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Liang C, Yuan J, Tang X, Kan H, Cai W, Chen J. The influence of humid heat on morbidity of megacity Shanghai in China. ENVIRONMENT INTERNATIONAL 2024; 183:108424. [PMID: 38219539 DOI: 10.1016/j.envint.2024.108424] [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: 08/25/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Increased attention has been paid to humid-heat extremes as they are projected to increase in both frequency and intensity. However, it remains unclear how compound extremes of heat and humidity affects morbidity when the climate is projected to continue warming in the future, in particular for a megacity with a large population. METHODS We chose the Wet-Bulb Globe Temperature (WBGT) index as the metric to characterize the humid-heat exposure. The historical associations between daily outpatient visits and daily mean WBGT was established using a Distributed Lag Non-linear Model (DLNM) during the warm season (June to September) from 2013 to 2015 in Shanghai, a prominent megacity of China. Future morbidity burden related to the combined effect of high temperature and humidity were projected under four greenhouse gases (GHGs) emission scenarios (SSP126, SSP245, SSP370 and SSP585). RESULTS The humid-heat weather was significantly associated with a higher risk of outpatient visits in Shanghai than the high-temperature conditions. Relative to the baseline period (2010-2019), the morbidity burden due to humid-heat weather was projected to increase 4.4 % (95 % confidence interval (CI): 1.1 %-10.1 %) even under the strict emission control scenario (SSP126) by 2100. Under the high-GHGs emission scenario (SSP585), this burden was projected to be 25.4 % (95 % CI: 15.8 %-38.4 %), which is 10.1 % (95 % CI: 6.5 %-15.8 %) more than that due to high-temperature weather. Our results also indicate that humid-hot nights could cause large morbidity risks under high-GHGs emission scenarios particularly in heat-sensible diseases such as the respiratory and cardiovascular disease by the end of this century. CONCLUSIONS Humid heat exposures significantly increased the all-cause morbidity risk in the megacity Shanghai, especially in humid-hot nights. Our findings suggest that the combined effect of elevated temperature and humidity is projected to have more substantial impact on health compared to high temperature alone in a warming climate.
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Affiliation(s)
- Chen Liang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China.
| | - Xu Tang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
| | - Haidong Kan
- IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenjia Cai
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing 100084, China
| | - Jianmin Chen
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology, Fudan University, Shanghai 200438, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China
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Ohashi Y, Ihara T, Oka K, Takane Y, Kikegawa Y. Machine learning analysis and risk prediction of weather-sensitive mortality related to cardiovascular disease during summer in Tokyo, Japan. Sci Rep 2023; 13:17020. [PMID: 37813975 PMCID: PMC10562479 DOI: 10.1038/s41598-023-44181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023] Open
Abstract
Climate-sensitive diseases developing from heat or cold stress threaten human health. Therefore, the future health risk induced by climate change and the aging of society need to be assessed. We developed a prediction model for mortality due to cardiovascular diseases such as myocardial infarction and cerebral infarction, which are weather or climate sensitive, using machine learning (ML) techniques. We evaluated the daily mortality of ischaemic heart disease (IHD) and cerebrovascular disease (CEV) in Tokyo and Osaka City, Japan, during summer. The significance of delayed effects of daily maximum temperature and other weather elements on mortality was previously demonstrated using a distributed lag nonlinear model. We conducted ML by a LightGBM algorithm that included specified lag days, with several temperature- and air pressure-related elements, to assess the respective mortality risks for IHD and CEV, based on training and test data for summer 2010-2019. These models were used to evaluate the effect of climate change on the risk for IHD mortality in Tokyo by applying transfer learning (TL). ML with TL predicted that the daily IHD mortality risk in Tokyo would averagely increase by 29% and 35% at the 95th and 99th percentiles, respectively, using a high-level warming-climate scenario in 2045-2055, compared to the risk simulated using ML in 2009-2019.
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Affiliation(s)
- Yukitaka Ohashi
- Faculty of Biosphere-Geosphere Science, Okayama University of Science, Kita-Ku, Okayama City, Okayama, Japan.
| | - Tomohiko Ihara
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa City, Chiba, Japan
| | - Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies (NIES), Tsukuba City, Ibaraki, Japan
| | - Yuya Takane
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba City, Ibaraki, Japan
| | - Yukihiro Kikegawa
- School of Science and Engineering, Meisei University, Hino City, Tokyo, Japan
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Rai M, Breitner S, Huber V, Zhang S, Peters A, Schneider A. Temporal variation in the association between temperature and cause-specific mortality in 15 German cities. ENVIRONMENTAL RESEARCH 2023; 229:115668. [PMID: 36958378 DOI: 10.1016/j.envres.2023.115668] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND There is limited evidence of temporal changes in the association between air temperature and the risk of cause-specific cardiovascular [CVD] and respiratory [RD] mortality. METHOD We explored temporal variations in the association between short-term exposures to air temperature and non-accidental and cause-specific CVD and RD mortality in the 15 largest German cities over 24 years (1993-2016) using time-stratified time series analysis. We applied location-specific confounder-adjusted Poisson regression with distributed lag non-linear models with a lag period of 14 days to estimate the temperature-mortality associations. We then pooled the estimates by a multivariate meta-analytical model. We analysed the whole study period and the periods 1993-2004 and 2005-16, separately. We also carried out age- and sex-stratified analysis. Cold and heat effects are reported as relative risk [RR] at the 1st and the 99th temperature percentile, relative to the 25th and the 75th percentile, respectively. RESULT We analysed a total of 3,159,292 non-accidental, 1,063,198 CVD and 183,027 RD deaths. Cold-related RR for CVD mortality was seen to rise consistently over time from 1.04 (95% confidence interval [95% CI] 1.02, 1.06) in the period 1993-2004 to 1.10 (95% CI 1.09, 1.11) in the period 2005-16. A similar increase in cold-related RR was also observed for RD mortality with risk increasing from 0.99 (95% CI 0.96, 1.03) to 1.07 (95% CI 1.03, 1.10). Cold-related ischemic, cerebrovascular, and heart failure mortality risk were seen to be increasing over time. Similarly, COPD, the commonly speculated driver of heat-related RD mortality was found to have a constant heat-related risk over time. Males were increasingly vulnerable to cold with time for all causes of death. Females showed increasing sensitivity to cold for CVD mortality. Our results indicated a significant increased cold and heat vulnerability of the youngest age-groups (<64) to non-accidental and RD mortality, respectively. Similarly, the older age group (>65) were found to have significantly increased susceptibility to cold for CVD mortality. CONCLUSION We found evidence of rising population susceptibility to both heat- and cold-related CVD and RD mortality risk from 1993 to 2016. Climate change mitigation and targeted adaptation strategies might help to reduce the number of temperature-related deaths in the future.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany.
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany
| | - Veronika Huber
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology -IBE, Pettenkofer School of Public Health LMU Munich, Munich, Germany; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich, Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Fu J, Liu Y, Zhao Y, Chen Y, Chang Z, Xu KF, Huang C, Fan Z. Association between the temperature difference and acute exacerbations of chronic obstructive pulmonary disease: A time-series analysis with 143,318 hospital admissions in Beijing, China. Front Public Health 2023; 11:1112926. [PMID: 36778544 PMCID: PMC9909227 DOI: 10.3389/fpubh.2023.1112926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Purpose Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has the adverse influence on quality of life and creates significant healthcare costs. However, there were sparse studies investigating the correlation between AECOPD hospital admissions and temperature change. Therefore, it is noteworthy to investigate the impact of various temperature differences and recognize the susceptible population. The purpose of this study was to investigate the impact of temperature differences on AECOPD hospital admissions, and to give potentially helpful material for disease preventative efforts. Methods The distributed lag non-linear model was adopted to characterize the exposure-response relationship and to assess the impact of temperature difference. The stratified analysis and sensitivity analysis were also conducted to determine the susceptible populations and examine the robustness of the results. Results There were 143,318 AECOPD hospital admissions overall during the study period. The AECOPD hospital admissions had significant association with the daily mean temperature difference (DTDmean) such as the extreme-cold temperature difference (1st DTDmean), the ultra-cold temperature difference (5th DTDmean), the ultra-hot temperature difference (95th DTDmean) and the extreme-hot temperature difference (99th DTDmean). Besides, there was the "U-shaped" association between DTDmean and 21 days cumulative relative risk of AECOPD. Conclusion The AECOPD hospital admissions was correlated with the DTDmean temperature differences, especially the extreme-cold and extreme-hot temperature difference. Moreover, people older than 65 years were more susceptible to the extreme-hot and extreme-cold temperature difference.
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Affiliation(s)
- Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanbo Liu
- Department of International Medical Services, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiong Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhenge Chang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai-Feng Xu
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Cheng Huang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China,Cheng Huang ✉
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China,*Correspondence: Zhongjie Fan ✉
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Chen K, Dubrow R, Breitner S, Wolf K, Linseisen J, Schmitz T, Heier M, von Scheidt W, Kuch B, Meisinger C, Peters A, Schneider A. Triggering of myocardial infarction by heat exposure is modified by medication intake. NATURE CARDIOVASCULAR RESEARCH 2022; 1:727-731. [PMID: 39196082 DOI: 10.1038/s44161-022-00102-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 08/29/2024]
Abstract
Acute myocardial infarction (MI) can be triggered by heat exposure, but it remains unknown whether patients taking certain cardiovascular medications have elevated vulnerability. Based on a validated and complete registration of all 2,494 MI cases in Augsburg, Germany, during warm seasons (May to September) from 2001 to 2014, here we show that heat-related non-fatal MI risk was elevated among users of anti-platelet medication and beta-receptor blockers, respectively, but not among non-users, with significant differences between users and non-users. We also found that these effect modifications were stronger among younger patients (25-59 years), who had a lower prevalence of pre-existing coronary heart disease (CHD, a potential confounder by indication), than among older patients (60-74 years), who had a higher prevalence of pre-existing CHD. Users of these medications may be more vulnerable than non-users to non-fatal MI risk due to heat exposure. Further research is needed to disentangle effect modification by medication use from effect modification by pre-existing CHD.
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Affiliation(s)
- Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Jakob Linseisen
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany
| | - Timo Schmitz
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Wolfgang von Scheidt
- Department of Internal Medicine I-Cardiology, University Hospital Augsburg, Augsburg, Germany
| | - Bernhard Kuch
- Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Nördlingen, Germany
| | - Christa Meisinger
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Augsburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Partner-Site Munich, German Research Center for Cardiovascular Research (DZHK), Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
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Rahman MM, Garcia E, Lim CC, Ghazipura M, Alam N, Palinkas LA, McConnell R, Thurston G. Temperature variability associations with cardiovascular and respiratory emergency department visits in Dhaka, Bangladesh. ENVIRONMENT INTERNATIONAL 2022; 164:107267. [PMID: 35533532 PMCID: PMC11213361 DOI: 10.1016/j.envint.2022.107267] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/30/2022] [Accepted: 04/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Greenhouse gas emissions are changing the Earth's climate, most directly by modifying temperatures and temperature variability (TV). Residents of low- and middle-income countries (LMICs) are likely more adversely affected, due to lack of air conditioning to compensate. To date, there is no local epidemiological evidence documenting the cardio-respiratory health effects of TV in Dhaka, Bangladesh, one of the most climate change vulnerable cities in the world. OBJECTIVES We assessed short-term TV associations with daily cardiovascular disease (CVD) and respiratory emergency department (ED) visits, as well as effect modification by age and season. METHODS TV was calculated from the standard deviations of the daily minimum and maximum temperatures over exposure days. Time-series regression modeling was applied to daily ED visits for respiratory and CVD from January 2014 through December 2017. TV effect sizes were estimated after controlling for long-term trends and seasonality, day-of-week, holidays, and daily mean relative humidity and ambient temperature. RESULTS A 1 °C increase in TV was associated with a 1.00% (95 %CI: 0.05%, 1.96%) increase in CVD ED visits at lag 0-1 days (TV0-1) and a 2.77% (95 %CI: 0.24%, 5.20%) increase in respiratory ED visits at lag 0-7 days (TV0-7). TV-CVD associations were larger in the monsoon and cold seasons. Respiratory ED visit associations varied by age, with older adults more affected by the TV across all seasons. A 1 °C increase in TV at lag 0-7 days (TV0-7) was associated with a 7.45% (95 %CI: 2.33%, 12.57%) increase in respiratory ED visits among patients above 50 years of age. CONCLUSION This study provided novel and important evidence that cardio-pulmonary health in Dhaka is adversely affected year-round by day-to-day increases in TV, especially among older adults. TV is a key factor that should be considered in evaluating the potential human health impacts of climate change induced temperature changes.
