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Cimmino G, Natale F, Alfieri R, Cante L, Covino S, Franzese R, Limatola M, Marotta L, Molinari R, Mollo N, Loffredo FS, Golino P. Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention? Biomedicines 2023; 11:2353. [PMID: 37760794 PMCID: PMC10525401 DOI: 10.3390/biomedicines11092353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular diseases (CVDs), such as arterial hypertension, myocardial infarction, stroke, heart failure, atrial fibrillation, etc., still represent the main cause of morbidity and mortality worldwide. They significantly modify the patients' quality of life with a tremendous economic impact. It is well established that cardiovascular risk factors increase the probability of fatal and non-fatal cardiac events. These risk factors are classified into modifiable (smoking, arterial hypertension, hypercholesterolemia, low HDL cholesterol, diabetes, excessive alcohol consumption, high-fat and high-calorie diet, reduced physical activity) and non-modifiable (sex, age, family history, of previous cardiovascular disease). Hence, CVD prevention is based on early identification and management of modifiable risk factors whose impact on the CV outcome is now performed by the use of CV risk assessment models, such as the Framingham Risk Score, Pooled Cohort Equations, or the SCORE2. However, in recent years, emerging, non-traditional factors (metabolic and non-metabolic) seem to significantly affect this assessment. In this article, we aim at defining these emerging factors and describe the potential mechanisms by which they might contribute to the development of CVD.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Naples, Italy
| | - Francesco Natale
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Roberta Alfieri
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Cante
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Simona Covino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Rosa Franzese
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Mirella Limatola
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Marotta
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Riccardo Molinari
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Noemi Mollo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Francesco S Loffredo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Paolo Golino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
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Chi H, Wu Y, Zheng H, Zhang B, Sun Z, Yan J, Ren Y, Guo L. Spatial patterns of climate change and associated climate hazards in Northwest China. Sci Rep 2023; 13:10418. [PMID: 37369846 DOI: 10.1038/s41598-023-37349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
Northwest China (NWC) is experiencing noticeable climate change accompanied with increasing impacts of climate hazards induced by changes in climate extremes. Towards developing climate adaptation strategies to mitigate the negative climatic impacts on both the ecosystem and socioeconomic system of the region, this study investigates systematically the spatial patterns of climate change and the associated climate hazards across NWC based on high resolution reanalysis climate dataset for the period 1979 to 2018. We find that NWC overall is under a warming and wetting transition in climate with change rate of temperature and precipitation around 0.49 °C/10a and 22.8 mm/10a respectively. Characteristics of climate change over the NWC however vary considerably in space. According to significance of long-term trends in both temperature and aridity index for each 0.1° × 0.1° grids, five types of climate change are identified across NWC, including warm-wetting, warm-drying, warm without wetting, wetting without warming and unchanging. The warm-wetting zone accounts for the largest proportion of the region (41%) and mainly locates in the arid or semi-arid northwestern NWC. Our findings show most region of NWC is under impacts of intensifying heatwave and rainstorm due to significant increases in high temperature extremes and precipitation extremes. The warming but without wetting zone is found under a more severe impact of heatwave, particularly for areas near northern Mount. Qinling and northern Loess Plateau. Areas with stronger wetting trend is suffering more from rainstorm.
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Affiliation(s)
- Haojing Chi
- Key Laboratory of Digital Earth Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
- International Research Center of Big Data for Sustainable Development Goals, Beijing, 100094, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yanhong Wu
- Key Laboratory of Digital Earth Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China.
- International Research Center of Big Data for Sustainable Development Goals, Beijing, 100094, China.
| | | | - Bing Zhang
- Key Laboratory of Digital Earth Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
- International Research Center of Big Data for Sustainable Development Goals, Beijing, 100094, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhonghua Sun
- Network and Information Center of Changjiang River Water Resources Commission, Wuhan, 430010, Hubei, China
| | - Jiaheng Yan
- Key Laboratory of Digital Earth Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
- International Research Center of Big Data for Sustainable Development Goals, Beijing, 100094, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yongkang Ren
- Key Laboratory of Digital Earth Science, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing, 100094, China
- International Research Center of Big Data for Sustainable Development Goals, Beijing, 100094, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Linan Guo
- Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Beijing, 100094, China
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Alam MM, Mahtab ASM, Ahmed MR, Hassan QK. Characterizing Cold Days and Spells and Their Relationship with Cold-Related Mortality in Bangladesh. SENSORS (BASEL, SWITZERLAND) 2023; 23:2832. [PMID: 36905035 PMCID: PMC10007433 DOI: 10.3390/s23052832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
This research examined the characteristics of cold days and spells in Bangladesh using long-term averages (1971-2000) of maximum (Tmax) and minimum temperatures (Tmin) and their standard deviations (SD). Cold days and spells were calculated and their rate of change during the winter months (December-February) of 2000-2021 was quantified. In this research, a cold day was defined as when the daily maximum or minimum temperature is ≤-1.5 the standard deviations of the long-term daily average of maximum or minimum temperature and the daily average air temperature was equal to or below 17 °C. The results showed that the cold days were more in the west-northwestern regions and far less in the southern and southeastern regions. A gradual decrease in cold days and spells was found from the north and northwest towards the south and southeast. The highest number of cold spells (3.05 spells/year) was experienced in the northwest Rajshahi division and the lowest (1.70 spells/year) in the northeast Sylhet division. In general, the number of cold spells was found to be much higher in January than in the other two winter months. In the case of cold spell severity, Rangpur and Rajshahi divisions in the northwest experienced the highest number of extreme cold spells against the highest number of mild cold spells in the Barishal and Chattogram divisions in the south and southeast. While nine (out of twenty-nine) weather stations in the country showed significant trends in cold days in December, it was not significant on the seasonal scale. Adapting the proposed method would be useful in calculating cold days and spells to facilitate regional-focused mitigation and adaptation to minimize cold-related deaths.
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Affiliation(s)
- Md. Mahbub Alam
- Department of Physics, Khulna University of Engineering and Technology, Khulna 9203, Bangladesh
| | - A. S. M. Mahtab
- Department of Physics, Khulna University of Engineering and Technology, Khulna 9203, Bangladesh
| | - M. Razu Ahmed
- Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Quazi K. Hassan
- Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
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Dai M, Chen S, Huang S, Hu J, Jingesi M, Chen Z, Su Y, Yan W, Ji J, Fang D, Yin P, Cheng J, Wang P. Increased emergency cases for out-of-hospital cardiac arrest due to cold spells in Shenzhen, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:1774-1784. [PMID: 35921008 DOI: 10.1007/s11356-022-22332-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
Cold spells have been associated with specific diseases. However, there is insufficient scientific evidence on the effects of cold spells on out-of-hospital cardiac arrest (OHCA). Data on OHCA cases and on meteorological factors and air pollutants were collected between 2013 and 2020. We adopted a quasi-Poisson generalized additive model with a distributed lag nonlinear model (DLNM) to estimate the effect of cold spells on daily OHCA incidence. Backward attributable risk within the DLNM framework was calculated to quantify the disease burden. We compared the effects and OHCA burden of cold spells using nine definitions. The risks of different cold spells on OHCA increased at higher intensities and longer durations. Based on Akaike's information criterion for the quasi-Poisson regression model and the attributable risk, the optimal cold spell was defined as a period in the cold month when the daily mean temperature was below the 10th percentile of the temperature distribution in the study period for at least 2 days. The single-day effect of the optimal cold spell on OHCA occurred immediately and lasted for approximately 1 week. The maximum single-day effect was 1.052 (95% CI: 1.018-1.087) at lag0, while the maximum cumulative effect was 1.433 (95% CI:1.148-1.788) after a 14-day lag. Men were more susceptible to cold spells. Young and middle-aged people were affected by cold spells similar to the elderly. Cold spells can increase the risk of OHCA with an approximately 1-week lag effect. Health regulators should take more targeted measures to protect susceptible populations during cold weather.
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Affiliation(s)
- Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ziwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Youpeng Su
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weiqi Yan
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Jiajia Ji
- Department of Environment and Health, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Daokui Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Wei J, Ren A, Zhang Y, Yin Y, Chu N, Ma Y, Du J, Cui L, Zhou C. Quantifying the effects of cold waves on carbon monoxide poisoning: A time-stratified case-crossover study in Jinan, China. Front Public Health 2023; 11:1050256. [PMID: 37143979 PMCID: PMC10152301 DOI: 10.3389/fpubh.2023.1050256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/15/2023] [Indexed: 05/06/2023] Open
Abstract
Background Previous studies have shown that carbon monoxide (CO) poisoning occurs mostly in winter and is associated with severe cold weather (e.g., ice storms, temperature drops). However, according to previous studies, the impact of low temperature on health has a delayed effect, and the existing research cannot fully reveal the delayed effect of cold waves on CO poisoning. Objectives The purpose of this study is to analyze the temporal distribution of CO poisoning in Jinan and to explore the acute effect of cold waves on CO poisoning. Methods We collected emergency call data for CO poisoning in Jinan from 2013 to 2020 and used a time-stratified case-crossover design combined with a conditional logistic regression model to evaluate the impact of the cold wave day and lag 0-8 days on CO poisoning. In addition, 10 definitions of a cold wave were considered to evaluate the impact of different temperature thresholds and durations. Results During the study period, a total of 1,387 cases of CO poisoning in Jinan used the emergency call system, and more than 85% occurred in cold months. Our findings suggest that cold waves are associated with an increased risk of CO poisoning in Jinan. When P01, P05, and P10 (P01, P05, and P10 refer to the 1st, 5th, and 10th percentiles of the lowest temperature, respectively) were used as temperature thresholds for cold waves, the most significant effects (the maximum OR value, which refers to the risk of CO poisoning on cold wave days compared to other days) were 2.53 (95% CI:1.54, 4.16), 2.06 (95% CI:1.57, 2.7), and 1.49 (95% CI:1.27, 1.74), respectively. Conclusion Cold waves are associated with an increased risk of CO poisoning, and the risk increases with lower temperature thresholds and longer cold wave durations. Cold wave warnings should be issued and corresponding protective policies should be formulated to reduce the potential risk of CO poisoning.
