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Shi C, Zhu J, Liu G, Du Z, Hao Y. Time series analysis of the interaction between ambient temperature and air pollution on hospitalizations for AECOPD in Ganzhou, China. Sci Rep 2024; 14:17106. [PMID: 39048614 PMCID: PMC11269578 DOI: 10.1038/s41598-024-67617-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024] Open
Abstract
This study aimed to investigate the univariate and bivariate effects of ambient temperature and air pollutants on 57,251 inpatients with AECOPD (Acute Exacerbation of Chronic Obstructive Pulmonary Disease) in Ganzhou from January 1, 2016, to December 31, 2019. We categorized the daily mean temperature and air pollutant variables based on the exposure-response curve of the Distributed Lag Non-Linear Model. Poisson regression model was used for interaction and stratification analysis. The Relative Excess Risk due to Interaction (RERI) with 95% confidence intervals (95% CI) between daily mean temperature (Tmean) and air pollutants including NO2, PM2.5, and PM10 were - 0.428 (95% CI - 0.637, - 0.218), -- 0.227 (95% CI - 0.293, - 0.161), and - 0.119 (95% CI - 0.159, - 0.079). Further stratification analysis showed the relative risk (RR) (95% CI) of high NO2 (> 33 μg/m3) at low Tmean (≤ 28 °C) was 1.119 (95% CI 1.096, 1.142). Low temperatures with high PM10 in men and high PM2.5 in women were associated with a higher risk of AECOPD hospitalization. The results indicate a higher risk of hospitalization for AECOPD when there is with high concentrations of air pollution at low temperatures.
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Affiliation(s)
- Chenyang Shi
- Department of Health Statistics, School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Jinyun Zhu
- Health Commission of Ganzhou Municipality, Ganzhou, 341000, Jiangxi, China
| | - Guoliang Liu
- School of Medical Information Engineering, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Yanbin Hao
- Department of Health Statistics, School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China.
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Shi C, Zhu J, Wu Q, Liu Y, Hao Y. Effects of ambient temperature and humidity on COPD mortality in Ganzhou city, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02705-6. [PMID: 38802581 DOI: 10.1007/s00484-024-02705-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/27/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
This study used the time series data of Ganzhou city to explore the individual and interaction effects of temperature and humidity on COPD death, and identify vulnerable subgroups of the population. We collected daily COPD mortality and meteorological data in Ganzhou from 2016 to 2019. The nonlinear distribution lag model was used to examine the associations and interaction between daily mean temperature and humidity and COPD mortality. For the total population, male and 65 years old or above, the relative risk (RR) for COPD mortality could be significant at extremely low temperature (3.3 ℃), reaching 1.799 (95% confidence interval [CI]: 1.216, 2.662), 1.894 (95% CI: 1.164, 3.084) and 1.779 (95% CI:1.185, 2.670). Also, at extremely low humidity (47.8%), the risk reached 1.888 (95% CI: 1.217, 2.930), 1.837 (95% CI: 1.066, 3.165) and 2.166 (95% CI: 1.375, 3.414). The cumulative COPD death risk for females was 3.524 (95% CI: 1.340, 9.267) at high temperature (30.7 ℃), 1.953(95% CI: 1.036, 3.683) at low humidity (47.8%) and 1.726 (95% CI: 1.048, 2.845) at high humidity (96.7%). For the total COPD deaths and subgroups, the interaction effects between daily temperature and humidity were not significant (p > 0.05). Both extremely low temperature and low humidity increased the risk of COPD death in Ganzhou city, especially for males and people over 65 years old. Females were more sensitive to extremely high temperature and humidity. Patients with COPD should pay attention to self-protection under extreme temperature and humidity weather conditions.
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Affiliation(s)
- Chenyang Shi
- Department of Health Statistics, School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Jinyun Zhu
- Health Commission of Ganzhou Municipality, Ganzhou, 341000, Jiangxi, China
| | - Qingfeng Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Yanhong Liu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China
| | - Yanbin Hao
- Department of Health Statistics, School of Public Health and Health Management, Gannan Medical University, Ganzhou, 341000, Jiangxi, China.
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Lee H, Yoon HY. Impact of ambient temperature on respiratory disease: a case-crossover study in Seoul. Respir Res 2024; 25:73. [PMID: 38317208 PMCID: PMC10845516 DOI: 10.1186/s12931-024-02699-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Respiratory diseases contribute to global morbidity and mortality, and temperature is a significant factor. We investigated the association between ambient temperature and emergency department (ED) visits for various respiratory diseases in Seoul, South Korea. METHODS Using data from the National Emergency Department Information System (2008-2017), we analysed 1,616,644 ED visits for respiratory diseases, categorised according to the Korean Standard Classification of Diseases 7th revision codes (J00-J99). Using a time-stratified case-crossover design and a distributed lag nonlinear model, we investigated the effect of temperature exposure on ED visits for respiratory diseases, calculating the relative risk (RR) for the maximum risk temperature (MaxRT) of both cold and hot extremes compared to the minimum risk temperature (MinRT). RESULTS Cold temperatures (MaxRT: -9.0 °C) resulted in a 2.68-fold increase (RR = 2.68, 95% CI = 2.26-3.14) in ED visits for total respiratory diseases, while hot temperatures (MaxRT: 29.4 °C) led to a 1.26-fold increase (RR = 1.26, 95% CI = 1.11-1.42) compared to the MinRT (24.8 °C). Cold temperatures increased the risk of most respiratory diseases, except interstitial lung disease, whereas hot temperatures increased ED visits for acute upper respiratory infections and influenza. Cold temperatures increased ED visits for all age groups, especially those aged 18-64 (RR = 3.54, 95% CI = 2.90-4.33), while hot temperatures significantly affected those < 18 (RR = 1.45, 95% CI = 1.27-1.66). The risk levels were similar in both males and females, regardless of hot and cold temperatures. CONCLUSION Our findings underscore the significant impact of both cold and heat exposure on ED visits for respiratory diseases, with varying intensities and risk profiles across different population groups.
