum stillbirths and associations were stronger during the hottest seasons. We conclude that short-term heat exposure may increase mortality risks, particularly for intrapartum stillbirths, raising the importance of improved intrapartum care.
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Affiliation(s)
- Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- London School of Hygiene and Tropical Medicine, London, UK.
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya.
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Federica Nobile
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Nathalie Roos
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Andrea Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Jean-Paul Dossou
- Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD), Cotonou, Benin
| | - Effie Chipeta
- Centre for Reproductive Health, Kamuzu University of Health Science, Blantyre, Malawi
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hussein Kidanto
- Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Cherie Part
- London School of Hygiene and Tropical Medicine, London, UK
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | | | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Danderyd, Sweden
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Hua Y, Zhou L, Liu F, Yang H, Wang L, Huang C, Liu C, Lu Y, Wang H, Kan H. Association between ambient temperature and cause-specific mortality: An individual-level case-crossover study in Suzhou, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 282:116687. [PMID: 38981395 DOI: 10.1016/j.ecoenv.2024.116687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024]
Abstract
The changing climate poses a growing challenge to the population health. The objective of this study was to assess the association between ambient temperature and cause-specific mortality in Suzhou. Based on the non-accidental mortality data collected during 2008-2022 in Suzhou, China, this study utilized an individual-level case-crossover design to evaluate the associations of temperature with cause-specific mortality. We applied a distributed lag nonlinear model with a maximum lag of 14 days to account for lag effects. Mortality risk due to extreme cold (<2.5th percentile) and extreme heat (>97.5th percentile) was analyzed. A total of 634,530 non-accidental deaths were analyzed in this study. An inverse J-shaped exposure-response relationship was observed between ambient temperature and non-accidental mortality, with the minimum mortality temperature (MMT) at 29.1℃. The relative risk (RR) of mortality associated with extreme cold (2.5th percentile) was 1.37 [95 % confidence interval (CI): 1.30, 1.44], higher than estimate of 1.09 (95 %CI: 1.07, 1.11) for extreme heat (97.5th percentile) relative to the MMT. Heat effect lasted for 2-3 days, while cold effect could persist for almost 14 days. Higher mortality risk estimates were observed for cardiorespiratory deaths compared to total deaths, with statistically significant between-group differences. Consequently, this study provides first-hand evidence on the associations between ambient temperatures and mortality risks from various causes, which could help local government and policy-makers in designing targeted strategies and public health measures against the menace of climate change.
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Affiliation(s)
- Yujie Hua
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Lu Zhou
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Fang Liu
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Haibing Yang
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Linchi Wang
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Chunyan Huang
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China
| | - Yan Lu
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China.
| | - Haitao Wang
- Department of Disease Control, SuZhou Municipal Health Commission, Suzhou 215002, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200032, China.
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Ding F, Liu X, Hu Z, Liu W, Zhang Y, Zhao Y, Zhao S, Zhao Y. Association between ambient temperature, PM 2.5 and tuberculosis in Northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3173-3187. [PMID: 38153391 DOI: 10.1080/09603123.2023.2299236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/20/2023] [Indexed: 12/29/2023]
Abstract
Existing evidence suggested that the risk of tuberculosis (TB) infection was associated to the variations in temperature and PM2.5. A total of 9,111 cases of TB were reported in Ningxia Hui Autonomous Region, China from 2013 to 2015 on a daily basis, and 57.2% of them were male. The TB risk was more prominent for a lower temperature in males (RR of 1.724, 95% CI: 1.241, 2.394), the aged over 64 years (RR of 2.241, 95% CI: 1.554, 3.231), and the high mobility occupation subpopulation (RR of 2.758, 95% CI: 1.745, 4.359). High concentration of PM2.5 showed a short-term effect and was only associated with an increased risk in the early stages of exposure for the female, and aged 36-64 years group. There were 15.06% (1370 cases) of cases of TB may be attributable to the temperature, and 2.94% (268 cases) may be attributable to the increase of PM2.5 exposures. Low temperatures may be associated with significantly increase in the risk of TB, and high PM2.5 concentrations have a short-term association on increasing the risk of TB. Strengthening the monitoring and regular prevention and control of high risk groups will provide scientific guidance to reduce the incidence of TB.
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Affiliation(s)
- Fan Ding
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Xianglong Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Zengyun Hu
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, China
| | - Weichen Liu
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Yajuan Zhang
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Yi Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
| | - Shi Zhao
- School of Public Health, Tianjin Medical University, Tianjin, China
- Centre for Health Systems and Policy Research, Chinese University of Hong Kong, Hong Kong, China
- CUHK Shenzhen Research Institute, Chinese University of Hong Kong, Shenzhen, China
| | - Yu Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, China
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Li Z, Liu Q, Chen L, Zhou L, Qi W, Wang C, Zhang Y, Tao B, Zhu L, Martinez L, Lu W, Wang J. Ambient air pollution contributed to pulmonary tuberculosis in China. Emerg Microbes Infect 2024:2399275. [PMID: 39206812 DOI: 10.1080/22221751.2024.2399275] [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: 09/04/2024]
Abstract
Published studies on outdoor air pollution and tuberculosis risk have shown heterogeneous results. Discrepancies in prior studies may be partially explained by the limited geographic scope, diverse exposure times, and heterogeneous statistical methods. Thus, we conducted a multi-province, multi-city time-series study to comprehensively investigate this issue. We selected 67 districts or counties from all geographic regions of China as study sites. We extracted data on newly diagnosed pulmonary tuberculosis (PTB) cases, outdoor air pollutant concentrations, and meteorological factors in 67 sites from January 1, 2014 to December 31, 2019. We utilized a generalized additive model to evaluate the relationship between ambient air pollutants and PTB risk. Between 2014 and 2019, there were 172 160 newly diagnosed PTB cases reported in 67 sites. With every 10-μg/m3 increase in SO2, NO2, PM10, PM2.5, and 1-mg/m3 in CO, the PTB risk increased by 1.97% [lag 0 week, 95% confidence interval (CI): 1.26, 2.68], 1.30% (lag 0 week, 95% CI: 0.43, 2.19), 0.55% (lag 8 weeks, 95% CI: 0.24, 0.85), 0.59% (lag 10 weeks, 95% CI: 0.16, 1.03), and 5.80% (lag 15 weeks, 95% CI: 2.96, 8.72), respectively. Our results indicated that ambient air pollutants were positively correlated with PTB risk, suggesting that decreasing outdoor air pollutant concentrations may help to reduce the burden of tuberculosis in countries with a high burden of tuberculosis and air pollution.
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Affiliation(s)
- Zhongqi Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009 China
| | - Qiao Liu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009 China
| | - Liang Chen
- Guangdong Provincial Institute of Public Health, Guangzhou, 510630 China
| | - Liping Zhou
- Institute of Tuberculosis Control, Center for Disease Control and Prevention of Hubei Province, Wuhan, 430070 China
| | - Wei Qi
- Department of tuberculosis, Center for Disease Control and Prevention of Liaoning Province, Shenyang, 110005 China
| | - Chaocai Wang
- Department of tuberculosis, Center for Disease Control and Prevention of Qinghai Province, Xining, 810007 China
| | - Yu Zhang
- Institute of Tuberculosis Control, Center for Disease Control and Prevention of Hubei Province, Wuhan, 430070 China
| | - Bilin Tao
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China
| | - Limei Zhu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009 China
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, United States
| | - Wei Lu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009 China
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China
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Bu Y, Sun Z, Tao Y, Zhao X, Zhao Y, Liang Y, Hang X, Han L. The synergistic effect of high temperature and relative humidity on non-accidental deaths at different urbanization levels. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 940:173612. [PMID: 38823719 DOI: 10.1016/j.scitotenv.2024.173612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/11/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024]
Abstract
Numerous studies have examined the impact of temperature on mortality, yet research on the combined effect of temperature and humidity on non-accidental deaths remains limited. This study investigates the synergistic impact of high temperature and humidity on non-accidental deaths in China, assessing the influence of urban development and urbanization level. Utilizing the distributed lag nonlinear model (DLNM) of quasi-Poisson regression, we analyzed the relationship between Wet Bulb Globe Temperature (WBGT) and non-accidental deaths in 30 Chinese cities from 2010 to 2016, including Guangzhou during 2012-2016. We stratified temperature and humidity across these cities to evaluate the influence of varying humidity levels on deaths under high temperatures. Then, we graded the duration of heat and humidity in these cities to assess the impact of deaths with different durations. Additionally, the cities were categorized based on gross domestic product (GDP), and a vulnerability index was calculated to examine the impact of urban development and urbanization level on non-accidental deaths. Our findings reveal a pronounced synergistic effect of high temperature and humidity on non-accidental deaths, particularly at elevated humidity levels. The synergies of high temperature and humidity are extremely complex. Moreover, the longer the duration of high temperature and humidity, the higher the risk of non-accidental death. Furthermore, areas with higher urbanization exhibited lower relative risks (RR) associated with the synergistic effects of heat and humidity. Consequently, it is imperative to focus on damp-heat related mortality among vulnerable populations in less developed regions.
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Affiliation(s)
- Yaqin Bu
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China; State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China
| | - Zhaobin Sun
- State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China.
| | - Yan Tao
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China
| | - Xiuge Zhao
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Yuxin Zhao
- State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China
| | - Yinglin Liang
- State Key Laboratory of Severe Weather (LASW), Chinese Academy of Meteorological Sciences (CAMS), China Meteorological Administration, Beijing 100081, China
| | - Xiaoyi Hang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Ling Han
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Yang Y, Li X, Wang S, Lei Y, Xu W, Li Y, Yang L, Miao J, Wang W, Yin L. Assessing the impact of temperature on acute exacerbation of chronic obstructive pulmonary disease hospitalizations in residents of Panzhihua City: a multi-districts study using a distributed lag non-linear model. BMC Public Health 2024; 24:2151. [PMID: 39112974 PMCID: PMC11308688 DOI: 10.1186/s12889-024-19677-2] [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: 01/02/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Temperature fluctuations can impact the occurrence and progression of respiratory system diseases. However, the current understanding of the impact of temperature on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains limited. Therefore, our study aims to investigate the relationship between daily mean temperature (DMT) and the risk of AECOPD hospitalizations within Panzhihua City. METHODS We systematically collected data on AECOPD hospitalizations at Panzhihua Central Hospital from 2015 to 2020 and meteorological factors across Panzhihua City's districts. A two-stage analysis method was used to establish a distributed lag non-linear model to elucidate the influence of DMT on the frequency of admissions for AECOPD. Subgroup analyses were conducted by gender and age to identify populations potentially susceptible to the impact of DMT. RESULTS A total of 5299 AECOPD hospitalizations cases were included. The DMT and the risk of AECOPD hospitalization showed a non-linear exposure-response pattern, with low temperatures exacerbating the risk of hospitalizations. The lag effects of low temperature and relatively low temperature peaked at 2th day, with the lag effects disappearing at 16-17 days. Females and elders aged ≥ 65 years were more sensitive to effects of low and relatively low temperature at lag 0-4 days, while male AECOPD patients exhibited longer lasting lag effects. CONCLUSIONS Low temperatures are associated with an increased risk of AECOPD hospitalizations. Females or elders aged ≥ 65 years with chronic obstructive pulmonary disease should pay more attention to taking protective measures in cold environments. These findings are crucial for the formulation of public health policies, as they will help significantly alleviate the burden of AECOPD and improve respiratory health in the face of climate challenges.
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Affiliation(s)
- Yan Yang
- Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
- Clinical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, 610225, China
| | - Yingchao Lei
- School of Health and Wellness, Panzhihua University, Panzhihua, Sichuan, 617000, China
| | - Wenhao Xu
- Discipline Construction Office, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Yongjun Li
- Panzhihua Meteorological Bureau, Panzhihua Meteorological Office, Panzhihua, Sichuan, 617000, China
| | - Lei Yang
- Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Jinli Miao
- The Yangtze River Delta Biological Medicine Research and Development Center of Zhejiang Province, Yangtze Delta Region Institution of Tsinghua University, Hangzhou, Zhejiang, 314006, China
| | - Wenmin Wang
- The Yangtze River Delta Biological Medicine Research and Development Center of Zhejiang Province, Yangtze Delta Region Institution of Tsinghua University, Hangzhou, Zhejiang, 314006, China
| | - Li Yin
- Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China.
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China.
