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Wang H, Geng M, Schikowski T, Areal AT, Hu K, Li W, Coelho MDSZS, Saldiva PHN, Sun W, Zhou C, Lu L, Zhao Q, Ma W. Increased Risk of Influenza Infection During Cold Spells in China: National Time Series Study. JMIR Public Health Surveill 2024; 10:e55822. [PMID: 39140274 PMCID: PMC11336504 DOI: 10.2196/55822] [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: 12/26/2023] [Revised: 05/13/2024] [Accepted: 06/01/2024] [Indexed: 08/15/2024] Open
Abstract
Background Studies have reported the adverse effects of cold events on influenza. However, the role of critical factors, such as characteristics of cold spells, and regional variations remain unresolved. Objective We aimed to systematically evaluate the association between cold spells and influenza incidence in mainland China. Methods This time series analysis used surveillance data of daily influenza from 325 sites in China in the 2014-2019 period. A total of 15 definitions of cold spells were adopted based on combinations of temperature thresholds and days of duration. A distributed lag linear model was used to estimate the short-term effects of cold spells on influenza incidence during the cool seasons (November to March), and we further explored the potential impact of cold spell characteristics (ie, intensity, duration, and timing during the season) on the estimated associations. Meta-regressions were used to evaluate the modification effect of city-level socioeconomic indicators. Results The overall effect of cold spells on influenza incidence increased with the temperature threshold used to define cold spells, whereas the added effects were generally small and not statistically significant. The relative risk of influenza-associated with cold spells was 3.35 (95% CI 2.89-3.88), and the estimated effects were stronger during the middle period of cool seasons. The health effects of cold spells varied geographically and residents in Jiangnan region were vulnerable groups (relative risk 7.36, 95% CI 5.44-9.95). The overall effects of cold spells were positively correlated with the urban population density, population size, gross domestic product per capita, and urbanization rate, indicating a sterner response to cold spells in metropolises. Conclusions Cold spells create a substantial health burden on seasonal influenza in China. Findings on regional and socioeconomic differences in the health effects of cold spells on seasonal influenza may be useful in formulating region-specific public health policies to address the hazardous effects of cold spells.
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Affiliation(s)
- Haitao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| | - Mengjie Geng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tamara Schikowski
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Ashtyn Tracey Areal
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Wen Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| | | | | | - Wei Sun
- Taierzhuang Center for Disease Control and Prevention, Zaozhuang, China
| | - Chengchao Zhou
- Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Liang Lu
- Shandong University Climate Change and Health Center, Jinan, China
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
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Ning Z, He S, Liao X, Ma C, Wu J. Health impacts of a cold wave and its economic loss assessment in China's high-altitude city, Xining. Arch Public Health 2024; 82:52. [PMID: 38632636 PMCID: PMC11025205 DOI: 10.1186/s13690-024-01284-7] [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: 02/08/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE Amidst climate change, extensive research has centered on the health impacts of heatwaves, yet the consequences of cold spells, particularly in cooler, higher-altitude regions, remain under-explored. METHODS Analyzing climatic data and non-accidental mortality in Xining, China's second-highest provincial capital, from 2016 to 2020, this study defines cold spells as daily mean temperatures below the 10th, 7.5th, or 5th percentiles for 2-4 consecutive days. A time-stratified case-crossover approach and distributional lag nonlinear modeling were used to assess the link between cold spells and mortality, calculating attributable fractions (AFs) and numbers (ANs) of deaths. The study also examined the impact of cold spells over different periods and analyzed the value of a statistical life (VSL) loss in 2018, a year with frequent cold spells. Stratified analyses by sex, age, and education level were conducted. RESULTS A significant association was found between cold spells and non-accidental mortality, with a relative risk of 1.548 (95% CI: 1.300, 1.845). The AF was 33.48%, with an AN of 9,196 deaths during the study's cold period. A declining trend in mortality risk was observed from 2019-2020. The 2018 VSL was approximately 2.875 billion CNY, about 1.75% of Xining's GDP. Higher risks were noted among males, individuals aged ≥ 65, and those with lower education levels. CONCLUSION The findings underscore the vulnerability and economic losses of high-altitude cities to cold spells. Implementing interventions such as improved heating, educational programs, and community support is vital for mitigating these adverse health effects.
