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Walkowiak MP, Walkowiak D. Beyond the sine wave: unveiling climate-driven baseline mortality cycles. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:861-869. [PMID: 38363364 DOI: 10.1007/s00484-024-02631-7] [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: 06/24/2023] [Revised: 12/20/2023] [Accepted: 01/28/2024] [Indexed: 02/17/2024]
Abstract
The relationship between temperature and mortality is well-established, with higher mortality rates occurring in moderate climates during winter. Studies on COVID-19 and influenza-related excess deaths often assume a sine-like wave pattern for baseline mortality. This study aims to assess the accuracy of this approximation in capturing the observed mortality pattern and explore its linkage with climate. Weekly mortality data from European regions (2000-2019) were modeled using the seasonal-trend decomposition procedure based on Loess. Cycles were grouped into clusters, and underlying trends were extracted using principal component analysis. Generalized linear models assuming a sine-like pattern were used to test predictive value. Cluster analysis divided the regional cycles approximately into continental and temperate climate regions, further subdivided into oceanic and Mediterranean. While the continental region exhibited a sine-like mortality pattern, it displayed modest deviations that compounded further south. The period of elevated winter mortality became shorter but more intense, while decreased summer mortality became more pronounced yet delayed. This study improves weekly estimations of excess mortality models by providing enhanced baselines. The deviation from the sine-like approximation mirrors the idealized outbreak pattern from epidemiological models with sharper surges and more gradual declines. The results point to winter infections, impacted by acquired immunity and weather conditions, as the primary drivers of fluctuations in mortality. In warmer regions, there is an apparent shift toward a lower number of overall infections within a compressed time span.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Święcickiego 6, 60-781, Poznań, Poland.
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
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Maleki A, Aboubakri O, Rezaee R, Alahmad B, Sera F. Seasonal variation of Covid-19 incidence and role of land surface and air temperatures: a case study in the west of Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:1342-1354. [PMID: 36998230 DOI: 10.1080/09603123.2023.2196057] [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: 11/29/2022] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
.In this study, we assessed the impact of satellite-based Land Surface Temperature (LST) and Air Temperature (AT) on covid-19. First, we spatio-temporally kriged the LST and applied bias correction. The epidemic shape, timing, and size were compared after and before adjusting for the predictors. Given the non-linear behavior of a pandemic, a semi-parametric regression model was used. In addition, the interaction effect between the predictors and season was assessed. Before adjusting for the predictors, the peak happened at the end of hot season. After adjusting, it was attenuated and slightly moved forward. Moreover, the Attributable Fraction (AF) and Peak to Trough Relative (PTR) were % 23 (95% CI; 15, 32) and 1.62 (95%CI; 1.34, 1.97), respectively. We found that temperature might have changed the seasonal variation of covid-19. However, given the large uncertainty after adjusting for the variables, it was hard to provide conclusive evidence in the region we studied.
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Affiliation(s)
- Afshin Maleki
- Green Technology and Sustainable Development in Construction Research Group, School of Engineering and Technology, Van Lang University, Ho Chi Minh City, Vietnam
- Faculty of Environment, School of Engineering and Technology, Van Lang University, Ho Chi Minh City, Vietnam
| | - Omid Aboubakri
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Rezaee
- Environmental Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Environmental and Occupational Health Department, College of Public Health, Kuwait University, Kuwait, Kuwait
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, University of London, London, UK
- Department of Statistics, Computer Science and Applications 'G.Parenti', University of Florence, Florence, Italy
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Walkowiak MP, Walkowiak D, Walkowiak J. Exploring the paradoxical nature of cold temperature mortality in Europe. Sci Rep 2024; 14:3181. [PMID: 38326605 PMCID: PMC10850168 DOI: 10.1038/s41598-024-53675-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/03/2024] [Indexed: 02/09/2024] Open
Abstract
While low winter temperatures are associated with increased mortality, this phenomenon has been suggested to be most severe in regions with seemingly mild winters. The study aimed to establish a temperature-based formula that could elucidate the previously ambiguous regional differences in vulnerability to low temperature. European weekly mortality data (2000-2019) were matched with meteorological data to determine for each region vulnerability to temperature decrease and the optimal temperature with lowest mortality. Regression models were developed to generalize and explain these findings considering regional temperature characteristics. Optimal temperature could be predicted based on local average summer temperature (R2 = 85.6%). Regional vulnerability to temperature decrease could be explained by combination of winter and summer temperatures (R2 = 86.1%). Regions with warm winters and cold summers showed the highest vulnerability to decrease of temperature during winter. Contrary to theories about economic disparities Eastern Europe exhibited resistance comparable to Scandinavia. The southern edges of Europe demonstrated serious low temperature vulnerability to decreased temperatures, even if temperature was relatively high around 20 °C. This suggests that the observed connection primarily reflects the modulation of the length of respiratory virus infection seasons by climate conditions, counterbalanced by varying levels of acquired immunity and the presence of heatwaves eliminating the most frail individuals. Thus, relatively low vulnerability and a flat mortality cycle in countries with harsh climates paradoxically imply the presence of threats throughout the whole year.