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Urbanowicz T, Skotak K, Bratkowski J, Olasińska-Wiśniewska A, Filipiak KJ, Michalak M, Grodecki K, Szczepański K, Tykarski A, Krasińska B, Krasiński Z, Krasińska-Płachta A, Jemielity M. Long-Term Survival after Coronary Artery Surgical Revascularization-Does Ambient Temperature Matter? MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1220. [PMID: 39202501 PMCID: PMC11356662 DOI: 10.3390/medicina60081220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/11/2024] [Accepted: 07/25/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: The progression of global warming results in an increased exposure to extreme heat, leading to exaggeration of preexisting diseases and premature deaths. The aim of the study was to present possible risk factors for all-cause long-term mortality in patients who underwent surgical revascularization, including an assessment of the influence of ambient temperature exposure. Materials and Methods: Retrospective analysis included 153 (123 (80%) males and 30 (20%) females) patients who underwent off-pump revascularization and were followed for a median time of 2533 (1035-3250) days. The demographical, clinical data and ambient temperature exposure were taken into analysis for prediction of all-cause mortality. Individual exposure was calculated based on the place of habitation. Results: In the multivariate logistic regression model with backward stepwise elimination method, risk factors such as dyslipidaemia (p = 0.001), kidney disease (p = 0.005), age (p = 0.006), and body mass index (p = 0.007) were found to be significant for late mortality prediction. In addition to traditional factors, environmental characteristics, including tropical nights (p = 0.043), were revealed to be significant. Conclusions: High night-time ambient temperatures known as tropical nights may be regarded as additional long-term mortality risk factor after surgical revascularization.
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Affiliation(s)
- Tomasz Urbanowicz
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Krzysztof Skotak
- Institute of Environmental Protection–National Research Institute, 02-170 Warsaw, Poland
| | - Jakub Bratkowski
- Institute of Environmental Protection–National Research Institute, 02-170 Warsaw, Poland
| | - Anna Olasińska-Wiśniewska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Krzysztof J. Filipiak
- Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, 00-136 Warsaw, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Kajetan Grodecki
- 1st Cardiology Department, Warsaw University of Medical Sciences, 02-091 Warsaw, Poland
| | - Krystian Szczepański
- Institute of Environmental Protection–National Research Institute, 02-170 Warsaw, Poland
| | - Andrzej Tykarski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Beata Krasińska
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Zbigniew Krasiński
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | | | - Marek Jemielity
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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10
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Lu CL, Sha JJ, Ma RF, Dong XT, Su XR, Cong B, Wang SJ. Severe Hypothermia Induces Ferroptosis in Cerebral Cortical Nerve Cells. Int J Mol Sci 2024; 25:8086. [PMID: 39125656 PMCID: PMC11311695 DOI: 10.3390/ijms25158086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
Abnormal shifts in global climate, leading to extreme weather, significantly threaten the safety of individuals involved in outdoor activities. Hypothermia-induced coma or death frequently occurs in clinical and forensic settings. Despite this, the precise mechanism of central nervous system injury due to hypothermia remains unclear, hindering the development of targeted clinical treatments and specific forensic diagnostic indicators. The GEO database was searched to identify datasets related to hypothermia. Post-bioinformatics analyses, DEGs, and ferroptosis-related DEGs (FerrDEGs) were intersected. GSEA was then conducted to elucidate the functions of the Ferr-related genes. Animal experiments conducted in this study demonstrated that hypothermia, compared to the control treatment, can induce significant alterations in iron death-related genes such as PPARG, SCD, ADIPOQ, SAT1, EGR1, and HMOX1 in cerebral cortex nerve cells. These changes lead to iron ion accumulation, lipid peroxidation, and marked expression of iron death-related proteins. The application of the iron death inhibitor Ferrostatin-1 (Fer-1) effectively modulates the expression of these genes, reduces lipid peroxidation, and improves the expression of iron death-related proteins. Severe hypothermia disrupts the metabolism of cerebral cortex nerve cells, causing significant alterations in ferroptosis-related genes. These genetic changes promote ferroptosis through multiple pathways.
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Affiliation(s)
| | | | | | | | | | - Bin Cong
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, College of Forensic Medicine, Hebei Medical University, No. 361 Zhong Shan Road, Shijiazhuang 050017, China; (C.-L.L.); (J.-J.S.); (R.-F.M.); (X.-T.D.); (X.-R.S.)
| | - Song-Jun Wang
- Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, College of Forensic Medicine, Hebei Medical University, No. 361 Zhong Shan Road, Shijiazhuang 050017, China; (C.-L.L.); (J.-J.S.); (R.-F.M.); (X.-T.D.); (X.-R.S.)
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11
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Chen Y, Zhou L, Zha Y, Wang Y, Wang K, Lu L, Guo P, Zhang Q. Impact of Ambient Temperature on Mortality Burden and Spatial Heterogeneity in 16 Prefecture-Level Cities of a Low-Latitude Plateau Area in Yunnan Province: Time-Series Study. JMIR Public Health Surveill 2024; 10:e51883. [PMID: 39045874 PMCID: PMC11287102 DOI: 10.2196/51883] [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: 08/16/2023] [Revised: 05/14/2024] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Background The relation between climate change and human health has become one of the major worldwide public health issues. However, the evidence for low-latitude plateau regions is limited, where the climate is unique and diverse with a complex geography and topography. objectives This study aimed to evaluate the effect of ambient temperature on the mortality burden of nonaccidental deaths in Yunnan Province and to further explore its spatial heterogeneity among different regions. Methods We collected mortality and meteorological data from all 129 counties in Yunnan Province from 2014 to 2020, and 16 prefecture-level cities were analyzed as units. A distributed lagged nonlinear model was used to estimate the effect of temperature exposure on years of life lost (YLL) for nonaccidental deaths in each prefecture-level city. The attributable fraction of YLL due to ambient temperature was calculated. A multivariate meta-analysis was used to obtain an overall aggregated estimate of effects, and spatial heterogeneity among 16 prefecture-level cities was evaluated by adjusting the city-specific geographical characteristics, demographic characteristics, economic factors, and health resources factors. Results The temperature-YLL association was nonlinear and followed slide-shaped curves in all regions. The cumulative cold and heat effect estimates along lag 0-21 days on YLL for nonaccidental deaths were 403.16 (95% empirical confidence interval [eCI] 148.14-615.18) and 247.83 (95% eCI 45.73-418.85), respectively. The attributable fraction for nonaccidental mortality due to daily mean temperature was 7.45% (95% eCI 3.73%-10.38%). Cold temperature was responsible for most of the mortality burden (4.61%, 95% eCI 1.70-7.04), whereas the burden due to heat was 2.84% (95% eCI 0.58-4.83). The vulnerable subpopulations include male individuals, people aged <75 years, people with education below junior college level, farmers, nonmarried individuals, and ethnic minorities. In the cause-specific subgroup analysis, the total attributable fraction (%) for mean temperature was 13.97% (95% eCI 6.70-14.02) for heart disease, 11.12% (95% eCI 2.52-16.82) for respiratory disease, 10.85% (95% eCI 6.70-14.02) for cardiovascular disease, and 10.13% (95% eCI 6.03-13.18) for stroke. The attributable risk of cold effect for cardiovascular disease was higher than that for respiratory disease cause of death (9.71% vs 4.54%). Furthermore, we found 48.2% heterogeneity in the effect of mean temperature on YLL after considering the inherent characteristics of the 16 prefecture-level cities, with urbanization rate accounting for the highest proportion of heterogeneity (15.7%) among urban characteristics. Conclusions This study suggests that the cold effect dominated the total effect of temperature on mortality burden in Yunnan Province, and its effect was heterogeneous among different regions, which provides a basis for spatial planning and health policy formulation for disease prevention.
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Affiliation(s)
- Yang Chen
- School of Public Health, Kunming Medical University, Kunming, China
- Institute for Noncommunicable Disease Prevention and Control, Yunnan Centers for Disease Prevention and Control, Kunming, China
| | - Lidan Zhou
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Yuanyi Zha
- Graduate School, Kunming University of Medical, Kunming, China
| | - Yujin Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Kai Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Lvliang Lu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
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12
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Qian K, Sun Q, Li Y, Chen J. Association of ambient temperature on acute ischemic stroke in Yancheng, China. BMC Public Health 2024; 24:1879. [PMID: 39010033 PMCID: PMC11247823 DOI: 10.1186/s12889-024-19423-8] [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: 04/13/2024] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Acute ischemic stroke (AIS) is a major global public health issue. There is limited research on the relationship between ambient temperature and AIS hospital admissions, and the results are controversial. Our objective is to assess the short-term impact of ambient temperature on the risk of AIS hospital admissions in Yancheng, China. METHODS We collected data on daily AIS hospital admissions, meteorological factors, and air quality in Yancheng from 2014 to 2019. We used Poisson regression to fit generalized linear models and distributed lag non-linear models to explore the association between ambient temperature and AIS hospital admissions. The effects of these associations were evaluated by stratified analysis by sex and age. RESULTS From 2014 to 2019, we identified a total of 13,391 AIS hospital admissions. We observed that the influence of extreme cold and heat on admissions for AIS manifests immediately on the day of exposure and continues for a duration of 3-5 days. Compared to the optimal temperature (24.4 °C), the cumulative relative risk under extreme cold temperature (-1.3 °C) conditions with a lag of 0-5 days was 1.88 (95%CI: 1.28, 2.78), and under extreme heat temperature (30.5 °C) conditions with a lag of 0-5 days was 1.48 (95%CI: 1.26, 1.73). CONCLUSIONS There is a non-linear association between ambient temperature and AIS hospital admission risk in Yancheng, China. Women and older patients are more vulnerable to non-optimal temperatures. Our findings may reveal the potential impact of climate change on the risk of AIS hospital admissions.
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Affiliation(s)
- Kai Qian
- Department of Neurology, Dongtai People's Hospital, Yancheng, 224200, Jiangsu, China
| | - Qian Sun
- Department of Respiratory Medicine, The First People's Hospital of Yancheng, Affiliated Hospital of Nanjing University Medical School, Yancheng, 224006, Jiangsu Province, China
| | - Yanlong Li
- Department of Neurology, Dongtai People's Hospital, Yancheng, 224200, Jiangsu, China
| | - Jin Chen
- Department of Neurology, The First People's Hospital of Yancheng, Affiliated Hospital of Nanjing University Medical School, No. 166 Yulong West Road, Yancheng, 224006, Jiangsu Province, China.
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13
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Gao Y, Lin L, Yin P, Kan H, Chen R, Zhou M. Heat Exposure and Dementia-Related Mortality in China. JAMA Netw Open 2024; 7:e2419250. [PMID: 38941091 PMCID: PMC11214125 DOI: 10.1001/jamanetworkopen.2024.19250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/27/2024] [Indexed: 06/29/2024] Open
Abstract
Importance Although existing research has found daily heat to be associated with dementia-related outcomes, there is still a gap in understanding the differing associations of nighttime and daytime heat with dementia-related deaths. Objectives To quantitatively assess the risk and burden of dementia-related deaths associated with short-term nighttime and daytime heat exposure and identify potential effect modifications. Design, Setting, and Participants This case-crossover study analyzed individual death records for dementia across all mainland China counties from January 1, 2013, to December 31, 2019, using a time-stratified case-crossover approach. Statistical analysis was conducted from January 1, 2013, to December 31, 2019. Exposures Two novel heat metrics: hot night excess (HNE) and hot day excess (HDE), representing nighttime and daytime heat intensity, respectively. Main Outcomes and Measures Main outcomes were the relative risk and burden of dementia-related deaths associated with HNE and HDE under different definitions. Analysis was conducted with conditional logistic regression integrated with the distributed lag nonlinear model. Results The study involved 132 573 dementia-related deaths (mean [SD] age, 82.5 [22.5] years; 73 086 women [55.1%]). For a 95% threshold, the median hot night threshold was 24.5 °C (IQR, 20.1 °C-26.2 °C) with an HNE of 3.7 °C (IQR, 3.1 °C-4.3 °C), and the median hot day threshold was 33.3 °C (IQR, 29.9 °C-34.7 °C) with an HDE of 0.6 °C (IQR, 0.5 °C-0.8 °C). Both nighttime and daytime heat were associated with increased risk of dementia-related deaths. Hot nights' associations with risk of dementia-related deaths persisted for 6 days, while hot days' associations with risk of dementia-related deaths extended over 10 days. Extreme HDE had a higher relative risk of dementia-related deaths, with a greater burden associated with extreme HNE at more stringent thresholds. At a 97.5% threshold, the odds ratio for dementia-related deaths was 1.38 (95% CI, 1.22-1.55) for extreme HNE and 1.46 (95% CI, 1.27-1.68) for extreme HDE, with an attributable fraction of 1.45% (95% empirical confidence interval [95% eCI], 1.43%-1.47%) for extreme HNE and 1.10% (95% eCI, 1.08%-1.11%) for extreme HDE. Subgroup analyses suggested heightened susceptibility among females, individuals older than 75 years of age, and those with lower educational levels. Regional disparities were observed, with individuals in the south exhibiting greater sensitivity to nighttime heat and those in the north to daytime heat. Conclusions and Relevance Results of this nationwide case-crossover study suggest that both nighttime and daytime heat are associated with increased risk of dementia-related deaths, with a greater burden associated with nighttime heat. These findings underscore the necessity of time-specific interventions to mitigate extreme heat risk.