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Affiliation(s)
- Hyewon Lee
- Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
- Department of Software Convergence, Soonchunhyang University Graduate School, Asan, Republic of Korea
| | - Hee-Young Yoon
- Division of Allergy and Respiratory Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwanro, Yongsan-gu, Seoul, 04401, Republic of Korea.
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Ribas IM, Gomes JPM, Valadares PAR, Jardim LS, Nogueira MC, Ferreira CDCM, Farias WCMD, Ferreira LDCM. Effects of air temperature on the risk of death from COPD in major microregions in Brazil: a time series study. J Bras Pneumol 2023; 49:e20220442. [PMID: 37991067 PMCID: PMC10760431 DOI: 10.36416/1806-3756/e20220442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 08/28/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To evaluate the association between the risk of death from COPD and air temperature events in ten major Brazilian microregions. METHODS This was a time series analysis of daily COPD deaths and daily mean air temperatures between 1996 and 2017. Using distributed nonlinear lag models, we estimated the cumulative relative risks of COPD mortality for four temperature percentiles (representing moderate and extreme cold and heat events) in relation to a minimum mortality temperature, with a lag of 21 days, in each microregion. RESULTS Significant associations were found between extreme air temperature events and the risk of death from COPD in the southern and southeastern microregions in Brazil. There was an association of extreme cold and an increased mortality risk in the following microregions: 36% (95% CI, 1.12-1.65), in Porto Alegre; 27% (95% CI, 1.03-1.58), in Curitiba; and 34% (95% CI, 1.19-1.52), in São Paulo; whereas moderate cold was associated with an increased risk of 20% (95% CI, 1.01-1.41), 33% (95% CI, 1.09-1.62), and 24% (95% CI, 1.12-1.38) in the same microregions, respectively. There was an increased COPD mortality risk in the São Paulo and Rio de Janeiro microregions: 17% (95% CI, 1.05-1.31) and 12% (95% CI, 1,02-1,23), respectively, due to moderate heat, and 23% (95% CI, 1,09-1,38) and 32% (95% CI, 1,15-1,50) due to extreme heat. CONCLUSIONS Non-optimal air temperature events were associated with an increased risk of death from COPD in tropical and subtropical areas of Brazil.
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Affiliation(s)
- Igor Magaton Ribas
- . Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
| | | | | | - Lucas Santos Jardim
- . Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
| | - Mário Círio Nogueira
- . Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora (MG) Brasil
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Palmeiro-Silva YK, Lescano AG, Flores EC, Astorga E Y, Rojas L, Chavez MG, Mora-Rivera W, Hartinger SM. Identifying gaps on health impacts, exposures, and vulnerabilities to climate change on human health and wellbeing in South America: a scoping review. LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100580. [PMID: 37876675 PMCID: PMC10593580 DOI: 10.1016/j.lana.2023.100580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/29/2023] [Accepted: 08/04/2023] [Indexed: 10/26/2023]
Abstract
There is an important gap in regional information on climate change and health, limiting the development of science-based climate policies in South American countries. This study aims to identify the main gaps in the existing scientific literature on the impacts, exposure, and vulnerabilities of climate change on population health. A scoping review was performed guided by four sub-questions focused on the impacts of climate change on physical and mental health, exposure and vulnerability factors of population to climate hazards. The main findings showed that physical impacts mainly included infectious diseases, while mental health impacts included trauma, depression, and anxiety. Evidence on population exposure to climate hazards is limited, and social determinants of health and individual factors were identified as vulnerability factors. Overall, evidence on the intersection between climate change and health is limited in South America and has been generated in silos, with limited transdisciplinary research. More formal and systematic information should be generated to inform public policy. Funding None.
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Affiliation(s)
- Yasna K. Palmeiro-Silva
- Institute for Global Health, University College London, London, United Kingdom
- Centro de Políticas Públicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andres G. Lescano
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Elaine C. Flores
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- The Stanford Center for Innovation in Global Health, Stanford University, Stanford, CA, USA
| | - Yamileth Astorga E
- Escuela de Tecnologías en Salud, Universidad de Costa Rica, San Pedro, San José, Costa Rica
| | - Luciana Rojas
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mario G. Chavez
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Wendel Mora-Rivera
- InterAmerican Center for Global Health (CISG), Puntarenas, Costa Rica
- Escuela de Enfermería, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Stella M. Hartinger
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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Du R, Jiao W, Ma J, Zhou Q, Liang ZS, Sun S, Ahmed OG, Rowan NR, Pinto JM, Ramanathan M, Zhang Z. Association between ambient temperature and chronic rhinosinusitis. Int Forum Allergy Rhinol 2023; 13:1906-1914. [PMID: 36897288 DOI: 10.1002/alr.23152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Chronic exposure to particulate matter air pollution (PM2.5 ) is associated with chronic rhinosinusitis (CRS). Elevated ambient temperature may increase PM2.5 levels and thereby exacerbate sinonasal symptoms. This study investigates the association between high ambient temperature and the risk of CRS diagnosis. METHODS Patients with CRS were diagnosed at Johns Hopkins hospitals from May to October 2013-2022, and controls were matched patients without CRS meanwhile. A total of 4752 patients (2376 cases and 2376 controls) were identified with a mean (SD) age of 51.8 (16.8) years. The effect of maximum ambient temperature on symptoms was estimated with a distributed lag nonlinear model (DLNM). Extreme heat was defined as 35.0°C (95th percentile of the maximum temperature distribution). Conditional logistic regression models estimated the association between extreme heat and the risk of CRS diagnosis. RESULTS Exposure to extreme heat was associated with increased odds of exacerbation of CRS symptoms (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03-1.19). The cumulative effect of extreme heat during 0-21 lag days was significant (OR 2.37, 95% CI 1.60-3.50) compared with the minimum morbidity temperature (MMT) at 25.3°C. Associations were more pronounced among young and middle-aged patients and patients with abnormal weight. CONCLUSIONS We found that short-term exposure to high ambient temperature is associated with increased CRS diagnosis, suggesting a cascading effect of meteorological phenomena. These results highlight climate change's potentially deleterious health effects on upper airway diseases, which could have a significant public health impact.
