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Ren Y, Li J, Yang J, Hu L, Xu Z, Fu R, Wu K, Guo M, Hu M, Ran L, Li X, Qiu H, Liao L, Zhang M, Luo Y, Zhou S, Ding F. Meteorological parameters and hospital-acquired falls-A multicenter retrospective study based on 10 years of adverse events reporting system data. Heliyon 2024; 10:e34193. [PMID: 39071631 PMCID: PMC11279767 DOI: 10.1016/j.heliyon.2024.e34193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024] Open
Abstract
Objective and rationale Hospital-acquired falls are common and serious adverse events in medical institutions, with high incidence and injury rates. Studying the occurrence patterns of hospital-acquired falls is important for preventing falls in hospitalized patients. However, the effect of meteorological factors on hospital-acquired falls has not been elucidated. Therefore, this study explored the impact of meteorological parameters on hospital-acquired falls in Chongqing, China, and provided new ideas for the clinical prevention of falls in patients. Methods Correlation analysis and distributed lag nonlinear models were employed to analyze the relationship between 3890 cases of hospital-acquired falls and meteorological data in 13 hospitals in 11 districts and counties in Chongqing from January 2013 to April 2023. Results The number of hospital-acquired falls demonstrated a nonlinear correlation with the daily average relative humidity and negatively correlated with sunshine duration; however, temperature, air pressure, and wind speed were not correlated. Compared to the reference humidity (87 %), the immediate effects of daily average relative humidity (65-68 % and 90-97 %) increased the risk of hospital-acquired falls on the same day (relative risk [RR]:1.027-1.243). When the daily average relative humidity was 95-97 %, lags of 0-1 d and 8-12 d had greater effects on falls (RR:1.073-1.243). The daily average relative humidities of 62-74 % and 91-97 % were statistically significant at cumulative relative risk (CRR)of 4, 7, 10, and 14 d with a cumulative lag (CRR: 1.111-4.277). On sex and age stratification, the lag and cumulative effects of relative humidity more significantly impacted falls in women and patients aged ≥65 years. Conclusion Daily average relative humidity had a nonlinear correlation and lag effect on hospital-acquired falls; therefore, medical institutions should pay attention to the effect of relative humidity on hospital-acquired falls in patients, especially old and female patients.
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Affiliation(s)
- Yuanyuan Ren
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jinyan Li
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jun Yang
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Lei Hu
- Information Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zhihui Xu
- Nursing Department, Hechuan District People's Hospital of Chongqing, Chongqing, 401533, China
| | - Rongjuan Fu
- Nursing Department, Dianjiang People's Hospital of Chongqing, Chongqing, 408300, China
| | - Kaihui Wu
- Nursing Department, Nanchuan District People's Hospital of Chongqing, Chongqing, 408400, China
| | - Min Guo
- Nursing Department, The 13th People's Hospital of Chongqing, Chongqing, 400050, China
| | - Mei Hu
- Nursing Department, Chongqing University Three Gorges Hospital, Chongqing, 404100, China
| | - Liu Ran
- Department of Endocrinology, Changshou District People's Hospital of Chongqing, Chongqing, 401220, China
| | - Xia Li
- Nursing Department, Qijiang District People's Hospital, Chongqing, 401420, China
| | - Huicheng Qiu
- Nursing Department, Liangping District People's Hospital, Chongqing, 405200, China
| | - Lianmei Liao
- Nursing Department, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401121, China
| | - Mengmeng Zhang
- Nursing Department, Banan District People's Hospital of Chongqing, Chongqing, 401320, China
| | - Yetao Luo
- Department of Nosocomial Infection Control, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, China
| | - Sumei Zhou
- Emergency Department, The First Affiliated Hospital of Chongqing Medical University, 400016, China
| | - Fu Ding
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
