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Li X, Zhang Y, Tian Z, Wang J, Zhao J, Lyu Y, Ni Y, Guo Y, Cui Z, Zhang W, Li C. Lag effect of ambient temperature on respiratory emergency department visits in Beijing: a time series and pooled analysis. BMC Public Health 2024; 24:1363. [PMID: 38773497 PMCID: PMC11106889 DOI: 10.1186/s12889-024-18839-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Although the association between ambient temperature and mortality of respiratory diseases was numerously documented, the association between various ambient temperature levels and respiratory emergency department (ED) visits has not been well studied. A recent investigation of the association between respiratory ED visits and various levels of ambient temperature was conducted in Beijing, China. METHODS Daily meteorological data, air pollution data, and respiratory ED visits data from 2017 to 2018 were collected in Beijing. The relationship between ambient temperature and respiratory ED visits was explored using a distributed lagged nonlinear model (DLNM). Then we performed subgroup analysis based on age and gender. Finally, meta-analysis was utilized to aggregate the total influence of ambient temperature on respiratory ED visits across China. RESULTS The single-day lag risk for extreme cold peaked at a relative risk (RR) of 1.048 [95% confidence interval (CI): 1.009, 1.088] at a lag of 21 days, with a long lag effect. As for the single-day lag risk for extreme hot, a short lag effect was shown at a lag of 7 days with an RR of 1.076 (95% CI: 1.038, 1.114). The cumulative lagged effects of both hot and cold effects peaked at lag 0-21 days, with a cumulative risk of the onset of 3.690 (95% CI: 2.133, 6.382) and 1.641 (95% CI: 1.284, 2.098), respectively, with stronger impact on the hot. Additionally, the elderly were more sensitive to ambient temperature. The males were more susceptible to hot weather than the females. A longer cold temperature lag effect was found in females. Compared with the meta-analysis, a pooled effect of ambient temperature was consistent in general. In the subgroup analysis, a significant difference was found by gender. CONCLUSIONS Temperature level, age-specific, and gender-specific effects between ambient temperature and the number of ED visits provide information on early warning measures for the prevention and control of respiratory diseases.
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Affiliation(s)
- Xuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Zhenbiao Tian
- Beijing Red Cross Emergency Center, Beijing, 100085, China
| | - Jianping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Jinhua Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuanjun Lyu
- Department of Endocrinology, Tianjin Hospital, Tianjin, China
| | - Ying Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, 300070, P.R. China.
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Yan R, Ying S, Jiang Y, Duan Y, Chen R, Kan H, Fu Q, Gu Y. Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:3004-3013. [PMID: 38072886 DOI: 10.1007/s11356-023-31248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/22/2023] [Indexed: 01/18/2024]
Abstract
Previous epidemiological studies have linked short-term exposure to particulate matter with outpatient visits for respiratory diseases. However, evidence on ultrafine particle (UFP) is still scarce in China. To investigate the association between short-term UFP exposure and outpatient visits for respiratory diseases as well as the corresponding lag patterns, information on outpatient visits for main respiratory diseases during January 1, 2017, to December 31, 2019 was collected from electronic medical records of two large tertiary hospitals in Shanghai, China. Generalized additive models employing a Quasi-Poisson distribution were employed to investigate the relationships between UFP and respiratory diseases. We computed the percentage change and its corresponding 95% confidence interval (CI) for outpatient visits related to respiratory diseases per interquartile range (IQR) increase in UFP concentrations. Based on a total of 1,034,394 hospital visits for respiratory diseases in Shanghai, China, we found that the strongest associations of total UFP with acute upper respiratory tract infection (AURTI), bronchitis, chronic obstructive pulmonary disease (COPD), and pneumonia occurred at lag 03, 03, 0, and 03 days, respectively. Each IQR increase in the total UFP concentrations was associated with increments of 9.02% (95% CI: 8.64-9.40%), 3.94% (95% CI: 2.84-5.06%), 4.10% (95% CI: 3.01-5.20%), and 10.15% (95% CI: 9.32-10.99%) for AURTI, bronchitis, COPD, and pneumonia, respectively. Almost linear concentration-response relationship curves without apparent thresholds were observed between total UFP and outpatient-department visits for four respiratory diseases. Stratified analyses illustrated significantly stronger associations of total UFP with AURTI, bronchitis, and pneumonia among female patients, while that with COPD was stronger among male patients. After adjustment of criteria air pollutants, these associations all remained robust. This time-series study indicates that short-term exposure to UFP was associated with increased risk of hospital visits for respiratory diseases, underscoring the importance of reducing ambient UFP concentrations for respiratory diseases control and prevention.
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Affiliation(s)
- Ran Yan
- 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
| | - Shengjie Ying
- Shanghai Minhang District Center for Disease Control and Prevention, Shanghai, 201101, China
| | - Yixuan Jiang
- 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
| | - Yusen Duan
- Shanghai Environmental Monitoring Center, Shanghai, 200235, China
| | - Renjie Chen
- 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
| | - Haidong Kan
- 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
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, 200235, China
| | - Yiqin Gu
- Shanghai Minhang District Center for Disease Control and Prevention, Shanghai, 201101, China.
- Shanghai Minhang Dental Disease Prevention and Treatment Institute, Shanghai, 201103, China.
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Zhang J, Bai S, Lin S, Cui L, Zhao X, Du S, Wang Z. Maternal apparent temperature during pregnancy on the risk of offspring asthma and wheezing: effect, critical window, and modifiers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:62924-62937. [PMID: 36952159 PMCID: PMC10034250 DOI: 10.1007/s11356-023-26234-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/27/2023] [Indexed: 05/10/2023]
Abstract
The objective of this study was to explore the impact of maternal AT during pregnancy on childhood asthma and wheezing, as well as the potential effect modifiers in this association. A cross-sectional study was implemented from December 2018 to March 2019 in Jinan to investigate the prevalence of childhood asthma and wheezing among aged 18 months to 3 years. Then, we conducted a case-control study based on population to explore the association between prenatal different AT exposure levels and childhood asthma and wheezing. The association was assessed by generalized additive models and logistic regression models, and stratified analyses were performed to explore potential effect modifiers. A total of 12,384 vaccinated children participated in screening for asthma and wheezing, 236 cases were screened, as well as 1445 controls were randomized. After adjusting for the covariates, childhood asthma and wheezing were significantly associated with cold exposure in the first trimester, with OR 1.731 (95% CI: 1.117-2.628), and cold exposure and heat exposure in the third trimester, with ORs 1.610 (95% CI: 1.030-2.473) and 2.039 (95% CI: 1.343-3.048). In the third trimester, enhanced impacts were found among girls, children whose distance of residence was close to the nearest main traffic road, and children whose parents have asthma. The study indicates that exposure to extreme AT during the first and third trimesters could increase the risk of childhood asthma and wheezing.
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Affiliation(s)
- Jiatao Zhang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Shuoxin Bai
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China
| | - Liangliang Cui
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China
| | - Xiaodong Zhao
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China
| | - Shuang Du
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Zhiping Wang
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong, 250012, People's Republic of China.
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Elser H, Rowland ST, Marek MS, Kiang MV, Shea B, Do V, Benmarhnia T, Schneider ALC, Casey JA. Wildfire smoke exposure and emergency department visits for headache: A case-crossover analysis in California, 2006-2020. Headache 2023; 63:94-103. [PMID: 36651537 PMCID: PMC10066880 DOI: 10.1111/head.14442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the association of short-term exposure to overall fine particulate matter of <2.5 μm (PM2.5 ) and wildfire-specific PM2.5 with emergency department (ED) visits for headache. BACKGROUND Studies have reported associations between PM2.5 exposure and headache risk. As climate change drives longer and more intense wildfire seasons, wildfire PM2.5 may contribute to more frequent headaches. METHODS Our study included adult Californian members (aged ≥18 years) of a large de-identified commercial and Medicare Advantage claims database from 2006 to 2020. We identified ED visits for primary headache disorders (subtypes: tension-type headache, migraine headache, cluster headache, and "other" primary headache). Claims included member age, sex, and residential zip code. We linked daily overall and wildfire-specific PM2.5 to residential zip code and conducted a time-stratified case-crossover analysis considering 7-day average PM2.5 concentrations, first for primary headache disorders combined, and then by headache subtype. RESULTS Among 9898 unique individuals we identified 13,623 ED encounters for primary headache disorders. Migraine was the most frequently diagnosed headache (N = 5534/13,623 [47.6%]) followed by "other" primary headache (N = 6489/13,623 [40.6%]). For all primary headache ED diagnoses, we observed an association of 7-day average wildfire PM2.5 (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95-1.44 per 10 μg/m3 increase) and by subtype we observed increased odds of ED visits associated with 7-day average wildfire PM2.5 for tension-type headache (OR 1.42, 95% CI 0.91-2.22), "other" primary headache (OR 1.40, 95% CI 0.96-2.05), and cluster headache (OR 1.29, 95% CI 0.71-2.35), although these findings were not statistically significant under traditional null hypothesis testing. Overall PM2.5 was associated with tension-type headache (OR 1.29, 95% CI 1.03-1.62), but not migraine, cluster, or "other" primary headaches. CONCLUSIONS Although imprecise, these results suggest short-term wildfire PM2.5 exposure may be associated with ED visits for headache. Patients, healthcare providers, and systems may need to respond to increased headache-related healthcare needs in the wake of wildfires and on poor air quality days.