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Affiliation(s)
- Runming Du
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Wangteng Jiao
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Junxiong Ma
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Qinfeng Zhou
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Zhi-Sheng Liang
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, China
| | - Omar G Ahmed
- Division of Rhinology, Sinus, Sleep & Skull Base Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, Illinois, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Zhenyu Zhang
- Department of Global Health, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
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Requia WJ, Vicedo-Cabrera AM, de Schrijver E, Amini H, Gasparrini A. Association of high ambient temperature with daily hospitalization for cardiorespiratory diseases in Brazil: A national time-series study between 2008 and 2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 331:121851. [PMID: 37211231 DOI: 10.1016/j.envpol.2023.121851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/28/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Further research is needed to examine the nationwide impact of temperature on health in Brazil, a region with particular challenges related to climate conditions, environmental characteristics, and health equity. To address this gap, in this study, we looked at the relationship between high ambient temperature and hospital admissions for circulatory and respiratory diseases in 5572 Brazilian municipalities between 2008 and 2018. We used an extension of the two-stage design with a case time series to assess this relationship. In the first stage, we applied a distributed lag non-linear modeling framework to create a cross-basis function. We next applied quasi-Poisson regression models adjusted by PM2.5, O3, relative humidity, and time-varying confounders. We estimated relative risks (RRs) of the association of heat (percentile 99th) with hospitalization for circulatory and respiratory diseases by sex, age group, and Brazilian regions. In the second stage, we applied meta-analysis with random effects to estimate the national RR. Our study population includes 23,791,093 hospital admissions for cardiorespiratory diseases in Brazil between 2008 and 2018. Among those, 53.1% are respiratory diseases, and 46.9% are circulatory diseases. The robustness of the RR and the effect size varied significantly by region, sex, age group, and health outcome. Overall, our findings suggest that i) respiratory admissions had the highest RR, while circulatory admissions had inconsistent or null RR in several subgroup analyses; ii) there was a large difference in the cumulative risk ratio across regions; and iii) overall, women and the elderly population experienced the greatest impact from heat exposure. The pooled national results for the whole population (all ages and sex) suggest a relative risk of 1.29 (95% CI: 1.26; 1.32) associated with respiratory admissions. In contrast, national meta-analysis for circulatory admissions suggested robust positive associations only for people aged 15-45, 46-65, >65 years old; for men aged 15-45 years old; and women aged 15-45 and 46-65 years old. Our findings are essential for the body of scientific evidence that has assisted policymakers to promote health equity and to create adaptive measures and mitigations.
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Affiliation(s)
- Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas Brasília, Distrito Federal, Brazil.
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Evan de Schrijver
- Institute of Social and Preventive Medicine, University of Bern, Oeschger Center for Climate Change Research, University of Bern, Graduate School of Health Sciences, University of Bern, Bern, Switzerland
| | - Heresh Amini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Bai J, Cui J, Yu C. Burden of chronic obstructive pulmonary disease attributable to non-optimal temperature from 1990 to 2019: a systematic analysis from the Global Burden of Disease Study 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:68836-68847. [PMID: 37129808 DOI: 10.1007/s11356-023-27325-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) has been the third leading cause of death worldwide. As the traditional risk factors (like smoking and ambient air pollution) on the burden of COPD being well characterized, the burden of COPD due to non-optimal temperature has been widely concerned. In this study, we extracted the relevant burden data of COPD attributable to non-optimal temperature from GBD 2019 and adopted estimated annual percent changes, Gaussian process regression (GPR), and age-period-cohort model to evaluate the spatiotemporal patterns, relationships with socio-demographic level, and the independent effects of age, period and cohort from 1990 to 2019. In brief, the global COPD burden attributable to non-optimal temperatures showed declining trends but was still more severe in the elderly, males, Asia, and regions with low socio-demographic index (SDI). And cold had a greater burden than heat. The inverted U-shape is expected for the relationship between SDI and the burden of COPD caused by non-optimal temperatures according to the GPR model, with the inflection point around SDI 0.45. Besides, the improvements were observed in period and cohort effects but were relatively limited in low and low-middle SDI regions. Public health managers should execute more targeted programs to lessen this burden predominantly among lower SDI countries.
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Affiliation(s)
- Jianjun Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No.185 Donghu Road, Wuhan, 430071, China
| | - Jiaxin Cui
- School of Nursing, Wuhan University, No.115 Donghu Road, Wuhan, 430071, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No.185 Donghu Road, Wuhan, 430071, China.
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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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10
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Zhao Z, Chu J, Xu X, Cao Y, Schikowski T, Geng M, Chen G, Bai G, Hu K, Xia J, Ma W, Liu Q, Lu Z, Guo X, Zhao Q. Association between ambient cold exposure and mortality risk in Shandong Province, China: Modification effect of particulate matter size. Front Public Health 2023; 10:1093588. [PMID: 36684922 PMCID: PMC9850236 DOI: 10.3389/fpubh.2022.1093588] [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: 11/09/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Numerous studies have reported the modification of particulate matters (PMs) on the association between cold temperature and health. However, it remains uncertain whether the modification effect may vary by size of PMs, especially in Shandong Province, China where the disease burdens associated with cold temperature and PMs are both substantial. This study aimed to examine various interactive effects of cold exposure and ambient PMs with diameters ≤1/2.5 μm (PM1 and PM2.5) on premature deaths in Shandong Province, China. Methods In the 2013-2018 cold seasons, data on daily mortality, PM1 and PM2.5, and weather conditions were collected from the 1822 sub-districts of Shandong Province. A time-stratified case-crossover study design was performed to quantify the cumulative association between ambient cold and mortality over lag 0-12 days, with a linear interactive term between temperature and PM1 and PM2.5 additionally added into the model. Results The mortality risk increased with temperature decline, with the cumulative OR of extreme cold (-16.9°C, the 1st percentile of temperature range) being 1.83 (95% CI: 1.66, 2.02), compared with the minimum mortality temperature. The cold-related mortality risk was 2.20 (95%CI: 1.83, 2.64) and 2.24 (95%CI: 1.78, 2.81) on high PM1 and PM2.5 days, which dropped to 1.60 (95%CI: 1.39, 1.84) and 1.60 (95%CI: 1.37, 1.88) on low PM1 and PM2.5 days. PM1 showed greater modification effect for per unit concentration increase than PM2.5. For example, for each 10?g/m3 increase in PM1 and PM2.5, the mortality risk associated with extreme cold temperature increased by 7.6% (95% CI: 1.3%, 14.2%) and 2.6% (95% CI: -0.7%, 5.9%), respectively. Discussion The increment of smaller PMs' modification effect varied by population subgroups, which was particularly strong in the elderly aged over 75 years and individuals with middle school education and below. Specific health promotion strategies should be developed towards the greater modification effect of smaller PMs on cold effect.