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Affiliation(s)
- Zhenxu Ning
- Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China
| | - Shuzhen He
- Department of Public Health, Xining Centre for Disease Control and Prevention, Xining, China.
| | - Xinghao Liao
- Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China
| | - Chunguang Ma
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Jing Wu
- Xining Centre for Disease Control and Prevention, Xining, China
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Liu P, Chen Z, Han S, Xia X, Wang L, Li X. The added effects of cold spells on stroke admissions: Differential effects on ischemic and hemorrhagic stroke. Int J Stroke 2024; 19:217-225. [PMID: 37697456 DOI: 10.1177/17474930231203129] [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] [Indexed: 09/13/2023]
Abstract
BACKGROUND Epidemiological evidence suggests an association between low ambient temperature and stroke risk, but available data are limited particularly on associations with different stroke subtypes. AIMS The aim of this study is to estimate the relationship between cold spells and stroke admissions, including the effect of cold spells on different stroke subtypes (ischemic stroke and intracerebral hemorrhage (ICH)). METHODS A total of 144,405 stroke admissions from the Tianjin Centre for Health and Meteorology Multidisciplinary Innovation in China, covering the period from January 2016 to December 2020, were studied, as well as meteorological and air pollutant data. A generalized additive model with a distributed lag nonlinear model was employed to assess the relationship, considering 12 different definitions of a cold spell based on various temperature thresholds and durations. The analysis controlled for lagged and nonlinear effects of temperature. Analyses were performed on all strokes as well as ischemic stroke and ICH. RESULTS There was a significant increase in stroke admissions during cold spells. Generally, the increased risk during cold spells increased as the temperature threshold decreased, but was not significantly affected by the duration. The optimal model was obtained using the cold-spell definition based on an average daily temperature below the 10th percentile (0.11°C) for 2 or more consecutive days. According to this model, the effect of cold spells on ischemic stroke admissions had a significant lag effect and was long-lasting, with a single-day effect occurring on lag 7d, peaking on lag 13d (relative risk (RR) = 1.05; 95% confidence interval (CI) = 1.02 to 1.09), and lasting until lag 20d. In contrast, the effect on ICH was immediate and short-lived, with the most significant single-day effect occurring on the current day (RR = 1.17; 95% CI = 1.06 to 1.29) and limited within 3 days. 14.15% of stroke cases could be attributed to cold spells, with ICH exhibiting a higher burden than ischemic stroke except for strict temperature threshold definitions. CONCLUSION Cold spells are associated with an increased stroke risk. Different patterns of association were seen for different stroke subtypes. The effect on ischemic stroke had a lag effect and a longer duration, whereas the effect on ICH had an immediate effect and a shorter duration. These findings support the development and improvement of stroke cold-spell early warning systems and highlight the importance of public health interventions to mitigate the adverse health impacts of cold spells.