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Affiliation(s)
- Marcin Piotr Walkowiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, Święcickiego 6, 60-781, Poznań, Poland.
| | - Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland
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Madaniyazi L, Armstrong B, Tobias A, Mistry MN, Bell ML, Urban A, Kyselý J, Ryti N, Cvijanovic I, Ng CFS, Roye D, Vicedo-Cabrera AM, Tong S, Lavigne E, Íñiguez C, da Silva SDNP, Madureira J, Jaakkola JJK, Sera F, Honda Y, Gasparrini A, Hashizume M. Seasonality of mortality under climate change: a multicountry projection study. Lancet Planet Health 2024; 8:e86-e94. [PMID: 38331534 DOI: 10.1016/s2542-5196(23)00269-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones. METHODS In this modelling study, we collected daily time series of mean temperature and mortality (all causes or non-external causes only) via the Multi-Country Multi-City Collaborative (MCC) Research Network. These data were collected during overlapping periods, spanning from Jan 1, 1969 to Dec 31, 2020. We projected daily mortality from Jan 1, 2000 to Dec 31, 2099, under four climate change scenarios corresponding to increasing emissions (Shared Socioeconomic Pathways [SSP] scenarios SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). We compared the seasonality in projected mortality between decades by its shape, timings (the day-of-year) of minimum (trough) and maximum (peak) mortality, and sizes (peak-to-trough ratio and attributable fraction). Attributable fraction was used to measure the burden of seasonality of mortality. The results were summarised by climate zones. FINDINGS The MCC dataset included 126 809 537 deaths from 707 locations within 43 countries or areas. After excluding the only two polar locations (both high-altitude locations in Peru) from climatic zone assessments, we analysed 126 766 164 deaths in 705 locations aggregated in four climate zones (tropical, arid, temperate, and continental). From the 2000s to the 2090s, our projections showed an increase in mortality during the warm seasons and a decrease in mortality during the cold seasons, albeit with mortality remaining high during the cold seasons, under all four SSP scenarios in the arid, temperate, and continental zones. The magnitude of this changing pattern was more pronounced under the high-emission scenarios (SSP3-7.0 and SSP5-8.5), substantially altering the shape of seasonality of mortality and, under the highest emission scenario (SSP5-8.5), shifting the mortality peak from cold seasons to warm seasons in arid, temperate, and continental zones, and increasing the size of seasonality in all zones except the arid zone by the end of the century. In the 2090s compared with the 2000s, the change in peak-to-trough ratio (relative scale) ranged from 0·96 to 1·11, and the change in attributable fraction ranged from 0·002% to 0·06% under the SSP5-8.5 (highest emission) scenario. INTERPRETATION A warming climate can substantially change the seasonality of mortality in the future. Our projections suggest that health-care systems should consider preparing for a potentially increased demand during warm seasons and sustained high demand during cold seasons, particularly in regions characterised by arid, temperate, and continental climates. FUNDING The Environment Research and Technology Development Fund of the Environmental Restoration and Conservation Agency, provided by the Ministry of the Environment of Japan.