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Affiliation(s)
- Zhonghui Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China
| | - Jie Chu
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Xiaohui Xu
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Yanwen Cao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China
| | - Tamara Schikowski
- Department of Epidemiology, Leibniz Institute for Environmental Medicine (IUF)-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Mengjie Geng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guannan Bai
- Department of Child Health Care, The Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Jingjing Xia
- School of Life Sciences, Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan University, Guangzhou, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China
| | - Qiyong Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China,Academy of Preventive Medicine, Shandong University, Jinan, China,Xiaolei Guo ✉
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China,Shandong University Climate Change and Health Center, Jinan, China,Department of Epidemiology, Leibniz Institute for Environmental Medicine (IUF)-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany,*Correspondence: Qi Zhao ✉
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11
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Atmospheric Episodes Linked to Climate Change and Their Impact on Respiratory Health. Arch Bronconeumol 2022; 59:201-202. [PMID: 36509607 DOI: 10.1016/j.arbres.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
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12
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Stolz D, Mkorombindo T, Schumann DM, Agusti A, Ash SY, Bafadhel M, Bai C, Chalmers JD, Criner GJ, Dharmage SC, Franssen FME, Frey U, Han M, Hansel NN, Hawkins NM, Kalhan R, Konigshoff M, Ko FW, Parekh TM, Powell P, Rutten-van Mölken M, Simpson J, Sin DD, Song Y, Suki B, Troosters T, Washko GR, Welte T, Dransfield MT. Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 2022; 400:921-972. [PMID: 36075255 PMCID: PMC11260396 DOI: 10.1016/s0140-6736(22)01273-9] [Citation(s) in RCA: 189] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/23/2022] [Accepted: 06/28/2022] [Indexed: 10/14/2022]
Abstract
Despite substantial progress in reducing the global impact of many non-communicable diseases, including heart disease and cancer, morbidity and mortality due to chronic respiratory disease continues to increase. This increase is driven primarily by the growing burden of chronic obstructive pulmonary disease (COPD), and has occurred despite the identification of cigarette smoking as the major risk factor for the disease more than 50 years ago. Many factors have contributed to what must now be considered a public health emergency: failure to limit the sale and consumption of tobacco products, unchecked exposure to environmental pollutants across the life course, and the ageing of the global population (partly as a result of improved outcomes for other conditions). Additionally, despite the heterogeneity of COPD, diagnostic approaches have not changed in decades and rely almost exclusively on post-bronchodilator spirometry, which is insensitive for early pathological changes, underused, often misinterpreted, and not predictive of symptoms. Furthermore, guidelines recommend only simplistic disease classification strategies, resulting in the same therapeutic approach for patients with widely differing conditions that are almost certainly driven by variable pathophysiological mechanisms. And, compared with other diseases with similar or less morbidity and mortality, the investment of financial and intellectual resources from both the public and private sector to advance understanding of COPD, reduce exposure to known risks, and develop new therapeutics has been woefully inadequate.
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Affiliation(s)
- Daiana Stolz
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Clinic of Respiratory Medicine and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Takudzwa Mkorombindo
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Desiree M Schumann
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Alvar Agusti
- Respiratory Institute-Hospital Clinic, University of Barcelona IDIBAPS, CIBERES, Barcelona, Spain
| | - Samuel Y Ash
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mona Bafadhel
- School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Department of Respiratory Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Chunxue Bai
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - James D Chalmers
- Scottish Centre for Respiratory Research, University of Dundee, Dundee, UK
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Shyamali C Dharmage
- Centre for Epidemiology and Biostatistics, School of Population and Global health, University of Melbourne, Melbourne, VIC, Australia
| | - Frits M E Franssen
- Department of Research and Education, CIRO, Horn, Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Urs Frey
- University Children's Hospital Basel, Basel, Switzerland
| | - MeiLan Han
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nadia N Hansel
- Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nathaniel M Hawkins
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Ravi Kalhan
- Department of Preventive Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melanie Konigshoff
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Fanny W Ko
- The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Trisha M Parekh
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Maureen Rutten-van Mölken
- Erasmus School of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jodie Simpson
- Priority Research Centre for Healthy Lungs, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Don D Sin
- Centre for Heart Lung Innovation and Division of Respiratory Medicine, Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada
| | - Yuanlin Song
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Respiratory Research Institute, Shanghai, China; Jinshan Hospital of Fudan University, Shanghai, China
| | - Bela Suki
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Thierry Troosters
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease, German Center for Lung Research, Hannover, Germany
| | - Mark T Dransfield
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA.
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13
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Konstantinoudis G, Minelli C, Vicedo-Cabrera AM, Ballester J, Gasparrini A, Blangiardo M. Ambient heat exposure and COPD hospitalisations in England: a nationwide case-crossover study during 2007-2018. Thorax 2022; 77:1098-1104. [PMID: 35459745 PMCID: PMC9606528 DOI: 10.1136/thoraxjnl-2021-218374] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/24/2022] [Indexed: 11/05/2022]
Abstract
Background There is emerging evidence suggesting a link between ambient heat exposure and chronic obstructive pulmonary disease (COPD) hospitalisations. Individual and contextual characteristics can affect population vulnerabilities to COPD hospitalisation due to heat exposure. This study quantifies the effect of ambient heat on COPD hospitalisations and examines population vulnerabilities by age, sex and contextual characteristics. Methods Individual data on COPD hospitalisation at high geographical resolution (postcodes) during 2007–2018 in England was retrieved from the small area health statistics unit. Maximum temperature at 1 km ×1 km resolution was available from the UK Met Office. We employed a case-crossover study design and fitted Bayesian conditional Poisson regression models. We adjusted for relative humidity and national holidays, and examined effect modification by age, sex, green space, average temperature, deprivation and urbanicity. Results After accounting for confounding, we found 1.47% (95% Credible Interval (CrI) 1.19% to 1.73%) increase in the hospitalisation risk for every 1°C increase in temperatures above 23.2°C (lags 0–2 days). We reported weak evidence of an effect modification by sex and age. We found a strong spatial determinant of the COPD hospitalisation risk due to heat exposure, which was alleviated when we accounted for contextual characteristics. 1851 (95% CrI 1 576 to 2 079) COPD hospitalisations were associated with temperatures above 23.2°C annually. Conclusion Our study suggests that resources should be allocated to support the public health systems, for instance, through developing or expanding heat-health alerts, to challenge the increasing future heat-related COPD hospitalisation burden.
