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Yang J, Zhou M, Guo C, Zhu S, Sakhvidi MJZ, Requia WJ, Sun Q, Tong S, Li M, Liu Q. Drivers of associations between daytime-nighttime compound temperature extremes and mortality in China. COMMUNICATIONS MEDICINE 2024; 4:125. [PMID: 38937621 PMCID: PMC11211425 DOI: 10.1038/s43856-024-00557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/19/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Temperature extremes are anticipated to become more frequent and more intense under the context of climate change. While current evidence on health effects of compound extreme temperature event is scarce. METHODS This nationwide cross-sectional study collected daily data on weather and mortality for 161 Chinese districts/counties during 2007-2013. A quasi-Poisson generalized linear model was first applied to assess effects of daytime-only, nighttime-only and compound daytime-nighttime heat wave (and cold spell) on cause-specific mortality. Then a random-effect meta-analysis was used to produce pooled estimates at national level. Stratification analyses were performed by relative humidity, individual and regional characteristics. RESULTS Here we show that mortality risks of compound daytime-nighttime temperature extremes are much higher than those occurring only in the daytime or nighttime. Humid weather further exaggerates the mortality risk during heat waves, while dry air enhances the risk during cold weather. People who are elderly, illiterate, and those with ischemic heart disease and respiratory disease are particularly vulnerable to extreme temperature. At the community-level, population size, urbanization rate, proportion of elderly and PM2.5 are positively associated with increased risks associated with heat waves. Temperature, humidity and normalized difference vegetation index are positively associated with the effects of cold weather, with an opposite trend for latitude and diurnal temperature range. CONCLUSIONS This nationwide study highlights the importance of incorporating compound daytime-nighttime extreme temperature events and humid conditions into early warning systems and urban design/planning.
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Affiliation(s)
- Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Cui Guo
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510080, China
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Qinghua Sun
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Shilu Tong
- Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai, 200127, China
- School of Public Health and Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - 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
| | - Qiyong Liu
- 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, China.
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Ye Y, Ma H, Dong J, Wang J. Ambient temperature and cardiovascular disease-related emergency room visits in Lanzhou, China from 2013 to 2019: A time-series study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02718-1. [PMID: 38896341 DOI: 10.1007/s00484-024-02718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/26/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
This study assessed the links between daily mean temperature and emergency room (ER) admissions for total and cause-specific cardiovascular diseases (CVD) in Lanzhou, China from 2013 to 2019. A quasi-Poisson Generalized Additive Model (GAM) and a Distributed Lag Non-Linear Model (DLNM) were used to determine the effects of temperature on total and cause-specific cardiovascular emergency visits. The relative risks (RR) at cold (hot) temperatures were calculated by comparing the 5th (95th) centile of temperature with the minimum morbidity temperature (MMT). Exposure-response curves demonstrating an inverted U-shape or an irregular M-shape association were observed between temperature and total and cause-specific CVD. The study found that both cold and hot temperatures had negative impacts on emergency room visits for various cardiovascular diseases. For people with total CVD, heart rhythm disturbances (HRD), or cerebrovascular diseases (CD), females were more sensitive to temperature than males, while for ischemic heart disease (IHD) and heart failure (HF), males were more vulnerable to temperature. The < 65 years old with total CVD, IHD, HRD, or CD was more susceptible to the effects of temperature. The results indicated that the relationship between temperature and total and cause-specific CVD was nonlinear, and susceptibility to temperature varied across disease subtype, gender, and age.
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Affiliation(s)
- Yilin Ye
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Hongran Ma
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Jiancheng Wang
- Gansu Health Vocational College, Lanzhou, 730000, People's Republic of China
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Li X, Zhang Y, Tian Z, Wang J, Zhao J, Lyu Y, Ni Y, Guo Y, Cui Z, Zhang W, Li C. Lag effect of ambient temperature on respiratory emergency department visits in Beijing: a time series and pooled analysis. BMC Public Health 2024; 24:1363. [PMID: 38773497 PMCID: PMC11106889 DOI: 10.1186/s12889-024-18839-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Although the association between ambient temperature and mortality of respiratory diseases was numerously documented, the association between various ambient temperature levels and respiratory emergency department (ED) visits has not been well studied. A recent investigation of the association between respiratory ED visits and various levels of ambient temperature was conducted in Beijing, China. METHODS Daily meteorological data, air pollution data, and respiratory ED visits data from 2017 to 2018 were collected in Beijing. The relationship between ambient temperature and respiratory ED visits was explored using a distributed lagged nonlinear model (DLNM). Then we performed subgroup analysis based on age and gender. Finally, meta-analysis was utilized to aggregate the total influence of ambient temperature on respiratory ED visits across China. RESULTS The single-day lag risk for extreme cold peaked at a relative risk (RR) of 1.048 [95% confidence interval (CI): 1.009, 1.088] at a lag of 21 days, with a long lag effect. As for the single-day lag risk for extreme hot, a short lag effect was shown at a lag of 7 days with an RR of 1.076 (95% CI: 1.038, 1.114). The cumulative lagged effects of both hot and cold effects peaked at lag 0-21 days, with a cumulative risk of the onset of 3.690 (95% CI: 2.133, 6.382) and 1.641 (95% CI: 1.284, 2.098), respectively, with stronger impact on the hot. Additionally, the elderly were more sensitive to ambient temperature. The males were more susceptible to hot weather than the females. A longer cold temperature lag effect was found in females. Compared with the meta-analysis, a pooled effect of ambient temperature was consistent in general. In the subgroup analysis, a significant difference was found by gender. CONCLUSIONS Temperature level, age-specific, and gender-specific effects between ambient temperature and the number of ED visits provide information on early warning measures for the prevention and control of respiratory diseases.
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Affiliation(s)
- Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Zhenbiao Tian
- Beijing Red Cross Emergency Center, Beijing, 100085, China
| | - Jianping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuanjun Lyu
- Department of Endocrinology, Tianjin Hospital, Tianjin, China
| | - Ying Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China.
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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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5
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Gay P, Pautas É. [A geriatric perspective on the sixth IPCC synthesis report]. SOINS. GERONTOLOGIE 2023; 28:37-40. [PMID: 37977763 DOI: 10.1016/j.sger.2023.09.009] [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: 11/19/2023]
Abstract
Climate change brings with it many foreseeable consequences for ecosystems and populations, including health consequences that could have a particular impact on older populations. Extreme climatic events, including heat waves, are associated with higher morbidity and mortality among the elderly. Air pollution has a deleterious effect on illnesses associated with aging, or which become more frequent with age. The health consequences of climate change must be anticipated, as they will require the adaptation of healthcare systems, which could be of particular interest to geriatric medicine.
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Affiliation(s)
- Pierre Gay
- Service de gériatrie aiguë, Hôpital européen Georges-Pompidou, GHU AP-HP centre université Paris-Cité, 20, rue Leblanc, 75015 Paris, France.
| | - Éric Pautas
- Service de gériatrie aiguë polyvalente, Hôpital Charles-Foix, GHU AP-HP Sorbonne université, Ivry-sur-Seine, France; UFR médecine, Sorbonne Université, Paris, France
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6
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Jiang Y, Yi S, Gao C, Chen Y, Chen J, Fu X, Yang L, Kong X, Chen M, Kan H, Xiang D, Su X, Chen R. Cold Spells and the Onset of Acute Myocardial Infarction: A Nationwide Case-Crossover Study in 323 Chinese Cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87016. [PMID: 37610263 PMCID: PMC10445528 DOI: 10.1289/ehp11841] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Few studies have explored the relationships between cold spells and acute myocardial infarction (AMI) using the information of symptom onset. OBJECTIVES We assessed the impact of cold spells on AMI onset and the potential effect modifiers. METHODS We conducted a time-stratified case-crossover study among 456,051 eligible patients with AMI from 2,054 hospitals in 323 Chinese cities between January 2015 and June 2021 during cold seasons (November to March). Nine definitions of cold spells were used by combining three relative temperature thresholds (i.e., lower than the 7.5th, 5th, and 2.5th percentiles) and three durations of at least 2-4 consecutive d. Conditional logistic regressions with distributed lag models were applied to evaluate the cumulated effects of cold spells on AMI onset over lags 0-6 d, after adjusting for daily mean temperature. RESULTS The associations generally appeared on lag 1 d, peaked on lag 3 d, and became nonsignificant approximately on lag 5 d. Cold spells defined by more stringent thresholds of temperature were associated with higher risks of AMI onset. For cold spell days defined by a daily mean temperature of ≤ 7.5 th percentile and durations of ≥ 2 d , ≥ 3 d , and ≥ 4 d , the percentage changes in AMI risk were 4.24% [95% confidence interval (CI): 2.31%, 6.20%], 3.48% (95% CI: 1.62%, 5.38%), and 2.82% (95% CI: 0.98%, 4.70%), respectively. Significant AMI risks associated with cold spells were observed among cases from regions without centralized heating, whereas null or much weaker risks were found among those from regions with centralized heating. Patients ≥ 65 years of age were more susceptible to cold spells. DISCUSSION This national case-crossover study presents compelling evidence that cold spells could significantly increase the risk of AMI onset. https://doi.org/10.1289/EHP11841.