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Affiliation(s)
- Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lin Lin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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14
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Qiu W, Wang B, Feng X, He H, Fan L, Ye Z, Nie X, Mu G, Liu W, Wang D, Zhou M, Chen W. Associations of short-term ambient temperature exposure with lung function in middle-aged and elderly people: A longitudinal study in China. ECO-ENVIRONMENT & HEALTH 2024; 3:165-173. [PMID: 38646096 PMCID: PMC11031725 DOI: 10.1016/j.eehl.2024.01.008] [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: 08/29/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 04/23/2024]
Abstract
The short-term associations of ambient temperature exposure with lung function in middle-aged and elderly Chinese remain obscure. The study included 19,128 participants from the Dongfeng-Tongji cohort's first (2013) and second (2018) follow-ups. The lung function for each subject was determined between April and December 2013 and re-assessed in 2018, with three parameters (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and peak expiratory flow [PEF]) selected. The China Meteorological Data Sharing Service Center provided temperature data during the study period. In the two follow-ups, a total of 25,511 records (average age: first, 64.57; second, 65.80) were evaluated, including 10,604 males (41.57%). The inversely J-shaped associations between moving average temperatures (lag01-lag07) and FVC, FEV1, and PEF were observed, and the optimum temperatures at lag04 were 16.5 °C, 18.7 °C, and 16.2 °C, respectively. At lag04, every 1 °C increase in temperature was associated with 14.07 mL, 9.78 mL, and 62.72 mL/s increase in FVC, FEV1, and PEF in the low-temperature zone (
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Affiliation(s)
- Weihong Qiu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaobing Feng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Heng He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Lieyang Fan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zi Ye
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiuquan Nie
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ge Mu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Min Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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15
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Urbanowicz TK, Skotak K, Lesiak M, Olasińska-Wiśniewska A, Filipiak KJ, Bratkowski J, Szczepański K, Grodecki K, Tykarski A, Jemielity M. Coronary artery culprit lesions progression and ambient temperature exposure - personalised analysis. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2024; 20:139-147. [PMID: 39022713 PMCID: PMC11249875 DOI: 10.5114/aic.2024.139815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 04/02/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Global warming is claimed to be an important cardiovascular disease risk factor. The air pollution and ambient temperatures are believed to have a significant influence on increased morbidity and premature deaths. Aim To point out possible causative factors for coronary angiography progression in patients presenting with chronic coronary syndrome. Material and methods There were 66 patients (41 [62%] men and 25 [38%] women) with a median age of 71.5 (62-76) years, who underwent repeated coronary angiographies due to chronic coronary syndrome within a median time interval of 145 (96-296) days. In 18 (27%) patients coronary artery lesion progression was observed despite optimal pharmacotherapy. The demographical, clinical, and personalised epidemiological factors including air pollution particles and ambient temperature exposure were taken into account in the analysis. Results In the multivariate logistic regression model with backward stepwise elimination method, tropical nights (p = 0.047) and mean daily temperatures (p = 0.043) were revealed as predictors of coronary lesion progression > 30%. The analysis of seasonal temperature changes showed significant differences related to minimal winter temperatures between both groups (p = 0.018). Conclusions Coronary artery lesion progression can be related to either high values of daily temperatures or to low ambient temperature. The dichotomous characteristics of temperature exposure to atherosclerosis progression suggest a detrimental role of environmental extremities on human health.
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Affiliation(s)
- Tomasz Kamil Urbanowicz
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Skotak
- Institute of Environmental Protection – National Research Institute, Warsaw, Poland
| | - Michał Lesiak
- 1 Cardiology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Olasińska-Wiśniewska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof J. Filipiak
- Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Jakub Bratkowski
- Institute of Environmental Protection – National Research Institute, Warsaw, Poland
| | - Krystian Szczepański
- Institute of Environmental Protection – National Research Institute, Warsaw, Poland
| | - Kajetan Grodecki
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Tykarski
- Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Jemielity
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland
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16
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Li XC, Qian HR, Zhang YY, Zhang QY, Liu JS, Lai HY, Zheng WG, Sun J, Fu B, Zhou XN, Zhang XX. Optimal decision-making in relieving global high temperature-related disease burden by data-driven simulation. Infect Dis Model 2024; 9:618-633. [PMID: 38645696 PMCID: PMC11026972 DOI: 10.1016/j.idm.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/27/2024] [Accepted: 03/09/2024] [Indexed: 04/23/2024] Open
Abstract
The rapid acceleration of global warming has led to an increased burden of high temperature-related diseases (HTDs), highlighting the need for advanced evidence-based management strategies. We have developed a conceptual framework aimed at alleviating the global burden of HTDs, grounded in the One Health concept. This framework refines the impact pathway and establishes systematic data-driven models to inform the adoption of evidence-based decision-making, tailored to distinct contexts. We collected extensive national-level data from authoritative public databases for the years 2010-2019. The burdens of five categories of disease causes - cardiovascular diseases, infectious respiratory diseases, injuries, metabolic diseases, and non-infectious respiratory diseases - were designated as intermediate outcome variables. The cumulative burden of these five categories, referred to as the total HTD burden, was the final outcome variable. We evaluated the predictive performance of eight models and subsequently introduced twelve intervention measures, allowing us to explore optimal decision-making strategies and assess their corresponding contributions. Our model selection results demonstrated the superior performance of the Graph Neural Network (GNN) model across various metrics. Utilizing simulations driven by the GNN model, we identified a set of optimal intervention strategies for reducing disease burden, specifically tailored to the seven major regions: East Asia and Pacific, Europe and Central Asia, Latin America and the Caribbean, Middle East and North Africa, North America, South Asia, and Sub-Saharan Africa. Sectoral mitigation and adaptation measures, acting upon our categories of Infrastructure & Community, Ecosystem Resilience, and Health System Capacity, exhibited particularly strong performance for various regions and diseases. Seven out of twelve interventions were included in the optimal intervention package for each region, including raising low-carbon energy use, increasing energy intensity, improving livestock feed, expanding basic health care delivery coverage, enhancing health financing, addressing air pollution, and improving road infrastructure. The outcome of this study is a global decision-making tool, offering a systematic methodology for policymakers to develop targeted intervention strategies to address the increasingly severe challenge of HTDs in the context of global warming.
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Affiliation(s)
- Xin-Chen Li
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Hao-Ran Qian
- School of Data Science, Fudan University, Shanghai, People's Republic of China
| | - Yan-Yan Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Qi-Yu Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jing-Shu Liu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Hong-Yu Lai
- School of Data Science, Fudan University, Shanghai, People's Republic of China
| | - Wei-Guo Zheng
- School of Data Science, Fudan University, Shanghai, People's Republic of China
| | - Jian Sun
- School of Data Science, Fudan University, Shanghai, People's Republic of China
| | - Bo Fu
- School of Data Science, Fudan University, Shanghai, People's Republic of China
| | - Xiao-Nong Zhou
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xiao-Xi Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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17
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Sun X, Xia X, Xue J, Gu Y, Chen Z, Liu P, Wang F, Zhou X, Liu J, Wang L, Li X. Seasonal variability of lesions distribution in acute ischemic stroke: A retrospective study. Sci Rep 2024; 14:11831. [PMID: 38783036 PMCID: PMC11116500 DOI: 10.1038/s41598-024-62631-w] [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: 03/16/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
Seasonal variability could have an impact on the incidence and outcome of stroke. However, little is known about the correlation between seasonal variability and location of acute cerebral infarction. This study aimed to explore the relationship between onset season and the lesions distribution of acute ischemic stroke (AIS). We retrospectively analysis data from 1488 AIS patients admitted to the Second Hospital of Tianjin Medical University from 2018 to 2022. All subjects completed head magnetic resonance imaging examination (MRI) and were divided into four groups according to the onset seasons. The lesions distribution of AIS was evaluated for anterior/posterior/double circulation infarction (DCI), unilateral/bilateral infarctions, and single/multiple cerebral infarctions based on MRI. Logistic regression models were employed to assess the association of season with lesions distribution of AIS. Subgroup analysis was performed in different stroke subtypes. Of 1488 patients, 387 (26.0%) AIS occurred in spring, 425 (28.6%) in summer, 331 (22.2%) in autumn and 345 (23.2%) in winter. Multivariate logistic regression demonstrated that the winter group had 2.15 times (95% CI:1.44-3.21) risk of multiple infarctions, 2.69 times (95% CI:1.80-4.02) of bilateral infarctions and 1.54 times (95% CI:1.05-2.26) of DCI compared with summer group, respectively. Subgroup analysis showed an increased risk of multiple (p < 0.01) or bilateral infarctions (p < 0.01) in small-artery occlusion (SAO) subtype, and higher risk of bilateral infarctions (p < 0.01) or DCI (p < 0.05) in large artery atherosclerosis (LAA) subtype during winter. No significant associations of season with lesions distribution in cardioembolism subtype. Our study highlighted a prominent seasonal variability in the lesions distribution of AIS, particularly in LAA and SAO subtypes. The findings could help to formulating meteorological risk warning strategies for different subtypes.
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Affiliation(s)
- Xiao Sun
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Juanjuan Xue
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yumeng Gu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Fuyin Wang
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiao Zhou
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jiaming Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China.
- Tianjin Center for Health and Meteorology Multidisciplinary Innovation, Tianjin, China.
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18
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Yang X, Wang J, Zhang G, Yu Z. Spatiotemporal distribution and lag effect of extreme temperature exposure on mortality of residents in Jiangsu, China. Heliyon 2024; 10:e30538. [PMID: 38765142 PMCID: PMC11098786 DOI: 10.1016/j.heliyon.2024.e30538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
Background With the ever-increasing occurrence of extreme weather events as a result of global climate change, the impact of extreme temperatures on human health has become a critical area of concern. Specifically, it is imperative to investigate the impact of extreme weather conditions on the health of residents. Methods In this study, we analyze the daily death data from 13 prefecture-level cities in Jiangsu Province from January 2014 to September 2022, using the distributed lag nonlinear model (DLNM) to comprehensively account for factors such as relative humidity, atmospheric pressure, air pollutants, and other factors to evaluate the lag and cumulative effects of extreme low temperature and high temperature on the death of residents across different age groups. Additionally, we utilize the Geographical Detector to analyze the effects of various meteorological and environmental factors on the distribution of resident death in Jiangsu Province. This provides valuable insights that can guide health authorities in decision-making and in the protection of residents. Results The experimental results indicate that both extreme low and high temperatures increase the mortality of residents. We observe that the impact of extreme low temperatures has a delayed effect, peaking after 3-5 days and lasting up to 11-21 days. In contrast, the impact of extreme high temperature is greatest on the first day, and lasts only 2-4 days. Conclusion Both extreme high and low temperatures increase the mortality of residents, with the former being more transient and stronger and the latter being more persistent and slower. Furthermore, residents over 75 years of age are more vulnerable to the effects of extreme temperatures. Finally, we note that the spatial distribution of resident deaths is most closely associated consistent with the spatial distribution of daily mean temperature, and there is significant spatial heterogeneity in deaths among residents in Jiangsu Province.
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Affiliation(s)
- Xu Yang
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, Jiangsu, 210023, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, Jiangsu, 210023, China
| | - Junshu Wang
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, Jiangsu, 210023, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, Jiangsu, 210023, China
| | - Guoming Zhang
- Health Information Center of Jiangsu Province, Nanjing, Jiangsu, 210008, China
| | - Zhaoyuan Yu
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, Jiangsu, 210023, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, Jiangsu, 210023, China
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Zhou L, Liu C, He C, Lei J, Zhu Y, Gao Y, Xuan J, Kan H, Chen R. Quantification of the Heat-Related Risk and Burden of Hospitalizations for Cause-Specific Injuries and Contribution of Human-Induced Climate Change: A Time-Stratified Case-Crossover Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57005. [PMID: 38752990 PMCID: PMC11098006 DOI: 10.1289/ehp14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000-2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (- 12.1 ° C ), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (< 18 years of age) or middle-aged (45-64 years of age) individuals, and those living in the North. The heat-related attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of human-induced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with human-induced change accounting for 6.7% to 10.6% of the burden. DISCUSSION This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. https://doi.org/10.1289/EHP14057.
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Affiliation(s)
- Lu Zhou
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cheng He
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jian Lei
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Sen University, Guangzhou, China
| | - Haidong Kan
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- National Center for Children’s Health, Children’s Hospital of Fudan University, Shanghai, China
| | - Renjie Chen
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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20
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Blaustein JR, Quisel MJ, Hamburg NM, Wittkopp S. Environmental Impacts on Cardiovascular Health and Biology: An Overview. Circ Res 2024; 134:1048-1060. [PMID: 38662864 PMCID: PMC11058466 DOI: 10.1161/circresaha.123.323613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Environmental stressors associated with human activities (eg, air and noise pollution, light disturbance at night) and climate change (eg, heat, wildfires, extreme weather events) are increasingly recognized as contributing to cardiovascular morbidity and mortality. These harmful exposures have been shown to elicit changes in stress responses, circadian rhythms, immune cell activation, and oxidative stress, as well as traditional cardiovascular risk factors (eg, hypertension, diabetes, obesity) that promote cardiovascular diseases. In this overview, we summarize evidence from human and animal studies of the impacts of environmental exposures and climate change on cardiovascular health. In addition, we discuss strategies to reduce the impact of environmental risk factors on current and future cardiovascular disease burden, including urban planning, personal monitoring, and mitigation measures.