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Affiliation(s)
- Holly Elser
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Population Health Sciences, Stanford University, Stanford, California, USA
| | - Sebastian T Rowland
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA.,PSE Healthy Energy, Oakland, New York, USA
| | - Maksym S Marek
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mathew V Kiang
- Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Brittany Shea
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
| | - Vivian Do
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California, USA
| | - Andrea L C Schneider
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Joan A Casey
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, New York, USA
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Jia H, Xu J, Ning L, Feng T, Cao P, Gao S, Shang P, Yu X. Ambient air pollution, temperature and hospital admissions due to respiratory diseases in a cold, industrial city. J Glob Health 2022; 12:04085. [PMID: 36243957 PMCID: PMC9569423 DOI: 10.7189/jogh.12.04085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The influences of air pollution exposure and temperature on respiratory diseases have become major global health concerns. This study investigated the relationship between ambient air pollutant concentrations and temperature in cold industrial cities that have the risk of hospitalization for respiratory diseases. Methods A time-series study was conducted in Changchun, China, from 2015 to 2019 to analyse the number of daily admissions for respiratory diseases, air pollutant concentrations, and meteorological factors. Time-series decomposition was applied to analyse the trend and characteristics of the number of admissions. Generalized additive models and distributed lag nonlinear models were constructed to explore the effects of air pollutant concentrations and temperature on the number of admissions. Results The number of daily admissions showed an increasing trend, and the seasonal fluctuation was obvious, with more daily admissions in winter and spring than in summer and autumn. There were positive and gradually decreasing lag effects of PM10, PM2.5, NO2, and CO concentrations on the number of admissions, whereas O3 showed a J-shaped trend. The results showed that within the 7-day lag period, 0.5°C was the temperature associated with the lowest relative risk of admission due to respiratory disease, and extremely low and high temperatures (<-18°C, >27°C, respectively) increased the risk of hospitalization for respiratory diseases by 8.3% and 12.1%, respectively. Conclusions From 2015 to 2019, respiratory diseases in Changchun showed an increasing trend with obvious seasonality. The increased concentrations of SO2, NO2, CO, PM2.5, O3 and PM10 lead to an increased risk of hospitalization for respiratory diseases, with a significant lag effect. Both extreme heat and cold could lead to increases in the risk of admission due to respiratory disease.
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Affiliation(s)
- Huanhuan Jia
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Jiaying Xu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Liangwen Ning
- School of Public Administration, Jilin University, Changchun City, Jilin Province, China
| | - Tianyu Feng
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Peng Cao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Shang Gao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Panpan Shang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
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Tasmin S, Ng CFS, Stickley A, Yasumoto S, Watanabe C. Acute effects of ambient temperature on lung function of a panel of school children living in Dhaka, Bangladesh. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156139. [PMID: 35618122 DOI: 10.1016/j.scitotenv.2022.156139] [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: 10/12/2021] [Revised: 05/17/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Short-term exposure to ambient temperature plays a significant role in human health. However, studies examining ambient temperature and lung function are scarce in locations with a tropical environment. To address this research gap, the current study investigated the effects of short-term ambient temperature on lung function in children and seasonal variation in this association in Dhaka, Bangladesh. METHODS The study was conducted in three schools located in three cities inside and around Dhaka. Repeated lung function measurements were obtained from a panel of 315 school children (including 86 asthmatic children) aged 9-16 years in 2013. Linear mixed-effects models adjusted for potential confounders were used to examine the effect of ambient temperature on lung function. RESULTS Short-term exposure to low ambient temperature was associated with a significant decrement in children's lung function. For each 1 °C decrease in daily mean temperature at cumulative lag of the current and previous day, lung function parameter values were -3.02% (95% CI, -1.69 to -4.35) for peak expiratory flow (PEF), and -1.48% (95% CI, -0.75 to -2.22) for forced expiratory volume within 1 s (FEV1). A significant seasonal variation was also observed in these associations, as the estimated adverse effects of decrease in daily mean temperature on lung function measures were primarily evident in winter. DISCUSSION This study suggests that short-term ambient exposure to decrease in temperature adversely affect lung function. A significant seasonal modification in the association between temperature and lung function was also observed for these children living in an environment with a tropical climatic condition as the adverse effect of decrease in ambient temperature was primarily observed in winter than in summer.
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Affiliation(s)
- Saira Tasmin
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA.
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Andrew Stickley
- Stockholm Center on Health and Social Change (Scohost), Södertörn University, 141 89 Huddinge, Sweden
| | - Shinya Yasumoto
- Kinugasa Research Organization, Ritsumeikan University, Japan
| | - Chiho Watanabe
- National Institute of Environmental Sciences, 16-2 Onogawa, Tsukuba 305-8506, Japan
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Lu C, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Qian H, Wang J, Liu W, Sun Y, Norbäck D, Deng Q. Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma. ENVIRONMENT INTERNATIONAL 2022; 167:107456. [PMID: 35952466 DOI: 10.1016/j.envint.2022.107456] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although mounting evidence has associated air pollution and environmental temperature with children's health problems, it is unclear whether there is an interaction between these factors on childhood asthma. OBJECTIVES To explore the effects of temperature-pollution interactions during pre- and post-natal periods on asthma among pre-schoolers. METHODS A retrospective cohort study of 39,782 pre-schoolers was performed during 2010-2012, in seven cities in China. Exposure to three temperature indicators (TI) and three critical ambient air pollutants, including particulate matter with aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) as proxies of industrial and vehicular air pollution, was estimated by an inverse distance weighted (IDW) method. Two-level logistical regression analysis was used to examine the association between both pre- and post-natal exposure and childhood asthma in terms of odds ratio (OR) and 95 % confidence interval (CI). RESULTS Asthma prevalence in pre-schoolers at age of 3-6 years (6.9 %) was significantly associated with traffic-related air pollutant (NO2) exposure, with ORs (95 % CI) of 1.17 (1.06, 1.28), 1.19 (1.05-1.34) and 1.16 (1.03-1.31) for an IQR increase in NO2 exposure during lifetime, pregnancy, and entire postnatal period respectively. Furthermore, childhood asthma was positively associated with exposure to increased temperature during lifetime, pregnancy, and entire postnatal period with ORs (95 % CI) = 1.89 (1.66, 2.16), 1.47 (1.34, 1.61), and 1.15 (1.11, 1.18) respectively, while was negatively associated with decreased temperatures. Childhood asthma was positively related with exposure to extreme heat days (EHD) during postnatal period particularly in first year of life respectively with ORs (95 % CI) = 1.23 (1.04, 1.46) and 1.26 (1.07, 1.47), but was not related with extreme cold days (ECD) exposure. A combination of high air pollutant levels and high temperatures significantly increased the risk of asthma during both pre- and post-natal periods. Strikingly, we found a significantly positive interaction of temperature and PM10 or SO2 on asthma risk among boys and younger children. CONCLUSIONS Prenatal and postnatal exposure to ambient air pollution and high temperatures are independently and jointly associated with asthma risk in early childhood.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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Tong M, Wondmagegn B, Xiang J, Hansen A, Dear K, Pisaniello D, Varghese B, Xiao J, Jian L, Scalley B, Nitschke M, Nairn J, Bambrick H, Karnon J, Bi P. Hospitalization Costs of Respiratory Diseases Attributable to Temperature in Australia and Projections for Future Costs in the 2030s and 2050s under Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159706. [PMID: 35955062 PMCID: PMC9368165 DOI: 10.3390/ijerph19159706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 05/06/2023]
Abstract
This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010-2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1-20.1%) and (5.1-6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.
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Affiliation(s)
- Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Berhanu Wondmagegn
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Alana Hansen
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Blesson Varghese
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jianguo Xiao
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Le Jian
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Benjamin Scalley
- Department of Health, Government of Western Australia, Perth, WA 6004, Australia
| | - Monika Nitschke
- Department of Health, Government of South Australia, Adelaide, SA 5000, Australia
| | - John Nairn
- Australian Bureau of Meteorology, Adelaide, SA 5000, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QL 4000, Australia
| | - Jonathan Karnon
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5001, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
- Correspondence: ; Tel.: +61-8-8313-3583
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Elser H, Rowland ST, Tartof SY, Parks RM, Bruxvoort K, Morello-Frosch R, Robinson SC, Pressman AR, Wei RX, Casey JA. Ambient temperature and risk of urinary tract infection in California: A time-stratified case-crossover study using electronic health records. ENVIRONMENT INTERNATIONAL 2022; 165:107303. [PMID: 35635960 PMCID: PMC9233468 DOI: 10.1016/j.envint.2022.107303] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/05/2022] [Accepted: 05/14/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND In the United States (US), urinary tract infections (UTI) lead to more than 10 million office visits each year. Temperature and season are potentially important risk factors for UTI, particularly in the context of climate change. METHODS We examined the relationship between ambient temperature and outpatient UTI diagnoses among patients followed from 2015 to 2017 in two California healthcare systems: Kaiser Permanente Southern California (KPSC) and Sutter Health in Northern California. We identified UTI diagnoses in adult patients using diagnostic codes and laboratory records from electronic health records. We abstracted patient age, sex, season of diagnosis, and linked community-level Index of Concentration at the Extremes (ICE-I, a measure of wealth and poverty concentration) based on residential address. Daily county-level average ambient temperature was assembled from the Parameter-elevation Regressions on Independent Slopes Model (PRISM). We implemented distributed lag nonlinear models (DLNM) to assess the association between UTI and lagged daily temperatures. Main analyses were confined to women. In secondary analyses, we stratified by season, healthcare system, and community-level ICE-I. RESULTS We observed 787,186 UTI cases (89% among women). We observed a threshold association between ambient temperature and UTI among women: an increase in daily temperature from the 5th percentile (6.0 ˚C) to the mean (16.2 ˚C) was associated with a 3.2% (95% CI: 2.4, 3.9%) increase in same-day UTI diagnosis rate, whereas an increase from the mean to 95th percentile was associated with no change in UTI risk (0.0%, 95% CI: -0.7, 0.6%). In secondary analyses, we observed the clearest monotonic increase in the rate of UTI diagnosis with higher temperatures in the fall. Associations did not differ meaningfully by healthcare system or community-level ICE-I. Results were robust to alternate model specifications. DISCUSSION Increasing temperature was related to higher rate of outpatient UTI, particularly in the shoulder seasons (spring, autumn).