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Affiliation(s)
- Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shaodong Yi
- Department of Cardiology, General Hospital of Southern Theater Command of People’s Liberation Army (PLA), Guangzhou, China
| | - Chuanyu Gao
- Department of Cardiology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Yuguo Chen
- Department of Emergency and Chest Pain Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xianghua Fu
- Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lixia Yang
- Department of Cardiology, 920th Hospital of Joint Logistics Support Force of the Chinese PLA, Yunnan, China
| | - Xiangqing Kong
- Department of Cardiology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Dingcheng Xiang
- Department of Cardiology, General Hospital of Southern Theater Command of People’s Liberation Army (PLA), Guangzhou, China
| | - Xi Su
- Department of Cardiology, Wuhan Asia General Hospital, Wuhan, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
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7
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Rai M, Stafoggia M, de'Donato F, Scortichini M, Zafeiratou S, Vazquez Fernandez L, Zhang S, Katsouyanni K, Samoli E, Rao S, Lavigne E, Guo Y, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Maasikmets M, Jaakkola JJK, Ryti N, Pascal M, Hashizume M, Fook Sheng Ng C, Alahmad B, Hurtado Diaz M, De la Cruz Valencia C, Nunes B, Madureira J, Scovronick N, Garland RM, Kim H, Lee W, Tobias A, Íñiguez C, Forsberg B, Åström C, Maria Vicedo-Cabrera A, Ragettli MS, Leon Guo YL, Pan SC, Li S, Gasparrini A, Sera F, Masselot P, Schwartz J, Zanobetti A, Bell ML, Schneider A, Breitner S. Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries. ENVIRONMENT INTERNATIONAL 2023; 174:107825. [PMID: 36934570 DOI: 10.1016/j.envint.2023.107825] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. OBJECTIVES We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries. METHODS Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model. RESULTS Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6-7.7), 11.3% (95%CI 11.2-11.3), and 14.3% (95% CI 14.1-14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5-1.6), 5.1 (95%CI 5.1-5.2), and 8.7 (95%CI 8.7-8.8) at low, medium, and high levels of O3, respectively. DISCUSSION We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesca de'Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | | | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Shilpa Rao
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada and Environmental Health Science & Research Bureau, Health Canada, Ottawa, Canada
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - 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
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Baltazar Nunes
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Noah Scovronick
- Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research. Universitat de València, València, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | | | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, and Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Pierre Masselot
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven CT, USA
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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Rai M, Breitner S, Huber V, Zhang S, Peters A, Schneider A. Temporal variation in the association between temperature and cause-specific mortality in 15 German cities. ENVIRONMENTAL RESEARCH 2023; 229:115668. [PMID: 36958378 DOI: 10.1016/j.envres.2023.115668] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND There is limited evidence of temporal changes in the association between air temperature and the risk of cause-specific cardiovascular [CVD] and respiratory [RD] mortality. METHOD We explored temporal variations in the association between short-term exposures to air temperature and non-accidental and cause-specific CVD and RD mortality in the 15 largest German cities over 24 years (1993-2016) using time-stratified time series analysis. We applied location-specific confounder-adjusted Poisson regression with distributed lag non-linear models with a lag period of 14 days to estimate the temperature-mortality associations. We then pooled the estimates by a multivariate meta-analytical model. We analysed the whole study period and the periods 1993-2004 and 2005-16, separately. We also carried out age- and sex-stratified analysis. Cold and heat effects are reported as relative risk [RR] at the 1st and the 99th temperature percentile, relative to the 25th and the 75th percentile, respectively. RESULT We analysed a total of 3,159,292 non-accidental, 1,063,198 CVD and 183,027 RD deaths. Cold-related RR for CVD mortality was seen to rise consistently over time from 1.04 (95% confidence interval [95% CI] 1.02, 1.06) in the period 1993-2004 to 1.10 (95% CI 1.09, 1.11) in the period 2005-16. A similar increase in cold-related RR was also observed for RD mortality with risk increasing from 0.99 (95% CI 0.96, 1.03) to 1.07 (95% CI 1.03, 1.10). Cold-related ischemic, cerebrovascular, and heart failure mortality risk were seen to be increasing over time. Similarly, COPD, the commonly speculated driver of heat-related RD mortality was found to have a constant heat-related risk over time. Males were increasingly vulnerable to cold with time for all causes of death. Females showed increasing sensitivity to cold for CVD mortality. Our results indicated a significant increased cold and heat vulnerability of the youngest age-groups (<64) to non-accidental and RD mortality, respectively. Similarly, the older age group (>65) were found to have significantly increased susceptibility to cold for CVD mortality. CONCLUSION We found evidence of rising population susceptibility to both heat- and cold-related CVD and RD mortality risk from 1993 to 2016. Climate change mitigation and targeted adaptation strategies might help to reduce the number of temperature-related deaths in the future.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Seasonal Pattern of Cerebrovascular Fatalities in Cancer Patients. Healthcare (Basel) 2023; 11:healthcare11040456. [PMID: 36832989 PMCID: PMC9957084 DOI: 10.3390/healthcare11040456] [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: 12/30/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Cancer patients are at increased risk of cerebrovascular events. The incidence of those events and the associated mortality are known to follow a seasonal pattern in the general population. However, it is unclear whether cerebrovascular mortality in cancer patients has seasonal variation. To address this question, we performed a retrospective analysis of the seasonality of deaths due to the fact of cerebrovascular diseases among patients with first primary malignancy registered between 1975 and 2016 in the SEER database. The presence of seasonality in death rates was modeled using the cosinor approach assuming a circa-annual pattern. A significant seasonal pattern with a peak in the first half of November was identified in all patient groups. The same peak was observed in almost all subgroups of patients defined based on demographic characteristics. However, not all entity-defined subgroups showed a seasonal pattern, which might be explained by the different pathologic processes affecting the circulatory system in each cancer type. Based on our findings, one can propose that the active monitoring of cancer patients for cerebrovascular events from the late autumn and during the winter can help in the reduction of mortality in this patient population.
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Chen H, Zhang X. Influences of temperature and humidity on cardiovascular disease among adults 65 years and older in China. Front Public Health 2023; 10:1079722. [PMID: 36699927 PMCID: PMC9868618 DOI: 10.3389/fpubh.2022.1079722] [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: 10/25/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Background The burden of cardiovascular disease (CVD) on the current aging society in China is substantial. Climate change, including extreme temperatures and humidity, has a detrimental influence on health. However, epidemiological studies have been unable to fully identify the association between climate change and CVD among older adults. Therefore, we investigated the associations between temperature and relative humidity and CVD among older adults in China. Methods We used cohort data from the China Longitudinal Health and Longevity Survey (CLHLS) conducted in 2002, 2005, 2008, 2011, 2014, and 2018. A total of 39,278 Chinese adults 65 years and older participated in the analyses. The average annual temperatures and relative humidity during 2001 and 2017 (before the survey year) at the city level in China were used as the exposure measures. We selected patients with hypertension, heart disease, and stroke to create a sample of CVD patients. The associations between temperature and relative humidity and CVD were analyzed using the generalized estimation equation (GEE) model. Covariates included sociodemographic factors, health status, lifestyle, and cognitive function. Results The average annual temperature was negatively correlated with the prevalence of CVD. Every 1°C increase in the average annual temperature reduced the rates of hypertension by 3% [odds ratio (OR): 0.97; 95% confidence interval (CI): 0.96-0.97], heart disease by 6% (OR: 0.94; 95% CI: 0.92-0.95), and stroke by 5% (OR: 0.95; 95% CI: 0.94-0.97). The results of the analyses stratified by sex, urban/rural residence, and educational level were robust. The average annual relative humidity was inversely associated with the likelihood of CVD among older adults. Every 1% increase in the average annual relative humidity reduced the rates of hypertension by 0.4% (OR: 0.996; 95% CI: 0.99-1.00), heart disease by 0.6% (OR: 0.994; 95% CI: 0.99-1.00), and stroke by 0.08% (OR: 0.992; 95% CI: 0.98-1.00). However, the effects were more obvious with higher humidity levels (>70). Conclusion Our findings suggest that higher temperatures and relative humidity may reduce the risk of CVD among older adults.
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Affiliation(s)
- Huashuai Chen
- Department of International Trade, Business School of Xiangtan University, Xiangtan, China,*Correspondence: Huashuai Chen ✉
| | - Xuebin Zhang
- School of Urban and Regional Science, Shanghai University of Finance and Economics, Shanghai, China
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Wen B, Su BB, Xue J, Xie J, Wu Y, Chen L, Dong Y, Wu X, Wang M, Song Y, Ma J, Zheng X. Temperature variability and common diseases of the elderly in China: a national cross-sectional study. Environ Health 2023; 22:4. [PMID: 36609287 PMCID: PMC9824998 DOI: 10.1186/s12940-023-00959-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND In the context of climate change, it has been well observed that short-term temperature variability (TV) could increase the overall and cause-specific mortality and morbidity. However, the association between long-term TV and a broader spectrum of diseases is not yet well understood, especially in the elderly. METHODS Our study used data from the fourth Urban and Rural Elderly Population (UREP) study. Long-term TV was calculated from the standard deviation (SD) of daily minimum and maximum temperatures within the study periods (2010-2014, 2011-2014, 2012-2014, 2013-2014, and 2014). Ten self-reported diseases and conditions were collected by questionnaire, including cataract, hypertension, diabetes, cardio-cerebrovascular diseases, stomach diseases, arthritis, chronic lung disease, asthma, cancer, and reproductive diseases. The province-stratified logistic regression model was used to quantify the association between long-term TV and the prevalence of each disease. RESULTS A total of 184,047 participants were included in our study. In general, there were significant associations between TV and the prevalence of most diseases at the national level. Cardio-cerebrovascular disease (OR: 1.16, 95% CI: 1.13, 1.20) generated the highest estimates, followed by stomach diseases (OR: 1.15, 95% CI: 1.10, 1.19), asthma (OR: 1.14, 95% CI: 1.06, 1.22), chronic lung diseases (OR: 1.08, 95% CI: 1.03, 1.13), arthritis (OR: 1.08, 95% CI: 1.05, 1.11), and cataract (OR: 1.06, 95% CI: 1.02, 1.10). Moreover, the associations varied by geographical regions and across subgroups stratified by sex, household income, physical activity, and education. CONCLUSIONS Our study showed that long-term exposure to TV was associated with the prevalence of main diseases in the elderly. More attention should be paid to the elderly and targeted strategies should be implemented, such as an early warning system.
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Affiliation(s)
- Bo Wen
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Bin Bin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, No.31, Beijige-3, Dongcheng District, Beijing, 100730, China
| | - Jiahui Xue
- First Clinical Medical College of Shanxi Medical University, No. 56 Xinjian South Road, Yingze District, Taiyuan City, 030001, Shanxi Province, China
| | - Junqing Xie
- Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford, Oxford, UK
| | - Yao Wu
- Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
| | - Xiaolan Wu
- China Research Center on Ageing, 48 Guang 'anmen South Street, Xicheng District, Beijing, 100054, China
| | - Mengfan Wang
- University of Toronto, St.Geogre, 27 King's College Cir, Toronto, ON, M5S, Canada
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, No.31, Beijige-3, Dongcheng District, Beijing, 100730, China.
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He F, Wei J, Dong Y, Liu C, Zhao K, Peng W, Lu Z, Zhang B, Xue F, Guo X, Jia X. Associations of ambient temperature with mortality for ischemic and hemorrhagic stroke and the modification effects of greenness in Shandong Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158046. [PMID: 35987239 DOI: 10.1016/j.scitotenv.2022.158046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence is scant on the relative and attributable contributions of ambient temperature on stroke subtypes mortality. Few studies have examined modification effects of multiple greenness indicators on such contributions, especially in China. We quantified the associations between ambient temperature and overall, ischemic, and hemorrhagic stroke mortality; further examined whether the associations were modified by greenness. METHODS We conducted a multicenter time-series analysis from January 1, 2013 to December 31, 2019. we adopted a distributed lag non-linear model to evaluate county-specific temperature-stroke mortality associations. We then applied a random-effects meta-analysis to pool county-specific effects. Attributable mortality was calculated for cold and heat, defined as temperatures below and above the minimum mortality temperature (MMT). Finally, We conducted a multivariate meta-regression to determine associations between greenness and stroke mortality risks for cold and heat, using normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and enhanced vegetation index (EVI) as quantitative indicators of greenness exposure. RESULTS In the study period, 138,749 deaths from total stroke were reported: 86,873 ischemic and 51,876 hemorrhagic stroke. We observed significant W-shaped relationships between temperature and stroke mortality, with substantial differences among counties and regions. With MMT as the temperature threshold, 17.16 % (95 % empirical CI, 13.38 %-19.75 %) of overall, 20.05 % (95 % eCI, 16.46 %-22.70 %) of ischemic, and 12.55 % (95 % eCI, 5.59 %-16.24 %) of hemorrhagic stroke mortality were attributable to non-optimum temperature (combining cold and heat), more mortality was caused by cold (14.94 %; 95 % eCI, 11.57 %-17.34 %) than by heat (2.22 %; 95 % eCI, 1.54 %-2.72 %). Higher levels of NDVI, SAVI and EVI were related to mitigated effects of non-optimum temperatures-especially heat. CONCLUSIONS Exposure to non-optimum temperatures aggravated stroke mortality risks; increasing greenness could alleviate that risks. This evidence has important implications for local communities in developing adaptive strategies to minimize the health consequences of adverse temperatures.