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Affiliation(s)
- Md Mostafijur Rahman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chris C Lim
- Department of Community, Environment, and Policy at the Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Marya Ghazipura
- New York University Langone Health, Department of Population Health, New York, NY; ZS Associates, Global Health Economics and Outcomes Research, New York, NY
| | - Nur Alam
- Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
| | - Lawrence A Palinkas
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - George Thurston
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population Health, New York University School of Medicine, New York, NY, USA
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Short-Term Effects of Apparent Temperature on Cause-Specific Mortality in the Urban Area of Thessaloniki, Greece. ATMOSPHERE 2022. [DOI: 10.3390/atmos13060852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although there is a growing interest in the association between ambient temperatures and mortality, little evidence is available for Thessaloniki, the second largest city of Greece. In this study, we present an assessment of the effects of temperature on daily mortality from 2006 to 2016 in the urban area of Thessaloniki, by describing the exposure-lag-response association between temperature and cause-specific mortality with the use of a distributed lag non-linear model (DLNM). A J-shaped relationship was found between temperature and mortality. The highest values of risk were evident for respiratory (RR > 10) and cardiovascular causes (RR > 3), probably due to the fact that health status of individuals with chronic respiratory and cardiovascular diseases rapidly deteriorates during hot periods. Cold effects had longer lags of up to 15 days, whereas heat effects were short-lived, up to 4 days. Percentage change in all- and cause-specific mortality per 1 °C change above and below Minimum Mortality Temperature showed a larger increase for all-cause mortality in heat (1.95%, 95% CI: 1.07–2.84), in contrast to a smaller increase in cold (0.54%, 95% CI: 0, 1.09). Overall, 3.51% of all-cause deaths were attributable to temperature, whereas deaths attributed to heat (2.34%) were more than deaths attributed to cold (1.34%). The findings of this study present important evidence for planning public-health interventions, to reduce the health impact of extreme temperatures.
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Frangione B, Rodríguez Villamizar LA, Lang JJ, Colman I, Lavigne E, Peters C, Anisman H, Villeneuve PJ. Short-term changes in meteorological conditions and suicide: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 207:112230. [PMID: 34688638 DOI: 10.1016/j.envres.2021.112230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Suicide is a leading cause of death, particularly for young adults. Suicidal behaviours are influenced by a wide-range of personal, social, and cultural factors. Emerging evidence suggests that daily changes in meteorological conditions, including temperature, increases the risk of suicide. METHODS We conducted a systematic review and meta-analysis of studies that examined associations between either daily, or weekly, variations for eight meteorological variables and suicide outcomes (attempts, or deaths). Meta-analytic methods were applied to derive summary measures of association using random effect models. We assessed the heterogeneity in these associations by region and biological sex. RESULTS We identified 29 studies of suicide. Of these, 26 reported associations between temperature, while fewer studies reported on rain (n = 4), solar radiation (n = 4), humidity (n = 3), sunshine (n = 3), atmospheric pressure (n = 2), wind (n = 2) and cloud cover (n = 2). The overall relative risk for suicide deaths/attempts per 1 °C increase in ambient temperature was 1.016 (95% CI: 1.013-1.019). Subgroup analysis of temperature found stronger associations with suicide when using the maximum rather than the mean daily temperature, among men, and for completed suicides relative to attempts. Regionally, the strongest associations were found in the East Asia and Pacific region. While associations were found for solar radiation and cloud coverage and suicide, we did not undertake a meta-analysis for these exposures as it was not possible to standardize measures of association across studies. Statistically significant associations were not observed for other identified meteorological variables. CONCLUSIONS Our findings suggest that daily increases in temperature increase the risk of suicide, particularly, among men and in the East Asia and Pacific region.
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Affiliation(s)
- Brianna Frangione
- Faculty of Science, Department of Health Sciences, Carleton University, K1S 5B6, Ottawa, Canada
| | | | - Justin J Lang
- Public Health Agency of Canada, Centre for Surveillance and Applied Research, K1S 5H4, Ottawa, Canada; Faculty of Science, Department of Neuroscience, Carleton University, K1S 5B6, Ottawa, Canada
| | - Ian Colman
- School of Mathematics and Statistics, Carleton University, K1S 5B6, Ottawa, Canada
| | - Eric Lavigne
- Faculty of Medicine, Department of Epidemiology and Public Health, University of Ottawa/université d'Ottawa, K1N 6N5, Ottawa, Canada; Health Canada/Santé Canada, K1A 0K9, Ottawa, Canada
| | - Cheryl Peters
- School of Epidemiology and Public Health, University of Ottawa, K1N 6N5, Ottawa, Canada; Cancer Epidemiology and Prevention Research, Alberta Health Services, T2S 3C3, Calgary, Canada
| | - Hymie Anisman
- Cumming School of Medicine, University of Calgary, T2N 4N1, Calgary, Canada
| | - Paul J Villeneuve
- Faculty of Science, Department of Neuroscience, Carleton University, K1S 5B6, Ottawa, Canada; CHAIM Research Centre, Carleton University, K1S 5B6, Ottawa, Canada.
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Mahmudimanesh M, Mirzaee M, Dehghan A, Bahrampour A. Forecasts of cardiac and respiratory mortality in Tehran, Iran, using ARIMAX and CNN-LSTM models. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:28469-28479. [PMID: 34993813 DOI: 10.1007/s11356-021-18205-8] [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: 08/03/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Cardiovascular diseases belong to the leading causes of disability and premature death worldwide, including in Iran. It is predicted that the burden of the disease in Iran in 2025 will be more than doubled compared to 2005. Therefore, many forecasting models have been used to predict disease progression, estimate mortality rates, and assess risk factors. Our study focused on two time series prediction on models: autoregressive integrated moving average with exogenous variable (ARIMAX) and Convolutional neural network-long short-term memory network (CNN-LSTM). ARIMAX (6,1,6) had the best MSE of 0.655 among time series regression models. The prediction of this model shows a significant association in lag 4 and lag 6. Nitrogen dioxide (NO2) was also significant in lag 6, while CNN-LSTM had a much better MSE of 0.21. For the time series analysis and forecasts studied in this paper, deep learning models provided more accurate results than classical methods such as ARIMAX.
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Affiliation(s)
- Marzieh Mahmudimanesh
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Azizallah Dehghan
- Noncommunicable Disease Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Abbas Bahrampour
- Department of Biostatistics and Epidemiology, Faculty of Health, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
- Griffith University, Brisbane, QLD, Australia.
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Scheerens C, Nurhussien L, Aglan A, Synn AJ, Coull BA, Koutrakis P, Rice MB. The impact of personal and outdoor temperature exposure during cold and warm seasons on lung function and respiratory symptoms in COPD. ERJ Open Res 2022; 8:00574-2021. [PMID: 35295231 PMCID: PMC8918937 DOI: 10.1183/23120541.00574-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/28/2021] [Indexed: 11/05/2022] Open
Abstract
Rationale Chronic obstructive pulmonary disease (COPD) patients often report aggravated symptoms due to heat and cold, but few studies have formally evaluated this. Methodology We followed 30 Boston-based former smokers with COPD for four non-consecutive 30-day periods over 12 months. Personal and outdoor temperature exposure were measured using portable and Boston-area outdoor stationary monitors. Participants recorded daily morning lung function measurements as well as any worsening breathing (breathlessness, chest tightness, wheeze) and bronchitis symptoms (cough, sputum colour and amount) compared to baseline. Using linear and generalised linear mixed-effects models, we assessed associations between personal and outdoor temperature exposure (1-3-day moving averages) and lung function and symptoms, adjusting for humidity, smoking pack-years and demographics. We also stratified by warm and cold season. Results Participants were on average 71.1±8.4 years old, with 54.4±30.7 pack-years of smoking. Each 5°C increase in personal temperature exposure was associated with 1.85 (95% CI 0.99-3.48) higher odds of worsening breathing symptoms. In the warm season, each 5°C increase in personal and outdoor temperature exposure was associated with 3.20 (95% CI 1.05-9.72) and 2.22 (95% CI 1.41-3.48) higher odds of worsening breathing symptoms, respectively. Each 5°C decrease in outdoor temperature was associated with 1.25 (95% CI 1.04-1.51) higher odds of worsening bronchitis symptoms. There were no associations between temperature and lung function. Conclusions Our findings suggest that higher temperature, including outdoor exposure during the warm season and personal temperature exposure year-round, may worsen dyspnoea, while colder outdoor temperature may trigger cough and phlegm symptoms among COPD patients.
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Affiliation(s)
- Charlotte Scheerens
- Division of Pulmonary, Sleep and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Dept of Public Health and Primary Care, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Lina Nurhussien
- Division of Pulmonary, Sleep and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Amro Aglan
- Division of Pulmonary, Sleep and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andrew J. Synn
- Division of Pulmonary, Sleep and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Brent A. Coull
- Dept of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Dept of Biostatistics, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Petros Koutrakis
- Dept of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mary B. Rice
- Division of Pulmonary, Sleep and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Denpetkul T, Phosri A. Daily ambient temperature and mortality in Thailand: Estimated effects, attributable risks, and effect modifications by greenness. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148373. [PMID: 34126499 DOI: 10.1016/j.scitotenv.2021.148373] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In recent years, many previous studies have examined the association between ambient temperature and mortality in different parts of the world. However, very few studies have explored the mortality burden attributable to temperature, especially those in developing countries. This study aimed to quantify the burden of mortality attributable to non-optimum temperature in Thailand and explore whether greenness, using normalized difference vegetation index (NDVI) as indicator, alleviates the mortality contributed by non-optimum ambient temperature. METHODS Daily number of mortality (i.e., all-cause, cardiovascular and respiratory diseases) and daily meteorological data were obtained over 65 provinces in Thailand during 2010 to 2017. The two-stage statistical approach was applied to estimate the association between temperature and mortality. First, the time-stratified case-crossover analysis was performed to examine province-specific temperature-mortality association. Second, province-specific association was pooled to derive national estimates using multivariate meta-regression. Mortality burden attributable to temperature was then estimated, and the association between attributed mortality and NDVI was explored using multivariate meta-regression models. RESULTS A total of 2,891,407 all-cause of death was included over the study period, in which 403,450 and 264,672 deaths were accounted for cardiovascular and respiratory diseases, respectively. The temperature-mortality association at cumulative lag 0-7 days was non-linear with J-shaped curve for all-cause and respiratory mortality, whereas V-shaped curve was observed for cardiovascular mortality. Using minimum mortality temperature (MMT) as optimum temperature, 3.72% (95% empirical CI: 2.18, 5.21) of all-cause, 2.92% (0.55, 5.10) of cardiovascular and 3.00% (0.27, 5.49) of respiratory mortality were attributable to non-optimum temperature (both hot and cold effects). Higher level of NDVI was associated with alleviated impacts of non-optimum temperature, especially hot temperature. CONCLUSION Exposure to non-optimum temperature was associated with increased risks of mortality in Thailand. This finding is useful for planning the public health interventions to reduce health effects of non-optimum ambient temperature.