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Affiliation(s)
- Jinli Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo. College of Medicine, Shandong University, Jinan, China
| | - Aifeng Ren
- Jinan Medical Emergency Center, Jinan, China
| | - Yingjian Zhang
- Jinan Municipal Center for Disease Control and Prevention, Jinan Municipal Center for Disease Control and Prevention Affiliated to Shandong University, Jinan, China
| | | | - Nan Chu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo. College of Medicine, Shandong University, Jinan, China
| | - Yiwen Ma
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo. College of Medicine, Shandong University, Jinan, China
| | - Jipei Du
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo. College of Medicine, Shandong University, Jinan, China
| | - Liangliang Cui
- Jinan Municipal Center for Disease Control and Prevention, Jinan Municipal Center for Disease Control and Prevention Affiliated to Shandong University, Jinan, China
- Liangliang Cui,
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo. College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- *Correspondence: Chengchao Zhou,
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da Silva I, Wikuats CFH, Hashimoto EM, Martins LD. Effects of Environmental and Socioeconomic Inequalities on Health Outcomes: A Multi-Region Time-Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16521. [PMID: 36554402 PMCID: PMC9778807 DOI: 10.3390/ijerph192416521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The gradual increase in temperatures and changes in relative humidity, added to the aging and socioeconomic conditions of the population, may represent problems for public health, given that future projections predict even more noticeable changes in the climate and the age pyramid, which require analyses at an appropriate spatial scale. To our knowledge, an analysis of the synergic effects of several climatic and socioeconomic conditions on hospital admissions and deaths by cardiorespiratory and mental disorders has not yet been performed in Brazil. Statistical analyses were performed using public time series (1996-2015) of daily health and meteorological data from 16 metropolitan regions (in a subtropical climate zone in South America). Health data were stratified into six groups according to gender and age ranges (40-59; 60-79; and ≥80 years old) for each region. For the regression analysis, two distributions (Poisson and binomial negative) were tested with and without zero adjustments for the complete series and percentiles. Finally, the relative risks were calculated, and the effects based on exposure-response curves were evaluated and compared among regions. The negative binomial distribution fit the data best. High temperatures and low relative humidity were the most relevant risk factors for hospitalizations for cardiovascular diseases (lag = 0), while minimum temperatures were important for respiratory diseases (lag = 2 or 3 days). Temperature extremes, both high and low, were the most important risk factors for mental illnesses at lag 0. Groups with people over 60 years old presented higher risks for cardiovascular and respiratory diseases, while this was observed for the adult group (40-59 years old) in relation to mental disorders. In general, no major differences were found in the results between men and women. However, regions with higher urbanization levels presented risks, mainly for respiratory diseases, while the same was observed for cardiovascular diseases for regions with lower levels of urbanization. The Municipal Human Development Index is an important factor for the occurrence of diseases and deaths for all regions, depending on the evaluated group, representing high risks for health outcomes (the value for hospitalization for cardiovascular diseases was 1.6713 for the female adult group in the metropolitan region Palmas, and the value for hospitalization for respiratory diseases was 1.7274 for the female adult group in the metropolitan region Campo Mourão). In general, less developed regions have less access to adequate health care and better living conditions.
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Affiliation(s)
- Iara da Silva
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo 05508-090, São Paulo, Brazil
| | - Caroline Fernanda Hei Wikuats
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo 05508-090, São Paulo, Brazil
| | - Elizabeth Mie Hashimoto
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
| | - Leila Droprinchinski Martins
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
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Çağlak S. Evaluation of the Effects of Thermal Comfort Conditions on Cardiovascular Diseases in Amasya City, Turkey. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-10. [PMID: 36404930 PMCID: PMC9640900 DOI: 10.1007/s10389-022-01773-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022]
Abstract
Aim Studies fall short when it comes to determining the relationship between thermal comfort and cardiovascular diseases. Studies examining the relationship between thermal comfort conditions and human health in Turkey, located in the transition zone of air masses at mid-latitudes, are quite limited. This is the first study conducted in Turkey that deals with thermal comfort conditions and CVDs, which is the leading cause of death. This study aimed to examine the relationship between thermal comfort conditions and CVDs of Amasya, a medium-sized exemplary Turkish city. Subject and methods To determine the thermal comfort conditions in the study area between 2014-2019, the physiologically equivalent temperature (PET) index obtained from the Rayman model, which uses hourly air temperature (ºC), relative humidity (%), wind speed (m/s), and cloud cover (octa) data, was used. The relationship between PET values and CVDs was determined by Pearson correlation analysis and linear regression analysis. Results The study indicated a negative, high, and moderate correlation between PET values and cardiovascular diseases (p < 0.001). The results show that when PET values increase by 1 ºC, patient admissions will decrease by about 104 to 108 patients (-104.737 to -108.619 units.). Conclusion These results can be informative and guiding for both the protection of public health and studies on climate change and human health.
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Styler M, Singhal S, Halkidis K, Patel P, Ward KM, Jain M. The Impact of Winter Months on Venous Thromboembolism (VTE) Patients: A Retrospective Analysis of Hospital Outcomes in the United States. Cureus 2022; 14:e29091. [PMID: 36249631 PMCID: PMC9556336 DOI: 10.7759/cureus.29091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/09/2022] Open
Abstract
Objective: We aimed to analyze the Health Care Utilization Project’s (HCUP) Nationwide Inpatient Sample (NIS) and compare mortality rates in hospitals by month to determine if there is seasonal variability in outcomes associated with venous thromboembolism (VTE). Methods: The Nationwide Inpatient Sample database was queried from 1998 to 2011. Inclusion criteria were a diagnosis of deep vein thrombosis (DVT) (ICD-9 {International Classification of Diseases, Ninth Revision, Clinical Modification} 453.4, 453.8) and/or VTE (ICD-9 415.1) in patients aged 18 years or more. Admission data was then analyzed to compare mortality rates in teaching and non-teaching hospitals over that time and by month. Demographics, Charlson Comorbidity Index, length of stay (LOS), hospital region, and admission types (emergent/urgent versus elective admissions) were assessed. Linear and logistic models were generated for complex survey design to analyze predictors of mortality and LOS. Results: A total of 1,449,113 DVT/VTE cases were identified in the Nationwide Inpatient Sample (weighted n= 7,150,613), 54.7% female, 56.38% white, 49% in teaching hospitals. Higher mortality was found in the months of November 6.52%, December 6.9%, January 6.94%, and February 6.93% versus overall mortality of 6.4% over 12 months. Higher mortality was noted in these winter months in all regions, along with a significantly increased LOS. Mortality in the total cohort was found to be higher in January, with odds ratio (OR) 1.11 (1.08-1.15), p<0.0001; February, OR 1.11 (1.07-1.15), p<0.0001; and December, OR 1.10 (1.06-1.14), p<0.0001 compared to June. Mortality was significantly lower in the Midwest or North Central regions (OR 0.78 {0.72-0.83}, p<0.0001) and West (OR 0.80 {0.73-0.87}, p<0.0001) compared to the Northeast. Mortality was also significantly higher in teaching hospitals than in non-teaching hospitals (OR 1.16 {1.10-1.22}, p<0.0001), with mortality trending higher in teaching hospitals each month. Emergent/urgent admission, larger hospital size, female sex, age, and urban location were also significantly associated with increased mortality. Conclusions: This national study identified an increased risk of mortality associated with hospitalizations for DVT/VTE in the winter months, independent of hospital teaching status or region.
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Rus AA, Mornoş C. The Impact of Meteorological Factors and Air Pollutants on Acute Coronary Syndrome. Curr Cardiol Rep 2022; 24:1337-1349. [PMID: 35932446 PMCID: PMC9361940 DOI: 10.1007/s11886-022-01759-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/04/2022]
Abstract
Purpose of Review Several studies have found that air pollution and climate change can have an impact on acute coronary syndromes (ACS), the leading cause of death worldwide. We synthesized the latest information about the impact of air pollution and climate change on ACS, the latest data about the pathophysiological mechanisms of meteorological factors and atmospheric pollutants on atherosclerotic disease, and an overall image of air pollution and coronary heart disease in the context of the COVID-19 pandemic. Recent Findings The variation of meteorological factors in different seasons increased the risk of ACS. Both the increase and the decrease in apparent temperature were found to be risk factors for ACS admissions. It was also demonstrated that exposure to high concentrations of air pollutants, especially particulate matter, increased cardiovascular morbidity and mortality. Summary Climate change as well as increased emissions of air pollutants have a major impact on ACS. The industrialization era and the growing population cause a constant increase in air pollution worldwide. Thus, the number of ACS favored by air pollution and the variations in meteorological factors is expected to increase dramatically in the next few years.
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Affiliation(s)
- Andreea-Alexandra Rus
- PhD School Department, Research Centre of the Institute for Cardiovascular Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041, Timisoara, Romania.
| | - Cristian Mornoş
- Department VI Cardiology, 2nd Discipline of Cardiology, Research Centre of the Institute for Cardiovascular Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041, Timisoara, Romania
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Ni W, Schneider A, Wolf K, Zhang S, Chen K, Koenig W, Peters A, Breitner S. Short-term effects of cold spells on plasma viscosity: Results from the KORA cohort study in Augsburg, Germany. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 302:119071. [PMID: 35231540 DOI: 10.1016/j.envpol.2022.119071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/11/2022] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
As the underlying mechanisms of the adverse effects of cold spells on cardiac events are not well understood, we explored the effects of cold spells on plasma viscosity, a blood parameter linked to cardiovascular disease. This cross-sectional study involved 3622 participants from the KORA S1 Study (1984-1985), performed in Augsburg, Germany. Exposure data was obtained from the Bavarian State Office for the Environment. Cold spells were defined as two or more consecutive days with daily mean temperatures below the 3rd, 5th, or 10th percentile of the distribution. The effects of cold spells on plasma viscosity were explored by generalized additive models with distributed lag nonlinear models (DLNM). We estimated cumulative effects at lags 0-1, 0-6, 0-13, 0-20, and 0-27 days separately. Cold spells (mean temperature <3rd, <5th or <10th percentile) were significantly associated with an increase in plasma viscosity with a lag of 0-1 days [%change of geometric mean (95% confidence interval): 1.35 (0.06-2.68), 1.35 (0.06-2.68), and 2.49 (0.34-4.69), respectively], and a lag of 0-27 days [18.81 (8.97-29.54), 17.85 (8.29-28.25), and 7.41 (3.35-11.0), respectively]. For the analysis with mean temperature <3rd or 10th percentile, we also observed significant associations at lag 0-20 days [8.34 (0.43-16.88), and 4.96 (1.68, 8.35), respectively]. We found that cold spells had significant immediate and longer lagged effects on plasma viscosity. This finding supports the complex interplay of multiple mechanisms of cold on adverse cardiac events and enriches the knowledge about how cold exposure acts on the human body.
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Affiliation(s)
- Wenli Ni
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, 06520, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Wolfgang Koenig
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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Sun Q, Sun Z, Chen C, Yan M, Zhong Y, Huang Z, He L, Li T. Health risks and economic losses from cold spells in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 821:153478. [PMID: 35093380 DOI: 10.1016/j.scitotenv.2022.153478] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cold significantly increases the risk of mortality. However, the health risks associated with cold spells, persistent and extreme cold temperature events, have yet to be investigated in detail. METHODS Meteorological and mortality data was collated from 280 counties in China from 2013 through 2019. GLM (Generalized Linear Models) was used to calculate county-level exposure-response relationships for nine different cold spell definitions. Next, we estimated the exposure-response associations between cold spells and mortality in national, Southern, and Northern China. Based on exposure-response relationships, along with the population and mortality data, we then calculated the number of excess deaths due to the cold spell of 2839 counties across China in 2018. Then, we calculated the loss of VSL (value of a statistical life) in each province. RESULTS We identified that P5day7 was the cold spell definition that was associated with the highest health in China. Compared with non-cold spell days, the risk of non-accidental mortality, circulatory mortality, and respiratory mortality, on cold spell days increased by 17.4% (95% confidence interval [CI]: 15.8%, 19.0%), 20.8% (95%CI: 18.8%, 23.0%), and 22.7% (95%CI: 19.5%, 25.9%) respectively at lag 7 day in the South. In the North, the risk increased by 13.0% (95% CI: 11.0%, 15.0%), 13.8% (95% CI: 11.4%, 16.2%), and 21.0% (95% CI: 16.6%, 25.6%), respectively. The number of related deaths in China were 57,783, 29,827, and 10,922. The corresponding VSLs were 229,195, 118,322, and 43,315 million CNY (Chinese Yuan), thus accounting for 0.25%, 0.13%, and 0.05% of national GDP (Gross Domestic Product). CONCLUSION Cold spells have caused a severe epidemiological and economic burden in China. South China should pay more attention to the health risks associated with cold spells.