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Affiliation(s)
| | - Cosetta Minelli
- NHLI, Imperial College London National Heart and Lung Institute, London, UK
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Oeschger Centre for Climate Change Research, University of Bern, Bern, Switzerland
| | - Joan Ballester
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.,Centre for Statistical Methodology, London School of Hygiene Tropical Medicine, London, UK.,Centre on Climate Change and Planetary Health, London School of Hygiene Tropical Medicine, London, UK
| | - Marta Blangiardo
- MRC Centre for Environment and Health, Imperial College London, London, UK
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14
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Chen L, Cai M, Li H, Wang X, Tian F, Wu Y, Zhang Z, Lin H. Risk/benefit tradeoff of habitual physical activity and air pollution on chronic pulmonary obstructive disease: findings from a large prospective cohort study. BMC Med 2022; 20:70. [PMID: 35220974 PMCID: PMC8883705 DOI: 10.1186/s12916-022-02274-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The combined health impact of physical activity (PA) and air pollution on chronic obstructive pulmonary disease (COPD) remains unclear. We investigated the joint effects of habitual PA and long-term fine particulate matter (PM2.5) exposure on COPD incidence in a prospective population-based cohort. METHODS A prospective cohort study was conducted using data from the UK Biobank. Incidence of COPD was ascertained through linkage to the UK National Health Services register. Annual mean PM2.5 concentration was obtained using land use regression model. PA was measured by questionnaire and wrist-worn accelerometer. Cox proportional hazard models were applied to examine the associations between PM2.5, PA, and COPD. Additive and multiplicative interactions were examined. RESULTS A total of 266,280 participants free of COPD at baseline were included in data analysis with an average follow-up of 10.64 years, contributing to around 2.8 million person-years. Compared with participants with low level of PA, those with higher PA levels had lower risks of COPD incidence [hazard ratio (HR): 0.769, 95% CI: 0.720, 0.820 for moderate level; HR: 0.726, 95% CI: 0.679, 0.776 for high level]. By contrast, PM2.5 was associated with increased risk of COPD (HR per interquartile range increment: 1.065, 95% CI: 1.032, 1.099). Limited evidence of interaction between habitual PA and PM2.5 exposure was found. Similar results were found for accelerometer-measured PA. CONCLUSIONS Our study suggests that habitual PA could reduce risk of COPD incidence, and such protective effects were not affected by ambient PM2.5 pollution exposure.
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Affiliation(s)
- Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Shenzhen University General Hospital, Shenzhen, 518055, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Fei Tian
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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15
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Wang Y, Chen Y, Chen J, Wu R, Guo P, Zha S, Zhang Q. Mortality risk attributable to diurnal temperature range: a multicity study in Yunnan of southwest China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:60597-60608. [PMID: 34160766 DOI: 10.1007/s11356-021-14981-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023]
Abstract
We aimed to estimate the non-accidental and cause-specific mortality burden attributed to diurnal temperature range (DTR) and the relative contributions of low, high, and extremely low and extremely high DTR in Yunnan, southwest China. Furthermore, we explored the possible effect modification of the DTR-mortality association by season, sex, age, ethnicity, marital status, and occupation. A standard time-series quasi-Poisson regression model combined with a distributed lag nonlinear model was used to derive estimates of city-specific DTR-mortality associations, then random effects meta-analysis was used to pool the estimated city-specific overall cumulative DTR-mortality association, estimating empirical confidence intervals (eCIs). The overall fraction of non-accidental mortality caused by DTR was 11.00% (95% eCI 3.40-17.28): high DTR accounted for most of burden (total estimate 10.03%, 95% eCI 2.59-16.32). The estimated mortality risk attributable to DTR was significantly associated with cardiovascular and respiratory mortality, with attributable fractions of 13.61% (95% eCI 3.91-21.13) and 14.32% (95% eCI 0.47-21.44), respectively. The estimated risk attributable to DTR was slightly greater for males, people ≥75 years old, married people, and non-farmers than their corresponding categories. Most of the DTR-related mortality burden was attributable to high DTR, and the mortality risk attributable to DTR might be modified by specific causes, sex, age, marital status, and occupation.
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Affiliation(s)
- Yujin Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Yang Chen
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, Yunnan, China
| | - Jiaqi Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Rong Wu
- 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
| | - Shun Zha
- Yunnan Center for Disease Control and Prevention, Kunming, 650022, Yunnan, China.
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong, China.
- Guangdong Provincial Key Laboratory for Breast Cancer Diagnosis and Treatment, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China.