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Affiliation(s)
- Fenfen He
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Yilin Dong
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
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Temperature, cardiovascular mortality, and the role of hypertension and renin-angiotensin-aldosterone axis in seasonal adversity: a narrative review. J Hum Hypertens 2022; 36:1035-1047. [PMID: 35618875 DOI: 10.1038/s41371-022-00707-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/25/2022] [Accepted: 05/12/2022] [Indexed: 12/14/2022]
Abstract
Environmental temperature is now well known to have a U-shaped relationship with cardiovascular (CV) and all-cause mortality. Both heat and cold above and below an optimum temperature, respectively, are associated with adverse outcomes. However, cold in general and moderate cold specifically is predominantly responsible for much of temperature-attributable adversity. Importantly, hypertension-the most important CV risk factor-has seasonal variation such that BP is significantly higher in winter. Besides worsening BP control in established hypertensives, cold-induced BP increase also contributes to long-term BP variability among normotensive and pre-hypertensive patients, also a known CV risk factor. Disappointingly, despite the now well-stablished impact of temperature on BP and on CV mortality separately, direct linkage between seasonal BP change and CV outcomes remains preliminary. Proving or disproving this link is of immense clinical and public health importance because if seasonal BP variation contributes to seasonal adversity, this should be a modifiable risk. Mechanistically, existing evidence strongly suggests a central role of the sympathetic nervous system (SNS), and secondarily, the renin-angiotensin-aldosterone axis (RAAS) in mediating cold-induced BP increase. Though numerous other inflammatory, metabolic, and vascular perturbations likely also contribute, these may also well be secondary to cold-induced SNS/RAAS activation. This review aims to summarize the current evidence linking temperature, BP and CV outcomes. We also examine underlying mechanisms especially in regard to the SNS/RAAS axis, and highlight possible mitigation measures for clinicians.
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Shivarov V, Shivarov H, Yordanov A. Seasonality of Deaths Due to Heart Diseases among Cancer Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1651. [PMID: 36422190 PMCID: PMC9693160 DOI: 10.3390/medicina58111651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/20/2022] [Accepted: 11/11/2022] [Indexed: 08/30/2023]
Abstract
Background and Objectives: Cancer patients are at increased short- and long-term risk of cardiac toxicity and mortality. It is well-known that cardiac morbidity and mortality follows a seasonal pattern. Here we address the question of whether heart disease-related fatalities among cancer patients also follow a seasonal pattern. Materials and Methods: We performed a retrospective analysis of seasonality of deaths due to heart diseases (n = 503,243) in patients with newly diagnosed cancer reported during the period from 1975 to 2016 in the US's largest cancer registry-the Surveillance, Epidemiology, and End Results (SEER) database. Seasonality was assessed through a classical cosinor model assuming a single annual peak. Results: We identified a significant seasonal peak in the first half of November. A peak with identical features was for all subgroups of patients defined based on demographic characteristics. This was also the case when analysis was performed on subgroups defined by the type of malignancy. Only patients with acute leukemias, pancreatic cancer and nervous system malignancies did not have a seasonal pattern in heart disease-related fatalities. Conclusion: the rate of heart disease-related fatalities after cancer diagnosis follows a seasonal pattern similar to that observed for the general population, albeit with an earlier peak in November. This suggests that close monitoring of the cardiovascular system in cancer survivors must be particularly active from late autumn and during the entire winter period.
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Affiliation(s)
- Velizar Shivarov
- Department of Experimental Research, Medical University Pleven, 5800 Pleven, Bulgaria
| | | | - Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria
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Rai M, Breitner S, Wolf K, Peters A, Schneider A, Chen K. Future temperature-related mortality considering physiological and socioeconomic adaptation: a modelling framework. Lancet Planet Health 2022; 6:e784-e792. [PMID: 36208641 DOI: 10.1016/s2542-5196(22)00195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/27/2022] [Accepted: 07/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND As the climate changes, it is crucial to focus not only on mitigation measures but also on building climate change resilience by developing efficient adaptation strategies. Although population adaptation is a major determinant of future climate-related health burden, it is not well accounted for in studies that project the health impact of climate change. We propose a methodological framework for temperature-related mortality that incorporates two simultaneous adaptation-sensitivity pathways: the physiological pathway, considering both heat adaptation and cold sensitivity, and the socioeconomic pathway, which is influenced by changes in future adaptive capacities. To demonstrate its utility we apply the framework to a case study mortality time-series dataset from Bavaria, Germany. METHODS In this modelling framework, we used extrapolated location-specific and age-specific baseline exposure-response functions and propose different future scenarios of cold sensitivity and heat adaptation on the basis of varying slopes of these exposure-response functions. We also incorporated future socioeconomic adaptation in the exposure-response functions using projections of gross domestic product under the respective shared socioeconomic pathways. Future adaptable fractions, representing the deaths avoided under each of the future scenarios, are projected under combinations of two climate change scenarios (shared socioeconomic pathway [SSP]1-2.6 and SSP3-7.0) and the respective plausible population projection scenarios (SSP1 and SSP3), also incorporating the future changes in demographic age structure and mortality. The case study for this framework was done for five districts in Bavaria, for both total non-accidental mortality and cardiovascular disease mortality. The baseline data was obtained for the period 1990-2006, and the future period was defined as 2083-99. FINDINGS In our Bavaria case study, average temperature was projected to increase by 2099 by an average of 1·1°C under SSP1-2.6 and by 4·1°C under SSP3-7.0. We observed the adaptable fraction to be largely influenced by socioeconomic adaptation for both total mortality and cardiovascular disease mortality, and for both climate change scenarios. For example, for total mortality, the highest adaptable fraction of 18·56% (95% empirical CI 10·77-23·67) was observed under the SSP1-2.6 future scenario, in the presence of socioeconomic adaptation and under the highest heat adaptation (10%) provided the cold sensitivity remains 0%. The cold adaptable fraction is lower than the heat adaptable fraction under all scenarios. In the absence of socioeconomic adaptation, population ageing will lead to higher temperature-related mortality. INTERPRETATION Our developed framework helps to systematically understand the effectiveness of adaptation mechanisms. In the future, socioeconomic adaptation is estimated to play a major role in determining temperature-related excess mortality. Furthermore, cold sensitivity might outweigh heat adaptation in the majority of locations worldwide. Similarly, population ageing is projected to continue to determine future temperature-related mortality. FUNDING EU Horizon 2020 (EXHAUSTION).
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Kai Chen
- Department of Environmental Health Sciences and Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Winklmayr C, Muthers S, Niemann H, Mücke HG, an der Heiden M. Heat-Related Mortality in Germany From 1992 to 2021. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:451-457. [PMID: 35583101 PMCID: PMC9639227 DOI: 10.3238/arztebl.m2022.0202] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 12/21/2021] [Accepted: 04/13/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND 2018-2020 were unusually warm years in Germany, and the summer of 2018 was the second warmest summer since record-keeping began in 1881. Higher temperatures regularly lead to increased mortality, particularly among the elderly. METHODS We used weekly data on all-cause mortality and mean temperature from the period 1992-2021 and estimated the number of heat-related deaths in all of Germany, and in the northern, central, and southern regions of Germany, employing a generalized additive model (GAM). To characterize long-term trends, we compared the effect of heat on mortality over the decades. RESULTS Our estimate reveals that the unusually high summer temperatures in Germany between 2018 and 2020 led to a statistically significant number of deaths in all three years. There were approximately 8700 heat-related deaths in 2018, 6900 in 2019, and 3700 in 2020. There was no statistically significant heat-related increase in deaths in 2021. A comparison of the past three decades reveals a slight overall decline in the effect of high temperatures on mortality. CONCLUSION Although evidence suggests that there has been some adaptation to heat over the years, the data from 2018-2020 in particular show that heat events remain a significant threat to human health in Germany.
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Affiliation(s)
- Claudia Winklmayr
- Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany,*Abteilung für Infektionsepidemiologie Robert Koch-Institut Nordufer 20, 13353 Berlin, Germany
| | - Stefan Muthers
- Research Centre Human Biometeorology, Deutscher Wetterdienst (DWD), Freiburg, Germany
| | - Hildegard Niemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute (RKI), Berlin, Germany
| | - Hans-Guido Mücke
- Department of Environmental Hygiene, German Environment Agency (UBA), Berlin, Germany
| | - Matthias an der Heiden
- Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
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Ghada W, Estrella N, Ankerst DP, Menzel A. Universal thermal climate index associations with mortality, hospital admissions, and road accidents in Bavaria. PLoS One 2021; 16:e0259086. [PMID: 34788302 PMCID: PMC8598056 DOI: 10.1371/journal.pone.0259086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/13/2021] [Indexed: 11/18/2022] Open
Abstract
When meteorological conditions deviate from the optimal range for human well-being, the risks of illness, injury, and death increase, and such impacts are feared in particular with more frequent and intense extreme weather conditions resulting from climate change. Thermal indices, such as the universal thermal climate index (UTCI), can better assess human weather-related stresses by integrating multiple weather components. This paper quantifies and compares the seasonal and spatial association of UTCI with mortality, morbidity, and road accidents in the federal state of Bavaria, Germany. Linear regression was applied to seasonally associate daily 56 million hospital admissions and 2.5 million death counts (1995-2015) as well as approximately 930,000 road accidents and 1.7 million people injured (2002-2015) with spatially interpolated same day- and lagged- (up to 14 days) average UTCI values. Additional linear regressions were performed stratifying by age, gender, region, and district. UTCI effects were clear in all three health outcomes studied: Increased UTCI resulted in immediate (1-2 days) rises in morbidity and even more strongly in mortality in summer, and lagged (up to 14 days) decreases in fall, winter, and spring. The strongest UTCI effects were found for road accidents where increasing UTCI led to immediate decreases in daily road accidents in winter but pronounced increases in all other seasons. Differences in UTCI effects were observed e.g. between in warmer north-western regions (Franconia, more districts with heat stress-related mortality, but hospital admissions for lung, heart and external reasons decreasing with summer heat stress), the touristic alpine regions in the south (immediate effect of increasing UTCI on road accidents in summer), and the colder south-eastern regions (increasing hospital admissions for lung, heart and external reasons in winter with UTCI). Districts with high percentages of elderly suffered from higher morbidity and mortality, particularly in winter. The influences of UTCI as well as the spatial and temporal patterns of this influence call for improved infrastructure planning and resource allocation in the health sector.