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Affiliation(s)
- Qinghua Sun
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiying Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yu Zhong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zihao Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lihua He
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Changes in Weather-Related Fatalities in the Czech Republic during the 1961–2020 Period. ATMOSPHERE 2022. [DOI: 10.3390/atmos13050688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Fatalities associated with severe weather, collected from newspapers and other documentary sources, were used to create a corresponding database for the 1961–2020 period for the Czech Republic. Fatalities attributed to floods, windstorms, convective storms, snow and glaze ice, frost, fog, and other severe weather, on the one hand, and vehicle accident fatalities connected with rain, snow, glaze ice, fog, and inclement weather, on the other, were analysed separately for two standard periods, 1961–1990 and 1991–2020. The number of weather-related fatalities between these two periods increased in the flood, windstorm, and especially frost categories, and decreased for the convective storm and fog categories. For snow and glaze ice they were the same. Despite significant differences in both 30-year periods, the highest proportions of fatalities corresponded to the winter months, and in individual fatality characteristics to males, adults, direct deaths, deaths by freezing or hypothermia, and to hazardous behaviour. A statistically significant (p < 0.05) Spearman rank correlation between fatalities and climate variables was only found in the 1991–2020 period for snow/glaze ice-related fatalities, with the number of days with snow cover depth and frost-related fatalities having days with daily minimum temperatures below −5 °C or −10 °C. Despite the highest proportions of the rain and wet road categories being in the number of vehicle accident fatalities, a statistically significant correlation was only found for the category of snow-related fatalities in the number of days with snowfall. The results and conclusions of this study have to be evaluated in the broader context of climatological, political, economic, and societal changes within the country, and have the potential to be used in risk management.
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Meng C, Ke F, Xiao Y, Huang S, Duan Y, Liu G, Yu S, Fu Y, Peng J, Cheng J, Yin P. Effect of Cold Spells and Their Different Definitions on Mortality in Shenzhen, China. Front Public Health 2022; 9:817079. [PMID: 35141195 PMCID: PMC8818748 DOI: 10.3389/fpubh.2021.817079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
A high premium has been put on researching the effects of cold spells because of their adverse influence on people's daily lives and health. The study aimed to find the most appropriate definition of the cold spell in Shenzhen and quantify the impact of cold spells on mortality. Based on the daily mortality data in Shenzhen from 2013 to 2017 and the meteorological and pollutant data from the same period, we quantified the effect of cold spells using eight different definitions in the framework of a distributed lag non-linear model with a quasi-Poisson distribution. In Shenzhen, low temperatures increase the risk of death more significantly than high temperatures (using the optimal temperature as the cut-off value). Comparing the quasi-Akaike information criterion value, attribution fraction (b-AF), and attribution number (b-AN) for all causes of deaths and non-accidental deaths, the optimal definition of the cold spell was defined as the threshold was 3rd percentile of the daily average temperature and duration for 3 or more consecutive days (all causes: b-AF = 2.31% [1.01–3.50%], b-AN = 650; non-accidental: b-AF = 1.92% [0.57–3.17%], b-AN = 471). For cardiovascular deaths, the best definition was the temperature threshold as the 3rd percentile of the daily average temperature with a duration of 4 consecutive days (cardiovascular: b-AF = 1.37% [0.05–2.51%], b-AN = 142). Based on the best definition in the model, mortality risk increased in cold spells, with a statistically significant lag effect occurring as early as the 4th day and the effect of a single day lasting for 6 days. The maximum cumulative effect occurred on the 14th day (all-cause: RR = 1.54 [95% CI, 1.20–1.98]; non-accidental: RR = 1.43 [95% CI, 1.11–1.84]; cardiovascular: RR = 1.58 [95% CI, 1.00–2.48]). The elderly and females were more susceptible to cold spells. Cold spells and their definitions were associated with an increased risk of death. The findings of this research provide information for establishing an early warning system, developing preventive measures, and protecting susceptible populations.
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Affiliation(s)
- Chengzhen Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Ke
- Children's Health Care Hospital, Wuhan, China
| | - Yao Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
- *Correspondence: Ji Peng
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Jinquan Cheng
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ping Yin
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Dynamic Changes and Temporal Association with Ambient Temperatures: Nonlinear Analyses of Stroke Events from a National Health Insurance Database. J Clin Med 2021; 10:jcm10215041. [PMID: 34768561 PMCID: PMC8584505 DOI: 10.3390/jcm10215041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The associations between ambient temperatures and stroke are still uncertain, although they have been widely studied. Furthermore, the impact of latitudes or climate zones on these associations is still controversial. The Tropic of Cancer passes through the middle of Taiwan and divides it into subtropical and tropical areas. Therefore, the Taiwan National Health Insurance Database can be used to study the influence of latitudes on the association between ambient temperature and stroke events. Methods: In this study, we retrieved daily stroke events from 2010 to 2015 in the New Taipei and Taipei Cities (the subtropical areas) and Kaohsiung City (the tropical area) from the National Health Insurance Research Database. Overall, 70,338 and 125,163 stroke events, including ischemic stroke and intracerebral hemorrhage, in Kaohsiung City and the Taipei Area were retrieved from the database, respectively. We also collected daily mean temperatures from the Taipei and Kaohsiung weather stations during the same period. The data were decomposed by ensemble empirical mode decomposition (EEMD) into several intrinsic mode functions (IMFs). There were consistent 6-period IMFs with intervals around 360 days in most decomposed data. Spearman’s rank correlation test showed moderate-to-strong correlations between the relevant IMFs of daily temperatures and events of stroke in both areas, which were higher in the northern area compared with those in the southern area. Conclusions: EEMD is a useful tool to demonstrate the regularity of stroke events and their associations with dynamic changes of the ambient temperature. Our results clearly demonstrate the temporal association between the ambient temperature and daily events of ischemic stroke and intracranial hemorrhage. It will contribute to planning a healthcare system for stroke seasonally. Further well-designed prospective studies are needed to elucidate the meaning of these associations.
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15
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Yamamoto S, Koh M, Matsumura K, Hamazaki K, Inadera H, Kuroda S. Impact of Low Ambient Temperature on the Occurrence of Spontaneous Intracerebral Hemorrhage-Analysis of Population-Based Stroke Registry in Toyama, Japan. J Stroke Cerebrovasc Dis 2021; 31:106156. [PMID: 34735898 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 09/25/2021] [Accepted: 10/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Although several studies have reported that some meteorological factors such as ambient temperature and atmospheric pressure, affect the incidence of spontaneous intracerebral hemorrhage (ICH), the correlation remains unclear. This retrospective time-series analysis was aimed to clarify the effects of meteorological parameters on the incidence of ICH. MATERIALS AND METHODS Data of patients with ICH were obtained from a population-based survey of acute stroke patients between April 2016 and March 2019. All days during the study period were categorized into "no ICH day" when no ICHs occurred, "single ICH day" when only one ICH occurred, and "cluster day" when two or more ICHs occurred. Meteorological data were compared for among the three categories. RESULTS 1,691 ICH patients from 19 hospitals were registered. In a total of 1,095 days, 250 were categorized as no ICH days, 361 as single ICH days, and 484 as cluster days. Daily ambient temperature declined in parallel with the daily number of ICHs, and it was a significant predictor for single ICH days and cluster days. Furthermore, the incidence of ICH in patients aged 65 years or above, men, those who emerged at home, those with modified Rankin Scale 3-5; and those with hypertension; and ICHs in the basal ganglia, brain stem, and cerebellum were more likely to be affected by low ambient temperature. CONCLUSION Daily ambient temperature was significantly associated with ICH incidence. Patients' activity, history of hypertension, and location of hemorrhage were also related to the impact of low ambient temperature on the incidence of ICH.
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Affiliation(s)
- Shusuke Yamamoto
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
| | - Masaki Koh
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
| | - Kenta Matsumura
- Toyama Regional Center for Japan Environment and Children's Study, University of Toyama, Toyama, Japan.
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Satoshi Kuroda
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.
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Association between extreme ambient temperature and onset of ischemic stroke: Time series study in Wuhan and Yichang, China. eNeurologicalSci 2021. [DOI: 10.1016/j.ensci.2021.100372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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17
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Wang M, Huang Y, Song Y, Chen J, Liu X. Study on Environmental and Lifestyle Factors for the North-South Differential of Cardiovascular Disease in China. Front Public Health 2021; 9:615152. [PMID: 34336751 PMCID: PMC8322531 DOI: 10.3389/fpubh.2021.615152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
Human death and life span are closely related to the geographical environment and regional lifestyle. These factors considerably vary among counties and regions, leading to the geographical disparity of disease. Quantitative studies on this phenomenon are insufficient. Cerebrovascular and heart diseases are the leading causes of death. The mortality rate of cerebrovascular and heart diseases is statistically higher in northern China than in southern China; the p-value of t-test for cerebrovascular and heart diseases was 0.047 and 0.000, respectively. The population attribution fraction of 12 major risk factors for cardiovascular disease (CVD) in each province was calculated based on their exposure and relative risk. The results found that residents in northern China consume high sodium-containing food, fewer vegetables, and less sea food products, and tend to be overweight. Fine particulate matter is higher in northern China than in southern China. Cold temperatures also cause a greater number of deaths than hot temperatures. All these factors have resulted in a higher CVD mortality rate in northern China. The attributive differential for sodium, vegetable, fruit, smoking, PM2.5, omega-3, obesity, low temperature, and high temperature of heart disease between the two parts of China is 9.1, 0.7, -2.5, 0.1, 1.4, 1.3, 2.0, 4.7, and -2.1%, respectively. Furthermore, the attributive differential for the above factors of cerebrovascular disease between the two parts of China is 8.7, 0.0, -5.2, 0.1, 1.0, 0.0, 2.4, 4.7, and -2.1%. Diet high in sodium is the leading cause of the north-south differential in CVD, resulting in 0.71 less years of life expectancy in northern compared with that in southern China.