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16
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Li C, Zhao Q, Zhao Z, Liu Q, Ma W. The association between tropical cyclones and dengue fever in the Pearl River Delta, China during 2013-2018: A time-stratified case-crossover study. PLoS Negl Trop Dis 2021; 15:e0009776. [PMID: 34499666 PMCID: PMC8454958 DOI: 10.1371/journal.pntd.0009776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/21/2021] [Accepted: 08/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Studies have shown that tropical cyclones are associated with several infectious diseases, while very few evidence has demonstrated the relationship between tropical cyclones and dengue fever. This study aimed to examine the potential impact of tropical cyclones on dengue fever incidence in the Pearl River Delta, China. Methods Data on daily dengue fever incidence, occurrence of tropical cyclones and meteorological factors were collected between June and October, 2013–2018 from nine cities in the Pearl River Delta. Multicollinearity of meteorological variables was examined via Spearman correlation, variables with strong correlation (r>0.7) were not included in the model simultaneously. A time-stratified case-crossover design combined with conditional Poisson regression model was performed to evaluate the association between tropical cyclones and dengue fever incidence. Stratified analyses were performed by intensity grades of tropical cyclones (tropical storm and typhoon), sex (male and female) and age-groups (<18, 18–59, ≥60 years). Results During the study period, 20 tropical cyclones occurred and 47,784 dengue fever cases were reported. Tropical cyclones were associated with an increased risk of dengue fever in the Pearl River Delta region, with the largest relative risk of 1.62 with the 95% confidence interval (1.45–1.80) occurring on the lag 5 day. The strength of association was greater and lasted longer for typhoon than for tropical storm. There was no difference in effect estimates between males and females. However, individuals aged over 60 years were more vulnerable than others. Conclusions Tropical cyclones are associated with increased risk of local dengue fever incidence in south China, with the elderly more vulnerable than other population subgroups. Health protective strategies should be developed to reduce the potential risk of dengue epidemic after tropical cyclones. Dengue fever, a mosquito-borne tropical infectious disease, has been increasingly serious in recent decades, causing great healthcare burden in low-latitude regions and countries. Aedes is the vector of dengue fever, particularly sensitive to climatic conditions during all stages of the life cycle. Numerous epidemiological studies have demonstrated the association between dengue fever and meteorological factors (e.g., temperature, precipitation and relative humidity). Tropical cyclones are a common extreme weather events in the low latitude and have been associated with the outbreak of several infectious diseases. However, the impact of tropical cyclones on the incidence of dengue fever has not been well clarified. In this study, we explored the association between tropical cyclones and dengue fever in the Pearl River Delta region, China. The results showed that the local incidence of dengue fever was substantially associated with tropical cyclones over a certain lag period, with the effect estimate greater for stronger tropical cyclones. The elderly was more vulnerable than any other population subgroups. The findings highlighted the importance of developing public health surveillance, preparedness, and response targeting the outbreak of dengue fever during the tropical cyclone season.
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Affiliation(s)
- Chuanxi Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| | - Zhe Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| | - Qiyong Liu
- Shandong University Climate Change and Health Center, Jinan, China.,State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
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17
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Li M, Chen S, Zhao H, Tang C, Lai Y, Ung COL, Su J, Hu H. The short-term associations of chronic obstructive pulmonary disease hospitalizations with meteorological factors and air pollutants in Southwest China: a time-series study. Sci Rep 2021; 11:12914. [PMID: 34155257 PMCID: PMC8217527 DOI: 10.1038/s41598-021-92380-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/31/2021] [Indexed: 11/09/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is the fourth major cause of mortality and morbidity worldwide and is projected to be the third by 2030. However, there is little evidence available on the associations of COPD hospitalizations with meteorological factors and air pollutants in developing countries/regions of Asia. In particular, no study has been done in western areas of China considering the nonlinear and lagged effects simultaneously. This study aims to evaluate the nonlinear and lagged associations of COPD hospitalizations with meteorological factors and air pollutants using time-series analysis. The modified associations by sex and age were also investigated. The distributed lag nonlinear model was used to establish the association of daily COPD hospitalizations of all 441 public hospitals in Chengdu, China from Jan/2015-Dec/2017 with the ambient meteorological factors and air pollutants. Model parameters were optimized based on quasi Akaike Information Criterion and model diagnostics was conducted by inspecting the deviance residuals. Subgroup analysis by sex and age was also performed. Temperature, relative humidity, wind and Carbon Monoxide (CO) have statistically significant and consistent associations with COPD hospitalizations. The cumulative relative risk (RR) was lowest at a temperature of 19℃ (relative humidity of 67%). Both extremely high and low temperature (and relative humidity) increase the cumulative RR. An increase of wind speed above 4 mph (an increase of CO above 1.44 mg/m3) significantly decreases (increases) the cumulative RR. Female populations were more sensitive to low temperature and high CO level; elderly (74+) populations are more sensitive to high relative humidity; younger populations (< = 74) are more susceptible to CO higher than 1.44 mg/m3. Therefore, people with COPD should avoid exposure to adverse environmental conditions of extreme temperatures and relative humidity, low wind speed and high CO level, especially for female and elderly patients who were more sensitive to extreme temperatures and relative humidity.
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Affiliation(s)
- Meng Li
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Shengqi Chen
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Hanqing Zhao
- Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China
| | - Chengxiang Tang
- School of Public Administration, Guangzhou University, Guangzhou, China
| | - Yunfeng Lai
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Jinya Su
- School of Computer Science and Electronic Engineering, University of Essex, Colchester, CO4 3SQ, UK.
| | - Hao Hu
- State Key Laboratory in Quality Research of Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China.
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18
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Cao D, Li D, Wu Y, Qian ZM, Liu Y, Liu Q, Sun J, Guo Y, Zhang S, Jiao G, Yang X, Wang C, McMillin SE, Zhang X, Lin H. Ambient PM 2.5 exposure and hospital cost and length of hospital stay for respiratory diseases in 11 cities in Shanxi Province, China. Thorax 2021; 76:thoraxjnl-2020-215838. [PMID: 34088786 DOI: 10.1136/thoraxjnl-2020-215838] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 04/09/2021] [Accepted: 05/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) on hospital cost and length of hospital stay for respiratory diseases in China. METHODS We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM2.5 using the standards of WHO (25 µg/m3) and China (75 µg/m3) as reference. RESULTS Each 10 µg/m3 increase in lag03 PM2.5 corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM2.5 exposures using WHO's guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case. CONCLUSION Significant respiratory burden could be attributable to PM2.5 exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.