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Affiliation(s)
- Holly Elser
- Department of Neurology, Hospital of the University of Pennsylvania, United States
| | - Sebastian T Rowland
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, United States
| | - Sara Y Tartof
- Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
| | - Robbie M Parks
- Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, United States; Earth Institute, Columbia University, New York, NY, United States
| | - Katia Bruxvoort
- Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rachel Morello-Frosch
- Department of Environment, Science, Policy, and Managmeent, UC Berkeley, Berkeley, CA, United States; School of Public Helath, UC Berkeley, Berkeley, CA, United States
| | - Sarah C Robinson
- Sutter Health Center for Health Systems Research, Walnut Creek, CA, United States
| | - Alice R Pressman
- Sutter Health Center for Health Systems Research, Walnut Creek, CA, United States; Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States
| | - Rong X Wei
- Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Joan A Casey
- Environmental Health Sciences, Columbia Mailman School of Public Health, 722 West 168th Street, Room 1206, New York, NY 212-304-5502, United States.
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10
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Thunderstorms, Pollen, and Severe Asthma in a Midwestern, USA, Urban Environment, 2007-2018. Epidemiology 2022; 33:624-632. [PMID: 35580240 DOI: 10.1097/ede.0000000000001506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous research has shown an association between individual thunderstorm events in the presence of high pollen, commonly called thunderstorm asthma, and acute severe asthma events, but little work has studied risk over long periods of time, using detailed measurements of storms and pollen. METHODS We estimated change in risk of asthma-related emergency room visits related to thunderstorm asthma events in the Minneapolis-St. Paul metropolitan area over the years 2007-2018. We defined thunderstorm asthma events as daily occurrence of two or more lightning strikes during high pollen periods interpolating weather and pollen monitor data and modeling lightning counts. We acquired daily counts of asthma-related emergency department visits from the Minnesota Hospital Association and used a quasi-Poisson time-series regression to estimate overall relative risk of emergency department visits during thunderstorm asthma events. RESULTS We observed a 1.047 times higher risk (95% CI:1.012,1.083) of asthma-related emergency department visits on the day of thunderstorm asthma event. Our findings are robust to adjustment for temperature, humidity, wind, precipitation, ozone, PM2.5, day of week, and seasonal variation in asthma cases. Occurrence of lightning alone or pollen alone showed no association with risk of severe asthma. A two-stage analysis combining individual zip code level results shows similar RR and we see no evidence of spatial correlation or spatial heterogeneity of effect. DISCUSSION Our results support an association between co-occurrence of lightning and pollen and risk of severe asthma events. Our approach incorporates lightning and pollen data and small-spatial area exposure and outcome counts.
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11
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Borsi SH, Khodadadi N, Khanjani N, Dastoorpoor M. Physiological equivalent temperature (PET) index and respiratory hospital admissions in Ahvaz, southwest of Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:51888-51896. [PMID: 33993447 DOI: 10.1007/s11356-021-14345-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
Although Ahvaz is considered as one of the warmest cities around the world, few epidemiological studies have been conducted on the adverse effects of temperature on human health using thermal indices in this city. This study investigates the relation between physiologically equivalent temperature (PET) and respiratory hospital admissions in Ahvaz. Distributed lag non-linear models (DLNMs) combined with quasi-Poisson regression models were used to investigate the relation between PET and respiratory disease hospital admissions, adjusted for the effect of time trend, air pollutants (NO2, SO2, and PM10), and weekdays. The analysis was performed by utilizing R software. Low PET values significantly decreased the risk of hospital admissions for total respiratory diseases, respiratory diseases in men and women, chronic obstructive pulmonary diseases (COPD), and bronchiectasis. However, low PET (16.9°C) in all lags except lag 0-30 significantly increased the risk of hospital admissions for asthma. The results indicate that in Ahvaz, which has a warm climate, cold weather decreased overall respiratory hospital admissions, except for asthma.
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Affiliation(s)
- Seyed Hamid Borsi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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12
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Xu H, Chen H. Impact of urban morphology on the spatial and temporal distribution of PM 2.5 concentration: A numerical simulation with WRF/CMAQ model in Wuhan, China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 290:112427. [PMID: 33895455 DOI: 10.1016/j.jenvman.2021.112427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/22/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
The urban morphology can significantly change the urban microclimate, which in turn affects the diffusion of air pollutants. Urban planning is the most important means of shaping urban morphology. Therefore, this study takes Wuhan as an example and uses the method of WRF/CMAQ coupled UCM model to analyze the spatial and temporal distribution characteristics of PM2.5 in the Wuhan metropolitan area in winter 2015. The six most important urban morphological indicators in urban planning: the floor area ratio and building height, building density and building width, vegetation coverage ratio, and urban fraction, are selected and classified into three groups. Studying their impact on the spatial and temporal distribution of PM2.5 concentration provides support for urban planners to improve air quality. The results show that the maximum value of PM2.5 concentration in Wuhan urban area occurs in the morning rush hour, and PM2.5 is distributed concentrically in the downtown of the city (within the second ring highway) according to the highways around the city. The PM2.5 concentration in the downtown area with the most extensive urban morphological index is the highest, and it decreases with increasing distance from the downtown. Among the six indicators, building density and urban fraction have the most significant impact on PM2.5 concentration because they have the greatest impact on the wind speed at 10 m. The height of the planetary boundary layer is the key factors affect the vertical and horizontal diffusion of air pollutants. Except for the vegetation coverage ratio, the increase of other urban morphological indicators will lead to a decrease of PM2.5 concentration in Wuhan urban area at night. During the daytime, increasing the floor area ratio and building height will cause an increasing of PM2.5 concentration, but other indicators have the opposite effects.
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Affiliation(s)
- Huahua Xu
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan, 430074, China.
| | - Hong Chen
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Hubei Engineering and Technology Research Center of Urbanization, Wuhan, 430074, China.
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13
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Ngo HKT, Luong LMT, Le HHTC, Dang TN, Le Pham A, Phung D, Thai PK. Impact of temperature on hospital admission for acute lower respiratory infection (ALRI) among pre-school children in Ho Chi Minh City, Vietnam. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1205-1214. [PMID: 33751218 DOI: 10.1007/s00484-021-02104-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Changes in ambient temperature have been reported as an important risk factor for respiratory diseases among pre-school children. However, there have been few studies so far on the effects of temperature on children respiratory health in developing countries including Vietnam. This study examined the impact of short-term changes in ambient temperature on hospital admissions for acute lower respiratory infection (ALRI) among children aged less than 5 years old in Ho Chi Minh City (HCMC), Vietnam. Data on daily hospital admissions from 2013 to 2017 were collected from two large paediatric hospitals of the city. Daily meteorological data of the same period were also collected. Time series analysis was performed to evaluate the association between risk of hospitalisations and temperatures categorised by seasons, age, and causes. We found that a 1 °C increase in maximum temperature was associated with 4.2 and 3.4% increase in hospital admission for ALRI among children 3-5 years old during the dry season and the rainy season, respectively. Surprisingly, in the rainy season, a rise of 1°C diurnal temperature range (DTR) was significantly associated with a decrease from 2.0 to 2.5% risk of hospitalisation for ALRI among children <3 years old. These findings suggested that although high temperature is a risk factor for hospital admissions among children in general, other modifiable factors such as age, exposure time, air conditioning usage, wearing protective clothing, socioeconomic status, and behaviour may influence the overall effect of high temperature on hospital admissions of children <5 years old in HCMC. The findings of this study have provided evidence for building public health policies aimed at preventing and minimizing the adverse health effects of temperature on children in HCMC.
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Affiliation(s)
- Hieu K T Ngo
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - Ly M T Luong
- Faculty of Environmental Sciences, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Hong H T C Le
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Tran Ngoc Dang
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - An Le Pham
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, 4102, Australia.