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Tupinier Martin F, Boudreault J, Campagna C, Lavigne É, Gamache P, Tandonnet M, Généreux M, Trottier S, Goupil-Sormany I. The relationship between hot temperatures and hospital admissions for psychosis in adults diagnosed with schizophrenia: A case-crossover study in Quebec, Canada. ENVIRONMENTAL RESEARCH 2024; 246:118225. [PMID: 38253191 DOI: 10.1016/j.envres.2024.118225] [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: 09/22/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Some studies have found hot temperatures to be associated with exacerbations of schizophrenia, namely psychoses. As climate changes faster in Northern countries, our understanding of the association between temperature and hospital admissions (HA) for psychosis needs to be deepened. OBJECTIVES 1) Among adults diagnosed with schizophrenia, measure the relationship between mean temperatures and HAs for psychosis during summer. 2) Determine the influence of individual and ecological characteristics on this relationship. METHODS A cohort of adults diagnosed with schizophrenia (n = 30,649) was assembled using Quebec's Integrated Chronic Disease Surveillance System (QICDSS). The follow-up spanned summers from 2001 to 2019, using hospital data from the QICDSS and meteorological data from the National Aeronautics and Space Administration's (NASA) Daymet database. In four geographic regions of the province of Quebec, a conditional logistic regression was used for the case-crossover analysis of the relationship between mean temperatures (at lags up to 6 days) and HAs for psychosis using a distributed lag non-linear model (DLNM). The analyses were adjusted for relative humidity, stratified according to individual (age, sex, and comorbidities) and ecological (material and social deprivation index and exposure to green space) factors, and then pooled through a meta-regression. RESULTS The statistical analyses revealed a statistically significant increase in HAs three days (lag 3) after elevated mean temperatures corresponding to the 90th percentile relative to a minimum morbidity temperature (MMT) (OR 1.040; 95% CI 1.008-1.074), while the cumulative effect over six days was not statistically significant (OR 1.052; 95% IC 0.993-1.114). Stratified analyses revealed non statistically significant gradients of increasing HAs relative to increasing material deprivation and decreasing green space levels. CONCLUSIONS The statistical analyses conducted in this project showed the pattern of admissions for psychosis after hot days. This finding could be useful to better plan health services in a rapidly changing climate.
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Affiliation(s)
- Frédéric Tupinier Martin
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City (Quebec), Canada; Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Jérémie Boudreault
- Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
| | - Céline Campagna
- Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Water Earth and Environment Research Center, National institute of scientific research (INRS), Quebec City (Quebec), Canada.
| | - Éric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa (Ontario), Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa (Ontario), Canada.
| | - Philippe Gamache
- Bureau d'information et d'études en santé des populations (BIESP), Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Matthieu Tandonnet
- Bureau d'information et d'études en santé des populations (BIESP), Quebec National Institute of Public Health, Quebec City (Quebec), Canada.
| | - Mélissa Généreux
- Department of Community health sciences, Faculty of medicine and health sciences, Sherbrooke University, Sherbrooke (Quebec), Canada; Estrie's Public Health Department, Sherbrooke (Quebec), Canada.
| | - Simon Trottier
- Service des bibliothèques et archives, Université de Sherbrooke, Sherbrooke (Quebec), Canada.
| | - Isabelle Goupil-Sormany
- Department of social and preventive medicine, Laval University, Quebec City (Quebec), Canada; Environmental and occupational health and toxicology unit, Quebec National Institute of Public Health, Quebec City (Quebec), Canada; Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Laval University, Quebec City (Quebec), Canada.