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Affiliation(s)
- Jacob R. Blaustein
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
| | - Matthew J. Quisel
- Department of Medicine, Boston University Chobanian and Avedision School of Medicine
| | - Naomi M. Hamburg
- Section of Vascular Biology, Whitaker Cardiovascular Institute, Chobanian and Avedisian School of Medicine, Boston University, Boston, USA
| | - Sharine Wittkopp
- New York University Grossman School of Medicine, Department of Medicine, Leon H. Charney Division of Cardiology, New York, USA
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21
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Bai X, Ming X, Zhao M, Zhou L. Explore the effect of apparent temperature and air pollutants on the admission rate of acute myocardial infarction in Chongqing, China: a time-series study. BMJ Open 2024; 14:e084376. [PMID: 38658006 PMCID: PMC11043748 DOI: 10.1136/bmjopen-2024-084376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE Limited research has been conducted on the correlation between apparent temperature and acute myocardial infarction (AMI), as well as the potential impact of air pollutants in modifying this relationship. The objective of this study is to investigate the lagged effect of apparent temperature on AMI and assess the effect modification of environmental pollutants on this association. DESIGN A time-series study. SETTING AND PARTICIPANTS The data for this study were obtained from the Academy of Medical Data Science at Chongqing Medical University, covering daily hospitalisations for AMI between 1 January 2015 and 31 December 2016. Meteorological and air pollutant data were provided by China's National Meteorological Information Centre. OUTCOME MEASURES We used a combined approach of quasi-Poisson generalised linear model and distributed lag non-linear model to thoroughly analyse the relationships. Additionally, we employed a generalised additive model to investigate the interaction between air pollutants and apparent temperature on the effect of AMI. RESULT A total of 872 patients admitted to hospital with AMI were studied based on the median apparent temperature (20.43°C) in Chongqing. Low apparent temperature (10th, 7.19℃) has obvious lagged effect on acute myocardial infarction, first appearing on the 8th day (risk ratio (RR) 1.081, 95% CI 1.010 to 1.158) and the greatest risk on the 11th day (RR 1.094, 95% CI 1.037 to 1.153). No lagged effect was observed at high apparent temperature. In subgroup analysis, women and individuals aged 75 and above were at high risk. The interaction analysis indicates that there exist significant interactions between PM2.5 and high apparent temperature, as well as nitrogen dioxide (NO2) and low apparent temperature. CONCLUSION The occurrence of decreased apparent temperature levels was discovered to be linked with a heightened relative risk of hospitalisations for AMI. PM2.5 and NO2 have an effect modification on the association between apparent temperature and admission rate of AMI.
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Affiliation(s)
- Xiuyuan Bai
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xin Ming
- Chongqing Health Center for Women and Children, Chongqing, China
- Department of quality management section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Mingming Zhao
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li Zhou
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
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22
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Liu J, Li M, Yang Z, Liu D, Xiao T, Cheng J, Su H, Ou CQ, Yang J. Rising trend and regional disparities of the global burden of disease attributable to ambient low temperature, 1990-2019: An analysis of data from the Global Burden of Disease 2019 study. J Glob Health 2024; 14:04017. [PMID: 38635810 PMCID: PMC11026037 DOI: 10.7189/jogh.14.04017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
Background Previous studies on the effect of global warming on the global burden of disease have mainly focussed on the impact of high temperatures, thereby providing limited evidence of the effect of lower temperatures. Methods We adopted a three-stage analysis approach using data from the Global Burden of Disease 2019 study. First, we explored the global burden of disease attributable to low temperatures, examining variations by gender, age, cause, region, and country. Second, we analysed temporal trends in low-temperature-related disease burdens from 1990 to 2019 by meta-regression. Finally, we fitted a mixed-effects meta-regression model to explore the effect modification of country-level characteristics. Results In 2019, low temperatures were responsible for 2.92% of global deaths and 1.03% of disability-adjusted life years (DALYs), corresponding to a death rate of 21.36 (95% uncertainty interval (UI) = 18.26, 24.73) and a DALY rate of 335 (95% UI = 280, 399) per 100 000 population. Most of the deaths (85.12%) and DALYs (94.38%) attributable to low temperatures were associated with ischaemic heart disease, stroke, and chronic obstructive pulmonary disease. In the last three decades, we observed an upward trend for the annual number of attributable deaths (P < 0.001) and a downward trend for the rates of death (P < 0.001) and DALYs (P < 0.001). The disease burden associated with low temperatures varied considerably among regions and countries, with higher burdens observed in regions with middle or high-middle socio-demographic indices, as well as countries with higher gross domestic product per capita and a larger proportion of ageing population. Conclusions Our findings emphasise the significance of raising public awareness and prioritising policies to protect global population health from the adverse effects of low temperatures, even in the face of global warming. Particular efforts should be targeted towards individuals with underlying diseases (e.g. cardiovascular diseases) and vulnerable countries or regions (e.g. Central Asia and central Europe).
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Affiliation(s)
- Jiangdong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengmeng Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Di Liu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Ting Xiao
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jun Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
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Yin P, He C, Chen R, Huang J, Luo Y, Gao X, Xu Y, Ji JS, Cai W, Wei Y, Li H, Zhou M, Kan H. Projection of Mortality Burden Attributable to Nonoptimum Temperature with High Spatial Resolution in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:6226-6235. [PMID: 38557021 DOI: 10.1021/acs.est.3c09162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The updated climate models provide projections at a fine scale, allowing us to estimate health risks due to future warming after accounting for spatial heterogeneity. Here, we utilized an ensemble of high-resolution (25 km) climate simulations and nationwide mortality data from 306 Chinese cities to estimate death anomalies attributable to future warming. Historical estimation (1986-2014) reveals that about 15.5% [95% empirical confidence interval (eCI):13.1%, 17.6%] of deaths are attributable to nonoptimal temperature, of which heat and cold corresponded to attributable fractions of 4.1% (eCI:2.4%, 5.5%) and 11.4% (eCI:10.7%, 12.1%), respectively. Under three climate scenarios (SSP126, SSP245, and SSP585), the national average temperature was projected to increase by 1.45, 2.57, and 4.98 °C by the 2090s, respectively. The corresponding mortality fractions attributable to heat would be 6.5% (eCI:5.2%, 7.7%), 7.9% (eCI:6.3%, 9.4%), and 11.4% (eCI:9.2%, 13.3%). More than half of the attributable deaths due to future warming would occur in north China and cardiovascular mortality would increase more drastically than respiratory mortality. Our study shows that the increased heat-attributable mortality burden would outweigh the decreased cold-attributable burden even under a moderate climate change scenario across China. The results are helpful for national or local policymakers to better address the challenges of future warming.
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Affiliation(s)
- Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Cheng He
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
- Institute of Epidemiology, Helmholtz Zentrum München─German Research Center for Environmental Health (GmbH), Neuherberg 85764, Germany
| | - Renjie Chen
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
| | - Jianbin Huang
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Yong Luo
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Xuejie Gao
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
- Climate Change Research Center, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100017, China
| | - Ying Xu
- National Climate Center, China Meteorological Administration, Beijing 100044, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modeling, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Haidong Kan
- School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200082, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai 200032, China
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24
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Xie Y, Zhou Z, Sun Q, Zhao M, Pu J, Li Q, Sun Y, Dai H, Li T. Social-economic transitions and vulnerability to extreme temperature events from 1960 to 2020 in Chinese cities. iScience 2024; 27:109066. [PMID: 38361620 PMCID: PMC10867637 DOI: 10.1016/j.isci.2024.109066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
Climate change leads to more frequent and intense extreme temperature events, causing a significant number of excess deaths. Using an epidemiological approach, we analyze all-cause deaths related to heatwaves and cold spells in 2,852 Chinese counties from 1960 to 2020. Economic losses associated with these events are determined through the value of statistical life. Findings reveal that cold-related cumulative excess deaths (1,133 thousand) are approximately 2.5 times higher than heat-related deaths, despite an increase in heat-related fatalities in recent decades. Monetized mortality due to heat-related events is estimated at 1,284 billion CNY, while cold-related economic loss is 1,510 billion CNY. Notably, cities located in colder regions experience more heat-related excess deaths, and vice versa. Economic development does not significantly reduce mortality risks to heatwaves across China. This study provides insights into the spatial-temporal heterogeneity of heatwaves and cold spells mortality, essential for policymakers ensuring long-term climate adaptation and sustainability.
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Affiliation(s)
- Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
| | - Ziqiao Zhou
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengdan Zhao
- School of Economics and Management, Beihang University, Beijing, China
| | - Jinlu Pu
- School of Economics and Management, Beihang University, Beijing, China
| | - Qiutong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hancheng Dai
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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25
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Yang Z, Liu J, Yang J, Li L, Xiao T, Zhou M, Ou CQ. Haze weather and mortality in China from 2014 to 2020: Definitions, vulnerability, and effect modification by haze characteristics. JOURNAL OF HAZARDOUS MATERIALS 2024; 466:133561. [PMID: 38295725 DOI: 10.1016/j.jhazmat.2024.133561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/26/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024]
Abstract
Haze weather, characterized by low visibility due to severe air pollution, has aroused great public concern. However, haze definitions are inconclusive, and multicentre studies on the health impacts of haze are scarce. We collected data on the daily number of deaths and environmental factors in 190 Chinese cities from 2014 to 2020. The city-specific association was estimated using quasi-Poisson regression and then pooled using meta-analysis. We found a negative association between daily visibility and non-accidental deaths, and mortality risk sharply increased when visibility was < 10 km. Haze weather, defined as a daily average visibility of < 10 km without a limit for humidity, produced the best model fitness and greatest effect on mortality. A haze day was associated with an increase of 2.53% (95% confidence interval [CI]:1.96, 3.10), 2.84 (95% CI: 2.13, 3.56), and 2.99% (95% CI: 1.94, 4.04) in all non-accident, cardiovascular and respiratory mortality, respectively. Haze had the greatest effect on lung cancer mortality. The haze-associated risk of mortality increased with age. Severe haze (visibility <2 km) and damp haze (haze with relative humidity >90%) had greater health impacts. Our findings can help in the development of early warning systems and effective public health interventions for haze.
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Affiliation(s)
- Zhou Yang
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention (NCNCD), Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Ting Xiao
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention (NCNCD), Chinese Center for Disease Control and Prevention (China CDC), Beijing 100050, China.
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Yang C, Lei L, Li Y, Huang C, Chen K, Bao J. Bidirectional modification effects on nonlinear associations of summer temperature and air pollution with first-ever stroke morbidity. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116034. [PMID: 38310820 DOI: 10.1016/j.ecoenv.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
High temperature and air pollution may induce stroke morbidity. However, whether associations between high temperature and air pollution with stroke morbidity are modified by each other is still unclear. Data on 23,578 first-ever stroke patients in Shenzhen, China, during the summers of 2014-2018 were collected. Distributed lag nonlinear models were used to assess the modifying effects of air pollution stratified by the median for the associations between summer temperature and stroke morbidity at 0-3 lag days; modifying effects of temperature stratified by the minimum morbidity temperature on the associations between air pollution and stroke morbidity at the same lags were also estimated. The attributable risks of high temperature and high pollution on stroke morbidity were quantified. Stratified analyses of gender, age, migration type, and complication type were conducted to assess vulnerable population characteristics. Summer high temperature may induce stroke morbidity at high-level PM2.5, PM10, O3, SO2, and NO2 conditions, with attributable fraction (AF) of 2.982% (95% empirical confidence interval [eCI]: 0.943, 4.929), 3.113% (0.948, 5.200), 2.841% (0.943, 4.620), 3.617% (1.539, 5.470), and 2.048% (0.279, 3.637), respectively. High-temperature effects were statistically insignificant at corresponding low-level air pollution conditions. High-level PM2.5, PM10, and O3 may induce stroke morbidity at high-temperature conditions, with AF of 3.664% (0.036, 7.196), 4.129% (0.076, 7.963), and 4.574% (1.009, 7.762), respectively. High-level PM2.5, PM10, and O3 were not associated with stroke morbidity at low-temperature conditions. The effects of high temperature and high pollution on stroke morbidity were statistically significant among immigrants and patients with hypertension, dyslipidemia, or diabetes but insignificant among natives and patients without complications. The associations of summer temperature and air pollution with first-ever stroke morbidity may be enhanced bidirectionally. Publicity on the health risks of combined high temperature and high pollution events should be strengthened to raise protection awareness of relevant vulnerable populations.