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14
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Kabir AF, Ng CFS, Yasumoto S, Hayashi T, Watanabe C. Effect of Ambient Temperature on Daily Nebulized Asthma Hospital Visits in a Tropical City of Dhaka, Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030890. [PMID: 33498592 PMCID: PMC7908622 DOI: 10.3390/ijerph18030890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/19/2022]
Abstract
The acute effect of temperature on asthma morbidity in Bangladesh is not well understood. As climate varies extensively in different parts of the world, the relation between temperature and asthma might also differ. We investigated the association between temperature and asthma-related hospital visits in the tropical city of Dhaka. We analyzed information from a total of 5989 asthma patients who received ambulatory care in the form of nebulized medication at the National Asthma Center in Mohakhali, Dhaka from February to November 2013. A time-stratified case-crossover study was conducted to estimate the effect of daily temperature, with consideration of delayed effects and possible confounders such as relative humidity and political strikes. An inverse association was observed between temperature and the number of hospital visits. The effect was delayed for approximately a week. A degree centigrade decrease in mean temperature (averaged across lags 0-6) was associated with an increase of approximately 4.5% (95% CI 1.5, 7.5) in all asthma visits. The association was evident in adult males but marginal in elderly males. A positive association (lag 0) was observed among adult females, whereas no association was observed among children. Strikes significantly modified the effect among the elderly. Findings suggest temperature declines affect asthma outcomes in a warm climate, and this effect can be delayed and vary by sex and age group.
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Affiliation(s)
- Ayesha Ferdosi Kabir
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
- Correspondence:
| | - Shinya Yasumoto
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
| | - Taiichi Hayashi
- Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan;
| | - Chiho Watanabe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
- National Institute for Environmental Studies, Tsukuba, Ibaraki 305-0053, Japan
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15
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Oh S, Ha TH, Kim H, Lee H, Myung W. Emergency department visits for panic attacks and ambient temperature: A time-stratified case-crossover analysis. Depress Anxiety 2020; 37:1099-1107. [PMID: 32301576 DOI: 10.1002/da.23019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/20/2020] [Accepted: 03/27/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Panic disorder is a common anxiety disorder affecting up to 5% of the population. Although its pathogenesis is unclear, evidence about its association with ambient temperature is limited. We aimed to investigate the association between short-term exposure to increased ambient temperature and exacerbation of panic attacks requiring emergency department visits. METHODS From the national emergency database of South Korea, we identified 1,926 patients who presented with panic attacks at the emergency department in Seoul from 2008 to 2014. Using a time-stratified case-crossover design and conditional logistic regression analysis, we compared ambient temperature levels on emergency department visits and correspondingly matched-control days. RESULTS Increased ambient temperature levels were significantly associated with panic attacks. The risk of a panic attack increased by 2.2% (95% confidence interval, 0.7-3.8%) per every 1°C increase in temperature. This association was significant after adjusting for air pollutants. CONCLUSIONS Our results provide new evidence that short-term exposure to increased ambient temperature may increase the risk of exacerbation of panic attacks. These findings may provide a basis for further research to establish the association between panic attacks and ambient temperature, thus establishing preventive measures for panic attacks.
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Affiliation(s)
- Sehhyun Oh
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Hyewon Lee
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
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16
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Lu C, Norbäck D, Li Y, Deng Q. Early-life exposure to air pollution and childhood allergic diseases: an update on the link and its implications. Expert Rev Clin Immunol 2020; 16:813-827. [PMID: 32741235 DOI: 10.1080/1744666x.2020.1804868] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although mounting evidence has linked environmental factors with childhood allergies, some specific key issues still remain unclear: what is the main environmental factor? what is the critical timing window? And whether these contribute to the development of disease? AREAS COVERED This selective review summarizes recent epidemiological studies on the association between early-life exposure to indoor/outdoor air pollution and childhood allergic diseases. A literature search was conducted in the PubMed and Web of Science for peer-reviewed articles published until April 2020. Exposure to the traffic-related air pollutant, NO2, exposure during pregnancy and early postnatal periods is found to be associated with childhood allergies, and exposure during different trimesters causes different allergic diseases. However, exposure to classical air pollutants (PM10 and SO2) also contributes to childhood allergy in developing countries. In addition, early-life exposure to indoor renovation and mold/dampness significantly increases the risk of allergy in children. A synergistic effect between indoor and outdoor air pollution is found in the development of allergic diseases. EXPERT OPINION Early-life exposure to outdoor air pollution and indoor environmental factors plays an important role in the development of childhood allergic diseases, and the synergy between indoor and outdoor exposures increases allergy risk. The available findings support the hypothesis of the 'fetal origins of childhood allergy,' with new implications for the effective control and early prevention of childhood allergies.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University , Changsha, China.,Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University , Changsha, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University , Uppsala, Sweden
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong , Hong Kong, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University , Changsha, China.,Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University , Changsha, China.,School of Energy Science and Engineering, Central South University , Changsha, China
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17
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Rojanasarot S, Carlson AM, St Peter WL, Karaca-Mandic P, Wolfson J, Schommer JC. Reducing potentially preventable health events among patients with asthma through multi-state, multi-center quality improvement program. J Asthma 2020; 58:874-882. [PMID: 32162561 DOI: 10.1080/02770903.2020.1741611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Enhancing Care for Patients with Asthma is a multi-state, multi-center quality improvement program developed to augment guideline-based practice among health care providers through Plan-Do-Study-Act cycle. This study examined the association between the implementation of the guideline-based quality improvement program and subsequent changes in asthma-related emergency room visits and hospitalizations. METHODS This retrospective, interrupted time-series study used administrative claims data from a private insurer that provided coverage to patients receiving care from participating health centers (15 centers in New Mexico, Oklahoma, Texas, and Illinois). The 12-month implementation period started in January 2013 for centers in Cohort 1 and October 2013 for centers in Cohort 2. The claims of 1,828 patients with asthma from January 2012 to May 2015 were analyzed. The data included 12-month pre-program implementation, 12-month program implementation, and 5-month post-program completion periods. RESULTS The average number of asthma-related emergency room visits and hospitalizations decreased from 2.22 to 1.38 and 1.97 to 1.04 per 100 patients per month, respectively, in the 12-month pre-implementation period as compared to 12-month implementation period. The results of three-level generalized linear mixed models found that during the 12-month implementation period, patients had 37.7% and 47.1% lower rates of emergency room visits and hospitalizations, respectively, compared to the 12-month pre-implementation period (p < 0.001 in both comparisons). CONCLUSIONS Enhancing Care for Patients with Asthma is an effective quality improvement program that was successfully executed in diverse geographical states and associated with reductions in potentially preventable health events. The findings support the widespread use of the program in other settings.
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Affiliation(s)
- Sirikan Rojanasarot
- Social and Administrative Pharmacy Graduate Program, Department of Pharmaceutical Care & Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Angeline M Carlson
- Department of Pharmaceutical Care & Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Wendy L St Peter
- Department of Pharmaceutical Care & Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Pinar Karaca-Mandic
- Department of Finance, Carlson School of Management, University of Minnesota, Minneapolis, MN, USA
| | - Julian Wolfson
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jon C Schommer
- Department of Pharmaceutical Care & Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
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18
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Zhao Y, Huang Z, Wang S, Hu J, Xiao J, Li X, Liu T, Zeng W, Guo L, Du Q, Ma W. Morbidity burden of respiratory diseases attributable to ambient temperature: a case study in a subtropical city in China. Environ Health 2019; 18:89. [PMID: 31651344 PMCID: PMC6814053 DOI: 10.1186/s12940-019-0529-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/01/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND There are significant associations between ambient temperature and respiratory disease mortality. However, few studies have assessed the morbidity burdens of various respiratory diseases that are attributable to different temperature ranges in subtropical regions. METHODS Daily outpatient visits, weather variables, and air pollution data were collected from January 2013 to August 2017 in a hospital in Dongguan city. A standard time series quasi-Poisson regression with a distributed lag non-linear model (DLNM) was applied to estimate the associations between daily mean temperature and morbidity for total respiratory diseases, bronchiectasis, chronic obstructive pulmonary disease (COPD), and asthma. Attributable fractions were then calculated to quantify disease burden relative to different temperature components. Finally, we conducted stratified analysis by age group. RESULTS Both low and high temperatures were associated with an increased risk of morbidity secondary to respiratory diseases. Compared with the optimum temperature, the accumulated relative risk (RR) during the seven lag days was 1.13 with a 95% confidence interval (CI) of 1.01-1.26 for extreme heat and 1.02 (95% CI: 0.99-1.05) for extreme cold. Heat-related respiratory morbidity risk was higher than cold-related risk for the total population, but an opposite result was observed for the elderly. About 8.4% (95% CI: 2.8-13.3%) of respiratory morbidity was attributable to non-optimal temperatures, and moderate heat was responsible for most of the excess respiratory morbidity (7.5, 95% CI: 2.4-12.2%). CONCLUSIONS We found that exposure to non-optimal temperatures increased the risk of respiratory morbidity in subtropical region, and moderate heat contributed to most of the temperature-related respiratory morbidities. This indicates a need for further examination of moderate, rather than extreme, heat in subtropical region.
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Affiliation(s)
- Yiju Zhao
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan, China
| | - Zhao Huang
- The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | | | - Jianxiong Hu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Qingfeng Du
- Nanhai Hospital of Southern Medical University, Foshan, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
- Nanhai Hospital of Southern Medical University, Foshan, China.