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Affiliation(s)
- Thammanitchpol Denpetkul
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
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Ma P, Zhang Y, Wang X, Fan X, Chen L, Hu Q, Wang S, Li T. Effect of diurnal temperature change on cardiovascular risks differed under opposite temperature trends. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:39882-39891. [PMID: 33768454 DOI: 10.1007/s11356-021-13583-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
Temperature change between neighboring days (TCN) is an important trigger for cardiovascular diseases, but the modulated effects by seasonal temperature trends have been barely taken into account. A quantified comparison between impacts of positive TCNs (temperature rise) and negative situations (temperature drop) is also needed. We evaluated the associations of TCNs with emergency room (ER) visits for coronary heart disease (CHD) and cerebral infarction (CI) in Beijing, China, from 2008 to 2012. A year was divided into two segments dominated by opposite temperature trends, quasi-Poisson regression with distributed lag nonlinear models estimating TCN-morbidity relations were employed, separately for each period. High morbidities of CHD and CI both occurred in transitional seasons accompanied by large TCNs. Under warming backgrounds, positive TCNs increased CHD risk in patients younger than 65 years, and old people showed limited sensitivity. In the cooling periods, negative TCNs induced CHD risk in females and the elderly; the highest RR showed on lag 6 d. In particular, a same diurnal temperature decrease (e.g., - 2°C) induced greater RR (RR = 1.113, 95% CIs: 1.033-1.198) on old people during warming periods than cooling counterparts (RR = 1.055, 95% CIs: 1.011-1.100). Moreover, positive TCNs elevated CI risk regardless of background temperatures, and males were particularly vulnerable. Seasonal temperature trends modify TCN-cardiovascular morbidity associations significantly, which may provide new insights into the health impact of unstable weathers.
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Affiliation(s)
- Pan Ma
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China.
| | - Ying Zhang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Xinzi Wang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Xingang Fan
- Department of Geography and Geology, Western Kentucky University, Bowling Green, KY, 42101, USA
- College of Electronic Engineering, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Lei Chen
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Qin Hu
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Shigong Wang
- Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, College of Atmospheric Science, Chengdu University of Information Technology, Chengdu, 610225, Sichuan, China
| | - Tanshi Li
- Chinese PLA General Hospital, Beijing, 100000, China
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Jacobson LDSV, de Oliveira BFA, Schneider R, Gasparrini A, Hacon SDS. Mortality Risk from Respiratory Diseases Due to Non-Optimal Temperature among Brazilian Elderlies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115550. [PMID: 34067373 PMCID: PMC8197018 DOI: 10.3390/ijerph18115550] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/16/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022]
Abstract
Over the past decade, Brazil has experienced and continues to be impacted by extreme climate events. This study aims to evaluate the association between daily average temperature and mortality from respiratory disease among Brazilian elderlies. A daily time-series study between 2000 and 2017 in 27 Brazilian cities was conducted. Data outcomes were daily counts of deaths due to respiratory diseases in the elderly aged 60 or more. The exposure variable was the daily mean temperature from Copernicus ERA5-Land reanalysis. The association was estimated from a two-stage time series analysis method. We also calculated deaths attributable to heat and cold. The pooled exposure–response curve presented a J-shaped format. The exposure to extreme heat increased the risk of mortality by 27% (95% CI: 15–39%), while the exposure to extreme cold increased the risk of mortality by 16% (95% CI: 8–24%). The heterogeneity between cities was explained by city-specific mean temperature and temperature range. The fractions of deaths attributable to cold and heat were 4.7% (95% CI: 2.94–6.17%) and 2.8% (95% CI: 1.45–3.95%), respectively. Our results show a significant impact of non-optimal temperature on the respiratory health of elderlies living in Brazil. It may support proactive action implementation in cities that have critical temperature variations.
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Affiliation(s)
- Ludmilla da Silva Viana Jacobson
- Department of Statistics, Fluminense Federal University, Niterói 24210-201, RJ, Brazil
- Brazilian Research Network on Global Climate Change–Rede Clima, São José dos Campos 12227-010 SP, Brazil;
- Correspondence:
| | | | - Rochelle Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK; (R.S.); (A.G.)
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK
- Forecast Department, European Centre for Medium-Range Weather Forecast, Reading RG29AX, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK; (R.S.); (A.G.)
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London WC1E7HT, UK
| | - Sandra de Souza Hacon
- Brazilian Research Network on Global Climate Change–Rede Clima, São José dos Campos 12227-010 SP, Brazil;
- Nacional School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, RJ, Brazil;
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The effect of air temperature on hospital admission of adults with community acquired pneumonia in Baotou, China. Sci Rep 2021; 11:9353. [PMID: 33931697 PMCID: PMC8087821 DOI: 10.1038/s41598-021-88783-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 04/12/2021] [Indexed: 11/08/2022] Open
Abstract
The relationship between air temperature and the hospital admission of adult patients with community-acquired pneumonia (CAP) was analyzed. The hospitalization data pertaining to adult CAP patients (age ≥ 18 years) in two tertiary comprehensive hospitals in Baotou, Inner Mongolia Autonomous Region, China from 2014 to 2018 and meteorological data there in the corresponding period were collected. The exposure-response relationship between the daily average temperature and the hospital admission of adult CAP patients was quantified by using a distributed lag non-linear model. A total of 4466 cases of adult patients with CAP were admitted. After eliminating some confounding factors such as relative humidity, wind speed, air pressure, long-term trend, and seasonal trend, a lower temperature was found to be associated with a higher risk of adult CAP. Compared to 21 °C, lower temperature range of 4 to -12 °C was associated with a greater number of CAP hospitalizations among those aged ≥ 65 years, and the highest relative risk (RR) was 2.80 (95% CI 1.15-6.80) at a temperature of - 10 °C. For those < 65 years, lower temperature was not related to CAP hospitalizations. Cumulative lag RRs of low temperature with CAP hospitalizations indicate that the risk associated with colder temperatures appeared at a lag of 0-7 days. For those ≥ 65 years, the cumulative RR of CAP hospitalizations over lagging days 0-5 was 1.89 (95% CI 1.01-3. 56). In brief, the lower temperature had age-specific effects on CAP hospitalizations in Baotou, China, especially among those aged ≥ 65 years.
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Ma Y, Zhou L, Chen K. Burden of cause-specific mortality attributable to heat and cold: A multicity time-series study in Jiangsu Province, China. ENVIRONMENT INTERNATIONAL 2020; 144:105994. [PMID: 32745780 DOI: 10.1016/j.envint.2020.105994] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/12/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Previous epidemiological studies primarily examined the temperature-related mortality burden of all-cause or cardiovascular diseases (CVD) and respiratory diseases. However, evidence on the heat- and cold-attributable mortality burden from other specific causes is limited. This paper aimed to systematically examine the association of heat and cold with a comprehensive spectrum of plausible temperature-related diseases, and to estimate the mortality burdens attributable to heat and cold. In the time-series study of 11 cities in Jiangsu, China, distributed lag non-linear models were applied to estimate city-specific temperature-mortality associations, and then meta-analysis was conducted to pool the estimates. A total of 1,368,648 cases of death were included in this study. Both extreme heat and cold were associated with increased mortality risks from all-cause, CVD, respiratory diseases, nervous diseases, and external causes. Short-term exposures to heat and cold were associated with excess burden of mortality for several specific diseases, accounting for 16.38% (95% eCI, 7.27-22.31%) for myocardial infarction (MI), 12.41% (95% eCI, 8.81-15.07%) for stroke, 27.97% (95% eCI, 18.42-33.35%) for hypertensive heart disease, 25.18% (95% eCI, 18.42-29.63%) for chronic obstructive pulmonary disease, and 28.46% (95% eCI: 4.93-33.57%) for Alzheimer's and dementia. Diabetes was only associated with extreme heat, with 4.61% (95% eCI, 0.13-7.13%) of diabetes mortality attributable to heat. In total, 11.98% (95% eCI, 10.46-13.08%) of mortality was attributable to heat and cold, with 3.49% (95% eCI, 2.87-4.00%) attributable to heat and 8.48% (95% eCI, 7.31-9.49%) attributable to cold, and about 64% of this overall temperature-related mortality burden was found in 6 aforementioned specific causes and about 10% of mortality burden in external causes. Extreme heat and/or cold are associated with increased risks of mortality from a wide range of causes, including previously identified causes in cardiorespiratory diseases and under-studied causes such as diabetes and Alzheimer's and dementia. Future research is needed to confirm the substantial mortality burden of heat and cold.
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Affiliation(s)
- Yiqun Ma
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Lian Zhou
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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16
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Ma Y, Jiao H, Zhang Y, Feng F, Cheng B, Ma B, Yu Z. Short-term effect of extreme air temperature on hospital emergency room visits for cardiovascular diseases from 2009 to 2012 in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:38029-38037. [PMID: 32621192 DOI: 10.1007/s11356-020-09814-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
Extreme air temperature directly affected human health. However, the short-term effect of extreme air temperature on the incidence of cardiovascular diseases has rarely been reported in China. In this study, we focused on Beijing, China, and assessed the effects of cold/warm days and nights on the number of hospital emergency room (ER) visits for cardiovascular diseases from 2009 to 2012. We used a generalized additive model (GAM) to estimate the association between extreme air temperature and the number of hospital ER visits for cardiovascular diseases. We divided the entire study group into two gender subgroups and three age subgroups. The results showed that the short-term effect of extreme air temperature on hospital ER visits for cardiovascular diseases was more profound in females and the elderly (aged ≥ 75 years). Among all the study subgroups, the highest relative risk (RR) of cardiovascular diseases associated with extremely cold days, warm days, cold nights, and warm nights was 3.0% (95% CI, 1.6%-4.4%), 0.8% (95% CI, - 0.9%-2.6%), 2.8% (95% CI, 1.6%-4.2%), and 1.8% (95% CI, 0.6%-4.3%), respectively. Overall, the effect of extremely low air temperature (during both days and nights) on the incidence of cardiovascular diseases was stronger and more acute than that of extremely high air temperature.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bingji Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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Chen K, Breitner S, Wolf K, Rai M, Meisinger C, Heier M, Kuch B, Peters A, Schneider A. Projection of Temperature-Related Myocardial Infarction in Augsburg, Germany: Moving on From the Paris Agreement on Climate Change. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:521-527. [PMID: 31554538 DOI: 10.3238/arztebl.2019.0521] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Substantial efforts are required to limit global warming to under 2 °C, with 1.5 °C as the target (Paris Agreement goal). We set out to project future temperature-related myocardial infarction (MI) events in Augsburg, Germany, at increases in warming of 1.5 °C, 2 °C, and 3 °C. METHODS Using daily time series of MI cases and temperature projections under two climate scenarios, we projected changes in temperature-related MIs at different increases in warming, assuming no changes in population structure or level of adaptation. RESULTS In a low-emission scenario that limits warming to below 2 °C throughout the 21st century, temperature-related MI cases will decrease slightly by -6 (confidence interval -60; 50) per decade at 1.5 °C of warming. In a high-emission scenario going beyond the Paris Agreement goals, temperature-related MI cases will increase by 18 (-64; 117) and 63 (-83; 257) per decade with warming of 2 °C and 3 °C, respectively. CONCLUSION The future burden of temperature-related MI events in Augsburg at 2 °C and 3 °C of warming will be greater than at 1.5 °C. Fulfilling the Paris Agreement goal of limiting global warming to no more than 1.5 °C is therefore essential to avoid additional MI events due to climate change.