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Meade RD, Akerman AP, Notley SR, Kirby NV, Sigal RJ, Kenny GP. Effects of Daylong Exposure to Indoor Overheating on Thermal and Cardiovascular Strain in Older Adults: A Randomized Crossover Trial. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:27003. [PMID: 38329752 PMCID: PMC10852046 DOI: 10.1289/ehp13159] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Health agencies recommend that homes of heat-vulnerable occupants (e.g., older adults) be maintained below 24-28°C to prevent heat-related mortality and morbidity. However, there is limited experimental evidence to support these recommendations. OBJECTIVE To aid in the development of evidence-based guidance on safe indoor temperatures for temperate continental climates, we evaluated surrogate physiological outcomes linked with heat-related mortality and morbidity in older adults during simulated indoor overheating. METHODS Sixteen older adults [six women; median age: 72 y, interquartile range (IQR): 70-73 y; body mass index: 24.6 ( IQR : 22.1 - 27.0 ) kg / m 2 ] from the Ottawa, Ontario, Canada, region (warm summer continental climate) completed four randomized, 8-h exposures to conditions experienced indoors during hot weather in continental climates (e.g., Ontario, Canada; 64 participant exposures). Ambient conditions simulated an air-conditioned environment (22°C; control), proposed indoor temperature upper limits (26°C), and temperatures experienced in homes without air-conditioning (31°C and 36°C). Core temperature (rectal) was monitored as the primary outcome; based on previous recommendations, between-condition differences > 0.3 ° C were considered clinically meaningful. RESULTS Compared with 22°C, core temperature was elevated to a meaningful extent in 31°C [+ 0 . 7 ° C ; 95% confidence interval (CI): 0.5, 0.8] and 36°C (+ 0 . 9 ° C ; 95% CI: 0.8, 1.1), but not 26°C (+ 0 . 2 ° C , 95% CI: 0.0, 0.3). Increasing ambient temperatures were also associated with elevated heart rate and reduced arterial blood pressure and heart rate variability at rest, as well as progressive impairments in cardiac and blood pressure responses to standing from supine. DISCUSSION Core temperature and cardiovascular strain were not appreciably altered following 8-h exposure to 26°C but increased progressively in conditions above this threshold. These data support proposals for the establishment of a 26°C indoor temperature upper limit for protecting vulnerable occupants residing in temperate continental climates from indoor overheating. https://doi.org/10.1289/EHP13159.
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Affiliation(s)
- Robert D. Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Ashley P. Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R. Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Nathalie V. Kirby
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ronald J. Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Wang J, Jiang C, Yang G, Bai G, Yu S. Study on thermal health and its safety management mode for the working environment. Front Public Health 2023; 11:1227630. [PMID: 37670839 PMCID: PMC10475595 DOI: 10.3389/fpubh.2023.1227630] [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: 05/23/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Thermal health concerns have gained significant attention due to the heightened health risks faced by workers who are exposed to extreme thermal environments for prolonged periods. To ensure the occupational health and safety of such workers, and to enhance work efficiency, it is imperative to examine the characteristics of thermal health in the working environment. This study proposes three key elements of thermal health in the working environment, namely thermal health states, absence of heat-related illnesses, and heat adaptability, which can be used to develop a safety management framework for thermal health. By exploring the interconnections between these elements, the study summarizes their features and outlines the necessary precautions to safeguard them. The PDCA (plan/do/check/action) cycle management mode is utilized as a framework, with the three components of thermal health forming the core, to establish a safety management mode for thermal health. To ensure that employees work in a safe, healthy, comfortable, and productive environment, the assessment and control objectives of the thermal environment are regularly revised through the use of labor protection technology and thermal environment control technology. This paper presents a PDCA cycle safety management mode based on the characteristics of thermal health, which offers novel insights and approaches for assessing and managing workers' thermal health.
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Affiliation(s)
- Jue Wang
- Key Laboratory of Mine Thermodynamic Disasters and Control of Ministry of Education, Liaoning Technical University, Fuxin, Liaoning, China
- School of Safety Science and Engineering, Liaoning Technical University, Fuxin, Liaoning, China
- School of Civil Engineering, Liaoning Technical University, Fuxin, Liaoning, China
| | - Cheng Jiang
- School of Civil Engineering, Liaoning Technical University, Fuxin, Liaoning, China
| | - Guang Yang
- School of Civil Engineering, Liaoning Technical University, Fuxin, Liaoning, China
| | - Gang Bai
- Key Laboratory of Mine Thermodynamic Disasters and Control of Ministry of Education, Liaoning Technical University, Fuxin, Liaoning, China
- School of Safety Science and Engineering, Liaoning Technical University, Fuxin, Liaoning, China
| | - Shixuan Yu
- School of Civil Engineering, Liaoning Technical University, Fuxin, Liaoning, China
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5
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Zhang B, Chen H, Lu B. An Early Warning System for Heatwave-Induced Health Risks in China: A Sub-Seasonal to Seasonal Perspective - China, 2022. China CDC Wkly 2023; 5:647-650. [PMID: 37529144 PMCID: PMC10388180 DOI: 10.46234/ccdcw2023.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/25/2023] [Indexed: 08/03/2023] Open
Abstract
What is already known about this topic? Climate change has had a detrimental impact on global health, particularly through the rise of extreme heatwaves. Presently, the early warning system for heatwave-related health risks can forecast potential dangers several days in advance; however, long-term warnings fall short. What is added by this report? This report introduces a novel early warning system aimed at predicting heatwave-induced health risks in China at sub-seasonal to seasonal timescales. The outcomes of the assessment suggest this system holds significant potential. What are the implications for public health practices? The system facilitates advanced assessment of both the scale and dispersal of risk among various demographic groups. This allows for the proactive management of potential risks with extended lead times.