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Spangler KR, Weinberger KR, Wellenius GA. Suitability of gridded climate datasets for use in environmental epidemiology. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:777-789. [PMID: 30538298 PMCID: PMC6559872 DOI: 10.1038/s41370-018-0105-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/03/2018] [Accepted: 11/16/2018] [Indexed: 05/18/2023]
Abstract
Epidemiologic analyses of the health effects of meteorological exposures typically rely on observations from the nearest weather station to assess exposure for geographically diverse populations. Gridded climate datasets (GCD) provide spatially resolved weather data that may offer improved exposure estimates, but have not been systematically validated for use in epidemiologic evaluations. As a validation, we linearly regressed daily weather estimates from two GCDs, PRISM and Daymet, to observations from a sample of weather stations across the conterminous United States and compared spatially resolved, population-weighted county average temperatures and heat indices from PRISM to single-pixel PRISM values at the weather stations to identify differences. We found that both Daymet and PRISM accurately estimate ambient temperature and mean heat index at sampled weather stations, but PRISM outperforms Daymet for assessments of humidity and maximum daily heat index. Moreover, spatially-resolved exposure estimates differ from point-based assessments, but with substantial inter-county heterogeneity. We conclude that GCDs offer a potentially useful approach to exposure assessment of meteorological variables that may, in some locations, reduce exposure measurement error, as well as permit assessment of populations distributed far from weather stations.
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Affiliation(s)
- Keith R. Spangler
- Department of Earth, Environmental, and Planetary Sciences, Brown University Box 1846, 324 Brook Street, Providence, Rhode Island 02912, USA
- Department of Epidemiology, School of Public Health, Brown University Box G-S121-2, 121 South Main Street, Providence, Rhode Island 02912, USA
- Institute at Brown for Environment and Society, Brown University Box 1951, 85 Waterman Street, Providence, Rhode Island 02912, USA
| | - Kate R. Weinberger
- Department of Epidemiology, School of Public Health, Brown University Box G-S121-2, 121 South Main Street, Providence, Rhode Island 02912, USA
- Institute at Brown for Environment and Society, Brown University Box 1951, 85 Waterman Street, Providence, Rhode Island 02912, USA
| | - Gregory A. Wellenius
- Department of Epidemiology, School of Public Health, Brown University Box G-S121-2, 121 South Main Street, Providence, Rhode Island 02912, USA
- Institute at Brown for Environment and Society, Brown University Box 1951, 85 Waterman Street, Providence, Rhode Island 02912, USA
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HUANG H, YANG H, DENG X, ZENG P, LI Y, ZHANG L, ZHU L. Influencing Mechanisms of Urban Heat Island on Respiratory Diseases. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1636-1646. [PMID: 31700819 PMCID: PMC6825676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Urban heat island (UHI) is being intensified with the progress of urbanization. Meanwhile, respiratory diseases caused by high temperature become common. This study explores the influences of UHI on respiratory diseases (J00-J99) and the evolutionary characteristics of the spatial pattern of such influences. METHODS The pattern-process-function and the influencing mechanism of UHI on respiratory diseases were evaluated through landscape pattern indexes from 1992 to 2018 in Tianjin, China. The basis was on data from Landsat TM/OLI/TIRS remote-sensing images, meteorological stations, and mortality of respiratory diseases. RESULTS The fluctuating influence of UHI on the respiratory diseases in Tianjin has increased from 1992 to 2018, showing a significant phase-based characteristic. During 2011-2018, the influence has soared greatly, and mortality risk has increased by 101%, and the influenced area has reached 349 km2. Furthermore, the regional space clustered, and the influenced patches are in irregular shape, and the highly influenced area is enlarged. Moreover, the indexes of the landscape level of the influenced areas all decrease. The patches at all levels are fragmented and distributed discontinuously. Spatially, the influenced areas gradually extend from the urban center to the suburbs. CONCLUSION UHI causes a higher mortality of respiratory diseases because it increases daily average air temperature in summer. With respect to landscape pattern, the influenced areas at low level is highly interconnected and relatively concentrated, whereas the influenced area at high level is distributed in clusters. In general, the influenced area is fragmented and discontinuously distributed in urban center.
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Affiliation(s)
- Huanchun HUANG
- Department of Urban Planning, School of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Hailin YANG
- Department of Urban Planning, School of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Xin DENG
- Department of Urban Planning, School of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Peng ZENG
- Department of Urban Planning, School of Architecture, Tianjin University, Tianjin, China,Corresponding Author:
| | - Yong LI
- People’s Hospital of Jiangsu Province, Nanjing Medical University, Nanjing, China
| | - Luning ZHANG
- Department of University Foreign Language Teaching Section, School of foreign Studies, Nanjing Forestry University, Nanjing, China
| | - Lei ZHU
- Center for Educational Research, Seoul National University, Seoul, South Korea
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Effects of Meteorological Factors on Hospitalizations in Adult Patients with Asthma: A Systematic Review. Can Respir J 2019; 2019:3435103. [PMID: 31281551 PMCID: PMC6589223 DOI: 10.1155/2019/3435103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/05/2019] [Accepted: 05/05/2019] [Indexed: 01/14/2023] Open
Abstract
Background Environmental factors such as weather variables contribute to asthma exacerbation. The impact of meteorological factors on asthma-related hospital admissions (HAs) or emergency department visits (EDVs) has been assessed in the literature. We conducted a systematic review to establish a conclusion of whether these findings from the literature are consistent and generalizable or if they vary significantly by certain subgroups. Objective This study aims to review the effect of meteorological variables on asthma HAs and EDVs in adults, to identify knowledge gaps and to highlight future research priorities. Method A systematic search was conducted in electronic databases such as PubMed, Embase, and CINAHL. All studies published in English were screened and included if they met the eligibility criteria. Two independent reviewers assessed the quality of the studies and extracted the data. The available evidence was summarized and presented using a harvest plot. Results Our initial search returned a total of 3887 articles. After screening titles, abstracts, and full texts, 16 studies were included. Thirty-one percent of the included studies (5/16) found that temperature was the only factor associated with asthma hospitalization or EDVs. Six studies (37%) found that both temperature and relative humidity were associated with HAs. Four studies (25%) identified thunderstorms as a possible factor associated with asthma hospitalization in adults. Conclusion Our review suggests that HAs and EDVs due to asthma are associated with many meteorological factors. Among the articles included in this review, changing temperature is the most commonly studied variable. We did not find studies that measured barometric pressure, weather phenomena, or the effect of tornados. To develop effective strategies to protect subjects at risk, further studies are required.
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Spangler KR, Manjourides J, Lynch AH, Wellenius GA. Characterizing Spatial Variability of Climate-Relevant Hazards and Vulnerabilities in the New England Region of the United States. GEOHEALTH 2019; 3:104-120. [PMID: 32159035 PMCID: PMC7007111 DOI: 10.1029/2018gh000179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/07/2019] [Accepted: 03/23/2019] [Indexed: 05/12/2023]
Abstract
Weather and climate have substantial effects on human health. While much is known about how morbidity and mortality are affected by moderate-to-extreme heat, poor air quality, and heavy precipitation individually, less is known about the cumulative occurrence of these climatic hazards, and the extent to which they spatially overlap with community-scale vulnerabilities. Specifically, there is interest in determining whether individuals living in places with the highest exposure to multiple health hazardous climatic conditions are also more vulnerable to having negative health outcomes. Presented here is a spatial analysis of the distribution of health-relevant climatic hazards and social vulnerabilities across the New England region of the northeastern United States. We show that the frequency of excessive heat days, heavy precipitation days, and ozone (O3) and fine particulate matter (PM2.5) exceedances during the warm seasons (May-September) from 2009 to 2014 have distinct spatial distributions and are statistically significantly correlated across space with indicators of social vulnerability. We further quantify an integrated measure of the hazards and vulnerabilities to illustrate the spatial heterogeneity of overall risk, as well as to demonstrate how the choice of spatial scale influences the identification of high-risk areas. These methods are transferrable to other locations and contexts, which could be of utility not only to geographers and epidemiologists, but also to policymakers tasked with allocating public health resources to populations at greatest risk of weather- and climate-related health effects.
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Affiliation(s)
- K. R. Spangler
- Department of Earth, Environmental, and Planetary SciencesBrown UniversityProvidenceRIUSA
- Department of Epidemiology, School of Public HealthBrown UniversityProvidenceRIUSA
- Institute at Brown for Environment and SocietyBrown UniversityProvidenceRIUSA
| | - J. Manjourides
- Department of Health Sciences, Bouvé College of Health SciencesNortheastern UniversityBostonMAUSA
| | - A. H. Lynch
- Department of Earth, Environmental, and Planetary SciencesBrown UniversityProvidenceRIUSA
- Institute at Brown for Environment and SocietyBrown UniversityProvidenceRIUSA
| | - G. A. Wellenius
- Department of Epidemiology, School of Public HealthBrown UniversityProvidenceRIUSA
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23
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Lam HCY, Hajat S, Chan EYY, Goggins WB. Different sensitivities to ambient temperature between first- and re-admission childhood asthma cases in Hong Kong - A time series study. ENVIRONMENTAL RESEARCH 2019; 170:487-492. [PMID: 30641275 DOI: 10.1016/j.envres.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/07/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Asthma can be triggered by various factors due to different etiologies. Environmental factors remain a common trigger of asthma, especially amongst children, and such ambient exposures can be harder to avoid compared to behavioral triggers. As such, the contribution of environmental factors may be enhanced when considering repeat asthma cases compared to initial presentations. To test this hypothesis, we assessed associations between ambient temperature and hospital admissions for asthma in Hong Kong and stratified admission records into first and repeat asthma hospitalizations. METHODS The daily number of asthma hospitalizations among children aged 0-5 years in Hong Kong during 2007-2011 was regressed on daily mean temperature using distributed lagged nonlinear models, with adjustment for seasonal patterns, day-of-week effects, and other meteorological factors and air-pollutants. Analyses were stratified by summer/winter and by type of admission (first admission and repeated admission). RESULTS About 33% of the 12284 asthma hospitalizations were repeat admissions. Repeat admissions demonstrated higher sensitivity to high temperature in the summer. During this period, high temperatures were associated with increased risk of repeat admission but not with first admissions: RR (95% CI) comparing 31 °C vs. 29 °C across lags 0-15 days was 3.40 (1.26, 9.18) and 0.74 (0.31, 1.77) for repeat and first admissions respectively. In the cold season, all admissions increased with falls in temperature, with slightly stronger associations apparent for repeat admissions compared to first admission: 1.20 (1.00, 1.44) vs. 1.10 (0.96, 1.26) respectively comparing risk at 15 °C vs. 12 °C across lags 0-5 days. CONCLUSIONS To our knowledge, this is the first study to show stronger associations between ambient temperature and repeat asthma admissions compared to first admissions. The higher sensitivity among those experiencing repeat admissions may allow for more personalized disease management. Given the substantial differences in associations by admission type, future studies of ambient exposures on asthma should consider analyzing the two groups separately.