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Affiliation(s)
- Wael Ghada
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
| | - Nicole Estrella
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
| | - Donna P. Ankerst
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
- Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Annette Menzel
- Department of Life Science Systems, Technical University of Munich, Freising, Germany
- Institute for Advanced Study, Technical University of Munich, Garching, Germany
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Yang Z, Yang J, Zhou M, Yin P, Chen Z, Zhao Q, Hu K, Liu Q, Ou CQ. Hourly temperature variability and mortality in 31 major Chinese cities: Effect modification by individual characteristics, season and temperature zone. ENVIRONMENT INTERNATIONAL 2021; 156:106746. [PMID: 34247007 DOI: 10.1016/j.envint.2021.106746] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In the context of ongoing climate change, temperature variability (TV) has been considered as an important trigger of death. However, evidence of association between mortality and hourly temperature variability (HTV) is scarce at the multi-city level, and the time window of health effects of HTV is lack of investigation. This study aims at quantifying the mortality risk and burden of HTV and exploring subpopulations susceptible to HTV from a large-scale multi-city perspective. METHODS Data on daily number of deaths and meteorology were collected for 31 Chinese major cities during 2007-2013. HTV was calculated as the standard deviation of hourly temperature within a few days. The optimal exposure period of HTV was chosen according to multiple scientific criteria. A quasi-Poisson regression combined with distributed lag nonlinear model was used to assess the city-specific HTV-mortality associations. Then, meta-analysis was further applied to pool city-specific effect estimates. Finally, we calculated the fraction of mortality attributable to HTV. Stratification analyses were conducted by individual characteristics (i.e. age, sex, and educational attainment), season, and region. RESULTS HTV calculated in a relatively long-time window like 18 d (HTV0-17) could capture the impact of HTV adequately. Per 1 °C raise of HTV0-17 associated with 1.38% (95%CI: 0.77, 1.99) increase of non-accidental mortality. During the study period, 5.47% (95%CI: 1.06, 9.64) of non-accidental mortality could be attributed to HTV. The females, the elderly, and individuals with low education level were more susceptible to HTV than their counterparts, respectively. Moreover, a stronger HTV-mortality association was observed in individuals who live in warmer season and temperature zone. CONCLUSION HTV is associated with a considerable mortality burden, which may be modified by season, geographic and individual-level factors. Our findings highlight the practical importance of establishing early warning systems and promoting health education to mitigate the impacts of temperature variability.
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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
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou 511443, China; JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou 511443, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Zhaoyue Chen
- 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
| | - Qi Zhao
- Department of Epidemiology, Shandong University, Jinan, China
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - 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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Denpetkul T, Phosri A. Daily ambient temperature and mortality in Thailand: Estimated effects, attributable risks, and effect modifications by greenness. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148373. [PMID: 34126499 DOI: 10.1016/j.scitotenv.2021.148373] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In recent years, many previous studies have examined the association between ambient temperature and mortality in different parts of the world. However, very few studies have explored the mortality burden attributable to temperature, especially those in developing countries. This study aimed to quantify the burden of mortality attributable to non-optimum temperature in Thailand and explore whether greenness, using normalized difference vegetation index (NDVI) as indicator, alleviates the mortality contributed by non-optimum ambient temperature. METHODS Daily number of mortality (i.e., all-cause, cardiovascular and respiratory diseases) and daily meteorological data were obtained over 65 provinces in Thailand during 2010 to 2017. The two-stage statistical approach was applied to estimate the association between temperature and mortality. First, the time-stratified case-crossover analysis was performed to examine province-specific temperature-mortality association. Second, province-specific association was pooled to derive national estimates using multivariate meta-regression. Mortality burden attributable to temperature was then estimated, and the association between attributed mortality and NDVI was explored using multivariate meta-regression models. RESULTS A total of 2,891,407 all-cause of death was included over the study period, in which 403,450 and 264,672 deaths were accounted for cardiovascular and respiratory diseases, respectively. The temperature-mortality association at cumulative lag 0-7 days was non-linear with J-shaped curve for all-cause and respiratory mortality, whereas V-shaped curve was observed for cardiovascular mortality. Using minimum mortality temperature (MMT) as optimum temperature, 3.72% (95% empirical CI: 2.18, 5.21) of all-cause, 2.92% (0.55, 5.10) of cardiovascular and 3.00% (0.27, 5.49) of respiratory mortality were attributable to non-optimum temperature (both hot and cold effects). Higher level of NDVI was associated with alleviated impacts of non-optimum temperature, especially hot temperature. CONCLUSION Exposure to non-optimum temperature was associated with increased risks of mortality in Thailand. This finding is useful for planning the public health interventions to reduce health effects of non-optimum ambient temperature.
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Affiliation(s)
- Thammanitchpol Denpetkul
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
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20
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Hu J, Hou Z, Xu Y, Zhou M, Zhou C, Xiao Y, Yu M, Huang B, Xu X, Lin L, Liu T, Xiao J, Gong W, Hu R, Li J, Jin D, Qin M, Zhao Q, Yin P, Xu Y, Zeng W, Li X, He G, Chen S, Guo L, Huang C, Ma W. Life loss of cardiovascular diseases per death attributable to ambient temperature: A national time series analysis based on 364 locations in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 756:142614. [PMID: 33082046 DOI: 10.1016/j.scitotenv.2020.142614] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/06/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although the effect of ambient temperature on cardiovascular disease (CVDs) has been well explored, studies using years of life lost (YLLs) as the outcome especially evaluating the average life loss per death attributable to temperatures were rare. We examine the associations between ambient temperature and YLLs of CVDs, and further quantify temperature-related life loss per death. METHODS Daily YLL rates were calculated using death data from 364 locations across China during 2006-2017, and meteorological data were collected for the same period. A distributed-lag nonlinear model and meta-regression were applied to examine the relationships between temperature and YLL rates of CVDs. Subgroup analyses by age, gender, region, and cause-specific CVDs were investigated. The total YLLs and average YLLs per death attributable to temperature were further quantified to assess life loss caused by non-optimal temperature. RESULTS Both high and low temperatures significantly increased YLL rates of CVDs, with greater effects for cold than heat. Cerebrovascular diseases (CEDs) account for the largest proportion (47.17%) of total YLLs of CVDs attributable to non-optimal temperature. On average, life loss per CVD death attributable to non-optimal temperatures was 1.51 (95% eCI: 1.33, 1.69) years, with 1.07 (95% eCI: 1.00, 1.15) years from moderate cold. Average life losses per death were observed higher for males (1.71, 95% eCI: 1.43, 1.99), younger population (3.82, 95% eCI: 2.86, 4.75), central China (1.62; 95% eCI: 1.41, 1.83) and hemorrhagic stroke (2.86, 95% eCI: 2.63, 3.10) than their correspondents. CONCLUSIONS We found that non-optimal temperature significantly aggravated premature death of CVD, with CEDs being the most affected, and most of temperature-related life loss of CVD was attributed to moderate cold. Our findings imply that peoples with CEDs in moderate cold days are vulnerable populations, which may contribute to a better understanding the adverse effects and pathogenesis of temperature on CVDs.
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Affiliation(s)
- Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Junhua Li
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Siqi Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
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Wang P, Zhang X, Hashizume M, Goggins WB, Luo C. A systematic review on lagged associations in climate-health studies. Int J Epidemiol 2021; 50:1199-1212. [PMID: 33448301 DOI: 10.1093/ije/dyaa286] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 12/18/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lagged associations in climate-health studies have already been ubiquitously acknowledged in recent years. Despite extensive time-series models having proposed accounting for lags, few studies have addressed the question of maximum-lag specification, which could induce considerable deviations of effect estimates. METHODS We searched the PubMed and Scopus electronic databases for existing climate-health literature in the English language with a time-series or case-crossover study design published during 2000-2019 to summarize the statistical methodologies and reported lags of associations between climate variables and 14 common causes of morbidity and mortality. We also aggregated the results of the included studies by country and climate zone. RESULTS The associations between infectious-disease outcomes and temperatures were found to be lagged for ∼1-2 weeks for influenza, 3-6 weeks for diarrhoea, 7-12 weeks for malaria and 6-16 weeks for dengue fever. Meanwhile, the associations between both cardiovascular and respiratory diseases and hot temperatures lasted for <5 days, whereas the associations between cardiovascular diseases and cold temperatures were observed to be 10-20 days. In addition, rainfall showed a 4- to 10-week lagged association with infectious diarrheal diseases, whereas the association could be further delayed to 8-12 weeks for vector-borne diseases. CONCLUSION Our findings indicated some general patterns for possible lagged associations between some common health outcomes and climatic exposures, and suggested a necessity for a biologically plausible and reasonable definition of the effect lag in the modelling practices for future environmental epidemiological studies.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xuyi Zhang
- Faculty of Architecture, The University of Hong Kong, Hong Kong, China
| | | | - William B Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Chao Luo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Ma Y, Zhou L, Chen K. Burden of cause-specific mortality attributable to heat and cold: A multicity time-series study in Jiangsu Province, China. ENVIRONMENT INTERNATIONAL 2020; 144:105994. [PMID: 32745780 DOI: 10.1016/j.envint.2020.105994] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/12/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Previous epidemiological studies primarily examined the temperature-related mortality burden of all-cause or cardiovascular diseases (CVD) and respiratory diseases. However, evidence on the heat- and cold-attributable mortality burden from other specific causes is limited. This paper aimed to systematically examine the association of heat and cold with a comprehensive spectrum of plausible temperature-related diseases, and to estimate the mortality burdens attributable to heat and cold. In the time-series study of 11 cities in Jiangsu, China, distributed lag non-linear models were applied to estimate city-specific temperature-mortality associations, and then meta-analysis was conducted to pool the estimates. A total of 1,368,648 cases of death were included in this study. Both extreme heat and cold were associated with increased mortality risks from all-cause, CVD, respiratory diseases, nervous diseases, and external causes. Short-term exposures to heat and cold were associated with excess burden of mortality for several specific diseases, accounting for 16.38% (95% eCI, 7.27-22.31%) for myocardial infarction (MI), 12.41% (95% eCI, 8.81-15.07%) for stroke, 27.97% (95% eCI, 18.42-33.35%) for hypertensive heart disease, 25.18% (95% eCI, 18.42-29.63%) for chronic obstructive pulmonary disease, and 28.46% (95% eCI: 4.93-33.57%) for Alzheimer's and dementia. Diabetes was only associated with extreme heat, with 4.61% (95% eCI, 0.13-7.13%) of diabetes mortality attributable to heat. In total, 11.98% (95% eCI, 10.46-13.08%) of mortality was attributable to heat and cold, with 3.49% (95% eCI, 2.87-4.00%) attributable to heat and 8.48% (95% eCI, 7.31-9.49%) attributable to cold, and about 64% of this overall temperature-related mortality burden was found in 6 aforementioned specific causes and about 10% of mortality burden in external causes. Extreme heat and/or cold are associated with increased risks of mortality from a wide range of causes, including previously identified causes in cardiorespiratory diseases and under-studied causes such as diabetes and Alzheimer's and dementia. Future research is needed to confirm the substantial mortality burden of heat and cold.