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Affiliation(s)
- Mengqi Wang
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Yi Huang
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Yanxin Song
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Jianwei Chen
- School of Geographic Sciences, Nantong University, Nantong, China
| | - Xiaoxiao Liu
- School of Geographic Sciences, Nantong University, Nantong, China
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Ma C, Yang J, Nakayama SF, Iwai-Shimada M, Jung CR, Sun XL, Honda Y. Cold Spells and Cause-Specific Mortality in 47 Japanese Prefectures: A Systematic Evaluation. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:67001. [PMID: 34128690 PMCID: PMC8204943 DOI: 10.1289/ehp7109] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Many studies have investigated the devastating health effects of heat waves, but less is known about health risks related to cold spells, despite evidence that extreme cold may contribute to a larger proportion of deaths. OBJECTIVES We aimed to systematically investigate the association between cold spells and mortality in Japan. METHODS Daily data for weather conditions and 12 common causes of death during the 1972-2015 cold seasons (November-March) were obtained from 47 Japanese prefectures. Cold spells were defined as ≥2 consecutive days with daily mean temperatures ≤5th percentile for the cold season in each prefecture. Quasi-Poisson regression was combined with a distributed lag model to estimate prefecture-specific associations, and pooled associations at the national level were obtained through random-effects meta-analysis. The potential influence of cold spell characteristics (intensity, duration, and timing in season) on associations between cold spells and mortality was examined using a similar two-stage approach. Temporal trends were investigated using a meta-regression model. RESULTS A total of 18,139,498 deaths were recorded during study period. Mortality was significantly higher during cold spell days vs. other days for all selected causes of death. Mortality due to age-related physical debilitation was more strongly associated with cold spells than with other causes of death. Associations between cold spells and mortality from all causes and several more specific outcomes were stronger for longer and more intense cold spells and for cold spells earlier in the cold season. However, although all outcomes were positively associated with cold spell duration, findings for cold spell intensity and seasonal timing were heterogeneous across the outcomes. Associations between cold spells and mortality due to cerebrovascular disease, cerebral infarction, and age-related physical debility decreased in magnitude over time, whereas temporal trends were relatively flat for all-cause mortality and other outcomes. DISCUSSION Our findings may have implications for establishing tailored public health strategies to prevent avoidable cold spell-related health consequences. https://doi.org/10.1289/EHP7109.
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Affiliation(s)
- Chaochen Ma
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, Guangdong, China
| | - Shoji F. Nakayama
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Miyuki Iwai-Shimada
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Chau-Ren Jung
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Xian-Liang Sun
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Abstract
The continuously growing number of COVID-19 cases pressures healthcare services worldwide. Accurate short-term forecasting is thus vital to support country-level policy making. The strategies adopted by countries to combat the pandemic vary, generating different uncertainty levels about the actual number of cases. Accounting for the hierarchical structure of the data and accommodating extra-variability is therefore fundamental. We introduce a new modelling framework to describe the pandemic's course with great accuracy and provide short-term daily forecasts for every country in the world. We show that our model generates highly accurate forecasts up to seven days ahead and use estimated model components to cluster countries based on recent events. We introduce statistical novelty in terms of modelling the autoregressive parameter as a function of time, increasing predictive power and flexibility to adapt to each country. Our model can also be used to forecast the number of deaths, study the effects of covariates (such as lockdown policies), and generate forecasts for smaller regions within countries. Consequently, it has substantial implications for global planning and decision making. We present forecasts and make all results freely available to any country in the world through an online Shiny dashboard.
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Affiliation(s)
- Thiago de Paula Oliveira
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Rafael de Andrade Moral
- Department of Mathematics and Statistics and Hamilton Institute, Maynooth University, Maynooth, W23 F2H6, Ireland.
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Abstract
There is a significant relationship between ambient temperature and mortality. In healthy individuals with no underlying co-morbid conditions, there is an efficient heat regulation system which enables the body to effectively handle thermal stress. However, in vulnerable groups, especially in elderly over the age of 65 years, infants and individuals with co-morbid cardiovascular and/or respiratory conditions, there is a deficiency in thermoregulation. When temperatures exceed a certain limit, being cold winter spells or heat waves, there is an increase in the number of deaths. In particular, it has been shown that at temperatures above 27 °C, the daily mortality rate increases more rapidly per degree rise compared to when it drops below 27 °C. This is especially of relevance with the current emergency of global warming. Besides the direct effect of temperature rises on human health, global warming will have a negative impact on primary producers and livestock, leading to malnutrition, which will in turn lead to a myriad of health related issues. This is further exacerbated by environmental pollution. Public health measures that countries should follow should include not only health-related information strategies aiming to reduce the exposure to heat for vulnerable individuals and the community, but improved urban planning and reduction in energy consumption, among many others. This will reduce the carbon footprint and help avert global warming, thus reducing mortality.
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Affiliation(s)
- Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Malta.
| | - Kathleen England
- Department of Health Information and Research, Ministry of Health, Malta
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Malta
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Liu X, He Y, Tang C, Wei Q, Xu Z, Yi W, Pan R, Gao J, Duan J, Su H. Association between cold spells and childhood asthma in Hefei, an analysis based on different definitions and characteristics. ENVIRONMENTAL RESEARCH 2021; 195:110738. [PMID: 33485910 DOI: 10.1016/j.envres.2021.110738] [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: 11/25/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
As the global climate continues to warm, there is an increased focus on heat, but the role of low temperatures on health has been overlooked, especially for developing countries. Methods We collected the admission data of childhood asthma in 2013-2016 from Anhui Provincial Children's Hospital, as well as meteorological data from the Meteorological Bureau for the study period and collected data of pollutants from 10 monitoring stations around Hefei city. Poisson's generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was used to estimate the short-term effects of cold spell on childhood asthma in cold seasons (November to March). 16 definitions of cold spells were clearly compared, which combining 4 temperature indexes (daily minimum and mean temperature; daily minimum and mean apparent temperature), 2 temperature thresholds (2.5th and 5th) and 3 durations of at least 2-4 days. We then have an analysis of the modifying effect of characteristics of cold spells and individuals(gender and age), with a view to discovering the susceptible population to cold spell. Results There was significant association between cold spells and admission risk for childhood asthma. And the definition, in which daily minimum apparent temperature falls below 5th percentile for at least 3 consecutive days, produced the optimum model fit performance. Based on this optimal fit we found that, for the total population, the effect of cold spell lasted approximately five days (lag1-lag5), with the largest effect occurring in lag 3 (RR = 1.110; 95% CI: 1.052-1.170). In subgroup analysis, the cumulative effect of lag0-7 was higher in males and school-age children than in females and other age groups, respectively. In addition, we found that the effect of is higher as the duration increases. Conclusion This study suggests an association between cold spell and childhood asthma, and minimum AT may be a better indicator to define the cold spells. Boys and school-age children are more vulnerable to cold spell. And one of our very interesting findings is that if a cold spell lasts for several days, the impact of the cold spell on those later days is likely to be greater than that of the previous days. In conclusion, we should pay more attention to the protection of boys and school-aged children in our future public health protection and give more attention to those cold spells that last longer. Therefore, we recommend that schools and health authorities need to take targeted measures to reduce the risk of asthma in children during the cold spell.
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Affiliation(s)
- Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Bruno RR, Wernly B, Masyuk M, Muessig JM, Schiffner R, Bäz L, Schulze C, Franz M, Kelm M, Jung C. No impact of weather conditions on the outcome of intensive care unit patients. Wien Med Wochenschr 2021; 172:40-51. [PMID: 33738633 PMCID: PMC8837525 DOI: 10.1007/s10354-021-00830-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/10/2021] [Indexed: 11/30/2022]
Abstract
Global warming leads to increased exposure of humankind to meteorological variation, including short-term weather changes. Weather conditions involve changes in temperature, heat and cold, in air pressure and in air humidity. Every single condition influences the incidence and mortality of different diseases such as myocardial infarction and stroke. This study investigated the impact of weather conditions on short- and long-term mortality of 4321 critically ill patients (66 ± 14 years, 2638 men) admitted to an intensive care unit (ICU) over a period of 5 years. Meteorological information (air temperature, air pressure and humidity) for the same period was retrieved. The influence of absolute weather parameters, different seasons, sudden weather changes including "warm" and "cold" spells on ICU and long-term mortality was analyzed. After correction for Simplified Acute Physiology Score (SAPS-2), no impact of meteorological conditions on mortality was found. Different seasons, sudden weather changes, "warm spells" or "cold spells" did not affect the outcome of critically ill patients.
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Affiliation(s)
- Raphael Romano Bruno
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Bernhard Wernly
- Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.,Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Maryna Masyuk
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Johanna M Muessig
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Rene Schiffner
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Orthopedic Department, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Laura Bäz
- Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology, and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| | - Christian Schulze
- Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology, and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| | - Marcus Franz
- Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology, and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.,Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany
| | - Christian Jung
- Division of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
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23
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López-Bueno JA, Linares C, Sánchez-Guevara C, Martinez GS, Mirón IJ, Núñez-Peiró M, Valero I, Díaz J. The effect of cold waves on daily mortality in districts in Madrid considering sociodemographic variables. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:142364. [PMID: 33370923 DOI: 10.1016/j.scitotenv.2020.142364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/24/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
Abstract
While there is much research that focuses on the association between cold waves and their impacts on daily mortality at the city level, few analyze the impact related to social context and demographic variables at levels lower than the municipal. The objective of this study was to determine the role of the percentage of people over age 65, income level and percentage of homes without heating in the analysis of the impact of cold waves on daily mortality between January 1, 2010 and December 31, 2013 in different districts of the municipality of Madrid. We calculated Relative Risks (RR) and Attributable Risks (RA) for each of 17 districts to determine correlations between the effect of cold waves and daily mortality due to natural causes (CIEX: A00-R99) using Generalized Linear Models (GLM) of the Poisson family (link log). The pattern of risks obtained by district was analyzed using binomial family models (link logit), considering socioeconomic and demographic variables. In terms of results, an impact of cold on mortality was detected in 9 of the 17 districts analyzed. The analysis of risk patterns revealed that the probability of detecting an impact in a district increases in a statistically significant way (p-value <0.05) with a higher percentage of homes without heating systems and a higher percentage of population over age 65. The results obtained identify the factors that should be considered in public health policies that target the district level to reduce the impact of cold waves.
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Affiliation(s)
- J A López-Bueno
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain
| | - C Linares
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain
| | - C Sánchez-Guevara
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | | | - I J Mirón
- Consejería de Sanidad, Junta de Comunidades de Castilla- La Mancha, Spain
| | - M Núñez-Peiró
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | - I Valero
- Escuela Técnica Superior de Arquitectura, Universidad Politécnica de Madrid, Spain
| | - J Díaz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Spain.
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24
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Impact of Extreme Temperatures on Ambulance Dispatches Due to Cardiovascular Causes in North-West Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239001. [PMID: 33287148 PMCID: PMC7729967 DOI: 10.3390/ijerph17239001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022]
Abstract
Introduction and objectives. The increase in mortality and hospital admissions associated with high and low temperatures is well established. However, less is known about the influence of extreme ambient temperature conditions on cardiovascular ambulance dispatches. This study seeks to evaluate the effects of minimum and maximum daily temperatures on cardiovascular morbidity in the cities of Vigo and A Coruña in North-West Spain, using emergency medical calls during the period 2005–2017. Methods. For the purposes of analysis, we employed a quasi-Poisson time series regression model, within a distributed non-linear lag model by exposure variable and city. The relative risks of cold- and heat-related calls were estimated for each city and temperature model. Results. A total of 70,537 calls were evaluated, most of which were associated with low maximum and minimum temperatures on cold days in both cities. At maximum temperatures, significant cold-related effects were observed at lags of 3–6 days in Vigo and 5–11 days in A Coruña. At minimum temperatures, cold-related effects registered a similar pattern in both cities, with significant relative risks at lags of 4 to 12 days in A Coruña. Heat-related effects did not display a clearly significant pattern. Conclusions. An increase in cardiovascular morbidity is observed with moderately low temperatures without extremes being required to establish an effect. Public health prevention plans and warning systems should consider including moderate temperature range in the prevention of cardiovascular morbidity.