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Affiliation(s)
- Holly Ching Yu Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, University of London, United Kingdom
| | - Emily Ying Yang Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - William Bernard Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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Rider CF, Carlsten C. Air pollution and resistance to inhaled glucocorticoids: Evidence, mechanisms and gaps to fill. Pharmacol Ther 2018; 194:1-21. [PMID: 30138638 DOI: 10.1016/j.pharmthera.2018.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Substantial evidence indicates that cigarette smoke exposure induces resistance to glucocorticoids, the primary maintenance medication in asthma treatment. Modest evidence also suggests that air pollution may reduce the effectiveness of these critical medications. Cigarette smoke, which has clear parallels with air pollution, has been shown to induce glucocorticoid resistance in asthma and it has been speculated that air pollution may have similar effects. However, the literature on an association of air pollution with glucocorticoid resistance is modest to date. In this review, we detail the evidence for, and against, the effects of air pollution on glucocorticoid effectiveness, focusing on results from epidemiology and controlled human exposure studies. Epidemiological studies indicate a correlation between increased air pollution exposure and worse asthma symptoms. But these studies also show a mix of beneficial and harmful effects of glucocorticoids on spirometry and asthma symptoms, perhaps due to confounding influences, or the induction of glucocorticoid resistance. We describe mechanisms that may contribute to reductions in glucocorticoid responsiveness following air pollution exposure, including changes to phosphorylation or oxidation of the glucocorticoid receptor, repression by cytokines, or inflammatory pathways, and epigenetic effects. Possible interactions between air pollution and respiratory infections are also briefly discussed. Finally, we detail a number of therapies that may boost glucocorticoid effectiveness or reverse resistance in the presence of air pollution, and comment on the beneficial effects of engineering controls, such as air filtration and asthma action plans. We also call attention to the benefits of improved clean air policy on asthma. This review highlights numerous gaps in our knowledge of the interactions between air pollution and glucocorticoids to encourage further research in this area with a view to reducing the harm caused to those with airways disease.
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Affiliation(s)
- Christopher F Rider
- Respiratory Medicine, Faculty of Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease (COERD), University of British Columbia, Vancouver, BC, Canada.
| | - Chris Carlsten
- Respiratory Medicine, Faculty of Medicine, Chan-Yeung Centre for Occupational and Environmental Respiratory Disease (COERD), University of British Columbia, Vancouver, BC, Canada; Institute for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Cong X, Xu X, Zhang Y, Wang Q, Xu L, Huo X. Temperature drop and the risk of asthma: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:22535-22546. [PMID: 28804860 DOI: 10.1007/s11356-017-9914-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/03/2017] [Indexed: 02/05/2023]
Abstract
The relationship between asthma and temperature changes remains controversial. The aim of this study was to investigate the association between temperature changes and the risk of asthma. A total of 26 studies (combined total number of subjects N > 26 million), covering 13 countries and Costa Rica, were identified by using a series of keywords in different combinations and searching the papers in PubMed, EMBSEA, Web of Science, MEDLINE, AIM, LILACS, and WPRIM before February 2016. Most of the papers were published in English. Random-effects meta-analyses were performed to evaluate the effect of temperature drop on risk of asthma. Several secondary analyses were also calculated based on stratification for different age, season, latitude, and region on risk of asthma. The odds ratio (OR) estimate between temperature drop and asthma was 1.05 (95% CI 1.02, 1.08) in the meta-analysis. For children, the overall OR was 1.09 (95% CI 1.03, 1.15). Dose-effect analyses showed stronger associations in asthma risk for each 1°1 °C decrement in short-term temperature (OR 1.055, 95% CI 1.00, 1.11). Further stratifications showed that winter (OR 1.03, 95% CI 1.01, 105) and low latitude (OR 1.72, 95% CI 1.23, 2.41) have a statistically significant association with the increased risk of asthma. Exposure of people to short-term temperature drop (per 1 °C decrement) was significantly associated with the risk of lower respiratory tract infections (LRTI) with asthma (OR 1.02, 95% CI 1.00, 1.04). Results suggest an adverse effect of temperature drop on asthma risk, especially in children and low-latitude areas. It may be opportune to consider the preventive actions against temperature drop, including simple face masks, to decrease the risk of asthma.
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Affiliation(s)
- Xiaowei Cong
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China.
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, China.
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Qihua Wang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Long Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xia Huo
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong, 510632, China.
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O'Lenick CR, Winquist A, Chang HH, Kramer MR, Mulholland JA, Grundstein A, Sarnat SE. Evaluation of individual and area-level factors as modifiers of the association between warm-season temperature and pediatric asthma morbidity in Atlanta, GA. ENVIRONMENTAL RESEARCH 2017; 156:132-144. [PMID: 28342349 PMCID: PMC5633283 DOI: 10.1016/j.envres.2017.03.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Previous studies have found associations between respiratory morbidity and high temperatures; however, few studies have explored associations in potentially sensitive sub-populations. METHODS We evaluated individual and area-level factors as modifiers of the association between warm-season (May-Sept.) temperature and pediatric respiratory morbidity in Atlanta. Emergency department (ED) visit data were obtained for children, 5-18 years old, with primary diagnoses of asthma or respiratory disease (diagnoses of upper respiratory infections, bronchiolitis, pneumonia, chronic obstructive pulmonary disease, asthma, or wheeze) in 20-county Atlanta during 1993-2012. Daily maximum temperature (Tmax) was acquired from the automated surface observing station at Atlanta Hartsfield International Airport. Poisson generalized linear models were used to estimate rate ratios (RR) between daily Tmax and asthma or respiratory disease ED visits, controlling for time and meteorology. Tmax effects were estimated for single-day lags of 0-6 days, for 3-, 5-, and 7-day moving averages and modeled with cubic terms to allow for non-linear relationships. Effect modification by individual factors (sex, race, insurance status) and area-level socioeconomic status (SES; ZIP code levels of poverty, education, and the neighborhood deprivation index) was examined via stratification. RESULTS Estimated RRs for Tmax and pediatric asthma ED visits were positive and significant for lag days 1-5, with the strongest single day association observed on lag day 2 (RR=1.06, 95% CI: 1.03, 1.09) for a change in Tmax from 27°C to 32°C (25th to 75th percentile). For the moving average exposure periods, associations increased as moving average periods increased. We observed stronger RRs between Tmax and asthma among males compared to females, non-white children compared to white children, children with private insurance compared to children with Medicaid, and among children living in high compared to low SES areas. Associations between Tmax and respiratory disease ED visits were weak and non-significant (p-value>0.05). CONCLUSIONS Results suggest socio-demographic factors (race/ethnicity, insurance status, and area-level SES) may confer vulnerability to temperature-related pediatric asthma morbidity. Our findings of weaker associations among children with Medicaid compared to other health insurance types and among children living in low compared to high SES areas run counter to our belief that children from disadvantaged households or ZIP codes would be more vulnerable to the respiratory effects of temperature. The potential reasons for these unexpected results are explored in the discussion.