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Affiliation(s)
- Chenlu Yang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yike Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Junzhe Bao
- College of Public Health, Zhengzhou University, Zhengzhou, China.
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Liu R, Xiang H, Liu C, Jiang Q, Liang Y, Wang G, Wang L, Sun Y, Yang G. Lateral Habenula Neurons Signal Cold Aversion and Participate in Cold Aversion. Neurochem Res 2024; 49:771-784. [PMID: 38102342 DOI: 10.1007/s11064-023-04076-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
The aversion to cold is a fundamental motivated behavior that contributes to the body temperature homeostasis. However, the involvement of the lateral habenula (LHb) as a regulatory hub for negative emotions in this physiological process remains uninvestigated. In this study, we demonstrate an elevation in the population activity of LHb neurons following exposure to cold stimuli. Additionally, we establish the necessity of Vglut2-expressing neurons within the LHb for the encoding of cold aversion behaviors. Furthermore, we have elucidated a neural circuit from excitatory neurons of the dorsomedial hypothalamus (DMH) to LHb that plays a crucial role in this progress. Manipulation of the DMH-LHb circuit has a significant impact on cold aversion behavior in mice. It is worth noting that this circuit does not exhibit any noticeable effects on autonomic thermoregulation or depression-like behavior. The identification of these neural mechanisms involved in behavioral thermoregulation provides a promising avenue for future research.
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Affiliation(s)
- Rui Liu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China
| | - Huan Xiang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China
| | - Chunyang Liu
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China
| | - Qiuyi Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China
| | - Yanchao Liang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China
| | - Guangzheng Wang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China
| | - Lu Wang
- Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), The Fourth Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, Heilongjiang Province, People's Republic of China.
| | - Yi Sun
- Department of Human Anatomy, Binzhou Medical College, 346 Guanhai Rd, Yantai City, People's Republic of China.
| | - Guang Yang
- Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Youzheng Street 23, Nangang District, Harbin, 150001, Heilongjiang Province, People's Republic of China.
- Institute of Brain Science, Harbin Medical University, Harbin, People's Republic of China.
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Yang J, Luo S, Liu Y, Hong M, Qiu X, Lin Y, Zhang W, Gao P, Li Z, Hu Z, Xia M. Cohort Profile: South China Cohort. Int J Epidemiol 2024; 53:dyae028. [PMID: 38412541 DOI: 10.1093/ije/dyae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Jialu Yang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyun Luo
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Minghuang Hong
- Department of Clinical Trial Centre, Sun Yat-sen University Cancer Centre, Guangzhou, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yingzi Lin
- School of Tropical Medicine, Hainan Medical University, Haikou, China
| | - Weisen Zhang
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Peisong Gao
- Luohu People's Hospital, Shen Zhen Luohu Hospital Group, Shenzhen, China
| | - Zhibin Li
- First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhijian Hu
- School of Public Health, Fujian Medical University, Fuzhou, China
| | - Min Xia
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Wu Y, Liu X, Gao L, Sun X, Hong Q, Wang Q, Kang Z, Yang C, Zhu S. Short-term exposure to extreme temperature and outpatient visits for respiratory diseases among children in the northern city of China: a time-series study. BMC Public Health 2024; 24:341. [PMID: 38302889 PMCID: PMC10832290 DOI: 10.1186/s12889-024-17814-5] [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: 10/10/2022] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Although studies have indicated that extreme temperature is strongly associated with respiratory diseases, there is a dearth of studies focused on children, especially in China. We aimed to explore the association between extreme temperature and children's outpatient visits for respiratory diseases and seasonal modification effects in Harbin, China. METHODS A distributed lag nonlinear model (DLNM) was used to explore the effect of extreme temperature on daily outpatient visits for respiratory diseases among children, as well as lag effects and seasonal modification effects. RESULTS Extremely low temperatures were defined as the 1st percentile and 2.5th percentile of temperature. Extremely high temperatures were defined as the 97.5th percentile and 99th percentile of temperature. At extremely high temperatures, both 26 °C (97.5th) and 27 °C (99th) showed adverse effects at lag 0-6 days, with relative risks (RRs) of 1.34 [95% confidence interval (CI): 1.21-1.48] and 1.38 (95% CI: 1.24-1.53), respectively. However, at extremely low temperatures, both - 26 °C (1st) and - 23 °C (2.5th) showed protective effects on children's outpatient visits for respiratory diseases at lag 0-10 days, with RRs of 0.86 (95% CI: 0.76-0.97) and 0.85 (95% CI: 0.75-0.95), respectively. We also found seasonal modification effects, with the association being stronger in the warm season than in the cold season at extremely high temperatures. CONCLUSIONS Our study indicated that extremely hot temperatures increase the risk of children's outpatient visits for respiratory diseases. Efforts to reduce the exposure of children to extremely high temperatures could potentially alleviate the burden of pediatric respiratory diseases, especially during the warm season.
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Affiliation(s)
- Ya Wu
- Department of Epidemiology and Statistics, School of Medicine, Jinan University, Guangzhou, 510632, China
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Xiaobo Liu
- Department of Environment, Harbin Center for Disease Control and Prevention, Harbin, 150056, China
| | - Lijie Gao
- Department of Epidemiology and Statistics, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Xiaohong Sun
- Department of Physicochemical Laboratory, Harbin Center for Disease Control and Prevention, Harbin, 150056, China
| | - Qianqi Hong
- Department of Environment, Harbin Center for Disease Control and Prevention, Harbin, 150056, China
| | - Qian Wang
- Department of Epidemiology and Statistics, School of Medicine, Jinan University, Guangzhou, 510632, China
| | - Zhen Kang
- Department of Environment, Harbin Center for Disease Control and Prevention, Harbin, 150056, China
| | - Chao Yang
- Harbin Center for Disease Control and Prevention, Harbin, 150056, China.
| | - Sui Zhu
- Department of Epidemiology and Statistics, School of Medicine, Jinan University, Guangzhou, 510632, China.
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Zhao W, Huang M, Bragazzi NL, Tang B, Dai H. Age-Period-Cohort Analysis of Cardiovascular Mortality Attributable to Environmental Risks in China. Am J Prev Med 2024; 66:371-379. [PMID: 37802306 DOI: 10.1016/j.amepre.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION This study aimed to analyze changes in cardiovascular disease (CVD) mortality attributable to major environmental risks in China during 1990-2019, and their associations with age, period, and birth cohort. METHODS Mortality data were obtained from the Global Burden of Disease Study 2019. Major environmental risks included ambient particulate matter pollution (APMP), household air pollution from solid fuels (HAP), low temperature, high temperature, and lead exposure. Age-period-cohort modeling was used to estimate the overall annual percentage change in CVD mortality (net drift), annual percentage change for each age group (local drift), expected longitudinal age-specific rate (longitudinal age curve), period and cohort relative risks (RRs, period/cohort effects) between 1990 and 2019. Analyses were conducted in 2021-2022. RESULTS In China, five major environmental risks led to 1.62 million CVD deaths in 2019. Among these risks, the primary contributor to CVD mortality transited from HAP in 1990 to APMP in 2019. There was also an improvement in attributable CVD mortality rates for low temperature and lead exposure during 1990-2019, while an unfavorable trend was noted for high temperature. The longitudinal age curve demonstrated increased attributable CVD mortality rates with age groups for all environmental risks, with similar patterns for both sexes. Period and cohort RRs suggested generally improved risks of attributable CVD mortality for HAP, low temperature, and lead exposure, but worsening risks for APMP and high temperature in both genders, except for period risks after 2010-2014 for APMP in both sexes, period risks after 2000-2004 for high temperature in females, and cohort risks in cohorts born after 1955 for APMP and high temperature in females. CONCLUSIONS Over the study period, there was a significant improvement in attributable CVD mortality rates in China for HAP, low temperature and lead exposure, but an unfavorable trend was noted for APMP and high temperature.
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Affiliation(s)
- Wuqiong Zhao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China
| | - Mengying Huang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Biao Tang
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China.
| | - Haijiang Dai
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Wang R, Lin Y, Chen M, Wang W, Chen Y, Qiu X, Miao X. Effects of Daily Mean Temperature on Daily Hospital Admissions for Coronary Artery Disease: A Retrospective Study. Risk Manag Healthc Policy 2024; 17:269-277. [PMID: 38313395 PMCID: PMC10838496 DOI: 10.2147/rmhp.s444451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/20/2024] [Indexed: 02/06/2024] Open
Abstract
Purpose Temperature changes unfavorably impact on cardiovascular disease. However, the association between temperature changes and coronary artery disease (CAD) is not well documented. This study aimed to explore the association between daily mean temperature and daily CAD hospital admissions on the southeast coast of China (Fuzhou City). Methods A total of 1883 CAD patients who underwent percutaneous coronary intervention between 2017 and 2019 were obtained. The severity of CAD was evaluated by the Gensini score. Distributed lag non-linear model (DLNM) combined with a quasi-Poisson regression model was used to examine the delayed effect between daily mean temperature and daily CAD hospital admissions. Stratified analyses were performed by Gensini score and severity of lesions. The relative risk (RR) with a 95% confidence interval (CI) was used to assess the relationship. Results Extreme cold (8°C) (RR=0.49, 95% CI: 0.25-0.99) and moderate cold (10°C) (RR=0.56, 95% CI: 0.31-0.99) daily mean temperature with a lag of 0-20 days were correlated with lower risk of daily CAD hospital admissions. Moderate heat (30°C) (RR=1.80, 95% CI: 1.01-3.20) and extreme heat (32°C) (RR=2.02, 95% CI: 1.01-4.04) daily mean temperature with a lag of 0-20 days related to a higher risk of daily CAD hospital admissions. Similar results were observed for daily mean temperature with a lag of 0-25 days. Stratified analysis showed the lagged effect of daily mean temperature (lag 0, 0-5, 0-15, 0-20, and 0-25 days) on the daily CAD hospital admissions was observed only in patients with a Gensini score ≤39 (tertile 1). Conclusion Cold temperatures may have a protective effect on daily CAD hospital admissions in the Fuzhou area, whereas hot temperatures can have an adverse effect.
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Affiliation(s)
- Rehua Wang
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, 350001, People's Republic of China
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - Yongjun Lin
- Department of General Medicine, the First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, 362000, People's Republic of China
| | - Mao Chen
- Department of Scientific Research, Fujian Provincial Hospital, Fuzhou, 350001, People's Republic of China
| | - Wei Wang
- Department of Psychiatry, Fuzhou Neuro-Psychiatric Hospital Affiliated to Fujian Medical University, Fuzhou, 350008, People's Republic of China
| | - Yongli Chen
- Department of Cardiology, Fujian Provincial Hospital South Branch, Fuzhou, 350028, People's Republic of China
| | - Xiaoxia Qiu
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, 350001, People's Republic of China
| | - Xing Miao
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, 350001, People's Republic of China
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, People's Republic of China
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De Vita A, Belmusto A, Di Perna F, Tremamunno S, De Matteis G, Franceschi F, Covino M. The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases. J Clin Med 2024; 13:759. [PMID: 38337453 PMCID: PMC10856578 DOI: 10.3390/jcm13030759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change.
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Affiliation(s)
- Antonio De Vita
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Antonietta Belmusto
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Federico Di Perna
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Saverio Tremamunno
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Giuseppe De Matteis
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Francesco Franceschi
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
| | - Marcello Covino
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
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Abbasi M, Golbabaei F, Yazdanirad S, Dehghan H, Ahmadi A. Validity of ten analytical heat stress indices in predicting the physiological parameters of people under various occupational and meteorological conditions. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:163-177. [PMID: 37962645 DOI: 10.1007/s00484-023-02580-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/07/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Until now, only a few comprehensive studies have validated analytical heat stress indices in different conditions. The present study aims to investigate the validity of these indicators in predicting the physiological parameters of workers. This cross-sectional study was conducted with 194 male employees working in warm environments. First, demographic information was collected. After participants rested for 30 min, their heart rate and tympanic temperature were measured. The subjects then performed their routine tasks. At the end of 90 min, their heart rate and tympanic temperature were again measured. Additionally, their metabolism rate and clothing thermal insulation were estimated. Environmental parameters were also measured at 30-, 60-, and 90-min time points. Additional information required to compute the indices was recorded. Then, the values of each of the indices were computed. Finally, the validity of the indices was assessed under different conditions. The results indicated that the highest regression coefficients with tympanic temperature were assigned to modified physiologically equivalent temperature (mPET) (0.7515), predicted heat strain (PHS) (0.7201), and predicted mean vote (PMV) (0.7082), index, respectively. Also, the greatest regression coefficients with heart rate belonged to mPET (0.7773), PMV (0.7624), and PHS (0.6479) index, respectively. Based on the results, the highest diagnostic accuracies of receiver operating characteristic (ROC) curves for tympanic temperature were related to indices of mPET, PHS, and PMV with the area under the ROC curve (AUC) of 0.945, 0.931, and 0.930, respectively. Of the studied indices, it was observed that mPET, PHS, PMV, and PPD showed more validity compared to others.