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Affiliation(s)
- Lina Madaniyazi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Malcolm N Mistry
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Department of Economics, Ca' Foscari University of Venice, Venice, Italy
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Carmen Íñiguez
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Statistics and Computational Research, Universitat de València, València, Spain
| | | | - Joana Madureira
- Environmental Health Department, National Institute of Health, Porto, Portugal; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Finnish Meteorological Institute, Helsinki, Finland
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Masahiro Hashizume
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Zoran MA, Savastru RS, Savastru DM, Tautan MN. Peculiar weather patterns effects on air pollution and COVID-19 spread in Tokyo metropolis. ENVIRONMENTAL RESEARCH 2023; 228:115907. [PMID: 37080275 PMCID: PMC10111861 DOI: 10.1016/j.envres.2023.115907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
As a pandemic hotspot in Japan, between March 1, 2020-October 1, 2022, Tokyo metropolis experienced seven COVID-19 waves. Motivated by the high rate of COVID-19 incidence and mortality during the seventh wave, and environmental/health challenges we conducted a time-series analysis to investigate the long-term interaction of air quality and climate variability with viral pandemic in Tokyo. Through daily time series geospatial and observational air pollution/climate data, and COVID-19 incidence and death cases, this study compared the environmental conditions during COVID-19 multiwaves. In spite of five State of Emergency (SOEs) restrictions associated with COVID-19 pandemic, during (2020-2022) period air quality recorded low improvements relative to (2015-2019) average annual values, namely: Aerosol Optical Depth increased by 9.13% in 2020 year, and declined by 6.64% in 2021, and 12.03% in 2022; particulate matter PM2.5 and PM10 decreased during 2020, 2021, and 2022 years by 10.22%, 62.26%, 0.39%, and respectively by 4.42%, 3.95%, 5.76%. For (2021-2022) period the average ratio of PM2.5/PM10 was (0.319 ± 0.1640), showing a higher contribution to aerosol loading of traffic-related coarse particles in comparison with fine particles. The highest rates of the daily recorded COVID-19 incidence and death cases in Tokyo during the seventh COVID-19 wave (1 July 2022-1 October 2022) may be attributed to accumulation near the ground of high levels of air pollutants and viral pathogens due to: 1) peculiar persistent atmospheric anticyclonic circulation with strong positive anomalies of geopotential height at 500 hPa; 2) lower levels of Planetary Boundary Layer (PBL) heights; 3) high daily maximum air temperature and land surface temperature due to the prolonged heat waves (HWs) in summer 2022; 4) no imposed restrictions. Such findings can guide public decision-makers to design proper strategies to curb pandemics under persistent stable anticyclonic weather conditions and summer HWs in large metropolitan areas.
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Affiliation(s)
- Maria A Zoran
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania.
| | - Roxana S Savastru
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania
| | - Dan M Savastru
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania
| | - Marina N Tautan
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania
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Yoshida S, Tanaka S, Okada M, Ohki T, Yamagishi K, Okuno Y. Development and validation of ischemic heart disease and stroke prognostic models using large-scale real-world data from Japan. Environ Health Prev Med 2023; 28:16. [PMID: 36792224 PMCID: PMC9989775 DOI: 10.1265/ehpm.22-00106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Previous cardiovascular risk prediction models in Japan have utilized prospective cohort studies with concise data. As the health information including health check-up records and administrative claims becomes digitalized and publicly available, application of large datasets based on such real-world data can achieve prediction accuracy and support social implementation of cardiovascular disease risk prediction models in preventive and clinical practice. In this study, classical regression and machine learning methods were explored to develop ischemic heart disease (IHD) and stroke prognostic models using real-world data. METHODS IQVIA Japan Claims Database was searched to include 691,160 individuals (predominantly corporate employees and their families working in secondary and tertiary industries) with at least one annual health check-up record during the identification period (April 2013-December 2018). The primary outcome of the study was the first recorded IHD or stroke event. Predictors were annual health check-up records at the index year-month, comprising demographic characteristics, laboratory tests, and questionnaire features. Four prediction models (Cox, Elnet-Cox, XGBoost, and Ensemble) were assessed in the present study to develop a cardiovascular disease risk prediction model for Japan. RESULTS The analysis cohort consisted of 572,971 invididuals. All prediction models showed similarly good performance. The Harrell's C-index was close to 0.9 for all IHD models, and above 0.7 for stroke models. In IHD models, age, sex, high-density lipoprotein, low-density lipoprotein, cholesterol, and systolic blood pressure had higher importance, while in stroke models systolic blood pressure and age had higher importance. CONCLUSION Our study analyzed classical regression and machine learning algorithms to develop cardiovascular disease risk prediction models for IHD and stroke in Japan that can be applied to practical use in a large population with predictive accuracy.