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Affiliation(s)
- Cassandra R O'Lenick
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - James A Mulholland
- School of Civil and Environmental Engineering, Georgia Institute of Technology, 790 Atlantic Drive NW, Atlanta, GA 30332 USA.
| | - Andrew Grundstein
- Department of Geography, University of Georgia, 210 Field St., Athens, GA 30602, USA.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Jagai JS, Grossman E, Navon L, Sambanis A, Dorevitch S. Hospitalizations for heat-stress illness varies between rural and urban areas: an analysis of Illinois data, 1987-2014. Environ Health 2017; 16:38. [PMID: 28388909 PMCID: PMC5384150 DOI: 10.1186/s12940-017-0245-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/30/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND The disease burden due to heat-stress illness (HSI), which can result in significant morbidity and mortality, is expected to increase as the climate continues to warm. In the United States (U.S.) much of what is known about HSI epidemiology is from analyses of urban heat waves. There is limited research addressing whether HSI hospitalization risk varies between urban and rural areas, nor is much known about additional diagnoses of patients hospitalized for HSI. METHODS Hospitalizations in Illinois for HSI (ICD-9-CM codes 992.x or E900) in the months of May through September from 1987 to 2014 (n = 8667) were examined. Age-adjusted mean monthly hospitalization rates were calculated for each county using U.S. Census population data. Counties were categorized into five urban-rural strata using Rural Urban Continuum Codes (RUCC) (RUCC1, most urbanized to RUCC5, thinly populated). Average maximum monthly temperature (°C) was calculated for each county using daily data. Multi-level linear regression models were used, with county as the fixed effect and temperature as random effect, to model monthly hospitalization rates, adjusting for the percent of county population below the poverty line, percent of population that is Non-Hispanic Black, and percent of the population that is Hispanic. All analyses were stratified by county RUCC. Additional diagnoses of patients hospitalized for HSI and charges for hospitalization were summarized. RESULTS Highest rates of HSI hospitalizations were seen in the most rural, thinly populated stratum (mean annual summer hospitalization rate of 1.16 hospitalizations per 100,000 population in the thinly populated strata vs. 0.45 per 100,000 in the metropolitan urban strata). A one-degree Celsius increase in maximum monthly average temperature was associated with a 0.34 increase in HSI hospitalization rate per 100,000 population in the thinly populated counties compared with 0.02 per 100,000 in highly urbanized counties. The most common additional diagnoses of patients hospitalized with HSI were dehydration, electrolyte abnormalities, and acute renal disorders. Total and mean hospital charges for HSI cases were $167.7 million and $20,500 (in 2014 US dollars). CONCLUSION Elevated temperatures appear to have different impacts on HSI hospitalization rates as function of urbanization. The most rural and the most urbanized counties of Illinois had the largest increases in monthly hospitalization rates for HSI per unit increase in the average monthly maximum temperature. This suggests that vulnerability of communities to heat is complex and strategies to reduce HSI may need to be tailored to the degree of urbanization of a county.
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Affiliation(s)
- Jyotsna S. Jagai
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Elena Grossman
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Livia Navon
- Centers for Disease Control and Prevention, Illinois Department of Public Health, Chicago, USA
| | - Apostolis Sambanis
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Samuel Dorevitch
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, USA
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Lam HCY, Li AM, Chan EYY, Goggins WB. The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study. Thorax 2016; 71:1097-1109. [PMID: 27343213 DOI: 10.1136/thoraxjnl-2015-208054] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 05/20/2016] [Accepted: 06/06/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have found associations between meteorological variables and asthma hospitalisations but the nature of these associations has varied and few studies have been done in subtropical areas or evaluated effect modification by age. OBJECTIVES This study aimed to evaluate associations between asthma hospitalisations and meteorological factors and to assess effect modification of these associations by age and season in Hong Kong. METHODS Poisson generalised additive models combined with distributed lag nonlinear models and piecewise linear models were used to model associations between daily asthma hospitalisations from 2004 to 2011 and meteorological factors and air pollutants, adjusting for day of week, seasonality and trend. Subgroup analyses by age and season were performed. RESULTS In the hot season, hospitalisations were lowest at 27°C, rose to a peak at 30°C, then plateaued between 30°C and 32°C. The cumulative relative risk for lags 0-3 days (RRlag0-3) for 30°C vs 27°C was 1.19 (95% CI 1.06 to 1.34). In the cold season, temperature was negatively associated with asthma hospitalisations. The cumulative RRlag0-3 for 12°C vs 25°C was 1.33 (95% CI 1.13 to 1.58). Adult admissions were most sensitive to temperatures in both seasons while admissions among children under 5 were least associated. Higher humidity and ozone levels in the hot season, and low humidity in the cold season were also associated with more asthma admissions. CONCLUSIONS People with asthma should avoid exposure to adverse conditions by limiting outdoor activities during periods of extreme temperatures, combinations of high humidity and high temperature, and low humidity and low temperature, and high ozone levels.
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Affiliation(s)
- Holly Ching-Yu Lam
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Albert Martin Li
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Emily Ying-Yang Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Sugg MM, Konrad CE, Fuhrmann CM. Relationships between maximum temperature and heat-related illness across North Carolina, USA. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:663-75. [PMID: 26364040 DOI: 10.1007/s00484-015-1060-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/28/2015] [Accepted: 08/29/2015] [Indexed: 05/25/2023]
Abstract
Heat kills more people than any other weather-related event in the USA, resulting in hundreds of fatalities each year. In North Carolina, heat-related illness accounts for over 2,000 yearly emergency department admissions. In this study, data on emergency department (ED) visits for heat-related illness (HRI) were obtained from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool to identify spatiotemporal relationships between temperature and morbidity across six warm seasons (May-September) from 2007 to 2012. Spatiotemporal relationships are explored across different regions (e.g., coastal plain, rural) and demographics (e.g., gender, age) to determine the differential impact of heat stress on populations. This research reveals that most cases of HRI occur on days with climatologically normal temperatures (e.g., 31 to 35 °C); however, HRI rates increase substantially on days with abnormally high daily maximum temperatures (e.g., 31 to 38 °C). HRI ED visits decreased on days with extreme heat (e.g., greater than 38 °C), suggesting that populations are taking preventative measures during extreme heat and therefore mitigating heat-related illness.
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Affiliation(s)
- Margaret M Sugg
- Department of Geography and Planning, Appalachian State University Boone, Rankin Science West, P.O. Box 32066, Boone, NC, 28608, USA.
| | - Charles E Konrad
- Southeast Regional Climate Center, Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Winquist A, Grundstein A, Chang HH, Hess J, Sarnat SE. Warm season temperatures and emergency department visits in Atlanta, Georgia. ENVIRONMENTAL RESEARCH 2016; 147:314-23. [PMID: 26922412 PMCID: PMC4821766 DOI: 10.1016/j.envres.2016.02.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/18/2016] [Accepted: 02/17/2016] [Indexed: 05/03/2023]
Abstract
PURPOSE Extreme heat events will likely increase in frequency with climate change. Heat-related health effects are better documented among the elderly than among younger age groups. We assessed associations between warm-season ambient temperature and emergency department (ED) visits across ages in Atlanta during 1993-2012. METHODS We examined daily counts of ED visits with primary diagnoses of heat illness, fluid/electrolyte imbalances, renal disease, cardiorespiratory diseases, and intestinal infections by age group (0-4, 5-18, 19-64, 65+years) in relation to daily maximum temperature (TMX) using Poisson time series models that included cubic terms for TMX at single-day lags of 0-6 days, controlling for maximum dew-point temperature, time trends, week day, holidays, and hospital participation periods. We estimated rate ratios (RRs) and 95% confidence intervals (CI) for TMX changes from 27°C to 32°C (25th to 75th percentile) and conducted extensive sensitivity analyses. RESULTS We observed associations between TMX and ED visits for all internal causes, heat illness, fluid/electrolyte imbalances, renal diseases, asthma/wheeze, diabetes, and intestinal infections. Age groups with the strongest observed associations were 65+years for all internal causes [lag 0 RR (CI)=1.022 (1.016-1.028)] and diabetes [lag 0 RR=1.050 (1.008-1.095)]; 19-64 years for fluid/electrolyte imbalances [lag 0 RR=1.170 (1.136-1.205)] and renal disease [lag 1 RR=1.082 (1.065-1.099)]; and 5-18 years for asthma/wheeze [lag 2 RR=1.059 (1.030-1.088)] and intestinal infections [lag 1 RR=1.120 (1.041-1.205)]. CONCLUSIONS Varying strengths of associations between TMX and ED visits by age suggest that optimal interventions and health-impact projections would account for varying heat health impacts across ages.
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Affiliation(s)
- Andrea Winquist
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Andrew Grundstein
- Department of Geography, University of Georgia, 210 Field Street, Atlanta, GA 30322, USA.
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Jeremy Hess
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Stefanie Ebelt Sarnat
- Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Angelon-Gaetz KA, Richardson DB, Marshall SW, Hernandez ML. Exploration of the effects of classroom humidity levels on teachers' respiratory symptoms. Int Arch Occup Environ Health 2016; 89:729-37. [PMID: 26814540 DOI: 10.1007/s00420-016-1111-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 01/14/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Previous studies indicate that teachers have higher asthma prevalence than other non-industrial worker groups. Schools frequently have trouble maintaining indoor relative humidity (RH) within the optimum range (30-50 %) for reducing allergens and irritants. However, the potential relationship between classroom humidity and teachers' health has not been explored. Thus, we examined the relationship between classroom humidity levels and respiratory symptoms among North Carolina teachers. METHODS Teachers (n = 122) recorded daily symptoms, while data-logging hygrometers recorded classroom RH levels in ten North Carolina schools. We examined effects of indoor humidity on occurrence of symptoms using modified Poisson regression models for correlated binary data. RESULTS The risk of asthma-like symptoms among teachers with classroom RH >50 % for 5 days was 1.27 (95 % Confidence Interval (CI) 0.81, 2.00) times the risk among the referent (teachers with classroom RH 30-50 %). The risk of cold/allergy symptoms among teachers with classroom RH >50 % for 5 days was 1.06 (95 % CI 0.82, 1.37) times the risk among the referent. Low RH (<30 %) for 5 days was associated with increased risk of asthma-like [risk ratio (RR) = 1.26 (95 % CI 0.73, 2.17)] and cold/allergy symptoms [RR = 1.11 (95 % CI 0.90, 1.37)]. CONCLUSIONS Our findings suggest that prolonged exposure to high or low classroom RH was associated with modest (but not statistically significant) increases in the risk of respiratory symptoms among teachers.