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Affiliation(s)
- Yiqun Ma
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Lian Zhou
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model. Int Arch Occup Environ Health 2020; 94:309-324. [PMID: 32936369 DOI: 10.1007/s00420-020-01577-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.
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Silveira IH, Cortes TR, Oliveira BFA, Junger WL. Temperature and cardiovascular mortality in Rio de Janeiro, Brazil: effect modification by individual-level and neighbourhood-level factors. J Epidemiol Community Health 2020; 75:69-75. [PMID: 32863272 DOI: 10.1136/jech-2020-215002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Many factors related to susceptibility or vulnerability to temperature effects on mortality have been proposed in the literature. However, there is limited evidence of effect modification by some individual-level factors such as occupation, colour/race, education level and community-level factors. We investigated the effect modification of the temperature-cardiovascular mortality relationship by individual-level and neighbourhood-level factors in the city of Rio de Janeiro, Brazil. METHODS We used a case-crossover study to estimate the total effect of temperature on cardiovascular mortality in Rio de Janeiro between 2001 and 2018, and the effect modification by individual-level and neighbourhood-level factors. Individual-level factors included sex, age, colour/race, education, and place of death. Neighbourhood-level characteristics included social development index (SDI), income, electricity consumption and demographic change. We used conditional Poisson regression models combined with distributed lag non-linear models, adjusted for humidity and public holidays. RESULTS Our results suggest a higher vulnerability to high temperatures among the elderly, women, non-hospitalised deaths, and people with a lower education level. Vulnerability to low temperatures was higher among the elderly, men, non-white people, and for primary education level. As for neighbourhood-level factors, we identified greater vulnerability to low and high temperatures in places with lower SDI, lower income, lower consumption of electricity, and higher demographic growth. CONCLUSION The effects of temperature on cardiovascular disease mortality in Rio de Janeiro vary according to individual-level and neighbourhood-level factors. These findings are valuable to inform policymakers about the most vulnerable groups and places, in order to develop more effective and equitable public policies.
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Affiliation(s)
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Iranpour S, Khodakarim S, Shahsavani A, Khosravi A, Etemad K. Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran. Epidemiol Health 2020; 42:e2020053. [PMID: 32777886 PMCID: PMC7871149 DOI: 10.4178/epih.e2020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/18/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). METHODS Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. RESULTS We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. CONCLUSIONS A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
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Affiliation(s)
- Sohrab Iranpour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Comparison of Respiratory and Ischemic Heart Mortalities and their Relationship to the Thermal Environment. ATMOSPHERE 2020. [DOI: 10.3390/atmos11080826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Chronic respiratory and ischemic heart diseases are globally important parts of total mortality. This study focuses on the occurrence of mortality due to these disease groups in Germany and possible effects of the thermal environment. A retrospective analysis on the mortality rates of chronic lower respiratory diseases (CLRD) and ischemic heart diseases (IHD) at the regional level in Germany for the period 2001–2015 was done in combination with meteorological observations from the network of the German Meteorological Service. In order to control the mortality data for long-term and seasonal trends, a 365-day Gaussian low-pass filter with a filter response function was applied. The thermal environment was analysed using 2 m air temperature (Ta) and the human biometeorological index Perceived Temperature (PT). The relationship of the Relative Risk (RR) of mortality to the thermal environment is displayed as an exposure–response curve, with threshold values at which RR increases significantly towards higher and lower temperature values. CLRD mortality increases above 17.6 °C, at approximately 4.4%/°C (CI: ± 0.3). The increase of IHD mortality above the threshold of 18.8 °C is less steep, at 3.5%/°C (CI: ± 0.2). During hot periods, CLRD mortality increases by 19.9%, which is twice as much as IHD mortality, with an increase of 9.8%. However, cold days and cold periods affect IHD slightly more than CLRD. The results highlight the concerns of CLRD patients during hot days as well as heat waves. This could lead to better precautions being taken for respiratory patients, which are already established for cardiac patients in Germany.
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Wang Y, Ding Z, Deng C, Guo P, You Y, Li L, Wang Y, Zhang Q. Years of life lost with premature death due to ambient temperatures in a southwest plateau region of China: a cause-specific and individual characteristics stratified mortality study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1333-1341. [PMID: 32436137 DOI: 10.1007/s00484-020-01912-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/22/2020] [Accepted: 03/30/2020] [Indexed: 02/05/2023]
Abstract
We aimed to explore whether there were cold and heat temperature adverse effects on years of life lost (YLL) for non-accidental mortality in Yuxi, a southwest plateau region of China. From data for 89,467 non-accidental deaths over an 8-year study period, we used a general linear regression model combined with a distributed lag non-linear model to assess the burden of disease non-accidental mortality due to ambient temperature with the YLL indicator. We estimated the mean YLL change per 1 °C decrease from the 25th to 1st percentile mean temperature as the cold effect and per 1 °C increase from the 75th to 99th percentile as the heat effect. The 95% empirical confidence intervals (eCIs) were calculated by using a bootstrap simulation method. The exposure-response curve between average temperature and YLL was U-shaped. The cold effect peaked at the first day after exposure and disappeared at 2 weeks, and the heat effect only lasted for the first 3 days. A per 1 °C decrease from the 25th to 1st mean temperature percentile was associated with an increase of 15.6 (95% eCI: 2.4, 22.9) in YLL for non-accidental diseases, and the cumulative effects due to cold were stronger in contrast to that attributed by heat. Cold temperature had a significant impact on YLL among the subgroups, with higher YLL in cardiovascular disease, stroke, males, Han nationality, married, and those engaged in agriculture than their corresponding categories. An increasing death burden of non-accidental in Yuxi of China due to cold temperature was demonstrated, and the association was also modified by specific disease causes and individual features.
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Affiliation(s)
- Yujin Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zan Ding
- Department of Science and Education, Baoan Central Hospital of Shenzhen, Shenzhen, 518102, Guangdong, China
| | - Changyu Deng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yingbin You
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Liujiu Li
- Yuxi Center for Disease Control and Prevention, Yuxi, 653000, Yunnan, China
| | - Yanfang Wang
- Yuxi Center for Disease Control and Prevention, Yuxi, 653000, Yunnan, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China.
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Liu G, Sun B, Yu L, Chen J, Han B, Li Y, Chen J. The Gender-Based Differences in Vulnerability to Ambient Air Pollution and Cerebrovascular Disease Mortality: Evidences Based on 26781 Deaths. Glob Heart 2020; 15:46. [PMID: 32923340 PMCID: PMC7427691 DOI: 10.5334/gh.849] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 12/21/2022] Open
Abstract
The gender-based differences in the vulnerability to ambient air pollution have not been widely explored. This study aimed to investigate vulnerability differences to the short-term effects of PM2.5, PM10 and O3 between cerebrovascular diseases (CEVD) deaths of men and women. The general additive models (GAMs) and distributed lag non-linear models (DLNMs) were adopted, and both single-pollutant and two-pollutant models were performed to analyze the associations between ambient air pollution and daily CEVD deaths. Both models indicated that O3 was the most suspicious pollutant that could induce excess CEVD deaths, and women tended to be more vulnerable to O3. These results were confirmed by seasonal analysis, in which we also found both genders were more vulnerable to O3 in winter. The exposure-response relationships revealed that women were usually more vulnerable to ambient air pollution than men, and the exposure-response curves differed significantly between genders. Our findings suggested that more attention should be paid on the adverse effects of ambient O3, and the protection of women CEVD population against air pollution should be emphasized.
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Affiliation(s)
- Guangcong Liu
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, CN
- Liaoning Key Laboratory of Urban Ecology, Shenyang Academy of Environmental Sciences, Shenyang, CN
| | - Baijun Sun
- Shenyang Center for Disease Control and Prevention, Shenyang, CN
| | - Lianzheng Yu
- Department of Noncommunicable Chronic Disease Prevention, Liaoning Center for Disease Control and Prevention, Shenyang, CN
| | - Jianping Chen
- Shenyang Center for Disease Control and Prevention, Shenyang, CN
| | - Bing Han
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, CN
| | - Yizhuo Li
- Liaoning Key Laboratory of Urban Ecology, Shenyang Academy of Environmental Sciences, Shenyang, CN
| | - Jie Chen
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, CN
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Aklilu D, Wang T, Amsalu E, Feng W, Li Z, Li X, Tao L, Luo Y, Guo M, Liu X, Guo X. Short-term effects of extreme temperatures on cause specific cardiovascular admissions in Beijing, China. ENVIRONMENTAL RESEARCH 2020; 186:109455. [PMID: 32311528 DOI: 10.1016/j.envres.2020.109455] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/21/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
Extreme temperature-related cardiovascular diseases (CVDs) have become a growing public health concern. However, the impact of temperature on the cause of specific CVDs has not been well studied in the study area. The objective of this study was to assess the impact of temperature on cause-specific cardiovascular hospital admissions in Beijing, China. We obtained data from 172 large general hospitals from the Beijing Public Health Information Center Cardiovascular Case Database and China. Meteorological Administration covering 16 districts in Beijing from 2013 to 2017. We used a time-stratified case crossover design with a distributed lag nonlinear model (DLNM) to derive the impact of temperature on CVD in hospitals back to 27 days on CVD admissions. The temperature data were stratified as cold (extreme and moderate ) and hot (moderate and extreme ). Within five years (January 2013-December 2017), a total of 460,938 (male 54.9% and female 45.1%) CVD admission cases were reported. The exposure-response relationship for hospitalization was described by a "J" shape for the total and cause-specific. An increase in the six-day moving average temperature from moderate hot (30.2 °C) to extreme hot (36.9 °C) resulted in a significant increase in CVD admissions of 16.1%(95% CI = 12.8%-28.9%). However, the effect of cold temperature exposure on CVD admissions over a lag time of 0-27 days was found to be non significant, with a relative risk of 0.45 (95% CI = 0.378-0.55) for extreme cold (-8.5 °C)and 0.53 (95% CI = 0.47-0.60) for moderate cold (-5.6 °C). The results of this study indicate that exposure to extremely high temperatures is highly associated with an increase in cause-specific CVD admissions. These finding may guide to create and raise awareness of the general population, government and private sectors regarding on the effects of current weather conditions on CVD.
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Affiliation(s)
- Deginet Aklilu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Tianqi Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Commission of Health and Family Planning Information Center, China
| | - Endwoke Amsalu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Zhiwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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Yin Q, Wang J, Ren Z, Li J, Guo Y. Mapping the increased minimum mortality temperatures in the context of global climate change. Nat Commun 2019; 10:4640. [PMID: 31604931 PMCID: PMC6789034 DOI: 10.1038/s41467-019-12663-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 09/23/2019] [Indexed: 01/14/2023] Open
Abstract
Minimum mortality temperature (MMT) is an important indicator to assess the temperature-mortality relationship. It reflects human adaptability to local climate. The existing MMT estimates were usually based on case studies in data rich regions, and limited evidence about MMT was available at a global scale. It is still unclear what the most significant driver of MMT is and how MMT will change under global climate change. Here, by analysing MMTs in 420 locations covering six continents (Antarctica was excluded) in the world, we found that although the MMT changes geographically, it is very close to the local most frequent temperature (MFT) in the same period. The association between MFT and MMT is not changed when we adjust for latitude and study year. Based on the MFT~MMT association, we estimate and map the global distribution of MMTs in the present (2010s) and the future (2050s) for the first time.