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Affiliation(s)
- Dawei Cao
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dongyan Li
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Yi Liu
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Xinri Zhang
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
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19
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Jacobson LDSV, de Oliveira BFA, Schneider R, Gasparrini A, Hacon SDS. Mortality Risk from Respiratory Diseases Due to Non-Optimal Temperature among Brazilian Elderlies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115550. [PMID: 34067373 PMCID: PMC8197018 DOI: 10.3390/ijerph18115550] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/16/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022]
Abstract
Over the past decade, Brazil has experienced and continues to be impacted by extreme climate events. This study aims to evaluate the association between daily average temperature and mortality from respiratory disease among Brazilian elderlies. A daily time-series study between 2000 and 2017 in 27 Brazilian cities was conducted. Data outcomes were daily counts of deaths due to respiratory diseases in the elderly aged 60 or more. The exposure variable was the daily mean temperature from Copernicus ERA5-Land reanalysis. The association was estimated from a two-stage time series analysis method. We also calculated deaths attributable to heat and cold. The pooled exposure–response curve presented a J-shaped format. The exposure to extreme heat increased the risk of mortality by 27% (95% CI: 15–39%), while the exposure to extreme cold increased the risk of mortality by 16% (95% CI: 8–24%). The heterogeneity between cities was explained by city-specific mean temperature and temperature range. The fractions of deaths attributable to cold and heat were 4.7% (95% CI: 2.94–6.17%) and 2.8% (95% CI: 1.45–3.95%), respectively. Our results show a significant impact of non-optimal temperature on the respiratory health of elderlies living in Brazil. It may support proactive action implementation in cities that have critical temperature variations.
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Affiliation(s)
- Ludmilla da Silva Viana Jacobson
- Department of Statistics, Fluminense Federal University, Niterói 24210-201, RJ, Brazil
- Brazilian Research Network on Global Climate Change–Rede Clima, São José dos Campos 12227-010 SP, Brazil;
- Correspondence:
| | | | - Rochelle Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK; (R.S.); (A.G.)
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK
- Forecast Department, European Centre for Medium-Range Weather Forecast, Reading RG29AX, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK; (R.S.); (A.G.)
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK
| | - Sandra de Souza Hacon
- Brazilian Research Network on Global Climate Change–Rede Clima, São José dos Campos 12227-010 SP, Brazil;
- Nacional School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, RJ, Brazil;
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20
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Shen Y, Zhang X, Chen C, Lin Q, Li X, Qu W, Liu X, Zhao L, Chang S. The relationship between ambient temperature and acute respiratory and cardiovascular diseases in Shenyang, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:20058-20071. [PMID: 33405157 PMCID: PMC7786187 DOI: 10.1007/s11356-020-11934-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 12/01/2020] [Indexed: 05/16/2023]
Abstract
The purpose of this study was to analyze the acute effect of ambient temperature on hospitalization due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD), stroke, and myocardial infarction (MI) in Shenyang, China. We used the distributed delayed nonlinear model to evaluate the impact of ambient temperature on respiratory and cardiovascular diseases. The study population was divided into four groups: < 65 group and ≥ 65 age groups, female and male groups. The < 65 age group of AECOPD patients was more likely to be affected by high ambient temperature, while the ≥ 65 age group of AECOPD patients was more sensitive to low ambient temperature. The hospitalization risk of MI admission increased in the ≥ 65 age group at 1-8 days delay under low ambient temperature conditions.
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Affiliation(s)
- Yang Shen
- Division of Biomedical Engineering, China Medical University, Shenyang, 110122, Liaoning, China
| | - Xudong Zhang
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No. 36 Sanhao Road, Heping District, Shenyang, 110000, Liaoning, China
| | - Cai Chen
- Shandong Institute of Advanced Technology, Chinese Academy of Sciences, Jinan, 250000, Shandong, China
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, Shandong, China
| | - Qianqian Lin
- College of Letters and Science, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Xiyuan Li
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, Shandong, China
| | - Wenxiu Qu
- Parexel China Co., Ltd. Shenyang Branch, Shenyang, 110000, China
| | - Xuejian Liu
- The First General Internal Medicine, Shengjing Hospital, China Medical University, No.16 Puhe Road, Shenbei New District, Shenyang, 110000, Liaoning, China
| | - Li Zhao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No. 36 Sanhao Road, Heping District, Shenyang, 110000, Liaoning, China.
| | - Shijie Chang
- Division of Biomedical Engineering, China Medical University, Shenyang, 110122, Liaoning, China.
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21
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What Are the Effects of Meteorological Factors on Exacerbations of Chronic Obstructive Pulmonary Disease? ATMOSPHERE 2021. [DOI: 10.3390/atmos12040442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the greatest global public health challenges. Acute exacerbations of COPD lead to the accelerated deterioration of lung function, reduced quality of life, a higher number of hospitalizations, and increased mortality. The factor causing the exacerbation is usually an infectious agent, but the impact of environmental factors is being studied more thoroughly. Among them, meteorological factors are the least examined. Multiple studies have shown that lower temperatures during the cold season, as well as sudden temperature changes regardless of the season, have the most significant negative effect on patients with COPD. However, higher temperatures, especially during summer heatwaves, can also cause COPD exacerbation and it is expected that this will be an even more important health problem in the future considering climate changes. The effects of other meteorological factors on acute exacerbation of COPD, such as atmospheric pressure, solar radiation, rainfall, wind speed, and humidity are far less investigated and opposing results have been obtained in different studies. Thus, there is a need for further research in this area that would result in clinical recommendations and public health interventions that could decrease the global burden of COPD.