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Affiliation(s)
- Milad Abbasi
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Farideh Golbabaei
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Yazdanirad
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
- School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Habibollah Dehghan
- Department of Occupational Health Engineering, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Ahmadi
- Modeling in Health Research Center and School of Public Health, Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Xia Y, Shi C, Li Y, Ruan S, Jiang X, Huang W, Chen Y, Gao X, Xue R, Li M, Sun H, Peng X, Xiang R, Chen J, Zhang L. Association between temperature and mortality: a multi-city time series study in Sichuan Basin, southwest China. Environ Health Prev Med 2024; 29:1. [PMID: 38220147 PMCID: PMC10788187 DOI: 10.1265/ehpm.23-00118] [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: 05/09/2023] [Accepted: 09/30/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND There are few multi-city studies on the association between temperature and mortality in basin climates. This study was based on the Sichuan Basin in southwest China to assess the association of basin temperature with non-accidental mortality in the population and with the temperature-related mortality burden. METHODS Daily mortality data, meteorological and air pollution data were collected for four cities in the Sichuan Basin of southwest China. We used a two-stage time-series analysis to quantify the association between temperature and non-accidental mortality in each city, and a multivariate meta-analysis was performed to obtain the overall cumulative risk. The attributable fractions (AFs) were calculated to access the mortality burden attributable to non-optimal temperature. Additionally, we performed a stratified analyses by gender, age group, education level, and marital status. RESULTS A total of 751,930 non-accidental deaths were collected in our study. Overall, 10.16% of non-accidental deaths could be attributed to non-optimal temperatures. A majority of temperature-related non-accidental deaths were caused by low temperature, accounting for 9.10% (95% eCI: 5.50%, 12.19%), and heat effects accounted for only 1.06% (95% eCI: 0.76%, 1.33%). The mortality burden attributable to non-optimal temperatures was higher among those under 65 years old, females, those with a low education level, and those with an alternative marriage status. CONCLUSIONS Our study suggested that a significant association between non-optimal temperature and non-accidental mortality. Those under 65 years old, females, and those with a low educational level or alternative marriage status had the highest attributable burden.
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Affiliation(s)
- Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
- Zigong Center for Disease Control and Prevention, No. 826, Huichuan Road, Ziliujing District, Zigong 643000, China
- School of Public Health, Chengdu Medical College, No. 783, Xindu Road, Xindu District, Chengdu 610500, China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No. 826, Huichuan Road, Ziliujing District, Zigong 643000, China
| | - Yu Chen
- School of Public Health, Chengdu Medical College, No. 783, Xindu Road, Xindu District, Chengdu 610500, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No. 6, Longxiang Road, Wuhou District, Chengdu 610041, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No. 996, Binhebei Road, Lizhou District, Guangyuan 628017, China
| | - Mingjiang Li
- Panzhi hua Center for Disease Control and Prevention, No. 996, Jichang Road, Dong District, Panzhi hua 617067, China
| | - Hongying Sun
- Mianyang Center for Disease Control and Prevention, No. 50, Mianxingdong Road, Gaoxin District, Mianyang 621000, China
| | - Xiaojuan Peng
- Yaan Center for Disease Control and Prevention, No. 9, Fangcao Road, Yucheng District, Yaan 625000, China
| | - Renqiang Xiang
- Fucheng Center for Disease Control and Prevention, No. 116, Changhong Road, Fucheng District, Mianyang 621000, China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No. 6, Zhongxue Road, Wuhou District, Chengdu 610041, China
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Qing M, Guo Y, Yao Y, Zhou C, Wang D, Qiu W, Guo Y, Zhang X. Effects of apparent temperature on daily outpatient and inpatient visits for cause-specific respiratory diseases in Ganzhou, China: a time series study. Environ Health Prev Med 2024; 29:20. [PMID: 38522902 DOI: 10.1265/ehpm.23-00188] [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] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Non-optimum temperatures are associated with increased risk of respiratory diseases, but the effects of apparent temperature (AT) on respiratory diseases remain to be investigated. METHODS Using daily data from 2016 to 2020 in Ganzhou, a large city in southern China, we analyzed the impact of AT on outpatient and inpatient visits for respiratory diseases. We considered total respiratory diseases and five subtypes (influenza and pneumonia, upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), asthma and chronic obstructive pulmonary disease [COPD]). Our analysis employed a distributed lag nonlinear model (DLNM) combined with a generalized additive model (GAM). RESULTS We recorded 94,952 outpatients and 72,410 inpatients for respiratory diseases. We found AT significantly non-linearly associated with daily outpatient and inpatient visits for total respiratory diseases, influenza and pneumonia, and URTI, primarily during comfortable AT levels, while it was exclusively related with daily inpatient visits for LRTI and COPD. Moderate heat (32.1 °C, the 75.0th centile) was observed with a significant effect on both daily outpatient and inpatient visits for total respiratory diseases at a relative risk of 1.561 (1.161, 2.098) and 1.276 (1.027, 1.585), respectively (both P < 0.05), while the results of inpatients became insignificant with the adjustment for CO and O3. The attributable fractions in outpatients and inpatients were as follows: total respiratory diseases (24.43% and 18.69%), influenza and pneumonia (31.54% and 17.33%), URTI (23.03% and 32.91%), LRTI (37.49% and 30.00%), asthma (9.83% and 3.39%), and COPD (30.67% and 10.65%). Stratified analyses showed that children ≤5 years old were more susceptible to moderate heat than older participants. CONCLUSIONS In conclusion, our results indicated moderate heat increase the risk of daily outpatient and inpatient visits for respiratory diseases, especially among children under the age of 5.
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Affiliation(s)
- Mengxia Qing
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Yanjun Guo
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Yuxin Yao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Chuanfei Zhou
- School of Public Health and Health Management, Gannan Medical University
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Weihong Qiu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - You Guo
- First Affiliated Hospital, Gannan Medical University
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University
- School of Public Health and Health Management, Gannan Medical University
| | - Xiaokang Zhang
- First Affiliated Hospital, Gannan Medical University
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University
- School of Public Health and Health Management, Gannan Medical University
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Yin P, Gao Y, Chen R, Liu W, He C, Hao J, Zhou M, Kan H. Temperature-related death burden of various neurodegenerative diseases under climate warming: a nationwide modelling study. Nat Commun 2023; 14:8236. [PMID: 38086884 PMCID: PMC10716387 DOI: 10.1038/s41467-023-44066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Limited knowledge exists regarding the ramifications of climate warming on death burden from neurodegenerative diseases. Here, we conducted a nationwide, individual-level, case-crossover study between 2013 and 2019 to investigate the effects of non-optimal temperatures on various neurodegenerative diseases and to predict the potential death burden under different climate change scenarios. Our findings reveal that both low and high temperatures are linked to increased risks of neurodegenerative diseases death. We project that heat-related neurodegenerative disease deaths would increase, while cold-related deaths would decrease. This is characterized by a steeper slope in the high-emission scenario, but a less pronounced trend in the scenarios involving mitigation strategies. Furthermore, we predict that the net changes in attributable death would increase after the mid-21st century, especially under the unrestricted-emission scenario. These results highlight the urgent need for effective climate and public health policies to address the growing challenges of neurodegenerative diseases associated with global warming.
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Affiliation(s)
- Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Junwei Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- National Center for Neurological Disorders, Beijing, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China.
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Achebak H, Garcia-Aymerich J, Rey G, Chen Z, Méndez-Turrubiates RF, Ballester J. Ambient temperature and seasonal variation in inpatient mortality from respiratory diseases: a retrospective observational study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100757. [PMID: 38115961 PMCID: PMC10730325 DOI: 10.1016/j.lanepe.2023.100757] [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: 06/29/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 12/21/2023]
Abstract
Background The seasonal fluctuation in mortality and hospital admissions from respiratory diseases, with a winter peak and a summer trough, is widely recognized in extratropical countries. However, little is known about the seasonality of inpatient mortality and the role of ambient temperature remains uncertain. We aimed to analyse the association between ambient temperature and in-hospital mortality from respiratory diseases in the provinces of Madrid and Barcelona, Spain. Methods We used data on daily hospitalisations, weather (ie, temperature and relative humidity) and air pollutants (ie, PM2.5, PM10, NO2 and O3) for the Spanish provinces of Madrid and Barcelona during 2006-2019. We applied a daily time-series quasi-Poisson regression in combination with distributed lag non-linear models (DLNM) to assess, on the one hand, the seasonal variation in fatal hospitalisations and the contribution of ambient temperature, and on the other hand, the day-to-day association between temperature and fatal hospital admissions. The analyses were stratified by sex, age and primary diagnostic of hospitalisation. Findings The study analysed 1 710 012 emergency hospital admissions for respiratory diseases (mean [SD] age, 60.4 [31.0] years; 44.2% women), from which 103 845 resulted in in-hospital death (81.4 [12.3] years; 45.1%). We found a strong seasonal fluctuation in in-hospital mortality from respiratory diseases. While hospital admissions were higher during the cold season, the maximum incidence of inpatient mortality was during the summer and was strongly related to high temperatures. When analysing the day-to-day association between temperature and in-hospital mortality, we only found an effect for high temperatures. The relative risk (RR) of fatal hospitalisation at the 99th percentile of the distribution of daily temperatures vs the minimum mortality temperature (MMT) was 1.395 (95% eCI: 1.211-1.606) in Madrid and 1.612 (1.379-1.885) in Barcelona. In terms of attributable burden, summer temperatures (June-September) were responsible for 16.2% (8.8-23.3) and 22.3% (15.4-29.2) of overall fatal hospitalisations from respiratory diseases in Madrid and Barcelona, respectively. Women were more vulnerable to heat than men, whereas the results by diagnostic of admission showed heat effects for acute bronchitis and bronchiolitis, pneumonia and respiratory failure. Interpretation Unless effective adaptation measures are taken in hospital facilities, climate warming could exacerbate the burden of inpatient mortality from respiratory diseases during the warm season. Funding European Research Council Consolidator Grant EARLY-ADAPT, European Research Council Proof-of-Concept Grants HHS-EWS and FORECAST-AIR.
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Affiliation(s)
- Hicham Achebak
- Inserm, France Cohortes, Paris, France
- ISGlobal, Barcelona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Jingesi M, Lan S, Hu J, Dai M, Huang S, Chen S, Liu N, Lv Z, Ji J, Li X, Wang P, Cheng J, Peng J, Yin P. Association between thermal stress and cardiovascular mortality in the subtropics. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2093-2106. [PMID: 37878088 DOI: 10.1007/s00484-023-02565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Affiliation(s)
- Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Shuhua Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ning Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen, 518020, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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Hu P, Chang J, Huang Y, Guo M, Lu F, Long Y, Liu H, Yang X, Qi Y, Sun J, Yang Z, Deng Q, Liu J. Nonoptimum Temperatures Are More Closely Associated With Fatal Myocardial Infarction Than With Nonfatal Events. Can J Cardiol 2023; 39:1974-1983. [PMID: 37924969 PMCID: PMC10715678 DOI: 10.1016/j.cjca.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/10/2023] [Accepted: 08/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Ambient temperatures trigger hospitalisation, mortality, and emergency department visits for myocardial infarction (MI). However, nonoptimum temperature-related risks of fatal and nonfatal MI have not yet been compared. METHODS From 2007 to 2019, 416,894 MI events (233,071 fatal and 183,823 nonfatal) were identified in Beijing, China. A time-series analysis with a distributed-lag nonlinear model was used to compare the relative and population-attributable risks of fatal and nonfatal MI associated with nonoptimum temperatures. RESULTS The reference was the optimum temperature of 24.3°C. For single-lag effects, cold (-5.2°C) and heat (29.6°C) effects had associations that persisted for more days for fatal MI than for nonfatal MI. For cumulative-lag effects over 0 to 21 days, cold effects were higher for fatal MI (relative risk [RR] 1.99, 95% confidence interval [CI] 1.68-2.35) than for nonfatal MI (RR 1.60, 95% CI 1.32-1.94) with a P value for difference in effect sizes of 0.048. In addition, heat effects were higher for fatal MI (RR 1.33, 95% CI 1.24-1.44) than for nonfatal MI (RR 0.99, 95% CI 0.91-1.08) with a P value for difference in effect sizes of 0.002. The attributable fraction of nonoptimum temperatures was higher for fatal MI (25.6%, 95% CI 19.7%-30.6%) than for nonfatal MI (19.1%, 95% CI 12.1%-25.0%). CONCLUSIONS Fatal MI was more closely associated with nonoptimum temperatures than nonfatal MI, as evidenced by single-lag effects that have associations which persisted for more days, higher cumulative-lag effects, and higher attributable risks for fatal MI. Strategies are needed to mitigate the adverse effects of nonoptimum temperatures.