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25
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Iranpour S, Khodakarim S, Shahsavani A, Khosravi A, Etemad K. Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran. Epidemiol Health 2020; 42:e2020053. [PMID: 32777886 PMCID: PMC7871149 DOI: 10.4178/epih.e2020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/18/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). METHODS Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. RESULTS We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. CONCLUSIONS A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
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Affiliation(s)
- Sohrab Iranpour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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26
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Guo S, Niu Y, Cheng Y, Chen R, Kan J, Kan H, Li X, Li J, Cao J. Association between ambient temperature and daily emergency hospitalizations for acute coronary syndrome in Yancheng, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:3885-3891. [PMID: 31823267 DOI: 10.1007/s11356-019-07084-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
Acute coronary syndrome (ACS) is a major public health concern worldwide. Few studies have directly evaluated the associations between ambient temperature and ACS incidence. To explore the association between ambient temperature and ACS emergency hospitalizations in the area of subtropical monsoon climate, data on ACS emergency hospitalizations were collected from two highest-ranking hospitals in the central urban area of Yancheng, China, from January 1, 2013, to December 31, 2018. We applied the time-series method to investigate the potentially lagged and non-linear effects of ambient temperature on ACS using the generalized linear model combined with the distributed lag non-linear model after adjusting for time trend, day of the week, holiday, and relative humidity. We identified a total of 5303 cases of ACS emergency hospitalizations during the study period. The exposure-response curves between ambient temperature and ACS hospitalizations were inverse "J-shaped." The effects of extreme low temperature on ACS hospitalizations occurred on the present day and lasted for 3 days, followed by the harvesting effect. The effects of extreme high temperature occurred on the present day and lasted for 5 days. The cumulative relative risks of ACS were 2.14 [95% confident interval (CI): 1.32 to 3.47] for extremely low temperature and 1.66 (95% CI: 1.33 to 2.06) for extremely high temperature over the lag of 0-5 days, compared with the reference temperature (25.0 °C). Both low and high temperatures were significantly associated with higher risks of emergency hospital admissions for ACS in Yancheng, China.
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Affiliation(s)
- Shumei Guo
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Yuexin Cheng
- Department of Hematology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Julia Kan
- University of Bristol Medical School, Bristol, BS8 1QU, UK
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Xu Li
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Jiading Li
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China
| | - Jingyan Cao
- Department of Cardiology, the First People's Hospital of Yancheng, Xuzhou Medical University, Jiangsu Province, 224006, China.
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27
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Xu X, Chen Z, Huo X, Wang C, Li N, Meng X, Wang Q, Liu Q, Bi P, Li J. The effects of temperature on human mortality in a Chinese city: burden of disease calculation, attributable risk exploration, and vulnerability identification. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1319-1329. [PMID: 31240387 DOI: 10.1007/s00484-019-01746-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 06/09/2023]
Abstract
Few studies have examined the attributable fraction (AF) of temperature to mortality and Years of Life Lost (YLL), especially in developing countries. This study aims to explore the short-term effect of the cold and hot temperatures on the cause-specific YLL and mortality, discover the attributable contributions from the temperature variations, and identify the vulnerable populations in Weifang, China. Daily registered death information and meteorological data over the period 2010-2016 were obtained in Weifang, a northern Chinese city. Generalized additive Poisson and Gaussian regression models were used to assess the impacts of temperatures on both mortality and YLL, explore the AF of the temperature variations on mortality, after adjusting for other covariates. Both hot and cold temperatures have had significant negative impacts on cause-specific mortality counts and YLL, with heat presented an acute and short effect and the cold temperatures had delayed effects and lasted for several days. In terms of the attributable fraction calculations, the contributions from cold effects was higher than that of hot effects on non-accidental, cardiovascular, and respiratory deaths (YLL 10.88 vs. 1.23%, 19.58 vs. 1.71%, and 14.47 vs. 3.05%; mortality 13.97 vs. 1.65%, 19.20 vs. 1.59%, and 14.89 vs. 3.09%), respectively. The elderly and women and people with low education level were the most vulnerable. The findings will provide important scientific evidences and policy implications for developing adaptation strategies to reduce the adverse effect of cold and hot exposure in Weifang, in terms of resource allocation, healthcare workforce capacity building, and community health education, especially for the vulnerable groups.
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Affiliation(s)
- Xin Xu
- Affiliated Hospital of Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Zuosen Chen
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Xiyuan Huo
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Chunping Wang
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Ning Li
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Xianfeng Meng
- Weifang Center for Disease Control and Prevention, Weifang, 261061, Shandong Province, People's Republic of China
| | - Qiang Wang
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China
| | - Qiyong Liu
- 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, 102206, Beijing, People's Republic of China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, 5005, SA, Australia
| | - Jing Li
- School of Public Health and Management, Weifang Medical University, Weifang, 261053, Shandong Province, People's Republic of China.
- "Health Shandong" Major Social Risk Prediction and Governance Collaborative Innovation Center, Weifang, 261053, Shandong Province, People's Republic of China.
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28
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Díaz J, López-Bueno JA, Sáez M, Mirón IJ, Luna MY, Sánchez-Martínez G, Carmona R, Barceló MA, Linares C. Will there be cold-related mortality in Spain over the 2021-2050 and 2051-2100 time horizons despite the increase in temperatures as a consequence of climate change? ENVIRONMENTAL RESEARCH 2019; 176:108557. [PMID: 31265969 DOI: 10.1016/j.envres.2019.108557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/20/2019] [Accepted: 06/24/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Global warming is resulting in an increase in temperatures which is set to become more marked by the end of the century and depends on the accelerating pace of greenhouse gas emissions into the atmosphere. Yet even in this scenario, so-called "cold waves" will continue to be generated and have an impact on health. OBJECTIVES This study sought to analyse the impact of cold waves on daily mortality at a provincial level in Spain over the 2021-2050 and 2051-2100 time horizons under RCP4.5 and RCP 8.5 emission scenarios, on the basis of two hypotheses: (1) that the cold-wave definition temperature (T threshold) would not vary over time; and, (2) that there would be a variation in T threshold. MATERIAL AND METHODS The results of a retrospective study undertaken for Spain as a whole across the period 2000-2009 enabled us to ascertain the cold-wave definition temperature at a provincial level and its impact on health, measured by reference to population attributable risk (PAR). The minimum daily temperatures projected for each provincial capital considering the above time horizons and emission scenarios were provided by the State Meteorological Agency. On the basis of the T threshold definition values and minimum daily temperatures projected for each province, we calculated the expected impact of low temperatures on mortality under the above two hypotheses. Keeping the PAR values constant, it was assumed that the mortality rate would vary in accordance with the available data. RESULTS If T threshold remained constant over the above time horizons under both emission scenarios, there would be no cold-related mortality. If T threshold were assumed to vary over time, however, then cold-related mortality would not disappear: it would instead remain practically constant over time and give rise to an estimated overall figure of around 250 deaths per year, equivalent to close on a quarter of Spain's current annual cold-related mortality and entailing a cost of approximately €1000 million per year. CONCLUSION Given that cold waves are not going to disappear and that their impact on mortality is far from negligible and is likely to remain so, public health prevention measures must be implemented to minimise these effects as far as possible.
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Affiliation(s)
- J Díaz
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain.
| | - J A López-Bueno
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - M Sáez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Calle de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos, 5, Pabellón 11, Planta Baja, 28029, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health Authority (Consejería de Sanidad, Torrijos (Toledo), Spain
| | - M Y Luna
- State Meteorological Agency (Agencia Estatal de Meteorología/AEMET), Madrid, Spain
| | | | - R Carmona
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - M A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Calle de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Avda. Monforte de Lemos, 5, Pabellón 11, Planta Baja, 28029, Madrid, Spain
| | - C Linares
- (a)National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029, Madrid, Spain
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29
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Wang Y, Wang A, Zhai J, Tao H, Jiang T, Su B, Yang J, Wang G, Liu Q, Gao C, Kundzewicz ZW, Zhan M, Feng Z, Fischer T. Tens of thousands additional deaths annually in cities of China between 1.5 °C and 2.0 °C warming. Nat Commun 2019; 10:3376. [PMID: 31388009 PMCID: PMC6684802 DOI: 10.1038/s41467-019-11283-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 07/03/2019] [Indexed: 12/16/2022] Open
Abstract
The increase in surface air temperature in China has been faster than the global rate, and more high temperature spells are expected to occur in future. Here we assess the annual heat-related mortality in densely populated cities of China at 1.5 °C and 2.0 °C global warming. For this, the urban population is projected under five SSPs, and 31 GCM runs as well as temperature-mortality relation curves are applied. The annual heat-related mortality is projected to increase from 32.1 per million inhabitants annually in 1986–2005 to 48.8–67.1 per million for the 1.5 °C warming and to 59.2–81.3 per million for the 2.0 °C warming, taking improved adaptation capacity into account. Without improved adaptation capacity, heat-related mortality will increase even stronger. If all 831 million urban inhabitants in China are considered, the additional warming from 1.5 °C to 2 °C will lead to more than 27.9 thousand additional heat-related deaths, annually. Heatwaves are expected to increase under climate change, and so are the associated deaths. Here the authors determine the regional high temperature thresholds for 27 metropolises in China and analyze the changes to heat-related mortality, showing that the additional global-warming temperature increase of 0.5°C, from 1.5°C to 2.0°C, will lead to tens of thousands of additional deaths, annually.
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Affiliation(s)
- Yanjun Wang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Anqian Wang
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jianqing Zhai
- National Climate Center, China Meteorological Administration, Beijing, 100081, China
| | - Hui Tao
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China
| | - Tong Jiang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China.
| | - Buda Su
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, 830011, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, 511443, China
| | - Guojie Wang
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Chao Gao
- Faculty of Architectural, Civil Engineering and Environment, Ningbo University, Ningbo, 31511, China
| | - Zbigniew W Kundzewicz
- Institute for Disaster Risk Management /School of Geographical Science, Nanjing University of Information Science & Technology, Nanjing, 210044, China.,Institute for Agricultural and Forest Environment, Polish Academy of Sciences, Poznan, Poland
| | | | - Zhiqiang Feng
- School of Geosciences, University of Edinburgh, Edinburgh, EH8 9XP, UK
| | - Thomas Fischer
- Department of Geosciences, Eberhard Karls University, Tübingen, 72070, Germany.