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22
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Wang H, Sun J, Qian Z, Gong Y, Zhong J, Yang R, Wan C, Zhang S, Ning D, Xian H, Chang J, Wang C, Shacham E, Wang J, Lin H. Association between air pollution and atopic dermatitis in Guangzhou, China: modification by age and season*. Br J Dermatol 2021; 184:1068-1076. [DOI: 10.1111/bjd.19645] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2020] [Indexed: 01/03/2023]
Affiliation(s)
- H.L. Wang
- Guangzhou Institute of Dermatology Guangzhou China
| | - J. Sun
- Department of Epidemiology and Biostatistics College for Public Health & Social Justice Saint Louis University St Louis MO USA
| | - Z.M. Qian
- Department of Epidemiology and Biostatistics College for Public Health & Social Justice Saint Louis University St Louis MO USA
| | - Y.Q. Gong
- Guangzhou Institute of Dermatology Guangzhou China
| | - J.B. Zhong
- Guangzhou Institute of Dermatology Guangzhou China
| | - R.D. Yang
- Guangzhou Institute of Dermatology Guangzhou China
| | - C.L. Wan
- Guangzhou Institute of Dermatology Guangzhou China
| | - S.Q. Zhang
- Guangzhou Institute of Dermatology Guangzhou China
| | - D.F. Ning
- Guangzhou Institute of Dermatology Guangzhou China
| | - H. Xian
- Department of Epidemiology and Biostatistics College for Public Health & Social Justice Saint Louis University St Louis MO USA
| | - J.J. Chang
- Department of Epidemiology and Biostatistics College for Public Health & Social Justice Saint Louis University St Louis MO USA
| | - C.J. Wang
- Department of Epidemiology and BiostatisticsCollege of Public HealthZhengzhou University Zhengzhou Henan China
| | - E. Shacham
- Department of Behavioral Science and Health Education College for Public Health & Social Justice Saint Louis University St Louis MO USA
| | - J.Q. Wang
- Guangzhou Institute of Dermatology Guangzhou China
| | - H.L. Lin
- Department of Epidemiology School of Public Health Sun Yat‐sen University Guangzhou China
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23
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Gayle AV, Quint JK, Fuertes EI. Understanding the relationships between environmental factors and exacerbations of COPD. Expert Rev Respir Med 2021; 15:39-50. [PMID: 32713218 DOI: 10.1080/17476348.2020.1801426] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant health burden both for patients and healthcare systems. Exposure to various environmental factors increases the risk of exacerbations. AREAS COVERED We searched PubMed and assessed literature published within the last 10 years to include epidemiological evidence on the relationships between air pollution, temperature and COPD exacerbation risk as well as the implications of extreme weather events on exacerbations. EXPERT OPINION Ongoing climate change is expected to increase air pollution levels, global temperature and the frequency and severity of extreme weather events, all of which are associated with COPD exacerbations. Further research is needed using patient-focused methodological approaches to better understand and quantify these relationships, so that effective mitigation strategies that decrease the risk of exacerbations can be developed.
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Affiliation(s)
- Alicia V Gayle
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
- Global Real World Evidence, AstraZeneca Plc , Cambridge, UK
| | - Jennifer K Quint
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
| | - Elaine I Fuertes
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
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24
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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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25
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Qiu H, Xia X, Man CL, Ko FWS, Yim SHL, Kwok TCY, Ho KF. Real-Time Monitoring of the Effects of Personal Temperature Exposure on the Blood Oxygen Saturation Level in Elderly People with and without Chronic Obstructive Pulmonary Disease: A Panel Study in Hong Kong. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:6869-6877. [PMID: 32363866 DOI: 10.1021/acs.est.0c01799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Few studies have investigated the short-term effect of personal temperature exposure on blood oxygen saturation (SpO2). We conducted this longitudinal panel study with real-time monitoring of SpO2 and environmental exposure for 3 continuous days for 20 patients with chronic obstructive pulmonary disease (COPD) and 20 healthy volunteers in Hong Kong, to explore the time course (from minutes to hours) of change in SpO2 in response to temperature in elderly people. We employed a generalized additive mixed model to evaluate the acute effects of personal temperature exposure on changes in SpO2 and risk of oxygen desaturation while adjusting for seasonality, environmental co-exposures, and personal characteristics. We observed a concurrent decline in SpO2 by 0.27% (95% confidence interval [CI]: 0.22-0.32%) and an increase in the risk of oxygen desaturation by an OR of 1.14 (95% CI, 1.10-1.18) associated with a 1 °C increase in personal temperature, and the association lasted over several hours. Results showed that the decline in SpO2 in elderly people was associated with an increase in personal temperature exposure within minutes to hours, particularly in women and male patients with COPD. Temperature-induced oxygen desaturation may play a pivotal role in COPD exacerbation.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
| | - Xi Xia
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Chung Ling Man
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Fanny W S Ko
- Division of Respiratory Medicine, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Steve H L Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, HKSAR, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
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26
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Zhang Y, Liu X, Kong D, Fu J, Liu Y, Zhao Y, Lian H, Zhao X, Yang J, Fan Z. Effects of Ambient Temperature on Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results from a Time-Series Analysis of 143318 Hospitalizations. Int J Chron Obstruct Pulmon Dis 2020; 15:213-223. [PMID: 32099346 PMCID: PMC6996111 DOI: 10.2147/copd.s224198] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose To evaluate the associations between acute exacerbations of chronic obstructive pulmonary disease (AECOPD) hospitalizations and daily mean temperature (Tmean) as well as daily apparent temperature (AT), and to explore the practical values of these two indices in policymaking and patient education. Methods Daily AECOPD hospitalizations and Meteorological data in Beijing were obtained between 2013 and 2016. Distributed lag non-linear model was adopted to investigate the association between daily ambient temperature and AECOPD hospitalizations. The cumulative effects of cold/hot temperature were abstracted. For the extreme and moderate low-temperature effect estimates, we, respectively, computed the RR of AECOPD hospitalizations at the 1st and 10th percentiles of temperature in comparison with that at the 25th percentile of temperature. For the extreme and moderate high temperature effect estimates, we, respectively, computed the RR of AECOPD hospitalizations at the 99th and 90th percentiles of temperature in comparison with that at the 75th percentile of temperature. Results During the study period, 143, 318 AECOPD hospitalizations were collected. A reverse J-shape relationship was found between temperature and AECOPD hospitalizations. When comparing the effect of Tmean, higher RRs were associated with increases in AT on AECOPD hospitalizations but a lower value of Akaike’s Information Criterion for quasi-Poisson (Q-AIC). The RR of extremely low temperature of Tmean and AT were 1.55 (95% CI: 1.21,2.00) and 2.08 (95% CI: 1.44,3.01), respectively. Moderate low temperature also had an adverse impact on AECOPD hospitalizations. No associations were found between high temperature and AECOPD risk. We found the females and those aged <65 years to be more susceptible to temperature change. Conclusion Lower temperature is associated with a higher risk for AECOPD hospitalizations. Ambient temperature is probably a better predictor in terms of quantifying risk than mean temperature when studying temperature impact on health.
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Affiliation(s)
- Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Dehui Kong
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Hui Lian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaoyi Zhao
- Department of Physical Medicine and Rehabilitation, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, People's Republic of China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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