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Affiliation(s)
- Kai Chen
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Munich; Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich; Ludwig-Maximilians-Universität München, Chair of Epidemiology at UNIKA-T, University of Augsburg; Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Munich; MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg; KORA Study Center, University Hospital of Augsburg; Department of Internal Medicine I - Cardiology, University Hospital of Augsburg; Department of Internal Medicine/Cardiology, Nördlingen Hospital, Nördlingen; German Research Center for Cardiovascular Research (DZHK), Partner-Site Munich; The KORA-Study Group consists of A. Peters (spokesperson), H. Schulz, L. Schwettmann, R. Leidl, M. Heier, K. Strauch, and their co-workers, who are responsible for the design and conduct of the KORA studies
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18
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Tyler CJ, Lambert R, Kumar A, Stroud MA, Cheung SSS. Single-digit cold-induced vasodilation adaptations during an Antarctic expedition. Polar Biol 2020. [DOI: 10.1007/s00300-020-02659-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AbstractAn increasing number of people are spending time in Polar Regions for work and tourism and this can increase the risk of tissue injuries, e.g. frostbite. The risk would be reduced if beneficial peripheral blood flow adaptions occurred but data regarding the trainability of the cold-induced vasodilation (CIVD) response are equivocal. Five healthy males spent almost 8 months in Antarctica; five of them at a semi-permanent camp (− 44 °C; 2752 m). CIVD tests (30 min index finger immersion into 0 °C water) were performed on the 12th, 39–40th, 67–68th, 179th and 234th days of the expedition in a climate-controlled caboose. Heart rate (HR), thermal sensation of the finger, pain sensation, and mean arterial pressure (MAP) were recorded. Minimum, maximum, and mean finger temperature were greater, onset time was earlier (r = 0.34), and amplitude was greater (r = 0.55) on day 234 than day 12 suggesting that adaptation occurred. Time-point data suggested that the adaptations were progressive. Cardiovascular and perceptual data also showed some adaptation. MAP was lower on day 234 than day 12 (r = 0.47 and r = 0.47) but mean HR was higher (r = 0.55). Mean and peak thermal sensation (r = 0.31–0.59; r = 0.31) and perceived pain (r = 0.58; r = 0.36) both improved over the course of the expedition. Of interest to Polar Region visitors, beneficial peripheral and perceptual adaptations to prolonged Antarctic exposure can occur with 2 h of daily outdoor exposure although the rates at which adaptation occurs differ.
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Wang X, Jiang Y, Bai Y, Pan C, Wang R, He M, Zhu J. Association Between Air Temperature and the Incidence of Acute Coronary Heart Disease in Northeast China. Clin Interv Aging 2020; 15:47-52. [PMID: 32021132 PMCID: PMC6970246 DOI: 10.2147/cia.s235941] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/28/2019] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of this study was to examine the association between air temperature and incidence of acute coronary heart disease in Northeast China. Methods We obtained coronary heart disease (CHD) daily hospitalization data from January 2017 to June 2019, and collected meteorological data including average daily air temperature, air pressure, relative humidity, wind velocity, sunshine duration and water vapor pressure, for the same period. Totally, This study included data from 6775 patients with CHD. Results After adjusting for confounding factors, low air temperature was inversely associated with CHD. Additionally, in the warm season (April–September), the number of daily hospital admissions for CHD was higher (≥24.2°C) if the average daily air temperature was low (≤15.4°C). Conclusion Low air temperature might be a risk factor for CHD among the elderly, especially in the warm season.
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Affiliation(s)
- Xue Wang
- Institute of Environmental and Health, School of Public Health China Medical University, Shenyang, People's Republic of China
| | - Yizeng Jiang
- Department of Emergency, Horqin District First People's Hospital of Tongliao, Tongliao, People's Republic of China
| | - Yingzhe Bai
- Department of Air Detection Information Technology Support Center, Tongliao Meteorological Observation, Tongliao, People's Republic of China
| | - Chao Pan
- Department of Emergency, Horqin District First People's Hospital of Tongliao, Tongliao, People's Republic of China
| | - Renzi Wang
- Department of Clinical Medicine, Air Force Medical University, Xian, People's Republic of China
| | - Miao He
- Institute of Environmental and Health, School of Public Health China Medical University, Shenyang, People's Republic of China
| | - Jinghai Zhu
- Institute of Environmental and Health, School of Public Health China Medical University, Shenyang, People's Republic of China
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Lee JY, Kim H, Gasparrini A, Armstrong B, Bell ML, Sera F, Lavigne E, Abrutzky R, Tong S, Coelho MDSZS, Saldiva PHN, Correa PM, Ortega NV, Kan H, Garcia SO, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola JJK, Ryti NRI, Pascal M, Goodman PG, Zeka A, Michelozzi P, Scortichini M, Hashizume M, Honda Y, Hurtado M, Cruz J, Seposo X, Nunes B, Teixeira JP, Tobias A, Íñiguez C, Forsberg B, Åström C, Vicedo-Cabrera AM, Ragettli MS, Guo YLL, Chen BY, Zanobetti A, Schwartz J, Dang TN, Do Van D, Mayvaneh F, Overcenco A, Li S, Guo Y. Predicted temperature-increase-induced global health burden and its regional variability. ENVIRONMENT INTERNATIONAL 2019; 131:105027. [PMID: 31351381 DOI: 10.1016/j.envint.2019.105027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
An increase in the global health burden of temperature was projected for 459 locations in 28 countries worldwide under four representative concentration pathway scenarios until 2099. We determined that the amount of temperature increase for each 100 ppm increase in global CO2 concentrations is nearly constant, regardless of climate scenarios. The overall average temperature increase during 2010-2099 is largest in Canada (1.16 °C/100 ppm) and Finland (1.14 °C/100 ppm), while it is smallest in Ireland (0.62 °C/100 ppm) and Argentina (0.63 °C/100 ppm). In addition, for each 1 °C temperature increase, the amount of excess mortality is increased largely in tropical countries such as Vietnam (10.34%p/°C) and the Philippines (8.18%p/°C), while it is decreased in Ireland (-0.92%p/°C) and Australia (-0.32%p/°C). To understand the regional variability in temperature increase and mortality, we performed a regression-based modeling. We observed that the projected temperature increase is highly correlated with daily temperature range at the location and vulnerability to temperature increase is affected by health expenditure, and proportions of obese and elderly population.
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Affiliation(s)
- Jae Young Lee
- Graduate School of Public Health, Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Armstrong
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Francesco Sera
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, ON, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Rosana Abrutzky
- Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina
| | - Shilu Tong
- School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Shanghai Children's Medical Centre, Shanghi Jiao-Tong University, Shanghai, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Micheline de Sousa Zanotti Stagliorio Coelho
- Institute of Advanced Studies of the University of São Paulo, São Paulo, Brazil; Climate Change Cluster, Faculty of Sciences, University of Technology-Sydney, Sydney, Australia
| | | | | | | | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | | | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ene Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Niilo R I Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, French National Public Health Agency, Saint Maurice, France
| | | | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London, London, UK
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Masahiro Hashizume
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Science, University of Tsukuba, Tsukuba, Japan
| | - Magali Hurtado
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Julio Cruz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Xerxes Seposo
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
| | - João Paulo Teixeira
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, University of Valencia, Environmental Health Joint Research Unit FiSABIO-UV-UJI CIBERESP, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ana Maria Vicedo-Cabrera
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, National Taiwan University, NTU Hospital, Taipei, Taiwan
| | - Bing-Yu Chen
- Environmental and Occupational Medicine, National Taiwan University, NTU Hospital, Taipei, Taiwan
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tran Ngoc Dang
- Faculty of Public Health, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Viet Nam; The Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam
| | - Dung Do Van
- Faculty of Public Health, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Fetemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Ala Overcenco
- Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health of R. Moldova, Chisinau, Republic of Moldova
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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21
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Urbanization Effects on Human-Perceived Temperature Changes in the North China Plain. SUSTAINABILITY 2019. [DOI: 10.3390/su11123413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Urbanization and associated land use changes significantly alter the energy and radiation balance, land surface characteristics, and regional climates, posing challenges to natural ecosystems and human society. The combined effects of changes in air temperature (T), relative humidity (RH), and wind speed (WS) profoundly influence human-perceived temperature and the corresponding human thermal comfort, especially in urban areas with large population. This study analyzes the spatiotemporal changes in human-perceived temperatures in the North China Plain, represented by heat index (HI) in summer and wind chill temperature (WCT) in winter, and quantifies the effects of urbanization on temperature changes, based on the observational data of 56 meteorological stations during 1976–2016. The results show a significant warming trend, with human-perceived temperatures increasing faster than T. The warming trend in WCT is higher than that in HI, indicating more thermal discomfort in summer and more thermal comfort in winter. However, the warming trend moderately slows after 1996, partly due to the global surface warming hiatus. Urban areas experience stronger warming trends than non-urban areas, demonstrating the notable effects of urbanization. For the entire study area, urbanization and associated urban land expansion accelerate the increase in HI by 26% and the increase in WCT by 17%.
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Luo Q, Li S, Guo Y, Han X, Jaakkola JJK. A systematic review and meta-analysis of the association between daily mean temperature and mortality in China. ENVIRONMENTAL RESEARCH 2019; 173:281-299. [PMID: 30928859 DOI: 10.1016/j.envres.2019.03.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/17/2019] [Indexed: 05/15/2023]
Abstract
PURPOSE We summarized the evidence on the effects of heat and cold exposures on mortality in China. We included studies published on this topic in both Chinese and English, thereby filling a gap in knowledge using data from a country that consists of one-fifth of the world's population. METHODS We conducted a systematic search of peer-reviewed studies on the association between daily mean temperature and mortality published from 2001 up to July 2018. We searched one Chinese database (China National Knowledge infrastructure, http://www.cnki.net) and three English databases (PubMed, Scopus, Web of Science). We converted the effect estimates of heat/cold to rate ratios (RRs) associated with 1° increase/decrease beyond the heat/cold reference temperatures. For studies that provided lag-specific estimates, we used both the maximum and minimum of RR estimates. We calculated summary effect estimates for all-cause and cause-specific mortalities, as well as RRs stratified by sex, age, and socioeconomic status. We also investigated patterns of heat and cold adaptation at different latitudes, and at different reference temperatures. RESULTS In total, 45 articles were included in this systematic review. For every 1° temperature increase/decrease beyond reference points, the rate of non-accidental mortality increased by 2% (RR, 1.02; 95% confidence interval (95% CI [1.01-1.02]) for heat and 4% (RR, 1.04; 95% CI [1.03-1.04]) for cold, respectively; the rate of cardiovascular mortality increased 3% (RR, 1.03; 95% CI [1.03-1.04]) for heat and 6% (RR, 1.06; 95% CI [1.04-1.07]) for cold; the rate of respiratory mortality increased 2% (RR, 1.02; 95% CI [1.01-1.03]) for heat and 2% (RR, 1.02; 95% CI [1.00-1.04]) for cold; the rate of cerebrovascular mortality increased 2% (RR, 1.02; 95% CI [1.02-1.03]) for heat and 3% (RR, 1.03; 95% CI [1.02-1.04]) for cold. We identified a variation in optimal temperature range related to latitude of the residential area, and differences in people's capability to adapt to heat versus cold. CONCLUSION We found consistent evidence of the association between temperature and mortality, as well as evidence of patterns in human adaptation, and we discussed the implications of our findings.
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Affiliation(s)
- Qianlai Luo
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Shanshan Li
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Yuming Guo
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Xuemei Han
- NatureServe, 4600 North Fairfax Drive, Arlington, Virginia, 22203, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
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23
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Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. ENVIRONMENTAL RESEARCH 2019; 171:80-91. [PMID: 30660921 DOI: 10.1016/j.envres.2019.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 05/13/2023]
Abstract
Heat waves and high air temperature are associated with increased morbidity and mortality. However, the majority of research conducted on this topic is focused on high income areas of the world. Although heat waves have the most severe impacts on vulnerable populations, relatively few studies have studied their impacts in low and middle income countries (LMICs). The aim of this paper is to review the existing evidence in the literature on the impact of heat on human health in LMICs. We identified peer-reviewed epidemiologic studies published in English between January 1980 and August 2018 investigating potential associations between high ambient temperature or heat waves and mortality or morbidity. We selected studies according to the following criteria: quantitative studies that used primary and/or secondary data and report effect estimates where ambient temperature or heat waves are the main exposure of interest in relation to human morbidity or mortality within LMICs. Of the total 146 studies selected, eighty-two were conducted in China, nine in other countries of East Asia and the Pacific, twelve in South Asia, ten in Sub-Saharan Africa, eight in the Middle East and North Africa, and seven in each of Latin America and Europe. The majority of studies (92.9%) found positive associations between heat and human morbidity/mortality. Additionally, while outcome variables and study design differed greatly, most utilized a time-series study design and examined overall heath related morbidity/mortality impacts in an entire population, although it is notable that the selected studies generally found that the elderly, women, and individuals within the low socioeconomic brackets were the most vulnerable to the effects of high temperature. By highlighting the existing evidence on the impact of extreme heat on health in LMICs, we hope to determine data needs and help direct future studies in addressing this knowledge gap. The focus on LMICs is justified by the lack of studies and data studying the health burden of higher temperatures in these regions even though LMICs have a lower capacity to adapt to high temperatures and thus an increased risk.