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Affiliation(s)
- Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yulin Huang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Moning Guo
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, China
| | - Feng Lu
- Beijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, China
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China
| | - Huan Liu
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing, China
| | - Xudong Yang
- Departments of Building Science and Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yue Qi
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jiayi Sun
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Zhao Yang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Kivimäki M, Batty GD, Pentti J, Suomi J, Nyberg ST, Merikanto J, Nordling K, Ervasti J, Suominen SB, Partanen AI, Stenholm S, Käyhkö J, Vahtera J. Climate Change, Summer Temperature, and Heat-Related Mortality in Finland: Multicohort Study with Projections for a Sustainable vs. Fossil-Fueled Future to 2050. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127020. [PMID: 38150315 PMCID: PMC10752417 DOI: 10.1289/ehp12080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Climate change scenarios illustrate various pathways in terms of global warming ranging from "sustainable development" (Shared Socioeconomic Pathway SSP1-1.9), the best-case scenario, to 'fossil-fueled development' (SSP5-8.5), the worst-case scenario. OBJECTIVES We examined the extent to which increase in daily average urban summer temperature is associated with future cause-specific mortality and projected heat-related mortality burden for the current warming trend and these two scenarios. METHODS We did an observational cohort study of 363,754 participants living in six cities in Finland. Using residential addresses, participants were linked to daily temperature records and electronic death records from national registries during summers (1 May to 30 September) 2000 to 2018. For each day of observation, heat index (average daily air temperature weighted by humidity) for the preceding 7 d was calculated for participants' residential area using a geographic grid at a spatial resolution of 1 km × 1 km . We examined associations of the summer heat index with risk of death by cause for all participants adjusting for a wide range of individual-level covariates and in subsidiary analyses using case-crossover design, computed the related period population attributable fraction (PAF), and projected change in PAF from summers 2000-2018 compared with those in 2030-2050. RESULTS During a cohort total exposure period of 582,111,979 summer days (3,880,746 person-summers), we recorded 4,094 deaths, including 949 from cardiovascular disease. The multivariable-adjusted rate ratio (RR) for high (≥ 21 ° C ) vs. reference (14 - 15 ° C ) heat index was 1.70 (95% CI: 1.28, 2.27) for cardiovascular mortality, but it did not reach statistical significance for noncardiovascular deaths, RR = 1.14 (95% CI: 0.96, 1.36), a finding replicated in case-crossover analysis. According to projections for 2030-2050, PAF of summertime cardiovascular mortality attributable to high heat will be 4.4% (1.8%-7.3%) under the sustainable development scenario, but 7.6% (3.2%-12.3%) under the fossil-fueled development scenario. In the six cities, the estimated annual number of summertime heat-related cardiovascular deaths under the two scenarios will be 174 and 298 for a total population of 1,759,468 people. DISCUSSION The increase in average urban summer temperature will raise heat-related cardiovascular mortality burden. The estimated magnitude of this burden is > 1.5 times greater if future climate change is driven by fossil fuels rather than sustainable development. https://doi.org/10.1289/EHP12080.
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Affiliation(s)
- Mika Kivimäki
- University College London (UCL) Brain Sciences, UCL, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - G. David Batty
- University College London (UCL) Brain Sciences, UCL, London, UK
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
| | - Juuso Suomi
- Department of Geography and Geology, UTU, Turku, Finland
| | - Solja T. Nyberg
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Kalle Nordling
- Finnish Meteorological Institute, Helsinki, Finland
- Centre for International Climate and Environmental Research, Oslo, Norway
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Sakari B. Suominen
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Turku University Hospital, Turku, Finland
- School of Health Science, University of Skövde, Skövde, Sweden
| | | | - Sari Stenholm
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
| | - Jukka Käyhkö
- Department of Geography and Geology, UTU, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku (UTU), Turku, Finland
- Centre for Population Health Research, UTU, Turku, Finland
- Turku University Hospital, Turku, Finland
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Zhao Y, Xiong W, Li C, Zhao R, Lu H, Song S, Zhou Y, Hu Y, Shi B, Ge J. Hypoxia-induced signaling in the cardiovascular system: pathogenesis and therapeutic targets. Signal Transduct Target Ther 2023; 8:431. [PMID: 37981648 PMCID: PMC10658171 DOI: 10.1038/s41392-023-01652-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/10/2023] [Accepted: 09/13/2023] [Indexed: 11/21/2023] Open
Abstract
Hypoxia, characterized by reduced oxygen concentration, is a significant stressor that affects the survival of aerobic species and plays a prominent role in cardiovascular diseases. From the research history and milestone events related to hypoxia in cardiovascular development and diseases, The "hypoxia-inducible factors (HIFs) switch" can be observed from both temporal and spatial perspectives, encompassing the occurrence and progression of hypoxia (gradual decline in oxygen concentration), the acute and chronic manifestations of hypoxia, and the geographical characteristics of hypoxia (natural selection at high altitudes). Furthermore, hypoxia signaling pathways are associated with natural rhythms, such as diurnal and hibernation processes. In addition to innate factors and natural selection, it has been found that epigenetics, as a postnatal factor, profoundly influences the hypoxic response and progression within the cardiovascular system. Within this intricate process, interactions between different tissues and organs within the cardiovascular system and other systems in the context of hypoxia signaling pathways have been established. Thus, it is the time to summarize and to construct a multi-level regulatory framework of hypoxia signaling and mechanisms in cardiovascular diseases for developing more therapeutic targets and make reasonable advancements in clinical research, including FDA-approved drugs and ongoing clinical trials, to guide future clinical practice in the field of hypoxia signaling in cardiovascular diseases.
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Affiliation(s)
- Yongchao Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
| | - Weidong Xiong
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China
- Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Chaofu Li
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
| | - Ranzun Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Hao Lu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Shuai Song
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - You Zhou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Yiqing Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China.
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
| | - Junbo Ge
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China.
- Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China.
- Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China.
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, 200032, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
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Ribas IM, Gomes JPM, Valadares PAR, Jardim LS, Nogueira MC, Ferreira CDCM, Farias WCMD, Ferreira LDCM. Effects of air temperature on the risk of death from COPD in major microregions in Brazil: a time series study. J Bras Pneumol 2023; 49:e20220442. [PMID: 37991067 PMCID: PMC10760431 DOI: 10.36416/1806-3756/e20220442] [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: 11/25/2022] [Accepted: 08/28/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To evaluate the association between the risk of death from COPD and air temperature events in ten major Brazilian microregions. METHODS This was a time series analysis of daily COPD deaths and daily mean air temperatures between 1996 and 2017. Using distributed nonlinear lag models, we estimated the cumulative relative risks of COPD mortality for four temperature percentiles (representing moderate and extreme cold and heat events) in relation to a minimum mortality temperature, with a lag of 21 days, in each microregion. RESULTS Significant associations were found between extreme air temperature events and the risk of death from COPD in the southern and southeastern microregions in Brazil. There was an association of extreme cold and an increased mortality risk in the following microregions: 36% (95% CI, 1.12-1.65), in Porto Alegre; 27% (95% CI, 1.03-1.58), in Curitiba; and 34% (95% CI, 1.19-1.52), in São Paulo; whereas moderate cold was associated with an increased risk of 20% (95% CI, 1.01-1.41), 33% (95% CI, 1.09-1.62), and 24% (95% CI, 1.12-1.38) in the same microregions, respectively. There was an increased COPD mortality risk in the São Paulo and Rio de Janeiro microregions: 17% (95% CI, 1.05-1.31) and 12% (95% CI, 1,02-1,23), respectively, due to moderate heat, and 23% (95% CI, 1,09-1,38) and 32% (95% CI, 1,15-1,50) due to extreme heat. CONCLUSIONS Non-optimal air temperature events were associated with an increased risk of death from COPD in tropical and subtropical areas of Brazil.
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Affiliation(s)
- Igor Magaton Ribas
- . Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
| | | | | | - Lucas Santos Jardim
- . Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
| | - Mário Círio Nogueira
- . Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
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Ding J, Han S, Wang X, Yao Q. Impact of air pollution changes and meteorology on asthma outpatient visits in a megacity in North China Plain. Heliyon 2023; 9:e21803. [PMID: 38027642 PMCID: PMC10651508 DOI: 10.1016/j.heliyon.2023.e21803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/08/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023] Open
Abstract
The effects of air pollution and meteorology on asthma is less studied in North China Plain. In the last decade, air quality in this region is markedly mitigated. This study compared the short-term effects of air pollutants on daily asthma outpatient visits (AOV) within different sex and age groups from 2014 to 2016 and 2017-2019 in Tianjin, with the application of distributed lag nonlinear model. Moreover, relative humidity (RH) and temperature as well as the synergistic impact with air pollutants were assessed. Air pollutants-associated risk with linear (different reference values were used) and non-linear assumptions were compared. In 2014-2016, PM10 and PM2.5 exhibited a larger impact on AOV, with the corresponding cumulative excess risks (ER) for every 10 μg/m3 increase at 1.04 % (95%CI:0.67-1.40 %, similarly hereafter) and 0.79 % (0.35-1.23 %), as well as increased to 43 % (26-63 %) and 20 % (10-31 %) at severe pollution. In 2017-2019, NO2 and MDA8 O3 exhibited a larger impact on AOV, with a cumulative ER for every 10 μg/m3 increase at 1.0 (0.63-1.4 %) and 0.36 % (0.15-0.57 %), with corresponding values of 7.9 % (4.8-11 %) and 5.6 % (2.3-9.0 %), at severe pollution. SO2 associated risk was only significant from 2014 to 2016. Cold effect, including extremely low temperature exposure and sharp temperature drop could generate a pronounced increase in AOV at 9.6 % (3.8-16 %) and 24 % (9.1-41 %), respectively. Moderate low temperature combined with air pollutants can enhance AOV during winter. Higher temperature in spring and autumn could trigger asthma by increasing pollen levels. Low RH resulted in AOV increase by 4.6 % (2.4-6.9), while higher RH generated AOV increase by 3.4 % (1.6-5.3). Females, children, and older adults tended to have a higher risk for air pollution, non-optimum temperature, and RH. As air pollution-associated risks on AOV tends to be weaker due to air quality improvement in recent years, the impact of extreme meteorological condition amidst climate change on asthma visits warrants further attention.
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Affiliation(s)
- Jing Ding
- Tianjin Environmental Meteorological Center, Tianjin 300070, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin 300070, China
| | - Suqin Han
- Tianjin Environmental Meteorological Center, Tianjin 300070, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin 300070, China
| | - Xiaojia Wang
- Tianjin Environmental Meteorological Center, Tianjin 300070, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin 300070, China
| | - Qing Yao
- Tianjin Environmental Meteorological Center, Tianjin 300070, China
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research, Tianjin 300070, China
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Gui SY, Wang F, Qiao JC, Wang XC, Huang ZH, Yang F, Hu CY, Tao FB, Tao LM, Liu DW, Yi XL, Jiang ZX. Short-term effect of meteorological factors and extreme weather events on daily outpatient visits for dry eye disease between 2013 and 2020: a time-series study in Urumqi, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:111967-111981. [PMID: 37821738 DOI: 10.1007/s11356-023-29651-x] [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: 01/17/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023]
Abstract
Dry eye disease (DED) is a common disorder of tear secretion on the ocular surface caused by multiple factors with dry eyes as the main symptom, but until now studies focusing on relationship between local meteorological factors and ocular surface diseases in Urumqi are very limited. Besides, the effects of long-term and extreme meteorological factors on DED and the lag effect have not been fully evaluated. Electronic case information of 9970 DED outpatients from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China) between January 1, 2013, and December 31, 2020, was screened and analyzed. We used a time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) to fit the effects of exposure to different meteorological factors and extreme weather on DED outpatient visits. Subgroup analyses were further performed for gender, age, and season. The results showed that exposure to extremely low mean temperature (P1:RR = 1.18), atmospheric pressure (P1:RR = 1.11), and extremely high relative humidity (P99:RR = 1.35) were the risk factors, while extremely high atmospheric pressure (P90:RR = 0.883) and extremely low humidity (P10:RR = 0.856) appeared to have a positive effect on reduced risk of DED. Relative humidity exhibited a 1-day lag effect (RR = 1.06). Increased mean temperature positively affected female DED patients (RR = 0.761) with similar effects in the cold season (RR = 0.926). However, elevated relative humidity had a negative effect on female patients (RR = 1.14). We conducted the first large sample size time-series analysis study in this major city at the farthest distance from the ocean in the world and in northwest China, confirming the association of DED outpatient visits with the remaining three meteorological factors except wind speed in Urumqi, and a larger sample size multi-center epidemiological study with a longer duration is still needed.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fei Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin-Chen Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhi-Hao Huang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fan Yang
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Li-Ming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Dong-Wei Liu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Xiang-Long Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, 137 Liyu Shan Road, Urumqi, 830011, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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Liu J, Du X, Yin P, Kan H, Zhou M, Chen R. Cause-specific mortality and burden attributable to temperature variability in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 896:165267. [PMID: 37406687 DOI: 10.1016/j.scitotenv.2023.165267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Few large-scale, nationwide studies have assessed cause-specific mortality risks and burdens associated with temperature variability (TV). OBJECTIVE To estimate associations between TV and cause-specific mortality and quantify the mortality burden in China. METHODS Data on daily total and cause-specific mortality in 272 Chinese cities between 2013 and 2015 were recorded. TVs were computed as the standard deviations of daily minimum and maximum temperatures over a duration of 2 to 7 days. The time-series quasi-Poisson regression model with adjustment of the cumulative effects of daily mean temperature over the same duration was applied to evaluate the city-specific associations of TV and mortality. Then, we pooled the effect estimates using a random-effects meta-analysis and calculated the mortality burdens. RESULTS Overall, TV showed significant and positive associations with total and cause-specific mortality. The TV-mortality associations were generally stronger when using longer durations. A 1 °C increase in TV at 0-7 days (TV0-7) was associated with a 0.79 % [95 % confidence interval (CI): 0.55 %, 0.96 %] increase in total mortality. Mortality fractions attributable to TV0-7 were 4.37 % for total causes, 4.75 % for overall cardiovascular disease, 4.37 % for coronary heart disease, 5.05 % for stroke, 8.28 % for ischaemic stroke, 1.08 % for haemorrhagic stroke, 6.93 % for respiratory disease, and 6.81 % for COPD, respectively. The mortality risk and burden were generally higher in the temperate monsoon zone, females, and elders. CONCLUSION This nationwide study indicated that TV was an independent risk factor of mortality, and could result in significant burden for main cardiorespiratory diseases.