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Affiliation(s)
- Baichao Zhang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Huiqi Chen
- Sun Yat-Sen University, Guangzhou City, Guangdong Province, China
| | - Bo Lu
- National Climate Center, China Meteorological Administration, Beijing, China
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Meade RD, Notley SR, Akerman AP, McCormick JJ, King KE, Sigal RJ, Kenny GP. Efficacy of Cooling Centers for Mitigating Physiological Strain in Older Adults during Daylong Heat Exposure: A Laboratory-Based Heat Wave Simulation. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:67003. [PMID: 37262028 DOI: 10.1289/ehp11651] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Health agencies, including the U.S. Centers for Disease Control and Prevention and the World Health Organization, recommend that heat-vulnerable older adults without home air-conditioning should visit cooling centers or other air-conditioned locations (e.g., a shopping mall) during heat waves. However, experimental evidence supporting the effectiveness of brief air-conditioning is lacking. OBJECTIVE We evaluated whether brief exposure to an air-conditioned environment, as experienced in a cooling center, was effective for limiting physiological strain in older adults during a daylong laboratory-based heat wave simulation. METHODS Forty adults 64-79 years of age underwent a 9-h simulated heat wave (heat index: 37°C) with (cooling group, n=20) or without (control group, n=20) a cooling intervention consisting of 2-h rest in an air-conditioned room (∼23°C, hours 5-6). Core and skin temperatures, whole-body heat exchange and storage, cardiovascular function, and circulating markers of acute inflammation were assessed. RESULTS Core temperature was 0.8°C (95% CI: 0.6, 0.9) lower in the cooling group compared with the control group at the end of the cooling intervention (p<0.001; hour 6), and it remained 0.3°C (95% CI: 0.2, 0.4) lower an hour after returning to the heat (p<0.001; hour 7). Despite this, core temperatures in each group were statistically equivalent at hours 8 and 9, within ±0.3°C (p≤0.005). Cooling also acutely reduced demand on the heart and improved indices of cardiovascular autonomic function (p≤0.021); however, these outcomes were not different between groups at the end of exposure (p≥0.58). DISCUSSION Brief air-conditioning exposure during a simulated heat wave caused a robust but transient reduction in core temperature and cardiovascular strain. These findings provide important experimental support for national and international guidance that cooling centers are effective for limiting physiological strain during heat waves. However, they also show that the physiological impacts of brief cooling are temporary, a factor that has not been considered in guidance issued by health agencies. https://doi.org/10.1289/EHP11651.