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Affiliation(s)
- Hunter Green
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA
| | - Jennifer Bailey
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jennifer Vanos
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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24
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Lin YK, Maharani AT, Chang FT, Wang YC. Mortality and morbidity associated with ambient temperatures in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 651:210-217. [PMID: 30227291 DOI: 10.1016/j.scitotenv.2018.09.161] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 05/03/2023]
Abstract
BACKGROUND This study evaluated integrated risks of all-cause mortality, emergency room visits (ERVs), and outpatient visits associated with ambient temperature in all cities and counties of Taiwan. In addition, the modifying effects of socio-economic and environmental factors on temperature-health associations were also evaluated. METHODS A distributed lag non-linear model was applied to estimate the cumulative relative risks (RRs) with confidence intervals of all-cause mortality, ERVs, and outpatient visits associated with extreme temperature events. Random-effect meta-analysis was used to estimate the pooled RR of all-cause mortality, ERVs, and outpatient visits influenced by socio-economic and environmental factors. RESULTS Temperature-related risks varied with study area and health outcome. Meta-analysis showed greater all-cause mortality risk occurred in low temperatures than in high temperatures. Integrated RR of all-cause mortality was 1.71 (95% confidence interval [CI]:1.43-2.04) in the 5th percentile temperature and 1.10 (95% CI: 1.05-1.15) in the 95th percentile temperature, while the lowest mortality risk was in the 60th percentile temperature (22.2 °C). Risk for ERVs increased when temperature increased (RR was 1.21 [95% CI: 1.17-1.26] in 95th percentile temperature), but risk of outpatient visits increased at low temperatures (RR was 1.06 [95% CI: 1.01-1.12] in the 5th percentile temperature). Certain socio-economic factors significantly modified low-temperature-related mortality risks, including number of employed populations, elders living alone from lower-income families, and public and medical services. CONCLUSIONS This study found that mortality and outpatient visits were higher at low temperature, while ERVs risk was higher at high temperature. Future plans for public health and emerging medical services responding to extreme temperatures should consider regional and integrated evaluations of temperature-related health risks and modifying factors.
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Affiliation(s)
- Yu-Kai Lin
- Department of Health and Welfare, University of Taipei, College of City Management, 101, Sec. 2, Zhongcheng Road, Taipei 111, Taiwan
| | - Aussie Tahta Maharani
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Fang-Tzu Chang
- Department of Health and Welfare, University of Taipei, College of City Management, 101, Sec. 2, Zhongcheng Road, Taipei 111, Taiwan; Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan.
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Sohn S, Cho W, Kim JA, Altaluoni A, Hong K, Chun BC. 'Pneumonia Weather': Short-term Effects of Meteorological Factors on Emergency Room Visits Due to Pneumonia in Seoul, Korea. J Prev Med Public Health 2019; 52:82-91. [PMID: 30971074 PMCID: PMC6459762 DOI: 10.3961/jpmph.18.232] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/31/2018] [Indexed: 12/21/2022] Open
Abstract
Objectives Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea. Methods Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups. Results A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a 1°C increase in pneumonia temperature above the threshold of 6°C was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed. Conclusions The term ‘pneumonia temperature’ is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.
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Affiliation(s)
- Sangho Sohn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Wonju Cho
- Korea University Graduate School of Public Health, Seoul, Korea
| | - Jin A Kim
- Korea University Graduate School of Public Health, Seoul, Korea
| | - Alaa Altaluoni
- Korea University Graduate School of Public Health, Seoul, Korea
| | - Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Li W, Pei L, Li A, Luo K, Cao Y, Li R, Xu Q. Spatial variation in the effects of air pollution on cardiovascular mortality in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2501-2511. [PMID: 30471063 DOI: 10.1007/s11356-018-3725-0] [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: 03/10/2018] [Accepted: 11/09/2018] [Indexed: 05/22/2023]
Abstract
Due to lack of data from multiple air quality monitoring stations, studies about spatial association between concentrations of ambient pollutants and mortality in China are rare. To investigate the spatial variation of association between concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM10) and nitrogen dioxide (NO2) and cardiovascular mortality in Beijing, China, we collected data including daily deaths, concentrations of PM10 and NO2, and meteorological factors from January 1, 2009, to December 31, 2010, in all 16 districts of Beijing. Generalized additive model (GAM) and generalized additive mixed model (GAMM) were used to examine the citywide and district-specific effects of PM10 and NO2 on cardiovascular mortality. The citywide effect derived from GAMM was lower than that derived from GAM and the strongest effects were identified for 2-day moving average lag 0-1. For every 10 μg/m3 increases in concentrations of PM10 and NO2, the corresponding daily cardiovascular mortality increases in 0.31% (95%CI 0.15%, 0.46%) and 1.63% (95%CI 1.11%, 2.13%), respectively. The death risk associated with air pollutants varied across different geographic districts in Beijing. We found spatially varied adverse effects of air pollution on cardiovascular deaths in Beijing. But there was insufficient evidence to show the significant spatial heterogeneity in mortality effects of PM10 and NO2 in this study.
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Affiliation(s)
- Wenjing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Lu Pei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Kai Luo
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 85, Örebro, Sweden
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17 177, Stockholm, Sweden
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Science, Beijing, 100101, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.
- Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China.
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27
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Li Y, Wang XL, Zheng X. Impact of weather factors on influenza hospitalization across different age groups in subtropical Hong Kong. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:1615-1624. [PMID: 29804235 DOI: 10.1007/s00484-018-1561-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 04/18/2018] [Accepted: 05/09/2018] [Indexed: 05/19/2023]
Abstract
Accumulating evidence demonstrates the significant influence of weather factors, especially temperature and humidity, on influenza seasonality. However, it is still unclear whether temperature variation within the same day, that is diurnal temperature range (DTR), is related to influenza seasonality. In addition, the different effects of weather factors on influenza seasonality across age groups have not been well documented in previous studies. Our study aims to explore the effects of DTR and humidity on influenza seasonality, and the differences in the association between weather factors and influenza seasonality among different age groups in Hong Kong, China. Generalized additive models were conducted to flexibly assess the impact of DTR, absolute humidity (vapor pressure, VP), and relative humidity on influenza seasonality in Hong Kong, China, from January 2012 to December 2016. Stratified analyses were performed to determine if the effects of weather factors differ across age groups (< 5, 5-9, 10-64, and > 64 years). The results suggested that DTR, absolute humidity, and relative humidity were significantly related to influenza seasonality in dry period (when VP is less than 20 mb), while no significant association was found in humid period (when VP is greater than 20 mb). The percentage changes of hospitalization rates due to influenza associated with per unit increase of weather factors in the very young children (age 0-4) and the elderly (age 65+) were higher than that in the adults (age 10-64). Diurnal temperature range is significantly associated with influenza seasonality in dry period, and the effects of weather factors differ across age groups in Hong Kong, China.
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Affiliation(s)
- Yapeng Li
- Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China
| | - Xi-Ling Wang
- Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China
| | - Xueying Zheng
- Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, 200032, China.
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28
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Lee JY, Choi H, Kim H. Dependence of future mortality changes on global CO 2 concentrations: A review. ENVIRONMENT INTERNATIONAL 2018; 114:52-59. [PMID: 29477019 DOI: 10.1016/j.envint.2018.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 06/08/2023]
Abstract
The heterogeneity among previous studies of future mortality projections due to climate change has often hindered comparisons and syntheses of resulting impacts. To address this challenge, the present study introduced a novel method to normalize the results from projection studies according to different baseline and projection periods and climate scenarios, thereby facilitating comparison and synthesis. This study reviewed the 15 previous studies involving projected climate change-related mortality under Representative Concentration Pathways. To synthesize their results, we first reviewed the important study design elements that affected the reported results in previous studies. Then, we normalized the reported results by CO2 concentration in order to eliminate the effects of the baseline period, projection period, and climate scenario choices. For twenty-five locations worldwide, the normalized percentage changes in temperature-attributable mortality per 100 ppm increase in global CO2 concentrations ranged between 41.9% and 330%, whereas those of total mortality ranged between 0.3% and 4.8%. The normalization methods presented in this work will guide future studies to provide their results in a normalized format and facilitate research synthesis to reinforce our understanding on the risk of climate change.
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Affiliation(s)
- Jae Young Lee
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea.
| | - Hayoung Choi
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea
| | - Ho Kim
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea.
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Li Y, Ren T, Kinney PL, Joyner A, Zhang W. Projecting future climate change impacts on heat-related mortality in large urban areas in China. ENVIRONMENTAL RESEARCH 2018; 163:171-185. [PMID: 29448153 DOI: 10.1016/j.envres.2018.01.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/10/2018] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
Global climate change is anticipated to raise overall temperatures and has the potential to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world's largest developing country, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging and underexplored, particularly in developing countries. This is an exploratory study aimed at projecting future heat-related mortality risk in major urban areas in China. We focus on the 51 largest Chinese cities that include about one third of the total population in China, and project the potential changes in heat-related mortality based on 19 different global-scale climate models and three Representative Concentration Pathways (RCPs). City-specific risk estimates for high temperature and all-cause mortality were used to estimate annual heat-related mortality over two future twenty-year time periods. We estimated that for the 20-year period in Mid-21st century (2041-2060) relative to 1970-2000, incidence of excess heat-related mortality in the 51 cities to be approximately 37,800 (95% CI: 31,300-43,500), 31,700 (95% CI: 26,200-36,600) and 25,800 (95% CI: 21,300-29,800) deaths per year under RCP8.5, RCP4.5 and RCP2.6, respectively. Slowing climate change through the most stringent emission control scenario RCP2.6, relative to RCP8.5, was estimated to avoid 12,900 (95% CI: 10,800-14,800) deaths per year in the 51 cities in the 2050s, and 35,100 (95% CI: 29,200-40,100) deaths per year in the 2070s. The highest mortality risk is primarily in cities located in the North, East and Central regions of China. Population adaptation to heat is likely to reduce excess heat mortality, but the extent of adaptation is still unclear. Future heat mortality risk attributable to exposure to elevated warm season temperature is likely to be considerable in China's urban centers, with substantial geographic variations. Climate mitigation and heat risk management are needed to reduce such risk and produce substantial public health benefits.
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Affiliation(s)
- Ying Li
- Department of Environmental Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Ting Ren
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Andrew Joyner
- Department of Geosciences, East Tennessee State University, Johnson City, TN 37614, USA
| | - Wei Zhang
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China.
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Li W, Cao Y, Li R, Ma X, Chen J, Wu Z, Xu Q. The spatial variation in the effects of air pollution on cardiovascular mortality in Beijing, China. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:297-304. [PMID: 29666509 DOI: 10.1038/jes.2016.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 05/28/2023]
Abstract
Owing to lack of data from multiple air quality monitoring stations, studies about spatial association between concentrations of ambient pollutants and mortality in China are rare. To investigate the spatial variation of association between concentrations of particulate matter less than 10 μm in aerodynamic diameter (PM10), nitrogen dioxide (NO2) and carbon monoxide (CO) and cardiovascular mortality in Beijing, China, we collected data including daily deaths, concentrations of PM10, NO2 and CO, and meteorological factors from 1 January 2009 to 31 December 2010 in all 16 districts of Beijing. Generalized additive model (GAM) and generalized additive mixed model (GAMM) were used to examine the citywide and district-specific effects of PM10, NO2 and CO on cardiovascular mortality. The citywide effect derived from GAMM was lower than that derived from GAM, and the strongest effects were identified for 2-day moving average lag 0-1. The interquartile increases in concentrations of PM10, NO2 and CO were associated with 2.46 (95% confidence interval (CI), 1.22-3.72), 4.11 (95%CI, 2.82-5.42) and 2.23 (95%CI, 1.14-3.33) percentage increases in daily cardiovascular mortality by GAMM, respectively. The relative risk of each district compared with reference district was generally statistically significant. The death risk associated with air pollutants varies across different geographic districts in Beijing. The data indicate that the risk is high in suburban areas and rural counties. We found significant and spatially varied adverse effects of air pollution on cardiovascular deaths across the rural and urban areas in Beijing.