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Affiliation(s)
- Shigeto Yoshida
- Data Science and Advanced Analytics, IQVIA Solutions Japan K.K
| | - Shu Tanaka
- Real-World Evidence Solutions, IQVIA Solutions Japan K.K
| | - Masafumi Okada
- Real-World Evidence Solutions, IQVIA Solutions Japan K.K
| | - Takuya Ohki
- Real-World Evidence Solutions, IQVIA Solutions Japan K.K
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba
| | - Yasushi Okuno
- Medical Sciences Innovation Hub Program, RIKEN.,Graduate School of Medicine, Kyoto University
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Temperature, cardiovascular mortality, and the role of hypertension and renin-angiotensin-aldosterone axis in seasonal adversity: a narrative review. J Hum Hypertens 2022; 36:1035-1047. [PMID: 35618875 DOI: 10.1038/s41371-022-00707-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/25/2022] [Accepted: 05/12/2022] [Indexed: 12/14/2022]
Abstract
Environmental temperature is now well known to have a U-shaped relationship with cardiovascular (CV) and all-cause mortality. Both heat and cold above and below an optimum temperature, respectively, are associated with adverse outcomes. However, cold in general and moderate cold specifically is predominantly responsible for much of temperature-attributable adversity. Importantly, hypertension-the most important CV risk factor-has seasonal variation such that BP is significantly higher in winter. Besides worsening BP control in established hypertensives, cold-induced BP increase also contributes to long-term BP variability among normotensive and pre-hypertensive patients, also a known CV risk factor. Disappointingly, despite the now well-stablished impact of temperature on BP and on CV mortality separately, direct linkage between seasonal BP change and CV outcomes remains preliminary. Proving or disproving this link is of immense clinical and public health importance because if seasonal BP variation contributes to seasonal adversity, this should be a modifiable risk. Mechanistically, existing evidence strongly suggests a central role of the sympathetic nervous system (SNS), and secondarily, the renin-angiotensin-aldosterone axis (RAAS) in mediating cold-induced BP increase. Though numerous other inflammatory, metabolic, and vascular perturbations likely also contribute, these may also well be secondary to cold-induced SNS/RAAS activation. This review aims to summarize the current evidence linking temperature, BP and CV outcomes. We also examine underlying mechanisms especially in regard to the SNS/RAAS axis, and highlight possible mitigation measures for clinicians.
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Du Y, Jing M, Lu C, Zong J, Wang L, Wang Q. Global Population Exposure to Extreme Temperatures and Disease Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13288. [PMID: 36293869 PMCID: PMC9603138 DOI: 10.3390/ijerph192013288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The frequency and duration of extreme temperature events continues to increase worldwide. However, the scale of population exposure and its quantitative relationship with health risks remains unknown on a global scale, limiting our ability to identify policy priorities in response to climate change. Based on data from 171 countries between 2010 and 2019, this study estimated the exposure of vulnerable populations to extreme temperatures, and their contemporary and lag associations with disease burden attributed to non-optimal temperatures. Fixed-effects models and dynamic panel models were applied. Increased vulnerable population exposure to extreme temperatures had adverse contemporary effects on the burden of disease attributed to non-optimal temperature. Health risks stemming from extreme cold could accumulate to a greater extent, exhibiting a larger lag effect. Population exposure to extreme cold was mainly distributed in high-income countries, while extreme heat occurred more in low-income and middle-income countries. However, the association between population exposure to extreme cold and burden of disease was much stronger in low-income and middle-income countries than in high-income countries, whereas the effect size of population exposure to extreme heat was similar. Our study highlighted that differential strategies should be determined and implemented according to the characteristics in different countries.
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Affiliation(s)
- Yajie Du
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Ming Jing
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Science), Jinan 250353, China
| | - Chunyu Lu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Jingru Zong
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Lingli Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
| | - Qing Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Institute of Health Data Science of China, Shandong University, Jinan 250012, China
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Xu E, Li Y, Li T, Li Q. Association between ambient temperature and ambulance dispatch: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:66335-66347. [PMID: 35499723 DOI: 10.1007/s11356-022-20508-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Previous studies have quantified the associations between ambient temperature and dispatch of ambulances, but the conclusions are still controversial. Therefore, a systematic review and meta-analysis were conducted to summarize all the current evidence. A systematic review of published literature was undertaken to characterize the effect of temperature on ambulance dispatch. We completed the literature search by the end of January 5, 2022. The pooled estimates for different temperature exposures were calculated using a random effects model. Differences among temperature pooled estimates were determined using subgroup analysis. This study was registered with PROSPERO under the number CRD42021284434. This is the first meta-analysis investigating the association between temperature and ambulance dispatch. A total of 25 studies were eligible for this study. The overall increased risks of high temperature, expressed as relative risks, were 1.734 (95% CI: 1.481-2.031). Subgroup analysis found that for the study using daily mean temperature, the high temperature increased the risk of ambulance dispatch by 15.2% (RR = 1.152, 95%CI: 1.081-1.228). In the ambulance dispatch of all-cause subgroups, the RR was 1.179 (95% CI: 1.085-1.282). The results also reported a significant association between low temperature and ambulance dispatch (RR = 1.130, 95% CI: 1.052-1.213). In the subgroup, the RR for cardiovascular disease was 1.209 (95% CI: 1.033-1.414), and respiratory disease was 1.126 (95% CI: 1.012-1.253). Sensitivity analysis indicated that the results were robust, and no obvious publication bias was observed. High temperature and low temperature are important factors influencing the dispatch of ambulances. These findings help improve the understanding of temperature effect on ambulance dispatch, demonstrating the need to consider wider surveillance of acute health outcomes in different environments.