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Affiliation(s)
- Kim A Angelon-Gaetz
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
| | - David B Richardson
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Stephen W Marshall
- Epidemiology Department, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Michelle L Hernandez
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
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Chen H, Wang J, Li Q, Yagouti A, Lavigne E, Foty R, Burnett RT, Villeneuve PJ, Cakmak S, Copes R. Assessment of the effect of cold and hot temperatures on mortality in Ontario, Canada: a population-based study. CMAJ Open 2016; 4:E48-58. [PMID: 27280114 PMCID: PMC4866918 DOI: 10.9778/cmajo.20150111] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Ambient high temperature is associated with death; however, heat-related risk of death has not been quantified systematically in Ontario, the most populous province in Canada. Less is known about cold-related risk in this population. Our objective was to quantify the health impact from cold and hot temperatures in Ontario. METHODS The study population consisted of all residents of Ontario who died between Jan. 1, 1996, and Dec. 31, 2010, from any nonaccidental cause. A case-crossover analysis was applied to assess the relation between daily temperature fluctuation and deaths from nonaccidental and selected causes in cold (December-February) and warm (June-August) seasons, respectively, adjusting for various potential confounders. Risk estimates were obtained for each census division, then pooled across Ontario. We examined potential effect modification for selected comorbidities and sociodemographic characteristics. RESULTS In warm seasons, each 5°C increase in daily mean temperature was associated with a 2.5% increase in nonaccidental deaths (95% confidence interval [CI] = 1.3% to 3.8%) on the day of exposure (lag 0). In cold seasons, each 5°C decrease in daily temperature was associated with a 3.0% (95% CI 1.8% to 4.2%) increase in nonaccidental deaths, which persisted over 7 days (lag 0-6). The cold-related effects (lag 0-6) were stronger for cardiovascular-related deaths (any cardiovascular death: 4.1%, 95% CI 2.3% to 5.9%; ischemic heart disease: 5.8%, 95% CI 3.6% to 8.1%), especially among people less than 65 years of age (8.0%, 95% CI 3.0% to 13.0%). Conversely, heat most strongly increased respiratory-related deaths during admission to hospital (26.0%, 95% CI 0% to 61.4%). Across Ontario, each 5°C change in daily temperature was estimated to induce 7 excess deaths per day in cold seasons and 4 excess deaths in warm seasons. INTERPRETATION Heat contributed to excess deaths in Ontario, although the effect of cold weather appeared to be greater. Further work is required to better define high-risk subgroups, which might include the homeless and people with inadequately heated housing.
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Affiliation(s)
- Hong Chen
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Jun Wang
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Qiongsi Li
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Abderrahmane Yagouti
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Eric Lavigne
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Richard Foty
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Richard T Burnett
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Paul J Villeneuve
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Sabit Cakmak
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Ray Copes
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
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Liu Y, Guo Y, Wang C, Li W, Lu J, Shen S, Xia H, He J, Qiu X. Association between temperature change and outpatient visits for respiratory tract infections among children in Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:439-54. [PMID: 25568973 PMCID: PMC4306872 DOI: 10.3390/ijerph120100439] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/23/2014] [Indexed: 11/16/2022]
Abstract
The current study examined the association between temperature change and clinical visits for childhood respiratory tract infections (RTIs) in Guangzhou, China. Outpatient records of clinical visits for pediatric RTIs, which occurred from 1 January 2012 to 31 December 2013, were collected from Guangzhou Women and Children’s Hospital. Records for meteorological variables during the same period were obtained from the Guangzhou Meteorological Bureau. Temperature change was defined as the difference between the mean temperatures on two consecutive days. A distributed lag non-linear model (DLNM) was used to examine the impact of temperature change on pediatric outpatient visits for RTIs. A large temperature decrease was associated with a significant risk for an RTI, with the effect lasting for ~10 days. The maximum effect of a temperature drop (−8.8 °C) was reached at lag 2~3 days. Children aged 0–2 years, and especially those aged <1 year, were particularly vulnerable to the effects of temperature drop. An extreme temperature decrease affected the number of patient visits for both upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs). A temperature change between consecutive days, and particularly an extreme temperature decrease, was significantly associated with increased pediatric outpatient visits for RTIs in Guangzhou.
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Affiliation(s)
- Yu Liu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Yong Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Changbing Wang
- Central Laboratory, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Weidong Li
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Jianrong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Sun Yat-sen University, 9 Jinsui Road, Guangzhou 510623, China.
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Zhang Y, Peng L, Kan H, Xu J, Chen R, Liu Y, Wang W. Effects of meteorological factors on daily hospital admissions for asthma in adults: a time-series analysis. PLoS One 2014; 9:e102475. [PMID: 25019158 PMCID: PMC4097056 DOI: 10.1371/journal.pone.0102475] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 06/19/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is limited evidence for the impacts of meteorological changes on asthma hospital admissions in adults in Shanghai, China. OBJECTIVES To quantitatively evaluate the short-term effects of daily mean temperature on asthma hospital admissions. METHODS Daily hospital admissions for asthma and daily mean temperatures between January 2005 and December 2012 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) combined with a distributed lag non-linear model were used to explore the associations between temperature and hospital admissions for asthma. RESULTS During the study periods, there were 15,678 hospital admissions for asthma by residents of Shanghai, an average 5.6 per day. Pearson correlation analysis found a significant negative correlation (r = -0.174, P<0.001) between asthma hospitalizations and daily mean temperature (DMT). The DMT effect on asthma increased below the median DMT, with lower temperatures associated with a higher risk of hospital admission for asthma. Generally, the cold effect appeared to be relatively acute, with duration lasting several weeks, while the hot effect was short-term. The relative risk of asthma hospital admissions associated with cold temperature (the 25th percentile of temperature relative to the median temperature) was 1.20 (95% confidence interval [CI], 1.01∼1.41) at lag0-14. However, warmer temperatures were not associated with asthma hospital admissions. CONCLUSIONS Cold temperatures may trigger asthmatic attacks. Effective strategies are needed to protect populations at risk from the effects of cold.
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Affiliation(s)
- Yue Zhang
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Li Peng
- Shanghai Center for Urban Environmental Meteorology, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Haidong Kan
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China
| | - Jianming Xu
- Shanghai Center for Urban Environmental Meteorology, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Renjie Chen
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Yuan Liu
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Weibing Wang
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China
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Sokol K, Sur S, Ameredes BT. Inhaled environmental allergens and toxicants as determinants of the asthma phenotype. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 795:43-73. [PMID: 24162902 DOI: 10.1007/978-1-4614-8603-9_4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The driving environmental factors behind the development of the asthma phenotype remain incompletely studied and understood. Here, we present an overview of inhaled allergic/atopic and mainly nonallergic/nonatopic or toxicant shapers of the asthma phenotype, which are present in both the indoor and outdoor environment around us. The inhaled allergic/atopic factors include fungus, mold, animal dander, cockroach, dust mites, and pollen; these allergic triggers and shapers of the asthma phenotype are considered in the context of their ability to drive the immunologic IgE response and potentially induce interactions between the innate and adaptive immune responses, with special emphasis on the NADPH-dependent reactive oxygen-species-associated mechanism of pollen-associated allergy induction. The inhaled nonallergic/nonatopic, toxicant factors include gaseous and volatile agents, such as sulfur dioxide, ozone, acrolein, and butadiene, as well as particulate agents, such as rubber tire breakdown particles, and diesel exhaust particles. These toxicants are reviewed in terms of their relevant chemical characteristics and hazard potential, ability to induce airway dysfunction, and potential for driving the asthma phenotype. Special emphasis is placed on their interactive nature with other triggers and drivers, with regard to driving the asthma phenotype. Overall, both allergic and nonallergic environmental factors can interact to acutely exacerbate the asthma phenotype; some may also promote its development over prolonged periods of untreated exposure, or possibly indirectly through effects on the genome. Further therapeutic considerations should be given to these environmental factors when determining the best course of personalized medicine for individuals with asthma.
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Affiliation(s)
- Kristin Sokol
- Division of Allergy and Immunology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA,
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Xu Z, Huang C, Hu W, Turner LR, Su H, Tong S. Extreme temperatures and emergency department admissions for childhood asthma in Brisbane, Australia. Occup Environ Med 2013; 70:730-5. [PMID: 23884454 DOI: 10.1136/oemed-2013-101538] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the effect of extreme temperatures on emergency department admissions (EDAs) for childhood asthma. METHODS An ecological design was used in this study. A Poisson linear regression model combined with a distributed lag non-linear model was used to quantify the effect of temperature on EDAs for asthma among children aged 0-14 years in Brisbane, Australia, during January 2003-December 2009, while controlling for air pollution, relative humidity, day of the week, season and long-term trends. The model residuals were checked to identify whether there was an added effect due to heat waves or cold spells. RESULTS There were 13 324 EDAs for childhood asthma during the study period. Both hot and cold temperatures were associated with increases in EDAs for childhood asthma, and their effects both appeared to be acute. An added effect of heat waves on EDAs for childhood asthma was observed, but no added effect of cold spells was found. Male children and children aged 0-4 years were most vulnerable to heat effects, while children aged 10-14 years were most vulnerable to cold effects. CONCLUSIONS Both hot and cold temperatures seemed to affect EDAs for childhood asthma. As climate change continues, children aged 0-4 years are at particular risk for asthma.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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