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Affiliation(s)
- Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Suqin Han
- Research Institute of Meteorological Science, Tianjin, China
- Tianjin Center for Health and Meteorology Multidisciplinary Innovation, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Center for Health and Meteorology Multidisciplinary Innovation, Tianjin, China
| | - Lin Wang
- Tianjin Center for Health and Meteorology Multidisciplinary Innovation, Tianjin, China
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
- Tianjin Center for Health and Meteorology Multidisciplinary Innovation, Tianjin, China
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Wang W, Ma Y, Qin P, Liu Z, Zhao Y, Jiao H. Assessment of mortality risks due to a strong cold spell in 2022 in China. Front Public Health 2023; 11:1322019. [PMID: 38131020 PMCID: PMC10733490 DOI: 10.3389/fpubh.2023.1322019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Background With the intensification of global climate warming, extreme low temperature events such as cold spells have become an increasingly significant threat to public health. Few studies have examined the relationship between cold spells and mortality in multiple Chinese provinces. Methods We employed health impact functions for temperature and mortality to quantify the health risks of the first winter cold spell in China on November 26th, 2022, and analyzed the reasons for the stronger development of the cold spell in terms of the circulation field. Results This cold spell was a result of the continuous reinforcement of the blocking high-pressure system in the Ural Mountains, leading to the deepening of the cold vortex in front of it. Temperature changes associated with the movement of cold fronts produced additional mortality risks and mortality burdens. In general, the average excess risk (ER) of death during the cold spell in China was 2.75%, with a total cumulative excess of 369,056 deaths. The health risks associated with temperatures were unevenly distributed spatially in China, with the ER values ranging from a minimum of 0.14% to a maximum of 5.72%, and temperature drops disproportionately affect southern regions of China more than northern regions. The cumulative excess deaths exibited the highest in eastern and central China, with 87,655 and 80,230 respectively, and the lowest in northwest China with 27,474 deaths. Among the provinces, excess deaths pronounced the highest in Shandong with 29,492 and the lowest in Tibet with only 196. Conclusion The study can provide some insight into the mortality burden of cold spells in China, while emphasising the importance of understanding the complex relationship between extreme low temperature events and human health. The outcomes could provide valuable revelations for informing pertinent public health policies.
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Affiliation(s)
- Wanci Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Pengpeng Qin
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Zongrui Liu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Yuhan Zhao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, China
| | - Haoran Jiao
- Liaoning Provincial Meteorological Bureau, Shenyang, China
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Feng J, Cao D, Zheng D, Qian ZM, Huang C, Shen H, Liu Y, Liu Q, Sun J, Jiao G, Yang X, McMillin SE, Wang C, Lin H, Zhang X, Zhang S. Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:160726. [PMID: 36502973 DOI: 10.1016/j.scitotenv.2022.160726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.
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Affiliation(s)
- Jin Feng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dawei Cao
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Dashan Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 102200, China; Institute of Healthy China, Tsinghua University, Beijing 102200, China
| | - Huiqing Shen
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Yi Liu
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102200, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310000, Zhejiang, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing 102200, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing 102200, China
| | - Stephen Edward McMillin
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 63103, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450000, Henan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xinri Zhang
- NHC Key Laboratory of Pneumoconiosis, Shanxi Key Laboratory of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi, China.
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
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Alam MM, Mahtab ASM, Ahmed MR, Hassan QK. Characterizing Cold Days and Spells and Their Relationship with Cold-Related Mortality in Bangladesh. SENSORS (BASEL, SWITZERLAND) 2023; 23:2832. [PMID: 36905035 PMCID: PMC10007433 DOI: 10.3390/s23052832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
This research examined the characteristics of cold days and spells in Bangladesh using long-term averages (1971-2000) of maximum (Tmax) and minimum temperatures (Tmin) and their standard deviations (SD). Cold days and spells were calculated and their rate of change during the winter months (December-February) of 2000-2021 was quantified. In this research, a cold day was defined as when the daily maximum or minimum temperature is ≤-1.5 the standard deviations of the long-term daily average of maximum or minimum temperature and the daily average air temperature was equal to or below 17 °C. The results showed that the cold days were more in the west-northwestern regions and far less in the southern and southeastern regions. A gradual decrease in cold days and spells was found from the north and northwest towards the south and southeast. The highest number of cold spells (3.05 spells/year) was experienced in the northwest Rajshahi division and the lowest (1.70 spells/year) in the northeast Sylhet division. In general, the number of cold spells was found to be much higher in January than in the other two winter months. In the case of cold spell severity, Rangpur and Rajshahi divisions in the northwest experienced the highest number of extreme cold spells against the highest number of mild cold spells in the Barishal and Chattogram divisions in the south and southeast. While nine (out of twenty-nine) weather stations in the country showed significant trends in cold days in December, it was not significant on the seasonal scale. Adapting the proposed method would be useful in calculating cold days and spells to facilitate regional-focused mitigation and adaptation to minimize cold-related deaths.