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Affiliation(s)
- Qian Yin
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences. A11, Datun Road, Chaoyang District, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences. A11, Datun Road, Chaoyang District, Beijing, China.
- University of Chinese Academy of Sciences, A19, Yuquan Road, Shijingshan District, Beijing, China.
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences. A11, Datun Road, Chaoyang District, Beijing, China
| | - Jie Li
- School of Resources and Environment, Ningxia University, No.489, Helanshan Road, Xixia District, Yinchuan, Ningxia, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, Henan, China
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Ferreira LDCM, Nogueira MC, Pereira RVDB, de Farias WCM, Rodrigues MMDS, Teixeira MTB, Carvalho MS. Ambient temperature and mortality due to acute myocardial infarction in Brazil: an ecological study of time-series analyses. Sci Rep 2019; 9:13790. [PMID: 31551489 PMCID: PMC6760184 DOI: 10.1038/s41598-019-50235-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/21/2019] [Indexed: 01/08/2023] Open
Abstract
Ambient temperature may lead to decompensation of cardiovascular diseases and deaths by acute myocardial infarction (AMI). Little is known about this relationship in South American countries located in regions of a hot climate. This study aims to investigate the effects of ambient temperature on mortality due to AMI in six Brazilian micro-regions, which present different climates. We analyzed daily records of deaths by AMI between 1996 and 2013. We estimated the accumulate relative and attributable risks with lags of up to 14 days, using distributed non-linear lag model. Micro-regions that were closest to the equator did not show an association between temperature and mortality. The lowest risk temperatures varied between 22 °C and 28 °C, in the Southern region of Brazil and the Midwest region, respectively. Low temperatures associated with the highest mortality risk were observed in the same areas, varying between 5 °C and 15 °C. The number of deaths attributed to cold temperatures varied from 176/year in Brasilia to 661/year in São Paulo and those deaths attributed to hot temperatures in Rio de Janeiro amounted to 115/year. We showed the relative risk and the attributable risk of warmer and colder days in tropical regions. The estimate of the number of deaths due to climate, varying according to each area, is a way of bringing information to those responsible for health policies based on easily-understood measurements.
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Affiliation(s)
| | - Mário Círio Nogueira
- Public Health Department, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | | | | | | | - Marilia Sá Carvalho
- Oswaldo Cruz Foundation, Scientific Computing Program, Rio de Janeiro, RJ, Brazil
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Herrmann A, Haefeli WE, Lindemann U, Rapp K, Roigk P, Becker C. [Epidemiology and prevention of heat-related adverse health effects on elderly people]. Z Gerontol Geriatr 2019; 52:487-502. [PMID: 31346679 DOI: 10.1007/s00391-019-01594-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/14/2019] [Indexed: 11/25/2022]
Abstract
Heat waves increase the morbidity and mortality in Germany, particularly of older patients in need of care. Due to climate change the number of heat waves in Germany will increase threefold by the end of the century. In addition, the proportion of patients at risk will grow due to demographic change. Therefore, the Government and the Federal States have developed recommendations for heat action plans, in which the medical profession should also participate in the prevention of heat-related damage to health. Physicians and their team should first become acquainted with the topic. In addition, they should inform patients at risk and their relatives of the risks and preventive measures. In the summer a critical check of drugs is also needed because medications impair cooling mechanisms in heat waves, the pharmacokinetics can change and unwanted side effects of drugs occur more frequently. Lastly, due to their central position in the healthcare system, physicians should participate in the coordination of a good nursing care and intensification of social contacts during heat waves.
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Affiliation(s)
- A Herrmann
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland.
| | - W E Haefeli
- Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Medizinische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - U Lindemann
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - K Rapp
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - P Roigk
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - C Becker
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
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Liu M, Xue X, Zhou B, Zhang Y, Sun B, Chen J, Li X. Population susceptibility differences and effects of air pollution on cardiovascular mortality: epidemiological evidence from a time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:15943-15952. [PMID: 30963427 DOI: 10.1007/s11356-019-04960-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/22/2019] [Indexed: 05/22/2023]
Abstract
There is insufficient evidence on the relationship between air pollution and mortality from cardiovascular disease (CVD) in northeast China. Here, we explored the short-term effects of air pollution on CVD mortality and preliminarily investigated differences in population susceptibility to air pollution in Shenyang, China. CVD mortality, air pollution, and meteorological data during 2013-2016 were obtained. Time-series analysis was applied to evaluate the association between air pollution and daily CVD mortality with different lag structures. In the single-pollutant model, each 10 μg/m3 increase in PM2.5, PM10, SO2, NO2, and O3 concentrations and 1 mg/m3 increase in CO concentrations at lag0 (same day) was significantly associated with an increase of 0.40% (95% confidence interval, 0.22-0.59%), 0.26% (0.12-0.40%), 0.43% (0.16-0.70%), 0.90% (0.14-1.67%), 0.76% (0.21-1.32%), and 3.33% (0.97-5.75%), respectively, in overall CVD mortality. Susceptibility to air pollutants was higher among females, elderly people, and ischemic heart disease patients. Furthermore, air pollution effects on CVD mortality were 2-8 times greater during the non-heating period. In conclusion, the air pollutants PM2.5, PM10, SO2, NO2, O3, and CO showed significant positive effects on CVD mortality in Shenyang, China. These findings highlight the adverse effects of air pollution and suggest the need for personal protective equipment and reduction of air pollution sources.
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Affiliation(s)
- Mengyao Liu
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, People's Republic of China
| | - Xiaoxia Xue
- Science Experiment Center, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, People's Republic of China
| | - Baosen Zhou
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, People's Republic of China
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale Cancer Center, Yale School of Public Health, 60 College Street LEPH 440, New Haven, CT, 06520, USA
| | - Baijun Sun
- Shenyang Center for Disease Control and Prevention, No. 37 Qishan Road, Huanggu District, Shenyang, 110031, Liaoning Province, People's Republic of China
| | - Jianping Chen
- Shenyang Center for Disease Control and Prevention, No. 37 Qishan Road, Huanggu District, Shenyang, 110031, Liaoning Province, People's Republic of China
| | - Xuelian Li
- Department of Epidemiology, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, People's Republic of China.
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Yu Y, Yao S, Dong H, Wang L, Wang C, Ji X, Ji M, Yao X, Zhang Z. Association between short-term exposure to particulate matter air pollution and cause-specific mortality in Changzhou, China. ENVIRONMENTAL RESEARCH 2019; 170:7-15. [PMID: 30554054 DOI: 10.1016/j.envres.2018.11.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/08/2018] [Accepted: 11/25/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Extensive studies have linked ambient particulate matter (PM) to an increased mortality burden from a wide range of causes. However, the effects of PM on mortality rates from specific causes were unclear. This study aimed to estimate the detrimental effects of PM on cause specific deaths in Changzhou, China. METHOD Data representing daily mortality rates, weather conditions and particulate air pollution levels were obtained from government-controlled agencies of Changzhou, from January 1, 2015 to December 31, 2016. An inverse distance weighting method was used to assess the population exposure to PM and a time-series was performed to detect the detrimental effects of PM. RESULTS Positive associations were identified between PMs and daily mortality rates from non-accidental, circulatory, hypertensive, respiratory and chronic lower respiratory causes at a lag of 0-3 days. The effects of PMs were strongest on hypertensive mortality, with an increase of 5.27% (95% confidence interval (CI): 2.43-8.19%) and 3.52% (95% CI: 1.55-5.53%), per 10 μg/m3 increment in PM2.5 and PM10 respectively. The elderly exhibited a higher mortality risk with PMs exposure. Females were more vulnerable to circulatory, hypertensive and respiratory death while males were more sensitive to chronic lower respiratory and neurodegenerative mortality. The effects were stronger in warm seasons for circulatory mortality and stronger in cold seasons for respiratory mortality. CONCLUSION These findings indicate that PM could exert adverse influences on the outcomes of several pathological processes, especially for women and the elderly with hypertension disease.
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Affiliation(s)
- Yongquan Yu
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China
| | - Shen Yao
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China; Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu 213022, PR China
| | - Huibin Dong
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu 213022, PR China
| | - Li Wang
- Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China
| | - Chao Wang
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China
| | - Xiaoming Ji
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China
| | - Minghui Ji
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China
| | - Xingjuan Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu 213022, PR China
| | - Zhan Zhang
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China; Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu 211166, PR China.
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Deng C, Ding Z, Li L, Wang Y, Guo P, Yang S, Liu J, Wang Y, Zhang Q. Burden of non-accidental mortality attributable to ambient temperatures: a time series study in a high plateau area of southwest China. BMJ Open 2019; 9:e024708. [PMID: 30772855 PMCID: PMC6398624 DOI: 10.1136/bmjopen-2018-024708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 12/21/2018] [Accepted: 01/02/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To examine the total non-accidental mortality burden attributable to ambient temperatures and assess the effect modification of the burden by specific causes of death and individual characteristics in a high plateau area in southwest China. METHODS Using daily mortality and meteorological data from 2009 to 2016, we applied a quasi-Poisson model combined with a distributed lag non-linear model to estimate the temperature-mortality association with the assessment of attributable fraction and number. We calculated attributable fractions and deaths with 95% empirical CIs (eCIs), that were due to cold and heat, defined as temperatures below and above the median temperature, and for mild and extreme temperatures, defined by cut-offs at the 2.5th and 97.5th temperature percentiles. RESULTS We analysed 89 467 non-accidental deaths; 4131 were attributable to overall temperatures, with an attributable fraction of 4.75% (95% eCI 2.33% to 6.79%). Most of the mortality burden was caused by cold (4.08%; 0.86% to 7.12%), whereas the burden due to heat was low and non-significant (0.67%; -2.44% to 3.64%). Extreme cold (1.17%; 0.58% to 1.69%) was responsible for 24.6% (ie, 1.17% divided by 4.75%) of the total death burden. In the stratification analyses, attributable risk due to cold was higher for cardiovascular than respiratory disease (6.18% vs 3.50%). We found a trend of risk of increased death due to ambient temperatures with increasing age, with attributable fractions of 1.83%, 2.27% and 6.87% for age ≤64, 65-74 and ≥75 years old, respectively. The cold-related burden was slightly greater for females, farmers, ethnic minorities and non-married individuals than their corresponding categories. CONCLUSIONS Most of the burden of death was attributable to cold, and specific causes and individual characteristics might modify the mortality burden attributable to ambient temperatures. The results may help make preventive measures to confront climate change for susceptible population in this region.