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Affiliation(s)
- Er Xu
- Hospital Infection Management Office, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Yanni Li
- Public Health Department, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Tingting Li
- Department of Endocrinology, Rheumatology and Immunology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China
| | - Qing Li
- Hospital Infection Management Office, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, People's Republic of China.
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, Anhui, People's Republic of China.
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Umishio W, Ikaga T, Kario K, Fujino Y, Suzuki M, Ando S, Hoshi T, Yoshimura T, Yoshino H, Murakami S. Electrocardiogram abnormalities in residents in cold homes: a cross-sectional analysis of the nationwide Smart Wellness Housing survey in Japan. Environ Health Prev Med 2021; 26:104. [PMID: 34641787 PMCID: PMC8513347 DOI: 10.1186/s12199-021-01024-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Background Excess winter mortality caused by cardiovascular disease is particularly profound in cold houses. Consistent with this, accumulating evidence indicates that low indoor temperatures at home increase blood pressure. However, it remains unclear whether low indoor temperatures affect other cardiovascular biomarkers. In its latest list of priority medical devices for management of cardiovascular diseases, the World Health Organization (WHO) included electrocardiography systems as capital medical devices. We therefore examined the association between indoor temperature and electrocardiogram findings. Methods We collected electrocardiogram data from 1480 participants during health checkups. We also measured the indoor temperature in the living room and bedroom for 2 weeks in winter, and divided participants into those living in warm houses (average exposure temperature ≥ 18 °C), slightly cold houses (12–18 °C), and cold houses (< 12 °C) in accordance with guidelines issued by the WHO and United Kingdom. The association between indoor temperature (warm vs. slightly cold vs. cold houses) and electrocardiogram findings was analyzed using multivariate logistic regression models, with adjustment for confounders such as demographics (e.g., age, sex, body mass index, household income), lifestyle (e.g., eating habit, exercise, smoking, alcohol drinking), and region. Results The average temperature at home was 14.7 °C, and 238, 924, and 318 participants lived in warm, slightly cold, and cold houses, respectively. Electrocardiogram abnormalities were observed in 17.6%, 25.4%, and 30.2% of participants living in warm, slightly cold, and cold houses, respectively (p = 0.003, chi-squared test). Compared to participants living in warm houses, the odds ratio of having electrocardiogram abnormalities was 1.79 (95% confidence interval: 1.14–2.81, p = 0.011) for those living in slightly cold houses and 2.18 (95% confidence interval: 1.27–3.75, p = 0.005) for those living in cold houses. Conclusions In addition to blood pressure, living in cold houses may have adverse effects on electrocardiogram. Conversely, keeping the indoor thermal environment within an appropriate range through a combination of living in highly thermal insulated houses and appropriate use of heating devices may contribute to good cardiovascular health. Trial registration The trial was retrospectively registered on 27 Dec 2017 to the University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, https://www.umin.ac.jp/ctr/, registration identifier number UMIN000030601). Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-01024-1.
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Affiliation(s)
- Wataru Umishio
- Department of Architecture and Building Engineering, School of Environment and Society, Tokyo Institute of Technology, W8-11, 2-12-1, Ookayama, Meguro-ku, Tokyo, 152-8552, Japan. .,Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Kanagawa, Japan.
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Kanagawa, Japan
| | - Kazuomi Kario
- Department of Cardiology, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Masaru Suzuki
- Department of Emergency Medicine, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Chiba, Japan
| | - Shintaro Ando
- Department of Architecture, Faculty of Environmental Engineering, University of Kitakyushu, Kitakyushu, Fukuoka, Japan
| | - Tanji Hoshi
- Tokyo Metropolitan University, Hachioji, Tokyo, Japan
| | - Takesumi Yoshimura
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | | | - Shuzo Murakami
- Institute for Building Environment and Energy Conservation, Kojimachi, Chiyoda-ku, Tokyo, Japan
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