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Affiliation(s)
- Md. Mahbub Alam
- Department of Physics, Khulna University of Engineering and Technology, Khulna 9203, Bangladesh
| | - A. S. M. Mahtab
- Department of Physics, Khulna University of Engineering and Technology, Khulna 9203, Bangladesh
| | - M. Razu Ahmed
- Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Quazi K. Hassan
- Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
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Wang Y, Lin L, Xu Z, Wang L, Huang J, Zhou M, Li G. Have residents adapted to heat wave and cold spell in the 21st century? Evidence from 136 Chinese cities. ENVIRONMENT INTERNATIONAL 2023; 173:107811. [PMID: 36878108 DOI: 10.1016/j.envint.2023.107811] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Global climate change has increased the probability and intensity of extreme weather events. The adverse health effect of extreme temperature has gone through a temporal variation over years. Time-series data including city-level daily cardiovascular death records and meteorological data were collected from 136 Chinese cities during 2006 and 2019. A time-varying distributed lag model with interaction terms was applied to assess the temporal change of mortality risk and attributable mortality of heat wave and cold spell. The mortality effect of heat wave generally increased and that of cold spell decreased significantly in the total population during the study period. The heat wave effect increased especially among the female and people aged 65 to 74. As for the cold spell, the reduced susceptibility was detected both in the temperate and cold climatic zone. Our findings appeal for counterpart measures corresponding to sub-populations and regions responding to future extreme climate events from the public and individuals.
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Affiliation(s)
- Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Lin Lin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Environmental Research Group, MRC Centre for Environment and Health, Sir Michael Uren Building, Imperial College London, White City Campus, 80-92 Wood Lane, London W12 0BZ, United Kingdom.
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Hu X, Tao J, Zheng H, Ding Z, Cheng J, Shen T. Impact of cold spells on COPD mortality in Jiangsu Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:6048-6054. [PMID: 35986849 DOI: 10.1007/s11356-022-22387-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
Ambient cold is associated with substantial population attributable fraction of mortality in China, and respiratory health is vulnerable to cold exposure. This study aimed to examine the effect of cold spells on risk of deaths from chronic obstructive pulmonary disease (COPD). We collected daily data on deaths from COPD and climatic factors from 1 January 2016 to 31 December 2019 in 13 cities of Jiangsu Province, China. We used a quasi-Poisson generalized linear model coupled with a distributed lag non-linear model to quantify the association between risk of COPD deaths and exposure to cold spells (defined as 2 or more consecutive days with mean temperature ≤ 5th percentile of daily mean temperature distribution in cold months). Stratification analyses by age, sex, education, and occupation were undertaken to identify vulnerable subgroups. The results suggested that exposure to cold spells was associated with a higher risk of COPD deaths in Lianyungang (relative risk (RR): 1.70; 95% confidence interval (CI): 1.31, 2.21), Nanjing (RR: 1.54; 95% CI: 1.16, 2.04), Nantong (RR: 1.97; 95% CI: 1.68, 2.31), Suzhou (RR: 1.97; 95% CI: 1.55, 2.50), Suqian (RR: 1.68; 95% CI: 1.23, 2.29), Taizhou (RR: 1.70; 95% CI: 1.32, 2.19), Wuxi (RR: 1.99; 95% CI: 1.53, 2.60), Xuzhou (RR: 1.71; 95% CI: 1.01, 2.90), Yancheng (RR: 1.78; 95% CI: 1.53, 2.06), Yangzhou (RR: 2.78; 95% CI: 2.06, 3.76), and Zhenjiang (RR: 1.79; 95% CI: 1.26, 2.55). All subgroups seemed to be vulnerable to the effect of cold spells. The recommendation of this study is that individuals with pre-existing COPD, regardless of age, sex, education, or occupation, should be made aware of the health risk posed by cold spells and should be encouraged to take cold adaptation actions before cold season arrives. The main limitation of this study is that it is subject to ecological fallacy.