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Affiliation(s)
- Changyu Deng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, the Fifth Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Liujiu Li
- Yuxi Center for Disease Control and Prevention, Yuxi, China
| | - Yanfang Wang
- Yuxi Center for Disease Control and Prevention, Yuxi, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Shaoyi Yang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Ju Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Yue Wang
- 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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Xiong L, Xu Z, Tan J, Wang H, Liu Z, Wang A, Xie D, Kong F. Acute effects of air pollutants on adverse birth outcomes in Changsha, China: A population data with time-series analysis from 2015 to 2017. Medicine (Baltimore) 2019; 98:e14127. [PMID: 30653143 PMCID: PMC6370066 DOI: 10.1097/md.0000000000014127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Evidence for the acute effects of air pollutants on adverse birth outcomes is not yet conclusive. Furthermore, there are no investigations relating to the association between air pollutants and macrosomia. The aim of this study was to determine the relationship between air pollutants and low birth weight, preterm birth, and macrosomia in Changsha. Time-series analysis, using a generalized additive model was applied. Data about the adverse birth outcomes was collected from 78 midwifery institutions. Air pollution data including SO2, NO2, particulate matter <10 μm in diameter (PM10), particulate matter <2.5 μm in diameter (PM2.5), O3, CO, and climate data were respectively collected from the Changsha Environmental Protection Agency and the Changsha Meteorological Bureau from January 2015 to December 2017. During the study period, there were 344,880 live births to be studied. In a single pollutant model, for every increase of 10 μg/m in PM10 and PM2.5, low birth weight increased by 0.12% (95% confidence interval [CI]: 0.01-0.23%) at a lag 06 and 0.44% (95% CI: 0.35-0.53%) at a lag 3, respectively. Preterm birth increased most by 1.60% (95% CI: 1.41-1.80%) at a lag 2 for every increase of 10 μg/m in SO2. The highest increases in macrosomia associated with a 10 μg/m increase in air pollutant were 3.53% (95% CI: 3.41-3.64%) for NO2 at lag 0, 3.33% (95% CI: 3.05-3.60%) for SO2 at lag03. Multi-pollutant models showed that only PM10 increased the low birth weight and preterm birth risk effect by 3.91% (95% CI: 3.67-4.12%) and 0.25% (95% CI: 0.14-0.37%). NO2 increased macrosomia risk by 4.14% (95% CI: 3.97-4.31%) with a 10 μg/m increase. There was no association observed between the air pollutants O3 and CO and adverse birth outcomes. Pregnant women should also take steps to limit their exposure to high levels of air pollutants during the final weeks of pregnancy.
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Affiliation(s)
- Lili Xiong
- Hunan Province Maternal and Children Care Hospital
| | | | - Jie Tan
- Hunan Province Environmental Monitoring Centre, Changsha, China
| | - Hua Wang
- Hunan Province Maternal and Children Care Hospital
| | - Zhiyu Liu
- Hunan Province Maternal and Children Care Hospital
| | - Aihua Wang
- Hunan Province Maternal and Children Care Hospital
| | - Donghua Xie
- Hunan Province Maternal and Children Care Hospital
| | - Fanjuan Kong
- Hunan Province Maternal and Children Care Hospital
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de Souza AGL, Bueno da Silva L, de Leon EB, Trimer R, Mendonça ASGB. Students' blood pressure and heart rate while performing cognitive tasks at education institutions in Northern and Northeastern Brazil. Work 2018; 61:437-448. [PMID: 30373987 DOI: 10.3233/wor-182808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The use of information and communication technologies improves the versatility of learning environments by broadening the scope of educational practices, allowing students to communicate with other institutions and providing access to information in real time. However, these tools, in addition to environmental characteristics, can increase the internal thermal load, which is directly influenced by the external environment, with a consequent impact on body physiology. OBJECTIVE The present study investigated the relationship between air temperature and blood pressure and heart rate among students performing cognitive tasks at computer laboratories in four public universities (three in Northeastern Brazil and one in Northern Brazilian). METHODS Thermal conditions and physiological parameters were analysed over three consecutive days, and the participants were subjected to changes in air temperature from 20°C to 33°C. Blood pressure and heart rate were measured before and after testing. RESULTS Analyses of the experimental data showed changes in heart rate at high temperatures, with a greater risk of students from Teresina and Manaus institutions presenting heart rates above 100 bpm during cognitive tasks. CONCLUSIONS Within the temperature range applied, on the day of the highest temperature, we observed the highest percentage of participants who reported thermal discomfort (63%, 33°C; 58%, 29°C; 38%, 28°C) and a reduction of cognitive performance (15 to 10 points when the air temperature increases from 20 to 33°C).
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Affiliation(s)
- Adriana G L de Souza
- Production Engineering Department, Federal University of Paraiba, João Pessoa, Brazil
| | - Luiz Bueno da Silva
- Production Engineering Department, Federal University of Paraiba, João Pessoa, Brazil
| | - Elisa B de Leon
- Department of Physical Therapy, Federal University of Amazonas, Manaus, Brazil
| | - Renata Trimer
- Department of Physical Therapy, Federal University of Amazonas, Manaus, Brazil
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Herrmann A, Sauerborn R. General Practitioners' Perceptions of Heat Health Impacts on the Elderly in the Face of Climate Change-A Qualitative Study in Baden-Württemberg, Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050843. [PMID: 29695135 PMCID: PMC5981882 DOI: 10.3390/ijerph15050843] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 11/16/2022]
Abstract
Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is important to investigate GPs’ perceptions of HHI. Twenty four qualitative expert interviews were conducted with GPs and analyzed using the framework approach. GPs were generally aware of heat health impacts, focusing on cardiovascular morbidity and volume imbalances. Perceptions of mortality and for instance impacts on respiratory diseases or potentially risky drugs in heat waves partly diverged from findings in literature. GPs judged the current relevance of HHI differently depending on their attitudes towards: (i) sensitivity of the elderly, (ii) status of nursing care and (iii) heat exposure in Baden-Württemberg. Future relevance of HHI was perceived to be increasing by most GPs. The main cause identified for this was population aging, while impacts of climate change were judged as uncertain by many. GPs’ perceptions, partly diverging from literature, show that GPs’ knowledge and awareness on HHI and climate change needs to be strengthened. However, they also emphasize the need for more research on HHI in the ambulant health care setting. Furthermore, GPs perceptions suggest that strong nursing care and social networks for elderly are major elements of a climate resilient health system.
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Affiliation(s)
- Alina Herrmann
- Institute of Public Health Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany.
- Network Aging Research, University of Heidelberg, 69115 Heidelberg, Germany.
| | - Rainer Sauerborn
- Institute of Public Health Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Naddafi K, Yekaninejad MS. The Effects of Apparent Temperature on Cardiovascular Mortality Using a Distributed Lag Nonlinear Model Analysis: 2005 to 2014. Asia Pac J Public Health 2018; 30:361-368. [PMID: 29671331 DOI: 10.1177/1010539518768036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relationship between apparent temperature and cardiovascular disease (CVD) mortality was studied in Rasht, Iran, from 2005 to 2014. The effects of apparent temperature on CVD mortality were investigated using the distributed lag nonlinear model. Data on all types of cardiovascular mortality cases according to the International Classification of Diseases were collected from the only cardiovascular hospital in Rasht, and the meteorological variables were obtained from Rasht Meteorological Center during the period of study. Our findings showed that low temperatures had significant impacts on CVD mortality, and a reverse J-shaped temperature-mortality relationship was found. Moreover, immediate effects of hot temperatures on CVD mortality with the strongest effects on the same day but delayed effects of cold temperature was observed. This study showed that exposure to both hot and cold apparent temperatures was associated with increased cardiovascular mortality in Rasht.
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- 1 Guilan University of Medical Sciences, Rasht, Iran.,2 Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- 2 Tehran University of Medical Sciences, Tehran, Iran.,3 Harvard Humanitarian Initiative, Cambridge, MA, USA
| | | | - Kazem Naddafi
- 2 Tehran University of Medical Sciences, Tehran, Iran
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Zhou L, Chen K, Chen X, Jing Y, Ma Z, Bi J, Kinney PL. Heat and mortality for ischemic and hemorrhagic stroke in 12 cities of Jiangsu Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 601-602:271-277. [PMID: 28558275 DOI: 10.1016/j.scitotenv.2017.05.169] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/03/2017] [Accepted: 05/19/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Little evidence exists on the relationship between heat and subtypes of stroke mortality, especially in China. Moreover, few studies have reported the effect modification by individual characteristics on heat-related stroke mortality. In this study, we aimed to evaluate the effect of heat exposure on total, ischemic, and hemorrhagic stroke mortality and its individual modifiers in 12 cities in Jiangsu Province, China during 2009 to 2013. METHODS We first used a distributed lag non-linear model with quasi-Poisson regression to examine the city-specific heat-related total, ischemic, and hemorrhagic stroke mortality risks at 99th percentile vs. 75th percentile of daily mean temperature in the whole year for each city, while adjusting for long-term trend, season, relative humidity, and day of the week. Then, we used a random-effects meta-analysis to pool the city-specific risk estimates. We also considered confounding by air pollution and effect modification by gender, age, education level, and death location. RESULTS Overall, the heat-related mortality risk in 12 Jiangsu cities was 1.54 (95%CI: 1.44 to 1.65) for total stroke, 1.63 (95%CI: 1.48 to 1.80) for ischemic stroke, and 1.36 (95%CI: 1.26 to 1.48) for hemorrhagic stroke, respectively. Estimated total, ischemic, and hemorrhagic stroke mortality risks were higher for women versus men, older people versus younger people, those with low education levels versus high education levels, and deaths that occurred outside of hospital. Air pollutants did not significantly influence the heat-related stroke mortality risk. CONCLUSIONS Heat exposure significantly increased both ischemic and hemorrhagic stroke mortality risks in Jiangsu Province, China. Females, the elderly, and those with low education levels are particularly vulnerable to this effect.
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Affiliation(s)
- Lian Zhou
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Kai Chen
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China
| | - Xiaodong Chen
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Yuanshu Jing
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters/Key Laboratory of Meteorological Disaster, Ministry of Education, Nanjing, China.
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Jiangsu, China
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Jiangsu, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
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Zhang C, Ding R, Xiao C, Xu Y, Cheng H, Zhu F, Lei R, Di D, Zhao Q, Cao J. Association between air pollution and cardiovascular mortality in Hefei, China: A time-series analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 229:790-797. [PMID: 28797522 DOI: 10.1016/j.envpol.2017.06.022] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 06/08/2017] [Accepted: 06/09/2017] [Indexed: 05/05/2023]
Abstract
In recent years, air pollution has become an alarming problem in China. However, evidence on the effects of air pollution on cardiovascular mortality is still not conclusive to date. This research aimed to assess the short-term effects of air pollution on cardiovascular morbidity in Hefei, China. Data of air pollution, cardiovascular mortality, and meteorological characteristics in Hefei between 2010 and 2015 were collected. Time-series analysis in generalized additive model was applied to evaluate the association between air pollution and daily cardiovascular mortality. During the study period, the annual average concentration of PM10, SO2, and NO2 was 105.91, 20.58, and 30.93 μg/m3, respectively. 21,816 people (including 11,876 man, and 14,494 people over 75 years of age) died of cardiovascular diseases. In single pollutant model, the effects of multi-day exposure were greater than single-day exposure of the air pollution. For every increase of 10 μg/m3 in SO2, NO2, and PM10 levels, CVD mortality increased by 5.26% (95%CI: 3.31%-7.23%), 2.71% (95%CI: 1.23%-4.22%), and 0.68% (95%CI: 0.33%-1.04%) at a lag03, respectively. The multi-pollutant models showed that PM10 and SO2 remained associated with CVD mortality, although the effect estimates attenuated. However, the effect of NO2 on CVD mortality decreased to statistically insignificant. Subgroup analyses further showed that women were more vulnerable than man upon air pollution exposure. These findings showed that air pollution could significantly increase the CVD mortality.