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Affiliation(s)
- Wenjing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Yang Cao
- Unit of Biostatistics, Institute of Environmental Medicine, KarolinskaInstitutet, Stockholm 17177, Sweden
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro 70185, Sweden
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Science, Beijing 100101, China
| | - Xinming Ma
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Jieying Chen
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Zhenglai Wu
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China
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Mohammadi R, Soori H, Alipour A, Bitaraf E, Khodakarim S. The impact of ambient temperature on acute myocardial infarction admissions in Tehran, Iran. J Therm Biol 2018; 73:24-31. [DOI: 10.1016/j.jtherbio.2018.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/06/2018] [Accepted: 02/11/2018] [Indexed: 12/27/2022]
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Liu PF, Yan P, Zhao DH, Shi WF, Meng S, Liu Y, Liu B, Li GF, Xie LX. The effect of environmental factors on the differential expression of miRNAs in patients with chronic obstructive pulmonary disease: a pilot clinical study. Int J Chron Obstruct Pulmon Dis 2018. [PMID: 29535514 PMCID: PMC5836692 DOI: 10.2147/copd.s156865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective The objective of the study was to analyze the effect of environmental factors on the differential expression of microRNAs in the peripheral blood of migratory and local patients in northern People’s Republic of China and on clinical symptoms of local patients in northern People’s Republic of China with COPD. Methods A total of 118 patients in the northern region and 8 migratory patients were enrolled in this prospective study. We collected general information. Blood samples were collected from 9 patients in the Beijing group, from 8 patients in the migratory group and from 9 healthy control subjects. After extracting the total RNA from these 3 groups, serum miRNA was identified by Solexa sequencing. We collected COPD assessment test (CAT) and Modified British Medical Research Council (mMRC) scores at different levels of air pollution and also collected the number of exacerbations over the year prior to the baseline and in the year preceding the follow-up. Results In total 9 miRNAs were differentially expressed. When air quality index (AQI) >100, the CAT and mMRC scores at baseline were significantly higher than those when the AQI ≤100 (P<0.001). When AQI >100, the follow-up CAT and mMRC scores were significantly higher than those when AQI ≤100 (P<0.001). Follow-up mMRC scores were significantly higher than baseline scores (P=0.04). When AQI ≤100, the baseline CAT score of the group with fewer symptoms was 6.50 (4.00–8.75). However, when AQI >100, the baseline CAT score of this fewer symptoms group was 10.00 (6.25–12.00). The median CAT score was close to 10. When AQI ≤100, the follow-up CAT score of the fewer symptoms group was 8.00 (4.25–12.00). However, when AQI >100, the follow-up CAT score of the fewer symptoms group was 9.50 (6.00–16.75). The median CAT score was close to 10. Conclusion Environmental factors may cause differential expression of miRNAs in the peripheral blood of migratory and local patients in northern People’s Republic of China. Air pollution may aggravate clinical symptoms of patients with COPD.
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Affiliation(s)
- Peng-Fei Liu
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing
| | - Peng Yan
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing
| | - Da-Hui Zhao
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing
| | - Wen-Fang Shi
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing
| | - Song Meng
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing
| | - Yang Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, Tianjin, People's Republic of China
| | - Bin Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, Tianjin, People's Republic of China
| | - Guo-Feng Li
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, Tianjin, People's Republic of China
| | - Li-Xin Xie
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing
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Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2018; 13:2125-2131. [PMID: 27684429 DOI: 10.1513/annalsats.201605-329oc] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE There is limited evidence of the effect of exposure to heat on chronic obstructive pulmonary disease (COPD) morbidity, and the interactive effect between indoor heat and air pollution has not been established. OBJECTIVES To determine the effect of indoor and outdoor heat exposure on COPD morbidity and to determine whether air pollution concentrations modify the effect of temperature. METHODS Sixty-nine participants with COPD were enrolled in a longitudinal cohort study, and data from the 601 participant days that occurred during the warm weather season were included in the analysis. Participants completed home environmental monitoring with measurement of temperature, relative humidity, and indoor air pollutants and simultaneous daily assessment of respiratory health with questionnaires and portable spirometry. MEASUREMENTS AND MAIN RESULTS Participants had moderate to severe COPD and spent the majority of their time indoors. Increases in maximal indoor temperature were associated with worsening of daily Breathlessness, Cough, and Sputum Scale scores and increases in rescue inhaler use. The effect was detected on the same day and lags of 1 and 2 days. The detrimental effect of temperature on these outcomes increased with higher concentrations of indoor fine particulate matter and nitrogen dioxide (P < 0.05 for interaction terms). On days during which participants went outdoors, increases in maximal daily outdoor temperature were associated with increases in Breathlessness, Cough, and Sputum Scale scores after adjusting for outdoor pollution concentrations. CONCLUSIONS For patients with COPD who spend the majority of their time indoors, indoor heat exposure during the warmer months represents a modifiable environmental exposure that may contribute to respiratory morbidity. In the context of climate change, adaptive strategies that include optimization of indoor environmental conditions are needed to protect this high-risk group from the adverse health effects of heat.
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Zhao Q, Zhao Y, Li S, Zhang Y, Wang Q, Zhang H, Qiao H, Li W, Huxley R, Williams G, Zhang Y, Guo Y. Impact of ambient temperature on clinical visits for cardio-respiratory diseases in rural villages in northwest China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 612:379-385. [PMID: 28858748 DOI: 10.1016/j.scitotenv.2017.08.244] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/14/2017] [Accepted: 08/23/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND The association between temperature and cardio-respiratory disease in urban areas has been widely reported but there is limited information from populations living in rural areas that may be disproportionately affected by climate change. OBJECTIVES To quantify the associations between daily temperature and clinical visits due to cardiovascular and/or respiratory disease in rural villages in the Ningxia Hui Autonomous Region, China over 2012-2015. METHODS Daily data on clinical visits and weather conditions were collated from 203 villages. A quasi-Poisson regression with distributed lag non-linear model was used to examine the associations between daily temperature and clinical visits up to 28days, after controlling for potential confounders. RESULTS Over three years, 158,733 and 1,272,212 clinical visits were recorded for cardiovascular and respiratory diseases, respectively. Both low and high temperatures were associated with an increased risk of clinical visits for cardiovascular-related conditions, whereas only low temperatures were associated with increased clinical visits related to respiratory illness. The cold effect on cardiovascular visits appeared at the lag 6th day and persisted until the 22nd day, resulting in a cumulative relative risk (RR) 1.55 (95% CI: 1.26-1.92), compared with the minimum-clinical visit temperature. The cold effect on respiratory visits appeared immediately and lasted over the lag 0-28days, with a cumulative RR 2.96 (2.74-3.21). Suboptimal temperature accounted for approximately 13% and 26% of clinic visits due to cardiovascular and respiratory disorders, respectively, with the majority of cases attributable to moderate - rather than extreme - cold temperature. CONCLUSIONS In rural settings, sub-optimal temperatures explained nearly one quarter of all clinical visits due to cardiovascular and respiratory diseases. Although extreme cold temperature had a stronger, more immediate, prolonged effect on respiratory disease than for cardiovascular disease, moderately cold temperatures accounted for most of the overall burden of clinical visits.
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Affiliation(s)
- Qi Zhao
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, 4006, Queensland, Australia
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - Yajuan Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Qingan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Huiling Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Hui Qiao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Wuping Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China
| | - Rachel Huxley
- School of Public Health, Curtin University, Kent Street, Perth, 6102, Western Australia, Australia
| | - Gail Williams
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, 4006, Queensland, Australia
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, 750001, Ningxia Hui Autonomous Region, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia.
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Lokys HL, Junk J, Krein A. Short-term effects of air quality and thermal stress on non-accidental morbidity-a multivariate meta-analysis comparing indices to single measures. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:17-27. [PMID: 28243726 DOI: 10.1007/s00484-017-1326-0] [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: 03/01/2016] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 05/16/2023]
Abstract
Air quality and thermal stress lead to increased morbidity and mortality. Studies on morbidity and the combined impact of air pollution and thermal stress are still rare. To analyse the correlations between air quality, thermal stress and morbidity, we used a two-stage meta-analysis approach, consisting of a Poisson regression model combined with distributed lag non-linear models (DLNMs) and a meta-analysis investigating whether latitude or the number of inhabitants significantly influence the correlations. We used air pollution, meteorological and hospital admission data from 28 administrative districts along a north-south gradient in western Germany from 2001 to 2011. We compared the performance of the single measure particulate matter (PM10) and air temperature to air quality indices (MPI and CAQI) and the biometeorological index UTCI. Based on the Akaike information criterion (AIC), it can be shown that using air quality indices instead of single measures increases the model strength. However, using the UTCI in the model does not give additional information compared to mean air temperature. Interaction between the 3-day average of air quality (max PM10, max CAQI and max MPI) and meteorology (mean air temperature and mean UTCI) did not improve the models. Using the mean air temperature, we found immediate effects of heat stress (RR 1.0013, 95% CI: 0.9983-1.0043) and by 3 days delayed effects of cold stress (RR: 1.0184, 95% CI: 1.0117-1.0252). The results for air quality differ between both air quality indices and PM10. CAQI and MPI show a delayed impact on morbidity with a maximum RR after 2 days (MPI 1.0058, 95% CI: 1.0013-1.0102; CAQI 1.0068, 95% CI: 1.0030-1.0107). Latitude was identified as a significant meta-variable, whereas the number of inhabitants was not significant in the model.
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Affiliation(s)
- Hanna Leona Lokys
- Institute of Landscape Ecology, Climatology Group, University of Münster, Heisenbergstraße 2, 48149, Münster, Germany.
| | - Jürgen Junk
- ERIN-Environmental Research and Innovation Department, Luxembourg Institute of Science and Technology (LIST), 5, avenue des Hauts-Fourneaux, Esch/Alzette, 4362, Luxembourg
| | - Andreas Krein
- ERIN-Environmental Research and Innovation Department, Luxembourg Institute of Science and Technology (LIST), 5, avenue des Hauts-Fourneaux, Esch/Alzette, 4362, Luxembourg
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Zhou L, Chen K, Chen X, Jing Y, Ma Z, Bi J, Kinney PL. Heat and mortality for ischemic and hemorrhagic stroke in 12 cities of Jiangsu Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 601-602:271-277. [PMID: 28558275 DOI: 10.1016/j.scitotenv.2017.05.169] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/03/2017] [Accepted: 05/19/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Little evidence exists on the relationship between heat and subtypes of stroke mortality, especially in China. Moreover, few studies have reported the effect modification by individual characteristics on heat-related stroke mortality. In this study, we aimed to evaluate the effect of heat exposure on total, ischemic, and hemorrhagic stroke mortality and its individual modifiers in 12 cities in Jiangsu Province, China during 2009 to 2013. METHODS We first used a distributed lag non-linear model with quasi-Poisson regression to examine the city-specific heat-related total, ischemic, and hemorrhagic stroke mortality risks at 99th percentile vs. 75th percentile of daily mean temperature in the whole year for each city, while adjusting for long-term trend, season, relative humidity, and day of the week. Then, we used a random-effects meta-analysis to pool the city-specific risk estimates. We also considered confounding by air pollution and effect modification by gender, age, education level, and death location. RESULTS Overall, the heat-related mortality risk in 12 Jiangsu cities was 1.54 (95%CI: 1.44 to 1.65) for total stroke, 1.63 (95%CI: 1.48 to 1.80) for ischemic stroke, and 1.36 (95%CI: 1.26 to 1.48) for hemorrhagic stroke, respectively. Estimated total, ischemic, and hemorrhagic stroke mortality risks were higher for women versus men, older people versus younger people, those with low education levels versus high education levels, and deaths that occurred outside of hospital. Air pollutants did not significantly influence the heat-related stroke mortality risk. CONCLUSIONS Heat exposure significantly increased both ischemic and hemorrhagic stroke mortality risks in Jiangsu Province, China. Females, the elderly, and those with low education levels are particularly vulnerable to this effect.