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Shor E, Roelfs D. Climate shock: Moving to colder climates and immigrant mortality. Soc Sci Med 2019; 235:112397. [DOI: 10.1016/j.socscimed.2019.112397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/17/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
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Chen J, Yang J, Zhou M, Yin P, Wang B, Liu J, Chen Z, Song X, Ou CQ, Liu Q. Cold spell and mortality in 31 Chinese capital cities: Definitions, vulnerability and implications. ENVIRONMENT INTERNATIONAL 2019; 128:271-278. [PMID: 31071590 DOI: 10.1016/j.envint.2019.04.049] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 03/26/2019] [Accepted: 04/20/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND In the context of global warming, most researches have been conducted on health influences of heat waves, with limited understanding of health impacts of cold spells, especially for developing countries. METHODS We collected daily mortality and meteorological data for 31 capital cities across China during the maximum period of 2007-2013. A quasi-Poisson regression model combined with a distributed lag non-linear model was used to estimate the short-term effects of cold spells on mortality in cold seasons (November to March). 19 definitions of cold spell were clearly compared, including three definitions from the China Meteorological Administration (CMA) and 16 definitions by combining two temperature indicators (daily minimum and mean temperature), two temperature thresholds (3rd and 5th percentile) and four durations of at least 2-5 days. Then, a random effect meta-analysis was applied to pool the effect estimates at national level. Furthermore, a stratified analysis was constructed to identify the vulnerable subpopulations to cold spells. RESULTS The definition, in which daily mean temperature falls below 5th percentile for at least two consecutive days, produced the optimum model fit performance. Generally, the mortality risk increased to the maximum after 3-6 days' exposure to cold spell and then leveled off in the next 3 weeks. The pooled relative risks (RR) of non-accidental mortality for cold spells were 1.03 (95% CI: 1.01-1.05), 1.27 (1.19-1.35) and 1.55 (1.40-1.70) at lag 0, lag 0-14 and lag 0-27 days, respectively. The greatest effect estimates of cold spells were found among total respiratory diseases and COPD, with RR of 1.88 (1.65-2.11) and 1.88 (1.58-2.19), respectively. The elderly, less-educated individuals and residents in southern China were more vulnerable to cold spells. CONCLUSION There are remarkable mortality effects of cold spells, with effect estimates varying with the definition of cold spell and subpopulations. Using the official definition of cold spells may fail to capture the mortality risk associated with cold spells. These findings may facilitate the development of cold alert warning system and preventive actions to the vulnerable populations.
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Affiliation(s)
- Jinjian Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China; Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Zhaoyue Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xiuping Song
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China.
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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Benmarhnia T, Zhao X, Wang J, Macdonald M, Chen H. Evaluating the potential public health impacts of the Toronto cold weather program. ENVIRONMENT INTERNATIONAL 2019; 127:381-386. [PMID: 30954724 DOI: 10.1016/j.envint.2019.03.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/01/2019] [Accepted: 03/17/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Extreme cold weather alert programs have been implemented in some areas to address the significant health impacts of exposure to cold. One such program is the Toronto Cold Weather Program (TCWP) that was implemented in the City of Toronto since 1996 to protect the public from extreme weather conditions. In this paper, we aim to evaluate the effectiveness of the TCWP in reducing mortality and morbidity outcomes related to cold temperatures. METHODS We applied a quasi-experimental study design using the Difference-in-Differences method coupled with propensity-score-matching to determine the effect of the TCMP on daily hospitalizations and deaths due to cardiovascular disease (CVD), coronary heart disease (CHD) or cerebrovascular disease, using two complementary analytical approaches. RESULTS Overall, the analysis did not detect an impact on reduced mortality/morbidity in the City of Toronto from the TCMP. For example, we obtained a Risk Difference (RD) of -0.88 (per 1,000,000 people) (95% CI: -3.27 to 1.51) and a Risk Ratio (RR) of 0.98 (95% CI: 0.91 to 1.05) people for CVD hospitalizations. CONCLUSIONS The TCWP was not found to be effective in reducing cold related mortality and morbidity which demonstrates the importance of improving existing policies related to cold in Canada and other countries.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps, Institution of Oceanography, University of California, San Diego, CA, USA.
| | - Xu Zhao
- Public Health Ontario, Toronto, Canada
| | - John Wang
- Public Health Ontario, Toronto, Canada
| | | | - Hong Chen
- Public Health Ontario, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Sharif Nia H, Chan YH, Froelicher ES, Pahlevan Sharif S, Yaghoobzadeh A, Jafari A, Goudarzian AH, Pourkia R, Haghdoost AA, Arefinia F, Nazari R. Weather fluctuations: predictive factors in the prevalence of acute coronary syndrome. Health Promot Perspect 2019; 9:123-130. [PMID: 31249799 PMCID: PMC6588813 DOI: 10.15171/hpp.2019.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 02/10/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Meteorological parameters and seasonal changes can play an important role in the occurrence of acute coronary syndrome (ACS). However, there is almost no evidence on a national level to suggest the associations between these variables and ACS in Iran. We aim to identify the meteorological parameters and seasonal changes in relationship to ACS. Methods: This retrospective cross-sectional study was conducted between 03/19/2015 to 03/18/2016 and used documents and records of patients with ACS in Mazandaran ProvinceHeart Center, Iran. The following definitive diagnostic criteria for ACS were used: (1) existence of cardiac enzymes (CK or CK-MB) above the normal range; (2) Greater than 1 mm ST-segment elevation or depression; (3) abnormal Q waves; and (4) manifestation of troponin enzyme in the blood. Data were collected daily, such as temperature (Celsius) changes, wind speed and its direction, rainfall, daily evaporation rate; number of sunny days, and relative humidity were provided by the Meteorological Organization of Iran. Results: A sample of 2,054 patients with ACS were recruited. The results indicated the highest ACS events from March to May. Generally, wind speed (18 PM) [IRR = 1.051 (95% CI: 1.019 to1.083), P=0.001], daily evaporation [IRR = 1.039 (95% CI: 1.003 to 1.077), P=0.032], daily maximum (P<0.001) and minimum (P=0.003) relative humidity was positively correlated withACS events. Also, negatively correlated variables were daily relative humidity (18 PM) [IRR =0.985 (95% CI: 0.978 to 0.992), P<0.001], and daily minimum temperature [IRR = 0.942 (95%CI: 0.927 to 0.958), P<0.001]. Conclusion: Climate changes were found to be significantly associated with ACS; especially from cold weather to hot weather in March, April and May. Further research is needed to fully understand the specific conditions and cold exposures.
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Affiliation(s)
- Hamid Sharif Nia
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, Department of Epidemiology & Biostatistics, University of California San Francisco, California, USA
| | | | | | - Azar Jafari
- Department of Nursing, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Hossein Goudarzian
- Faculty of Nursing, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghiyeh Pourkia
- Department of Cardiology, Cardiovascular Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Farhad Arefinia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghieh Nazari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
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Budhathoki NK, Zander KK. Socio-Economic Impact of and Adaptation to Extreme Heat and Cold of Farmers in the Food Bowl of Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1578. [PMID: 31064089 PMCID: PMC6539874 DOI: 10.3390/ijerph16091578] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/16/2022]
Abstract
Farmers worldwide have to deal with increasing climate variability and weather extremes. Most of the previous research has focused on impacts on agricultural production, but little is known about the related social and economic impacts on farmers. In this study, we investigated the social and economic impact of extreme weather events (EWE) on farmers in Nepal, and explored how they coped with and adapted to heat waves and cold spells between 2012 and 2017. To address these aims, we conducted a survey of 350 farms randomly selected from the Bardiya and Banke districts of the Terai lowlands of Nepal. They were specifically asked to rate the impacts of extreme temperatures, as well as their effect on labour productivity and collective farmer health, and the detailed preventative measures they had implemented. About 84% of the farmers self-reported moderate or severe heat stress during the last five years, and about 85%, moderate or severe cold stress. Likewise, the majority of respondents reported that both farmer health and labour productivity had been compromised by EWEs. Productivity loss had a strong association with the perceived levels of heat and cold stress, which, in turn, were more likely to be reported by farmers with previous EWE experience. Potentially due to the increased care required during EWEs, those farmers with livestock reported increased heat and cold stress, as, surprisingly, did those who had implemented adaptation measures. Farmers seemed to be less prepared for potential threats of cold spells than heat waves, and therefore less likely to adopt coping strategies, since these are a recent phenomenon. This study identified some limitations. The cross sectional and self-reported data, as a common source of information to estimate health impact, level of heat/cold stress and labour productivity loss. Community-based education/community engagement programs could be developed to facilitate proactive adaptation.
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Affiliation(s)
- Nanda Kaji Budhathoki
- Northern Institute, Charles Darwin University, Ellengowan Drive, Brinkin 0909, Darwin NT, Australia.
| | - Kerstin K Zander
- Northern Institute, Charles Darwin University, Ellengowan Drive, Brinkin 0909, Darwin NT, Australia.
- German Development Institute, 53113 Bonn, Germany.
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Urban A, Hondula DM, Hanzlíková H, Kyselý J. The predictability of heat-related mortality in Prague, Czech Republic, during summer 2015-a comparison of selected thermal indices. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:535-548. [PMID: 30739159 DOI: 10.1007/s00484-019-01684-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices-Universal Thermal Climate Index and Excess Heat Factor (EHF)-were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May-September) during 1994-2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, P.O. Box 875302, Tempe, AZ, 85287-5302, USA
| | - Hana Hanzlíková
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 165 21, Prague 6, Czech Republic
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 603 00, Brno, Czech Republic
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Smirnova MD, Svirida ON, Ageev FT. Protective measures of patients with cardiovascular diseases from exposure to heat waves: medicated and non-medicated. TERAPEVT ARKH 2019; 91:101-107. [PMID: 31090380 DOI: 10.26442/00403660.2019.01.000038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In conditions of climate warming with an increase in heat waves associated with an increase in cardiovascular morbidity and mortality, the particular interest is the effect of cardiovascular drugs on adaptation to high temperatures. The review reflects the results of European and domestic studies on the safety of therapy during long and short heat waves. Recommendations for the correction of therapy during this period are given. Self-control of blood pressure (SCAD) is a mandatory component of the therapy of arterial hypertension during heat waves. With the development of clinically significant hypotension, a reduction in the dose of antihypertensive drugs is necessary. It is recommended to start with a dose reduction and/or withdrawal of diuretics and nitrates. Not recommended the complete abolition of antihypertensive therapy because of the risk of hypertensive crises, characteristic of abnormal heat, as well as due to the increase in blood pressure when the weather changes and the temperature drops. With increasing blood pressure during heat waves, it is recommended to give preference to calcium channel antagonists, angiotensin converting enzyme inhibitors (ACE inhibitors) and selective beta-blockers. It is necessary to inform patients about the additional protective effect of statins in order to increase adherence to therapy. Patients taking diuretics require individual daily monitoring of fluid intake and body weight. An overview of recommendations on sanogenic behavior during heat waves is given. Details are considered rules for the use of air conditioning, methods of diagnosis of dehydration and drinking mode Keywords: heat waves, cardiovascular complications, preventive measures.
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Affiliation(s)
- M D Smirnova
- A.L. Myasnikov Research Institute of Cardiology of National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Russia.,Institute of Economic Forecasting Russian Academy of Sciences, Moscow, Russia
| | - O N Svirida
- A.L. Myasnikov Research Institute of Cardiology of National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - F T Ageev
- A.L. Myasnikov Research Institute of Cardiology of National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Moscow, Russia
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Díaz J, Carmona R, Mirón IJ, Luna MY, Linares C. Time trends in the impact attributable to cold days in Spain: Incidence of local factors. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 655:305-312. [PMID: 30471598 DOI: 10.1016/j.scitotenv.2018.11.254] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/06/2018] [Accepted: 11/17/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND While numerous studies have shown that the impact of cold waves is decreasing as result of various processes of adaptation, far fewer have analysed the time trend shown by such impact, and still fewer have done so for the different provinces of a single country, moreover using a specific cold waves definition for each. This study thus aimed to analyse the time trend of the impact of cold days on daily mortality in Spain across the period 1983-2003. METHODS For study purposes, we used daily mortality data for all natural causes except accidents in ten Spanish provinces. The time series was divided into three subperiods. For each period and province, the value of Tthreshold was obtained via the percentile corresponding to the cold day's definition for that province obtained in previous studies. Relative Risks (RRs) and Population Attributable Fraction (PARs) were calculated using Generalised Linear Models (GLMs) with the Poisson regression link. Seasonalities, trends and autoregressive components were controlled. Global RRs and ARs were calculated with the aid of a meta-analysis with random effects for each of the periods. RESULTS The results show that the RRs for Spain as a whole were 1.12 (95% CI: 1.08 1.16) for the first period, 1.15 (95% CI: 1.09 1.22) for the second and 1.18 (95% CI: 1.10 1.26) for the third. The impact of cold days has risen slightly over time, though the differences were not statistically significant. These findings show a clearly different behaviour pattern to that previously found for heat. CONCLUSION The results obtained in this study do not show a downward trend for colds days. The complexity of the biological mechanisms involved in cold-related mortality and the lack of robust results mean that more research must be done in this particular field of public health.