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Affiliation(s)
- Chao Zhang
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Rui Ding
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Changchun Xiao
- Hefei Centre for Disease Control and Prevention, Hefei, Anhui, China
| | - Yachun Xu
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Han Cheng
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Furong Zhu
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Ruoqian Lei
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Dongsheng Di
- Department of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Qihong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China
| | - Jiyu Cao
- Department of Occupational Health and Environmental Heath, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, China.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Keshtkar A, Naddafi K, Yekaninejad MS. Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis. PeerJ 2017; 5:e3574. [PMID: 28791197 PMCID: PMC5546177 DOI: 10.7717/peerj.3574] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. RESULT After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]). CONCLUSION Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Harvard Humanitarian Initiative, Harvard University, Cambridge, United States of America
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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A study of the short-term associations between hospital admissions and mortality from heart failure and meteorological variables in Hong Kong. Int J Cardiol 2017; 228:537-542. [DOI: 10.1016/j.ijcard.2016.11.106] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/06/2016] [Indexed: 11/21/2022]
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Wang Q, Li C, Guo Y, Barnett AG, Tong S, Phung D, Chu C, Dear K, Wang X, Huang C. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 575:276-286. [PMID: 27750133 DOI: 10.1016/j.scitotenv.2016.10.019] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research. METHODS We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1°C reduction in temperature were pooled using a random-effects meta-analysis. RESULTS Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1°C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26mmHg (95% CI: 0.18-0.33) and 0.13 (95% CI: 0.11-0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1°C decrease in indoor temperature was associated with 0.38mmHg (0.18-0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved. CONCLUSIONS Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted.
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Affiliation(s)
- Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Yanfang Guo
- Department of Chronic Disease Prevention, Bao'an Hospital for Chronic Disease Prevention and Treatment, 99 Wenwei Road, Shenzhen 518101, China
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Dung Phung
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Cordia Chu
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Keith Dear
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu 215316, China
| | - Xuemei Wang
- School of Atmospheric Sciences, Sun Yat-sen University, 135 Xingang Xi Road, Guangzhou 510275, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia.
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Zanobetti A, Coull BA, Kloog I, Sparrow D, Vokonas PS, Gold DR, Schwartz JD. Fine-scale spatial and temporal variation in temperature and arrhythmia episodes in the VA Normative Aging Study. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2017; 67:96-104. [PMID: 28001123 PMCID: PMC5543304 DOI: 10.1080/10962247.2016.1252808] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
UNLABELLED Many studies have demonstrated that cold and hot temperatures are associated with increased deaths and hospitalization rates; new findings indicate also an association with more specific cardiac risk factors. Most of these existing studies have relied on few weather stations to characterize exposures; few have used residence-specific estimates of temperature, or examined the exposure-response function. We investigated the association of arrhythmia episodes with spatial and temporal variation in temperature. We also evaluated the association btween monitored ambient temperature (central) and the same outcome. This longitudinal analysis included 701 older men participating in the VA Normative Aging Study. Arrhythmia episodes were measured as ventricular ectopy (VE) (bigeminy, trigeminy, or couplets episodes) by 4-min electrocardiogram (ECG) monitoring in repeated visits during 2000-2010. The outcome was defined as having or not VE episodes during a study visit. We applied a mixed-effect logistic regression model with a random intercept for subject, controlling for seasonality, weekday, medication use, smoking, diabetes status, body mass index, and age. We also examined effect modification by personal characteristics, confounding by air pollution, and the exposure-response function. For 1°C increase in the same day residence-specific temperature, the odds of having VE episodes was 1.10 (95% confidence interval [CI]: 1.04-1.17). The odds associated with 1°C increase in central temperature was 1.05 (95% CI: 1.02-1.09). The exposure-response function was nonlinear for averages of temperature, presenting a J-shaped pattern, suggesting greater risk at lower and higher temperatures. Increased warm temperature and decreased cold temperature may increase the risk of ventricular arrhythmias. IMPLICATIONS This is the first study to provide evidence that residence-specific temperature exposure is associated with increased risk of ventricular arrhythmias in cohort of elderly subjects without known chronic medical conditions; that the delayed effect of temperature has a nonlinear relationship; and therefore that both warm and cold temperature increase the risk of having ventricular arrhythmias. Moreover, we show that the use of residence-specific temperature data reduces downward bias due to exposure error, by comparing the estimated health effect based on our spatiotemporal exposure prediction model to those based on a single local weather monitor.
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Affiliation(s)
- Antonella Zanobetti
- Department of Environmental Health, Harvard School of Public Health, Boston, MA
| | - Brent A. Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Itai Kloog
- Department of Environmental Health, Harvard School of Public Health, Boston, MA
- The Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - David Sparrow
- VA Normative Aging Study, VA Boston Healthcare System and the Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Pantel S. Vokonas
- VA Normative Aging Study, VA Boston Healthcare System and the Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Diane R. Gold
- Department of Environmental Health, Harvard School of Public Health, Boston, MA
- Channing Laboratory, Brigham and Women’s Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Joel D. Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA
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Wang X, Li G, Liu L, Westerdahl D, Jin X, Pan X. Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:16136-56. [PMID: 26703637 PMCID: PMC4690978 DOI: 10.3390/ijerph121215042] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/12/2015] [Accepted: 12/14/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. METHODS We collected data from Beijing and Shanghai, China, during 2007-2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. RESULTS For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0-27, while the hot effects reached the strongest at lag 0-14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. CONCLUSION People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.
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Affiliation(s)
- Xuying Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Liqun Liu
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Dane Westerdahl
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14850, USA.
| | - Xiaobin Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
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Yang C, Meng X, Chen R, Cai J, Zhao Z, Wan Y, Kan H. Long-term variations in the association between ambient temperature and daily cardiovascular mortality in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 538:524-30. [PMID: 26318688 DOI: 10.1016/j.scitotenv.2015.08.097] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/22/2015] [Accepted: 08/17/2015] [Indexed: 05/24/2023]
Abstract
OBJECTIVE The objective of this study was to explore the long-term variation in the association between ambient temperature and daily cardiovascular (CVD) mortality in Shanghai, China. MATERIALS AND METHODS We collected daily data on ambient temperature and CVD mortality from a central urban district in Shanghai, China, during the period from 1981 to 2012. We used overdispersed generalized additive Poisson regression together with a distributed lag nonlinear model to estimate potentially lagged and nonlinear effects of temperature on CVD mortality after controlling for the seasonality, relative humidity, day of the week, holidays and population size. To allow for the evaluation of long-term variations in the effects, we divided the entire study period into six sub-periods (1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2012) and analyzed the effect estimates in each sub-period separately. RESULTS The association between temperature and daily CVD mortality was J-shaped with both low and high temperatures increasing the risk of CVD deaths. The effects of extremely low temperatures were delayed and persisted for two weeks, while extreme hot effects were limited to the first five days followed by a significant mortality displacement (9days). The relative risks (RRs) of extremely low, moderately low, moderately high, and extremely high temperatures comparing the 1st, 10th, 90th, and 99th percentile with the reference temperature (26°C) over the cumulative lags of 0-14days were 1.95 [95% confidence interval (CI): 1.84,2.07], 1.61 (95% CI: 1.57,1.66), 1.03 (95% CI: 1.01,1.05), and 1.14 (95% CI: 1.07,1.21). The RRs for extremely low and moderately low temperature attenuated substantially from 9.78 and 5.52 in 1981-1985 to 1.42 and 1.18 in 2006-2012, respectively, but the RRs remained almost stable for extremely high and moderately high temperatures. CONCLUSIONS This time-series study suggested that there might have been some human adaptation to low ambient temperature in Shanghai, China, over the last 3 decades.
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Affiliation(s)
- Changyuan Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Yue Wan
- Division of Environment and Health Management, Department of Science, Technology and Standards, Ministry of Environmental Protection, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
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Kozlovskaya IL, Bulkina OS, Lopukhova VV, Chernova NA, Ivanova OV, Kolmakova TE, Karpov YA. [Heat and cardiovascular diseases: A review of epidemiological surveys]. TERAPEVT ARKH 2015; 87:84-90. [PMID: 26591558 DOI: 10.17116/terarkh201587984-90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The review summarizes epidemiologic data on the effects of heat on cardiovascular morbidity and mortality. Patients with heart failure and cardiac arrhythmias are most susceptible to negative heat exposure. At the same time, measures aimed at preserving the health of the population lead to a considerable reduction in losses associated with an abnormal rise in air temperature.
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Affiliation(s)
- I L Kozlovskaya
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - O S Bulkina
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - V V Lopukhova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - N A Chernova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - O V Ivanova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - T E Kolmakova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
| | - Yu A Karpov
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow
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Lian H, Ruan Y, Liang R, Liu X, Fan Z. Short-Term Effect of Ambient Temperature and the Risk of Stroke: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:9068-88. [PMID: 26264018 PMCID: PMC4555265 DOI: 10.3390/ijerph120809068] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 07/26/2015] [Accepted: 07/29/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE The relationship between stroke and short-term temperature changes remains controversial. Therefore, we conducted a systematic review and meta-analysis to investigate the association between stroke and both high and low temperatures, and health assessment. METHODS We searched PubMed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI) and Wanfang Data up to 14 September 2014. Study selection, quality assessment, and author-contractions were steps before data extraction. We converted all estimates effects into relative risk (RR) per 1 °C increase/decrease in temperature from 75th to 99th or 25th to 1st percentiles, then conducted meta-analyses to combine the ultimate RRs, and assessed health impact among the population. RESULTS 20 articles were included in the final analysis. The overall analysis showed a positive relationship between 1 °C change and the occurrence of major adverse cerebrovascular events (MACBE), 1.1% (95% confidence intervals (CI), 0.6 to 1.7) and 1.2% (95% CI, 0.8 to 1.6) increase for hot and cold effects separately. The same trends can be found in both effects of mortality and the cold effect for morbidity. Hot temperature acted as a protective factor of hemorrhage stroke (HS), -1.9% (95% CI, -2.8 to -0.9), however, it acted as a risk factor for ischemic stroke (IS), 1.2% (95% CI, 0.7 to 1.8). CONCLUSION Short-term changes of both low and high temperature had statistically significant impacts on MACBE.
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Affiliation(s)
- Hui Lian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Yanping Ruan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Ruijuan Liang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
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