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Affiliation(s)
- Lian Zhou
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Kai Chen
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China
| | - Xiaodong Chen
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Yuanshu Jing
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters/Key Laboratory of Meteorological Disaster, Ministry of Education, Nanjing, China.
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Jiangsu, China
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Jiangsu Collaborative Innovation Center of Atmospheric Environment and Equipment Technology (CICAEET), Jiangsu, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
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Ban J, Xu D, He MZ, Sun Q, Chen C, Wang W, Zhu P, Li T. The effect of high temperature on cause-specific mortality: A multi-county analysis in China. ENVIRONMENT INTERNATIONAL 2017; 106:19-26. [PMID: 28554097 PMCID: PMC5760246 DOI: 10.1016/j.envint.2017.05.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/22/2017] [Accepted: 05/22/2017] [Indexed: 05/04/2023]
Abstract
Although existing studies have linked high temperature to mortality in a small number of regions, less evidence is available on the variation in the associations between high temperature exposure and cause-specific mortality of multiple regions in China. Our study focused on the use of time series analysis to quantify the association between high temperature and different cause-specific mortalities for susceptible populations for 43 counties in China. Two-stage analyses adopting a distributed lag non-linear model (DLNM) and a meta-analysis allowed us to obtain county-specific estimates and national-scale pooled estimates of the nonlinear temperature-mortality relationship. We also considered different populations stratified by age and sex, causes of death, absolute and relative temperature patterns, and potential confounding from air pollutants. All of the observed cause-specific mortalities are significantly associated with higher temperature. The estimated effects of high temperature on mortality varied by spatial distribution and temperature patterns. Compared with the 90th percentile temperature, the overall relative risk (RR) at the 99th percentile temperature for non-accidental mortality is 1.105 (95%CI: 1.089, 1.122), for circulatory disease is 1.107 (95%CI: 1.081, 1.133), for respiratory disease is 1.095 (95%CI: 1.050, 1.142), for coronary heart disease is 1.073 (95%CI: 1.047, 1.099), for acute myocardial infarction is 1.072 (95%CI: 1.042, 1.104), and for stroke is 1.095 (95%CI: 1.052, 1.138). Based on our findings, we believe that heat-related health effect in China is a significant issue that requires more attention and allocation of existing resources.
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Affiliation(s)
- Jie Ban
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Dandan Xu
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Mike Z He
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
| | - Qinghua Sun
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Chen Chen
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Wentao Wang
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Pengfei Zhu
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
| | - Tiantian Li
- National Institute for Environmental Health, Chinese Center for Disease Control and Prevention, No.7 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China.
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Pintarić S, Zeljković I, Pehnec G, Nesek V, Vrsalović M, Pintarić H. Impact of meteorological parameters and air pollution on emergency department visits for cardiovascular diseases in the city of Zagreb, Croatia. Arh Hig Rada Toksikol 2016; 67:240-246. [DOI: 10.1515/aiht-2016-67-2770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 07/01/2016] [Indexed: 11/15/2022] Open
Abstract
Abstract
The aim of this study was to investigate whether nitrogen dioxide (NO2), ozone (O3), and certain meteorological conditions had an impact on cardiovascular disease (CVD)-related emergency department (ED) visits in the metropolitan area of Zagreb. This retrospective, ecological study included 20,228 patients with a cardiovascular disease as their primary diagnosis who were examined in the EDs of two Croatian University Hospitals, Sisters of Charity and Holy Spirit, in the study period July 2008-June 2010. The median of daily CVD-related ED visits during the study period was 28 and was the highest during winter. A significant negative correlation was found between CVD-related emergency visits and air temperature measured no more than three days prior to the visit, and the highest negative correlation coefficient was measured two days earlier (R=0.266, p≤0.001). The number of CVD-related emergency visits significantly correlated with the average NO2 concentration on the same day (R=0.191, p<0.001). The results of multiple stepwise regression analysis showed that the number of CVD-related emergency visits depended on air temperature, and NO2 and O3 concentrations. The higher the air temperatures, the lower the number of daily CVD-related emergency visits (p<0.001). An increase in NO2 concentrations (p=0.005) and a decrease in O3 concentrations of two days earlier (p=0.006) led to an increase in CVD-related ED visits. In conclusion, the decrease in O3 concentrations and the increase in NO2, even if below the legally binding thresholds, could be associated with an increase in CVD-related emergency visits and a similar effect was observed with lower temperature measured no more than three days prior to the visit.
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Affiliation(s)
- Sanja Pintarić
- First School of Economics, University of Zagreb, Zagreb, Croatia
| | - Ivan Zeljković
- University Hospital Centre Sisters of Charity, Vinogradska 29, 10000 Zagreb, Croatia
| | - Gordana Pehnec
- Institute for Medical Research and Occupational Health, University of Zagreb, Zagreb, Croatia
| | - Višnja Nesek
- University Hospital Holy Spirit, University of Zagreb, Zagreb Croatia
- University of Zagreb, Zagreb, School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Mislav Vrsalović
- University Hospital Centre Sisters of Charity, University of Zagreb, Zagreb Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Hrvoje Pintarić
- University Hospital Centre Sisters of Charity, University of Zagreb, Zagreb Croatia
- School of Dental Medicine, University of Zagreb, Zagreb Croatia
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The Short-Term Effect of Ambient Temperature on Mortality in Wuhan, China: A Time-Series Study Using a Distributed Lag Non-Linear Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070722. [PMID: 27438847 PMCID: PMC4962263 DOI: 10.3390/ijerph13070722] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/06/2016] [Accepted: 07/14/2016] [Indexed: 01/03/2023]
Abstract
Less evidence concerning the association between ambient temperature and mortality is available in developing countries/regions, especially inland areas of China, and few previous studies have compared the predictive ability of different temperature indictors (minimum, mean, and maximum temperature) on mortality. We assessed the effects of temperature on daily mortality from 2003 to 2010 in Jiang'an District of Wuhan, the largest city in central China. Quasi-Poisson generalized linear models combined with both non-threshold and double-threshold distributed lag non-linear models (DLNM) were used to examine the associations between different temperature indictors and cause-specific mortality. We found a U-shaped relationship between temperature and mortality in Wuhan. Double-threshold DLNM with mean temperature performed best in predicting temperature-mortality relationship. Cold effect was delayed, whereas hot effect was acute, both of which lasted for several days. For cold effects over lag 0-21 days, a 1 °C decrease in mean temperature below the cold thresholds was associated with a 2.39% (95% CI: 1.71, 3.08) increase in non-accidental mortality, 3.65% (95% CI: 2.62, 4.69) increase in cardiovascular mortality, 3.87% (95% CI: 1.57, 6.22) increase in respiratory mortality, 3.13% (95% CI: 1.88, 4.38) increase in stroke mortality, and 21.57% (95% CI: 12.59, 31.26) increase in ischemic heart disease (IHD) mortality. For hot effects over lag 0-7 days, a 1 °C increase in mean temperature above the hot thresholds was associated with a 25.18% (95% CI: 18.74, 31.96) increase in non-accidental mortality, 34.10% (95% CI: 25.63, 43.16) increase in cardiovascular mortality, 24.27% (95% CI: 7.55, 43.59) increase in respiratory mortality, 59.1% (95% CI: 41.81, 78.5) increase in stroke mortality, and 17.00% (95% CI: 7.91, 26.87) increase in IHD mortality. This study suggested that both low and high temperature were associated with increased mortality in Wuhan, and that mean temperature had better predictive ability than minimum and maximum temperature in the association between temperature and mortality.
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Seposo XT, Dang TN, Honda Y. Effect modification in the temperature extremes by mortality subgroups among the tropical cities of the Philippines. Glob Health Action 2016; 9:31500. [PMID: 27357073 PMCID: PMC4928071 DOI: 10.3402/gha.v9.31500] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/26/2016] [Accepted: 05/30/2016] [Indexed: 11/19/2022] Open
Abstract
Background Temperature–mortality relationships have been extensively probed with varying temperature range but with relatively similar patterns and in some instances are being modified by specific mortality groups such as causes of mortality, sex, and age. Objective This study aimed to determine the risk attributions in the extreme temperatures and also identified the risks associated with the various mortality subgroups. Design We used the 2006–2010 daily average meteorological and daily mortality variables from the Philippine Atmospheric Geophysical and Astronomical Services Administration and Philippine Statistics Authority–National Statistics Office, respectively. Mortality data were divided according to cause (cardiovascular and respiratory), sex, and age (0–14 years, 15–64 years, and >64 years). We performed a two-stage analysis to estimate the extreme temperature effects stratified by the different mortality subgroups to observe the effect modification. Results In the pooled analysis, greater risks were observed in the extreme high temperature (99th temperature percentile; RR (relative risk)=2.48 CI: 1.55–3.98) compared to the extreme low temperature (1st temperature percentile; RR=1.23 CI: 0.88–1.72). Furthermore, effect modification by mortality subgroups was evident, especially higher risks for extreme temperatures with respiratory-related diseases, women, and elderly. Conclusions Both sex and age were found to effect modify the risks in extreme temperatures of tropical cities; hence, health-related policies should take these risk variations into consideration to create strategies with respect to the risk population.
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Affiliation(s)
- Xerxes T Seposo
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; ;
| | - Tran Ngoc Dang
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
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Abstract
Chronic Obstructive Pulmonary Disease (COPD) affects 12-16 million people in the United States and is the third-leading cause of death. In developed countries, smoking is the greatest risk factor for the development of COPD, but other exposures also contribute to the development and progression of the disease. Several studies suggest, though are not definitive, that outdoor air pollution exposure is linked to the prevalence and incidence of COPD. Among individuals with COPD, outdoor air pollutants are associated with loss of lung function and increased respiratory symptoms. In addition, outdoor air pollutants are also associated with COPD exacerbations and mortality. There is much less evidence for the impact of indoor air on COPD, especially in developed countries in residences without biomass exposure. The limited existing data suggests that indoor particulate matter and nitrogen dioxide concentrations are linked to increased respiratory symptoms among patients with COPD. In addition, with the projected increases in temperature and extreme weather events in the context of climate change there has been increased attention to the effects of heat exposure. Extremes of temperature-both heat and cold-have been associated with increased respiratory morbidity in COPD. Some studies also suggest that temperature may modify the effect of pollution exposure and though results are not conclusive, understanding factors that may modify susceptibility to air pollution in patients with COPD is of utmost importance.
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Affiliation(s)
- Nadia N. Hansel
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Meredith C. McCormack
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Victor Kim
- Temple University, Philadelphia, Pennsylvania, USA
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Davis RE, McGregor GR, Enfield KB. Humidity: A review and primer on atmospheric moisture and human health. ENVIRONMENTAL RESEARCH 2016; 144:106-116. [PMID: 26599589 DOI: 10.1016/j.envres.2015.10.014] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/14/2015] [Accepted: 10/14/2015] [Indexed: 05/18/2023]
Abstract
Research examining associations between weather and human health frequently includes the effects of atmospheric humidity. A large number of humidity variables have been developed for numerous purposes, but little guidance is available to health researchers regarding appropriate variable selection. We examine a suite of commonly used humidity variables and summarize both the medical and biometeorological literature on associations between humidity and human health. As an example of the importance of humidity variable selection, we correlate numerous hourly humidity variables to daily respiratory syncytial virus isolates in Singapore from 1992 to 1994. Most water-vapor mass based variables (specific humidity, absolute humidity, mixing ratio, dewpoint temperature, vapor pressure) exhibit comparable correlations. Variables that include a thermal component (relative humidity, dewpoint depression, saturation vapor pressure) exhibit strong diurnality and seasonality. Humidity variable selection must be dictated by the underlying research question. Despite being the most commonly used humidity variable, relative humidity should be used sparingly and avoided in cases when the proximity to saturation is not medically relevant. Care must be taken in averaging certain humidity variables daily or seasonally to avoid statistical biasing associated with variables that are inherently diurnal through their relationship to temperature.