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Affiliation(s)
- Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ashley P Akerman
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - James J McCormick
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Kelli E King
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ronald J Sigal
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Medicine, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Hahn MB, Kuiper G, Magzamen S. Association of Temperature Thresholds with Heat Illness- and Cardiorespiratory-Related Emergency Visits during Summer Months in Alaska. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:57009. [PMID: 37224069 DOI: 10.1289/ehp11363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Recent record-breaking hot temperatures in Alaska have raised concerns about the potential human health implications of heat exposure among this unacclimated population. OBJECTIVES We estimated cardiorespiratory morbidity associated with days above summer (June-August) heat index (HI, apparent temperature) thresholds in three major population centers (Anchorage, Fairbanks, and the Matanuska-Susitna Valley) for the years 2015-2019. METHODS We implemented time-stratified case-crossover analyses of emergency department (ED) visits for International Classification of Diseases, 10th Revision codes indicative of heat illness and major cardiorespiratory diagnostic codes using data from the Alaska Health Facilities Data Reporting Program. Using conditional logistic regression models, we tested maximum hourly HI temperature thresholds between 21.1°C (70°F) and 30°C (86°F) for a single day, 2 consecutive days, and the absolute number of previous consecutive days above the threshold, adjusting for the daily average concentration of particulate matter ≤2.5μg. RESULTS There were increased odds of ED visits for heat illness above a HI threshold as low as 21.1°C (70°F) [odds ratio (OR)=13.84; 95% confidence interval (CI): 4.05, 47.29], and this increased risk continued for up to 4 d (OR=2.43; 95% CI: 1.15, 5.10). Asthma and pneumonia were the only respiratory outcomes positively associated with the HI: ED visits for both were highest the day after a heat event (Asthma: HI>27°C(80°F) OR=1.18; 95% CI: 1.00, 1.39; Pneumonia: HI>28°C(82°F) OR=1.40; 95% CI: 1.06, 1.84). There was a decreased odds of bronchitis-related ED visits when the HI was above thresholds of 21.1-28°C (70-82°F) across all lag days. We found stronger effects for ischemia and myocardial infarction (MI) than for respiratory outcomes. Multiple days of warm weather were associated with an increased risk of health impacts. For each additional preceding day above a HI of 22°C (72°F), the odds of ED visits related to ischemia increased 6% (95% CI: 1%, 12%); for each additional preceding day above a HI of 21.1°C (70°F), the odds of ED visits related to MI increased 7% (95% CI: 1%, 14%). DISCUSSION This study demonstrates the importance of planning for extreme heat events and developing local guidance for heat warnings, even in areas with historically mild summertime climates. https://doi.org/10.1289/EHP11363.
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Affiliation(s)
- Micah B Hahn
- Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Grace Kuiper
- Institute for Circumpolar Health Studies, University of Alaska Anchorage, Anchorage, Alaska, USA
- Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, Colorado, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, Colorado, USA
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Ragettli MS, Saucy A, Flückiger B, Vienneau D, de Hoogh K, Vicedo-Cabrera AM, Schindler C, Röösli M. Explorative Assessment of the Temperature-Mortality Association to Support Health-Based Heat-Warning Thresholds: A National Case-Crossover Study in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4958. [PMID: 36981871 PMCID: PMC10049426 DOI: 10.3390/ijerph20064958] [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: 01/16/2023] [Revised: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Defining health-based thresholds for effective heat warnings is crucial for climate change adaptation strategies. Translating the non-linear function between heat and health effects into an effective threshold for heat warnings to protect the population is a challenge. We present a systematic analysis of heat indicators in relation to mortality. We applied distributed lag non-linear models in an individual-level case-crossover design to assess the effects of heat on mortality in Switzerland during the warm season from 2003 to 2016 for three temperature metrics (daily mean, maximum, and minimum temperature), and various threshold temperatures and heatwave definitions. Individual death records with information on residential address from the Swiss National Cohort were linked to high-resolution temperature estimates from 100 m resolution maps. Moderate (90th percentile) to extreme thresholds (99.5th percentile) of the three temperature metrics implied a significant increase in mortality (5 to 38%) in respect of the median warm-season temperature. Effects of the threshold temperatures on mortality were similar across the seven major regions in Switzerland. Heatwave duration did not modify the effect when considering delayed effects up to 7 days. This nationally representative study, accounting for small-scale exposure variability, suggests that the national heat-warning system should focus on heatwave intensity rather than duration. While a different heat-warning indicator may be appropriate in other countries, our evaluation framework is transferable to any country.
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Affiliation(s)
- Martina S. Ragettli
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Apolline Saucy
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
- Barcelona Institute for Global Health (ISGlobal), 08003 Barcelona, Spain
| | - Benjamin Flückiger
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Ana M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Oeschger Center for Climate Change Research (OCCR), University of Bern, 3012 Bern, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (SwissTPH), 4123 Allschwil, Switzerland
- University of Basel, 4001 Basel, Switzerland
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