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Affiliation(s)
- J Díaz
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
| | - R Carmona
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health Authority (Consejería de Sanidad), Torrijos, Toledo, Spain
| | - M Y Luna
- State Meteorological Agency (Agencia Estatal de Meteorología/AEMET), Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain
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Forty-year Seasonality Trends in Occurrence of Myocardial Infarction, Ischemic Stroke, and Hemorrhagic Stroke. Epidemiology 2018; 29:777-783. [DOI: 10.1097/ede.0000000000000892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Lin S, Lawrence WR, Lin Z, DiRienzo S, Lipton K, Dong GH, Leung R, Lauper U, Nasca P, Stuart N. Are the current thresholds, indicators, and time window for cold warning effective enough to protect cardiovascular health? THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 639:860-867. [PMID: 29929324 PMCID: PMC6021135 DOI: 10.1016/j.scitotenv.2018.05.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/07/2018] [Accepted: 05/11/2018] [Indexed: 06/08/2023]
Abstract
More extreme cold weather and larger weather variations have raised concerns regarding their effects on public health. Although prior studies assessed the effects of cold air temperature on health, especially mortality, limited studies evaluated wind chill temperatures on morbidity, and health effects under the current cold warning threshold. This study identified the thresholds, lag periods, and best indicators of extreme cold on cardiovascular disease (CVD) by comparing effects of wind chill temperatures and cold air temperatures on CVD emergency department (ED) visits in winter and winter transition months. Information was collected on 662,625 CVD ED visits from statewide hospital discharge dataset in New York State. Meteorological factors, including air temperature, wind speed, and barometric pressure were collected from National Oceanic and Atmospheric Administration. A case-crossover approach was used to assess the extreme cold-CVD relationship in winter (December-February) and transition months (November and March) after controlling for PM2.5. Conditional logistic regression models were employed to analyze the association between cold weather factors and CVD ED visits. We observed CVD effects occurred when wind chill temperatures were as high as -3.8 °C (25 °F), warmer than current wind chill warning standard (≤-28.8 °C or ≤-20 °F). Wind chill temperature was a more sensitive indicator of CVD ED visits during winter with temperatures ≤ -3.8 °C (25 °F) with delay effect (lag 6); however, air temperature was better during transition months for temperatures ≤ 7.2 °C (45 °F) at earlier lag days (1-3). Among all CVD subtypes, hypertension ED visit had the strongest negative association with both wind chill temperature and air temperature. This study recommends modifying the current cold warning temperature threshold given larger proportions of CVD cases are occurring at considerably higher temperatures than the current criteria. We also recommend issuing cold warnings in winter transitional months.
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Affiliation(s)
- Shao Lin
- Department of Environmental Health Science, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States.
| | - Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
| | - Ziqiang Lin
- Department of Environmental Health Science, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States; Department of Mathematics and Statistics, College of Arts and Sciences, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
| | - Stephen DiRienzo
- National Weather Service, National Oceanic and Atmospheric Administration, 251 Fuller Rd B-300, Albany, NY 12203, United States
| | - Kevin Lipton
- National Weather Service, National Oceanic and Atmospheric Administration, 251 Fuller Rd B-300, Albany, NY 12203, United States
| | - Guang-Hui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou, Guangdong 510080, China
| | - Ricky Leung
- Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
| | - Ursula Lauper
- Department of Environmental Health Science, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
| | - Philip Nasca
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
| | - Neil Stuart
- National Weather Service, National Oceanic and Atmospheric Administration, 251 Fuller Rd B-300, Albany, NY 12203, United States
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Liu Y, Hoppe BO, Convertino M. Threshold Evaluation of Emergency Risk Communication for Health Risks Related to Hazardous Ambient Temperature. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:2208-2221. [PMID: 29637591 DOI: 10.1111/risa.12998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/25/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
Emergency risk communication (ERC) programs that activate when the ambient temperature is expected to cross certain extreme thresholds are widely used to manage relevant public health risks. In practice, however, the effectiveness of these thresholds has rarely been examined. The goal of this study is to test if the activation criteria based on extreme temperature thresholds, both cold and heat, capture elevated health risks for all-cause and cause-specific mortality and morbidity in the Minneapolis-St. Paul Metropolitan Area. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear model is used to derive the exposure-response functions between daily maximum heat index and mortality (1998-2014) and morbidity (emergency department visits; 2007-2014). Specific causes considered include cardiovascular, respiratory, renal diseases, and diabetes. Six extreme temperature thresholds, corresponding to 1st-3rd and 97th-99th percentiles of local exposure history, are examined. All six extreme temperature thresholds capture significantly increased relative risks for all-cause mortality and morbidity. However, the cause-specific analyses reveal heterogeneity. Extreme cold thresholds capture increased mortality and morbidity risks for cardiovascular and respiratory diseases and extreme heat thresholds for renal disease. Percentile-based extreme temperature thresholds are appropriate for initiating ERC targeting the general population. Tailoring ERC by specific causes may protect some but not all individuals with health conditions exacerbated by hazardous ambient temperature exposure.
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Affiliation(s)
- Yang Liu
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Brenda O Hoppe
- Department of Health, Environmental Health Division, Minnesota, St. Paul, MN, USA
| | - Matteo Convertino
- Complexity Group, Division of Frontier Science & Media and Network Technologies, Laboratory of Information Communication Networks, Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
- Global Station for Big Data and Cybersecurity, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
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Ogbebor O, Odugbemi B, Maheswaran R, Patel K. Seasonal variation in mortality secondary to acute myocardial infarction in England and Wales: a secondary data analysis. BMJ Open 2018; 8:e019242. [PMID: 30030309 PMCID: PMC6059346 DOI: 10.1136/bmjopen-2017-019242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is a leading cause of death globally. Increase in AMI mortality during winter has also been identified in existing literature. This has been associated with low outdoor and indoor temperatures and increasing age. The relationship between AMI and other factors such as gender and socioeconomic factors varies from study to study. Influenza epidemics have also been identified as a contributory factor. OBJECTIVE This paper aims to illustrate the seasonal trend in mortality due to AMI in England and Wales with emphasis on excess winter mortality (EWM). METHODS Monthly mortality rates per 10 000 population were calculated from data provided by the UK Office for National Statistics (ONS) for 1997-2005. To quantify the seasonal variation in winter, the EWM estimates (EWM, EWM ratio, Excess Winter Mortality Index) for each year were calculated. Negative binomial regression model was used to estimate the relationship between increasing age and EWM. RESULTS The decline in mortality rate for AMI was 6.8% yearly between August 1997 and July 2005. Significant trend for reduction in AMI-associated mortality was observed over the period (p<0.001). This decline was not seen with EWM (p<0.001). 17% excess deaths were observed during winter. This amounted to about 20 000 deaths over the 8-year period. Increasing winter mortality was seen with increasing age for AMI. CONCLUSION EWM secondary to AMI does occur in England and Wales. Excess winter deaths due to AMI have remained high despite decline in overall mortality. More research is needed to identify the relationship of sex, temperature, acclimatisation, vitamin D and excess winter deaths due to AMI.
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Affiliation(s)
- Osakpolor Ogbebor
- Internal Medicine, Saint Peter’s University Hospital, New Brunswick, New Jersey, USA
| | | | | | - Kavya Patel
- Internal Medicine, Saint Peter’s University Hospital, New Brunswick, New Jersey, USA
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Manser CN, Kraus A, Frei T, Rogler G, Held L. The Impact of Cold Spells on the Incidence of Infectious Gastroenteritis and Relapse Rates of Inflammatory Bowel Disease: A Retrospective Controlled Observational Study. Inflamm Intest Dis 2018; 2:124-130. [PMID: 30018963 DOI: 10.1159/000477807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/29/2017] [Indexed: 12/20/2022] Open
Abstract
Goals We aimed to assess the impact of very cold days on inflammatory bowel disease (IBD) flares and infectious gastroenteritis (IG). We defined a cold day using the World Meteorological definition of an ice day, which is a day with a maximum temperature below 0°C. Background Recently, we have shown that heat waves increase the risk for IG and IBD flares. Study We retrospectively collected data from 738 IBD and 786 IG patients admitted to the University Hospital of Zurich between 2001 and 2005 and from 506 patients with other noninfectious chronic intestinal inflammations as controls. Climate data were received by the Swiss Federal Office for Meteorology and Climatology. Results There was no evidence for an increased risk of IBD flares (relative risk, RR = 0.99, 95% confidence interval, CI: 0.72-1.33, p = 0.94) or IG flares (RR = 1.16, 95% CI: 087-1.52, p = 0.30) on very cold days. This negative finding was confirmed in alternative formulations with lagged or cumulative (possibly lagged) effects. Conclusion In this retrospective controlled observational study, no evidence for an increase in hospital admissions due to flares of IBD and IG during cold days was observed. This may be attributed to not relevantly altered bacterial growth conditions during cold days compared to heat waves.
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Affiliation(s)
- Christine N Manser
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital, Zurich, Switzerland.,Division of Gastroenterology and Hepatology, Department of Internal Medicine, See-Spital Horgen, Horgen, Switzerland
| | - Andrea Kraus
- Department of Mathematics and Statistics, Masaryk University, Brno, Czech Republic
| | - Thomas Frei
- Environmental Research and Consulting, Arni, University of Zurich, Zurich, Switzerland
| | - Gerhard Rogler
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital, Zurich, Switzerland
| | - Leonhard Held
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Lee CC, Sheridan SC. A new approach to modeling temperature-related mortality: Non-linear autoregressive models with exogenous input. ENVIRONMENTAL RESEARCH 2018; 164:53-64. [PMID: 29482184 DOI: 10.1016/j.envres.2018.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/18/2018] [Accepted: 02/14/2018] [Indexed: 06/08/2023]
Abstract
Temperature-mortality relationships are nonlinear, time-lagged, and can vary depending on the time of year and geographic location, all of which limits the applicability of simple regression models in describing these associations. This research demonstrates the utility of an alternative method for modeling such complex relationships that has gained recent traction in other environmental fields: nonlinear autoregressive models with exogenous input (NARX models). All-cause mortality data and multiple temperature-based data sets were gathered from 41 different US cities, for the period 1975-2010, and subjected to ensemble NARX modeling. Models generally performed better in larger cities and during the winter season. Across the US, median absolute percentage errors were 10% (ranging from 4% to 15% in various cities), the average improvement in the r-squared over that of a simple persistence model was 17% (6-24%), and the hit rate for modeling spike days in mortality (>80th percentile) was 54% (34-71%). Mortality responded acutely to hot summer days, peaking at 0-2 days of lag before dropping precipitously, and there was an extended mortality response to cold winter days, peaking at 2-4 days of lag and dropping slowly and continuing for multiple weeks. Spring and autumn showed both of the aforementioned temperature-mortality relationships, but generally to a lesser magnitude than what was seen in summer or winter. When compared to distributed lag nonlinear models, NARX model output was nearly identical. These results highlight the applicability of NARX models for use in modeling complex and time-dependent relationships for various applications in epidemiology and environmental sciences.