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Affiliation(s)
- Robert E Davis
- Department of Environmental Sciences, University of Virginia, P.O. Box 400123, 291 McCormick Road, Charlottesville, VA 22904-4123, USA.
| | - Glenn R McGregor
- Department of Geography, Durham University, Durham DH1 3LE, United Kingdom.
| | - Kyle B Enfield
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
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Ageev FT, Smirnova MD, Svirida ON, Fofanova TV, Vitsenya MV, Blankova ZN, Mikhailov GV, Lankin VZ, Konovalova GG, Tikhaze AK, Ageeva NV. [Impact of a cold wave on disease course, hemodynamics, carbohydrate metabolism, and blood rheological properties in cardiac patents]. TERAPEVT ARKH 2015; 87:11-16. [PMID: 26591547 DOI: 10.17116/terarkh201587911-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To study the impact of cold waves on disease course, hemodynamics, lipid and carbohydrate metabolisms, oxidative stress, and blood rheological properties in patients with cardiovascular diseases (CVD). SUBJECTS AND METHODS 24 men and 36 women (their mean age was 62.9±9.7 years) were examined; coronary heart disease (CHD) and hypertension were present in 40 and 95% of the patients, respectively; selected therapy remained unchanged throughout the entire period. The investigators measured blood pressure and pulse wave velocity (PWV), carried out biochemical blood tests, estimated plasma oxidized low-density lipoproteins (oxLDL) and malondialdehyde (MDA) and erythrocyte superoxide dismutase (SOD) activity, calculated a MDA/SOD ratio, determined blood viscosity; as well as assessed quality of life using a visual analogue scale (VAS) and a specially developed questionnaire. RESULTS Female sex, CHD, type 2 diabetes mellitus (DM-2) were independent predictors of cardiovascular events (CVEs) in the frost period. The persons who had experienced CVEs in frost had higher baseline PWV. CVEs, such as hypertensive crisis, emergency calls, cardiac arrhythmias, and the larger number of adverse reactions, were more commonly recorded in frost. There was an increase in blood glucose levels, a decrease in oxLDL, a rise in η2/η1, and a reduction in plasma viscosity during frost and elevated glycation end product levels at visit 2. Conclusion. The cold wave is associated with the larger number of CVEs in some patients with CVD during selected therapy. CHD, DM-2, female sex are independent predictors of CVE in patients with CVD during the winter period. In this period, there were increases in the levels of glucose, glycation end products, and erythrocyte aggregation, and a reduction in plasma viscosity.
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Affiliation(s)
- F T Ageev
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - M D Smirnova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - O N Svirida
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - T V Fofanova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - M V Vitsenya
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - Z N Blankova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - G V Mikhailov
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - V Z Lankin
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - G G Konovalova
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - A K Tikhaze
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
| | - N V Ageeva
- A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of Russia, Moscow, Russia
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Kwon BY, Lee E, Lee S, Heo S, Jo K, Kim J, Park MS. Vulnerabilities to Temperature Effects on Acute Myocardial Infarction Hospital Admissions in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:14571-88. [PMID: 26580643 PMCID: PMC4661668 DOI: 10.3390/ijerph121114571] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 01/03/2023]
Abstract
Most previous studies have focused on the association between acute myocardial function (AMI) and temperature by gender and age. Recently, however, concern has also arisen about those most susceptible to the effects of temperature according to socioeconomic status (SES). The objective of this study was to determine the effect of heat and cold on hospital admissions for AMI by subpopulations (gender, age, living area, and individual SES) in South Korea. The Korea National Health Insurance (KNHI) database was used to examine the effect of heat and cold on hospital admissions for AMI during 2004-2012. We analyzed the increase in AMI hospital admissions both above and below a threshold temperature using Poisson generalized additive models (GAMs) for hot, cold, and warm weather. The Medicaid group, the lowest SES group, had a significantly higher RR of 1.37 (95% CI: 1.07-1.76) for heat and 1.11 (95% CI: 1.04-1.20) for cold among subgroups, while also showing distinctly higher risk curves than NHI for both hot and cold weather. In additions, females, older age group, and those living in urban areas had higher risks from hot and cold temperatures than males, younger age group, and those living in rural areas.
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Affiliation(s)
- Bo Yeon Kwon
- Department of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Eunil Lee
- Department of Preventive Medicine, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Suji Lee
- Department of Preventive Medicine, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Seulkee Heo
- Department of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Kyunghee Jo
- Graduate School of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Jinsun Kim
- Graduate School of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Man Sik Park
- Department of Statistics, College of Natural Science, Sungshin Women's University, 249-1, Dongseon-dong 3-ga, Seongbuk-gu, Seoul 02844, Korea.
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Abstract
BACKGROUND Multisite time-series studies for temperature-related mortality have been conducted mainly in the United States and Europe, but are lacking in Asia. This multisite time-series study examined mortality related to extreme temperatures (both cold and hot) in Northeast Asia, focusing on 15 cities of 3 high-income countries. METHODS This study includes 3 cities in Taiwan for 1994-2007, 6 cities in Korea for 1992-2010, and 6 cities in Japan for 1972-2009. We used 2-stage Bayesian hierarchical Poisson semiparametric regression to model the nonlinear relationship between temperature and mortality, providing city-specific and country-wide estimates for cold and heat effects. Various exposure time frames, age groups, and causes of death were considered. RESULTS Cold effects had longer time lags (5-11 days) than heat effects, which were immediate (1-3 days). Cold effects were larger for cities in Taiwan, whereas heat effects were larger for cities in Korea and Japan. Patterns of increasing effects with age were observed in both cold and heat effects. Both cold and heat effects were larger for cardiorespiratory mortality than for other causes of death. Several city characteristics related to weather or air pollution were associated with both cold and heat effects. CONCLUSIONS Mortality increased with either cold or hot temperature in urban populations of high-income countries in Northeast Asia, with spatial variations of effects among cities and countries. Findings suggest that climate factors are major contributors to the spatial heterogeneity of effects in this region, although further research is merited to identify other factors as determinants of variability.
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Liu C, Yavar Z, Sun Q. Cardiovascular response to thermoregulatory challenges. Am J Physiol Heart Circ Physiol 2015; 309:H1793-812. [PMID: 26432837 DOI: 10.1152/ajpheart.00199.2015] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/28/2015] [Indexed: 01/05/2023]
Abstract
A growing number of extreme climate events are occurring in the setting of ongoing climate change, with an increase in both the intensity and frequency. It has been shown that ambient temperature challenges have a direct and highly varied impact on cardiovascular health. With a rapidly growing amount of literature on this issue, we aim to review the recent publications regarding the impact of cold and heat on human populations with regard to cardiovascular disease (CVD) mortality/morbidity while also examining lag effects, vulnerable subgroups, and relevant mechanisms. Although the relative risk of morbidity/mortality associated with extreme temperature varied greatly across different studies, both cold and hot temperatures were associated with a positive mean excess of cardiovascular deaths or hospital admissions. Cause-specific study of CVD morbidity/mortality indicated that the sensitivity to temperature was disease-specific, with different patterns for acute and chronic ischemic heart disease. Vulnerability to temperature-related mortality was associated with some characteristics of the populations, including sex, age, location, socioeconomic condition, and comorbidities such as cardiac diseases, kidney diseases, diabetes, and hypertension. Temperature-induced damage is thought to be related to enhanced sympathetic reactivity followed by activation of the sympathetic nervous system, renin-angiotensin system, as well as dehydration and a systemic inflammatory response. Future research should focus on multidisciplinary adaptation strategies that incorporate epidemiology, climatology, indoor/building environments, energy usage, labor legislative perfection, and human thermal comfort models. Studies on the underlying mechanism by which temperature challenge induces pathophysiological response and CVD await profound and lasting investigation.
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Affiliation(s)
- Cuiqing Liu
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, China; and
| | - Zubin Yavar
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Qinghua Sun
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
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Li T, Ban J, Horton RM, Bader DA, Huang G, Sun Q, Kinney PL. Heat-related mortality projections for cardiovascular and respiratory disease under the changing climate in Beijing, China. Sci Rep 2015; 5:11441. [PMID: 26247438 PMCID: PMC4527092 DOI: 10.1038/srep11441] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 04/07/2015] [Indexed: 11/28/2022] Open
Abstract
Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4%, 47.8%, and 69.0% in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6%,73.8% and 134% in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.
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Affiliation(s)
- Tiantian Li
- 1] State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian 100875, Beijing, China [2] Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng, 100050 Beijing, China
| | - Jie Ban
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng, 100050 Beijing, China
| | - Radley M Horton
- Center for Climate Systems Research, Columbia University, 545 W112th Street, New York, NY 10027 USA
| | - Daniel A Bader
- Center for Climate Systems Research, Columbia University, 545 W112th Street, New York, NY 10027 USA
| | - Ganlin Huang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, No. 19 Xinjiekouwai Street, Haidian 100875, Beijing, China
| | - Qinghua Sun
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng, 100050 Beijing, China
| | - Patrick L Kinney
- Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1104E, NY 10032 New York, USA
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Cardiovascular mortality associated with low and high temperatures: determinants of inter-region vulnerability in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5918-33. [PMID: 26024362 PMCID: PMC4483679 DOI: 10.3390/ijerph120605918] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/11/2015] [Indexed: 11/17/2022]
Abstract
The objectives of this study were to estimate the effects of temperature on cardiovascular mortality in 26 regions in the south and west of China from 2008 to 2011, and to identify socioeconomic and demographic factors contributing to such inter-region variation in the temperature effect. A separate Poisson generalized additive model (GAM) was fitted to estimate percent changes in cardiovascular mortality at low and high temperatures on a daily basis for each region. The model used the smooth functions to model the nonlinear effects of temperature and humidity and to control for the seasonal factor using the calendar time variable. Given variation in the magnitude of the temperature effect on cardiovascular mortality, we employed a Bayesian network (BN) to identify potential region-specific socioeconomic and demographic factors that may explain the variation. In most regions, an increasing trend in high or low temperature was associated with an increase in cardiovascular mortality, with variation in the magnitude of the temperature effects across regions. Three factors, including per capita years of education (as an indicator of economic status), percentage of the population over 65 years of age and percentage of women had direct impact on cold-related cardiovascular mortality. Number of hospital beds (as an indicator of the availability of medical resources), percentage of population engaged in industrial occupations, and percentage of women showed direct impact on heat-related cardiovascular mortality. Due to the socioeconomic and demographic inequalities between regions, the development of customized prevention and adaptation programs to address the low/high temperatures in vulnerable regions should be prioritized.
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Abstract
PURPOSE OF REVIEW The relationship of altitude and cold to cardiovascular risk is complex. Cold is hard to separate from altitude. This review highlights the latest information on cardiovascular disease associated with high altitude and cold; both represent unique clinical situations. RECENT FINDINGS Evolution and genetics are relevant to high altitude, with much new information available. Specific physiology explains some congenital heart disease at altitude. New reports of hematological changes associated with altitude and cold help clarify thrombosis, which is relevant to reports of very late in-stent thrombosis at altitude. Multiple cardiovascular risk factors are affected by altitude and cold, and an increased incidence of myocardial infarction occurs. There is new research on acute mountain sickness associated with inflammation with relevance for clinical study of pulmonary edema. Socioeconomics plays a part in altitude and cold effects on cardiovascular disease. In addition to acute disease, high altitude involves chronic mountain sickness with new knowledge of associated cardiovascular endothelial abnormalities. SUMMARY High altitude and cold involve acute disease, chronic disease, and public health issues. Continued research is essential to enable the best clinical management in this era of rapid worldwide travel.
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