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Affiliation(s)
- Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xihao Du
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
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Nawaro J, Gianquintieri L, Pagliosa A, Sechi GM, Caiani EG. Heatwave Definition and Impact on Cardiovascular Health: A Systematic Review. Public Health Rev 2023; 44:1606266. [PMID: 37908198 PMCID: PMC10613660 DOI: 10.3389/phrs.2023.1606266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Objectives: We aimed to analyze recent literature on heat effects on cardiovascular morbidity and mortality, focusing on the adopted heat definitions and their eventual impact on the results of the analysis. Methods: The search was performed on PubMed, ScienceDirect, and Scopus databases: 54 articles, published between January 2018 and September 2022, were selected as relevant. Results: In total, 21 different combinations of criteria were found for defining heat, 12 of which were based on air temperature, while the others combined it with other meteorological factors. By a simulation study, we showed how such complex indices could result in different values at reference conditions depending on temperature. Heat thresholds, mostly set using percentile or absolute values of the index, were applied to compare the risk of a cardiovascular health event in heat days with the respective risk in non-heat days. The larger threshold's deviation from the mean annual temperature, as well as higher temperature thresholds within the same study location, led to stronger negative effects. Conclusion: To better analyze trends in the characteristics of heatwaves, and their impact on cardiovascular health, an international harmonization effort to define a common standard is recommendable.
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Affiliation(s)
- Julia Nawaro
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Lorenzo Gianquintieri
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | | | - Enrico Gianluca Caiani
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Milan, Italy
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Wang D, Zheng Z, Yu H, Dou D, Gao Y, Xu S, Li Z, Sun L, Qiu X, Zhong X. Impact of humid climate on rheumatoid arthritis faecal microbiome and metabolites. Sci Rep 2023; 13:16846. [PMID: 37803075 PMCID: PMC10558475 DOI: 10.1038/s41598-023-43964-4] [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: 07/01/2022] [Accepted: 09/30/2023] [Indexed: 10/08/2023] Open
Abstract
Studies have shown that high humidity is a condition that aggravates the pain of rheumatoid arthritis (RA), but the relevant mechanism is controversial. Currently, there is a lack of experimental animal studies on high humidity as an adverse factor related to the pathogenesis of RA. We used healthy SD rats and collagen-induced arthritis (CIA) rats to investigate the effects of high humidity on arthritis. Integrated metabolomics analyses of faeces and 16S rRNA sequencing of the faecal microbiota were performed to comprehensively assess the diversity of the faecal microbiota and metabolites in healthy and CIA rats. In this study, high humidity aggravated arthritis in CIA rats, which manifested as articular cartilage lesions, increased arthritis scores, and an increase in proinflammatory cytokines. High humidity had a certain effect on the articular cartilage extent, arthritis score and proinflammatory cytokines of healthy rats as well. Furthermore, high humidity caused significant changes in faecal microbes and metabolites in both healthy and CIA rats. 16S rRNA sequencing of faecal samples showed that high humidity increased the amount of inflammation-related bacteria in healthy and CIA rats. Faecal metabolomics results showed that high humidity significantly altered the level of faecal metabolites in healthy rats and CIA rats, and the changes in biological functions were mainly related to the inflammatory response and oxidative stress. Combined analysis showed that there was a strong correlation between the faecal microbiota and faecal metabolites. High humidity is an adverse factor for the onset and development of RA, and its mechanism is related to the inflammatory response and oxidative stress. However, the question of how high humidity impacts RA pathogenesis needs to be further investigated.
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Affiliation(s)
- Dingnan Wang
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Zhili Zheng
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Han Yu
- Formulas of Chinese Medicine, Basic Medical College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan, People's Republic of China
| | - Dou Dou
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Yining Gao
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Shuang Xu
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Zhiming Li
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Lili Sun
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Xudong Qiu
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Xianggen Zhong
- Institute of Synopsis of Golden Chamber Department, School of Chinese Medicine College, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
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Yang Z, Huang W, McKenzie JE, Xu R, Yu P, Ye T, Wen B, Gasparrini A, Armstrong B, Tong S, Lavigne E, Madureira J, Kyselý J, Guo Y, Li S. Mortality risks associated with floods in 761 communities worldwide: time series study. BMJ 2023; 383:e075081. [PMID: 37793693 PMCID: PMC10548259 DOI: 10.1136/bmj-2023-075081] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To evaluate lag-response associations and effect modifications of exposure to floods with risks of all cause, cardiovascular, and respiratory mortality on a global scale. DESIGN Time series study. SETTING 761 communities in 35 countries or territories with at least one flood event during the study period. PARTICIPANTS Multi-Country Multi-City Collaborative Research Network database, Australian Cause of Death Unit Record File, New Zealand Integrated Data Infrastructure, and the International Network for the Demographic Evaluation of Populations and their Health Network database. MAIN OUTCOME MEASURES The main outcome was daily counts of deaths. An estimation for the lag-response association between flood and daily mortality risk was modelled, and the relative risks over the lag period were cumulated to calculate overall effects. Attributable fractions of mortality due to floods were further calculated. A quasi-Poisson model with a distributed lag non-linear function was used to examine how daily death risk was associated with flooded days in each community, and then the community specific associations were pooled using random effects multivariate meta-analyses. Flooded days were defined as days from the start date to the end date of flood events. RESULTS A total of 47.6 million all cause deaths, 11.1 million cardiovascular deaths, and 4.9 million respiratory deaths were analysed. Over the 761 communities, mortality risks increased and persisted for up to 60 days (50 days for cardiovascular mortality) after a flooded day. The cumulative relative risks for all cause, cardiovascular, and respiratory mortality were 1.021 (95% confidence interval 1.006 to 1.036), 1.026 (1.005 to 1.047), and 1.049 (1.008 to 1.092), respectively. The associations varied across countries or territories and regions. The flood-mortality associations appeared to be modified by climate type and were stronger in low income countries and in populations with a low human development index or high proportion of older people. In communities impacted by flood, up to 0.10% of all cause deaths, 0.18% of cardiovascular deaths, and 0.41% of respiratory deaths were attributed to floods. CONCLUSIONS This study found that the risks of all cause, cardiovascular, and respiratory mortality increased for up to 60 days after exposure to flood and the associations could vary by local climate type, socioeconomic status, and older age.
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Affiliation(s)
- Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Joana Madureira
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
- EPIUnit - Instituto de Saude Publica, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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Li Y, Xia Y, Zhu H, Shi C, Jiang X, Ruan S, Wen Y, Gao X, Huang W, Li M, Xue R, Chen J, Zhang L. Impacts of exposure to humidex on cardiovascular mortality: a multi-city study in Southwest China. BMC Public Health 2023; 23:1916. [PMID: 37794404 PMCID: PMC10548730 DOI: 10.1186/s12889-023-16818-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Many studies have reported the association between ambient temperature and mortality from cardiovascular disease (CVD). However, the health effects of humidity are still unclear, much less the combined effects of temperature and humidity. In this study, we used humidex to quantify the effect of temperature and humidity combined on CVD mortality. METHODS Daily meteorological, air pollution, and CVD mortality data were collected in four cities in southwest China. We used a distributed lag non-linear model (DLNM) in the first stage to assess the exposure-response association between humidex and city-specific CVD mortality. A multivariate meta-analysis was conducted in the second stage to pool these effects at the overall level. To evaluate the mortality burden of high and low humidex, we determined the attributable fraction (AF). According to the abovementioned processes, stratified analyses were conducted based on various demographic factors. RESULTS Humidex and the CVD exposure-response curve showed an inverted "J" shape, the minimum mortality humidex (MMH) was 31.7 (77th percentile), and the cumulative relative risk (CRR) was 2.27 (95% confidence interval [CI], 1.76-2.91). At extremely high and low humidex, CRRs were 1.19 (95% CI, 0.98-1.44) and 2.52 (95% CI, 1.88-3.38), respectively. The burden of CVD mortality attributed to non-optimal humidex was 21.59% (95% empirical CI [eCI], 18.12-24.59%), most of which was due to low humidex, with an AF of 20.16% (95% eCI, 16.72-23.23%). CONCLUSIONS Low humidex could significantly increase the risk of CVD mortality, and vulnerability to humidex differed across populations with different demographic characteristics. The elderly (> 64 years old), unmarried people, and those with a limited level of education (1-9 years) were especially susceptible to low humidex. Therefore, humidex is appropriate as a predictor in a CVD early-warning system.
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Affiliation(s)
- Yang Li
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Yizhang Xia
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
- School of Public Health, Chengdu Medical College, No.783, Xindu Road, Xindu District, Chengdu, 610500, China
| | - Hongbin Zhu
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Chunli Shi
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Xianyan Jiang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Shijuan Ruan
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Yue Wen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, No.6, Longxiang Road, Wuhou District, Chengdu, 610041, China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, No.826, Huichuan Road, Ziliujing District, Zigong, 643000, China
| | - Mingjiang Li
- Panzhi hua Center for Disease Control and Prevention, No.996, Jichang Road, Dong District, Panzhi hua, 617067, China
| | - Rong Xue
- Guangyuan Center for Disease Control and Prevention, No.996, Binhebei Road,Lizhou District, Guangyuan, 628017, China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China.
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China.
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He C, Yin P, Chen R, Gao Y, Liu W, Schneider A, Bell ML, Kan H, Zhou M. Cause-specific accidental deaths and burdens related to ambient heat in a warming climate: A nationwide study of China. ENVIRONMENT INTERNATIONAL 2023; 180:108231. [PMID: 37778287 DOI: 10.1016/j.envint.2023.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/14/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on non-accidental morbidity or mortality, with far less research on heat-related accidental events. METHODS We collected individual accidental death records among all residents in Chinese mainland from June to August during 2013-2019. Accidental deaths were further divided into several subtypes by different causes. We used an individual-level, time-stratified, case-crossover study design to estimate the association between daily mean temperature and accidental deaths, and estimate its variation in seven geo-climatic zones, age (5-64, 65-74, ≥75), and sex (male, female). We then estimated the temperature-related excess accidental deaths under global warming scenarios of 1.5, 2, and 3℃. FINDINGS A total of 711,929 accidental death records were included in our study. We found that higher temperatures were associated with increased risks of deaths from the total accidental events and four main subtypes, including traffic, falls, drowning, and unintentional injuries. We also found that younger individuals (ages 5-64) and males faced a higher risk of heat-related mortality due to total accidents, traffic incidents, and drowning. For future climate scenarios, even under the 1.5℃ climate change scenario, 6,939 (95% eCI (empirical Confidence Interval): 6,818-7,067) excess accidental deaths per year are attributed to higher summertime daily temperature over mainland China, and the number of accidental deaths would increase by 16.71% and 33.59% under the 2℃ and 3℃ climate change scenarios, respectively. For residents living in southern coastal and northwest inland regions, the projected increase in accidental death is higher. CONCLUSIONS This nationwide study confirms that higher summer temperatures are linked to an increased risk of accidental deaths. Younger age groups and males face a higher risk. This indicates that current estimates of the health effects of climate change might be underestimated, particularly for younger populations.
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Affiliation(s)
- Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | | | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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