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Affiliation(s)
- Cameron C Lee
- Kent State University; Department of Geography, 413 McGilvrey Hall, 325 S. Lincoln St., Kent, OH 44242 USA.
| | - Scott C Sheridan
- Kent State University; Department of Geography, 413 McGilvrey Hall, 325 S. Lincoln St., Kent, OH 44242 USA
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Zolotokrylin AN, Titkova TB, Bokuchava DD. The influence of weather-climatic and social factors on population mortality from circulatory diseases in Russia. TERAPEVT ARKH 2018; 90:53-59. [PMID: 30701857 DOI: 10.26442/terarkh201890353-59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIM To study the links between the standard mortality rate of the population from circulatory system diseases (CSD) with factors: weather-climatic (inter-day jumps in air temperature and atmospheric pressure by seasons and for the year) and social (average annual income per person and the number of doctors of all specialties) in Russia for the period 1995-2015. MATERIALS AND METHODS According to station data and data of reanalysis, seasonal and annual amounts of day-to-day jumps in air temperature were calculated more than the absolute value of 4° and 6°C and the atmospheric pressure more than the absolute value of 8 GPa. The links between climate variables and the mortality rate of the population, taking into account social factors, were investigated using factor analysis, including regression and variance analyses. RESULTS Annual amounts of temperature (pressure) jumps of different signs vary greatly on the territory: the maximum amounts are 3-4 times higher than the minimum ones. The geographical distribution of air temperature fluctuations differs from the distribution of atmospheric pressure fluctuations. The sum of temperature jumps in the absolute value of more than 6°C is about twice less than the sum of jumps more than 4°C, but they are characterized by similarity of geographical distribution. The sum of the jumps of temperature (pressure) is reduced during the summer is approximately two times compared to the winter. The maximum jumps are observed mainly in the Northern regions with low population density, but with high per capita income, while the minimum is observed in the South-Western parts of the European part of the country with high population density, as well as middle and low income. Global warming does not significantly affect the reduction of annual amounts of temperature (pressure) jumps. Factor analysis of social and climatic variables in the territory for each year indicates the dominance of the influence of the social factor (per capita income) on the mortality rate from CSD. CONCLUSION Factor analysis is integrated in the annual scale climatic and social variables showed a dominant effect on the coefficient of mortality from CSD, the factor of standard of living (per capita income of the population). Then the significance of the impact factors is consistently reduced: negative atmospheric pressure jumps, average seasonal pressure, health care level, positive pressure jumps. The significance of temperature variables is the smallest.
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Affiliation(s)
- A N Zolotokrylin
- Institute of Geography Russian Academy of Sciences, Moscow, Russia
| | - T B Titkova
- Institute of Geography Russian Academy of Sciences, Moscow, Russia
| | - D D Bokuchava
- Institute of Geography Russian Academy of Sciences, Moscow, Russia
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Wang C, Zhang Z, Zhou M, Wang P, Yin P, Ye W, Zhang L. Different response of human mortality to extreme temperatures (MoET) between rural and urban areas: A multi-scale study across China. Health Place 2018; 50:119-129. [PMID: 29432981 DOI: 10.1016/j.healthplace.2018.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/19/2018] [Accepted: 01/30/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The environmental variation in mortality due to extreme temperatures has been well-documented by many studies. Mortality to extreme temperatures (MoET) was recognized to vary geographically, either by countries within a region or by areas within a country. However, so far, little attention has been paid to rural residents, with even lesser attention on the potential rural-urban differences. The aim of our study was to offer a quite comprehensive analysis on the differences in temperature-mortality relationship between rural and urban areas across China. METHOD A distributed lag nonlinear model was built to describe the temperature-mortality relationship, based on the mortality data and meteorological variable of 75 communities in China from 2007 to 2012. Subsequently, a meta-analysis was applied to compare the differences in the temperature-mortality relationship between rural and urban areas at various levels. RESULTS Distinct responses regarding MoET between rural and urban areas were observed at different spatial scales. At regional level, more U-shaped curves were observed for temperature-mortality relationships in urban areas, while more J-shaped curves were observed in rural areas. At national scale, we found that the cold effect was stronger in rural areas (RR: rural 1.69 vs. urban 1.51), while heat effect was stronger in urban areas (RR: rural 1.01 vs. urban 1.12). Moreover, the modifying influence of air pollution on temperature-mortality relationship was found to be very limited. CONCLUSION The difference in response of MoET between rural and urban areas was noticeable, cold effect is more significant in China both in rural and urban areas. Additionally, urban areas in southern China and rural areas in northern China suffered more from extreme temperature events. Our findings suggest that differences in rural-urban responses to MoET should be taken seriously when intervention measures for reducing the risks to residents' health were adopted.
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Affiliation(s)
- Chenzhi Wang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
| | - Zhao Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China.
| | - Pin Wang
- Institute of Remote Sensing and Earth Sciences, Hangzhou Normal University, No.1378, Wenyi West Street, Hangzhou 311121, China.
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China.
| | - Wan Ye
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
| | - Lingyan Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
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Allen MJ, Sheridan SC. Mortality risks during extreme temperature events (ETEs) using a distributed lag non-linear model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:57-67. [PMID: 26646668 DOI: 10.1007/s00484-015-1117-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 10/21/2015] [Accepted: 11/22/2015] [Indexed: 06/05/2023]
Abstract
This study investigates the relationship between all-cause mortality and extreme temperature events (ETEs) from 1975 to 2004. For 50 U.S. locations, these heat and cold events were defined based on location-specific thresholds of daily mean apparent temperature. Heat days were defined by a 3-day mean apparent temperature greater than the 95th percentile while extreme heat days were greater than the 97.5th percentile. Similarly, calculations for cold and extreme cold days relied upon the 5th and 2.5th percentiles. A distributed lag non-linear model assessed the relationship between mortality and ETEs for a cumulative 14-day period following exposure. Subsets for season and duration effect denote the differences between early- and late-season as well as short and long ETEs. While longer-lasting heat days resulted in elevated mortality, early season events also impacted mortality outcomes. Over the course of the summer season, heat-related risk decreased, though prolonged heat days still had a greater influence on mortality. Unlike heat, cold-related risk was greatest in more southerly locations. Risk was highest for early season cold events and decreased over the course of the winter season. Statistically, short episodes of cold showed the highest relative risk, suggesting unsettled weather conditions may have some relationship to cold-related mortality. For both heat and cold, results indicate higher risk to the more extreme thresholds. Risk values provide further insight into the role of adaptation, geographical variability, and acclimatization with respect to ETEs.
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Affiliation(s)
- Michael J Allen
- Department of Political Science and Geography, Old Dominion University, 7042 Batten Arts and Letters, Norfolk, VA, 23529, USA.
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Lavados PM, Olavarría VV, Hoffmeister L. Ambient Temperature and Stroke Risk. Stroke 2018; 49:255-261. [DOI: 10.1161/strokeaha.117.017838] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Pablo M. Lavados
- From the Departamento de Neurología y Psiquiatría (P.M.L., V.V.O.) y Departamento de Paciente Crítico (V.V.O.), Unidad de Neurología Vascular, Servicio de Neurología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Chile; Departamento de Ciencias Neurológicas, Universidad de Chile, Santiago (P.M.L.); and Escuela de Salud Pública, Facultad de Ciencias, Universidad Mayor, Santiago, Chile (L.H.)
| | - Verónica V. Olavarría
- From the Departamento de Neurología y Psiquiatría (P.M.L., V.V.O.) y Departamento de Paciente Crítico (V.V.O.), Unidad de Neurología Vascular, Servicio de Neurología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Chile; Departamento de Ciencias Neurológicas, Universidad de Chile, Santiago (P.M.L.); and Escuela de Salud Pública, Facultad de Ciencias, Universidad Mayor, Santiago, Chile (L.H.)
| | - Lorena Hoffmeister
- From the Departamento de Neurología y Psiquiatría (P.M.L., V.V.O.) y Departamento de Paciente Crítico (V.V.O.), Unidad de Neurología Vascular, Servicio de Neurología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Chile; Departamento de Ciencias Neurológicas, Universidad de Chile, Santiago (P.M.L.); and Escuela de Salud Pública, Facultad de Ciencias, Universidad Mayor, Santiago, Chile (L.H.)
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Summertime, and the livin’ is easy: Winter and summer pseudoseasonal life expectancy in the United States. DEMOGRAPHIC RESEARCH 2017. [DOI: 10.4054/demres.2017.37.45] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Zeng J, Zhang X, Yang J, Bao J, Xiang H, Dear K, Liu Q, Lin S, Lawrence WR, Lin A, Huang C. Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111383. [PMID: 29135955 PMCID: PMC5708022 DOI: 10.3390/ijerph14111383] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022]
Abstract
Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease (CVD) mortality in Zhejiang Province, China. Methods: We collected data on daily meteorological and CVD mortality from 11 cities in Zhejiang Province during 2010–2013. We first applied time-series Poisson regression analysis within the framework of distributed lag non-linear models to estimate the city-specific effect of temperature and humidity on CVD mortality, after controlling for temporal trends and potential confounding variables. We then applied a multivariate meta-analytical model to pool the effect estimates in the 11 cities to generate an overall provincial estimate. The joint effects between them were calculated by the attributable fraction (AF). The analyses were further stratified by gender, age group, education level, and location of cities. Results: In total, 120,544 CVD deaths were recorded in this study. The mean values of temperature and humidity were 17.6 °C and 72.3%. The joint effect between low temperature and high humidity had the greatest impact on the CVD death burden over a lag of 0–21 days with a significant AF of 31.36% (95% eCI: 14.79–38.41%), while in a condition of low temperature and low humidity with a significant AF of 16.74% (95% eCI: 0.89, 24.44). The AFs were higher at low temperature and high humidity in different subgroups. When considering the levels of humidity, the AFs were significant at low temperature and high humidity for males, youth, those with a low level of education, and coastal area people. Conclusions: The combination of low temperature and high humidity had the greatest impact on the CVD death burden in Zhejiang Province. This evidence has important implications for developing CVD interventions.
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Affiliation(s)
- Jie Zeng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Xuehai Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 510632, China.
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430072, China.
| | - Keith Dear
- School of Public Health, University of Adelaide, Adelaide 5005, Australia.
| | - Qiyong Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Shao Lin
- School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA.
| | - Wayne R Lawrence
- School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA.
| | - Aihua Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Keshtkar A, Naddafi K, Yekaninejad MS. Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis. PeerJ 2017; 5:e3574. [PMID: 28791197 PMCID: PMC5546177 DOI: 10.7717/peerj.3574] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. RESULT After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]). CONCLUSION Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Harvard Humanitarian Initiative, Harvard University, Cambridge, United States of America
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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