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Affiliation(s)
- Xinxin Hu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Junwen Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Zhen Ding
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Tong Shen
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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Psistaki K, Dokas IM, Paschalidou AK. The Impact of Ambient Temperature on Cardiorespiratory Mortality in Northern Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:555. [PMID: 36612877 PMCID: PMC9819162 DOI: 10.3390/ijerph20010555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
It is well-established that exposure to non-optimum temperatures adversely affects public health, with the negative impact varying with latitude, as well as various climatic and population characteristics. This work aims to assess the relationship between ambient temperature and mortality from cardiorespiratory diseases in Eastern Macedonia and Thrace, in Northern Greece. For this, a standard time-series over-dispersed Poisson regression was fit, along with a distributed lag nonlinear model (DLNM), using a maximum lag of 21 days, to capture the non-linear and delayed temperature-related effects. A U-shaped relationship was found between temperature and cardiorespiratory mortality for the overall population and various subgroups and the minimum mortality temperature was observed around the 65th percentile of the temperature distribution. Exposure to extremely high temperatures was found to put the highest risk of cardiorespiratory mortality in all cases, except for females which were found to be more sensitive to extreme cold. It is remarkable that the highest burden of temperature-related mortality was attributed to moderate temperatures and primarily to moderate cold. The elderly were found to be particularly susceptible to both cold and hot thermal stress. These results provide new evidence on the health response of the population to low and high temperatures and could be useful to local authorities and policy-makers for developing interventions and prevention strategies for reducing the adverse impact of ambient temperature.
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Affiliation(s)
- Kyriaki Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, 68200 Orestiada, Greece
| | - Ioannis M. Dokas
- Department of Civil Engineering, Democritus University of Thrace, 67100 Xanthi, Greece
| | - Anastasia K. Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, 68200 Orestiada, Greece
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Zhou F, Zhou W, Wang W, Fan C, Chen W, Ling L. Associations between Frailty and Ambient Temperature in Winter: Findings from a Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:513. [PMID: 36612832 PMCID: PMC9819953 DOI: 10.3390/ijerph20010513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Frailty is an accumulation of deficits characterized by reduced resistance to stressors and increased vulnerability to adverse outcomes. However, there is little known about the effect of ambient temperature in winter on frailty among older adults, a population segment with the highest frailty prevalence. Thus, the objective of this study is to investigate the associations between frailty and ambient temperature in winter among older adults. This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) of older adults aged ≥65 years from the 2005, 2008, 2011, and 2014 waves. The 39-item accumulation of frailty index (FI) was used to assess the frailty status of the participants. The FI was categorized into three groups as follows: robust (FI ≤ 0.10), prefrail (FI > 0.10 to <0.25), and frail (FI ≥ 0.25). Generalized linear mixed models (GLMMs) were conducted to explore the associations between frailty and ambient temperature in winter. A generalized estimating equation (GEE) modification was applied in the sensitivity analysis. A total of 9421 participants were included with a mean age of 82.81 (SD: 11.32) years. Compared with respondents living in the highest quartile (≥7.5 °C) of average temperature in January, those in the lowest quartile (<−1.9 °C) had higher odds of prefrailty (OR = 1.35, 95% CI 1.17−1.57) and frailty (OR = 1.61, 95%CI 1.32−1.95). The associations were stronger among the low-education groups, agricultural workers before retirement, and non-current exercisers. Additionally, results from the GEE model reported consistent findings. Lower levels of ambient temperature in winter were associated with higher likelihoods of prefrailty and frailty. The findings on vulnerability characteristics could help improve public health practices to tailor cold temperature health education and warning information.
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Du J, Cui L, Ma Y, Zhang X, Wei J, Chu N, Ruan S, Zhou C. Extreme cold weather and circulatory diseases of older adults: A time-stratified case-crossover study in jinan, China. ENVIRONMENTAL RESEARCH 2022; 214:114073. [PMID: 35964671 DOI: 10.1016/j.envres.2022.114073] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 07/11/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES We aimed to investigate the acute effect of extreme cold weather on circulatory disease mortality of older adults in Jinan, with individual and regional-scale characteristics as subgroup analyses to further identify vulnerable populations. METHODS This study contained the death data of Jinan from 2011 to 2020 (Nov-Mar). A time-stratified case-crossover method was used to estimate the effects of extreme cold weather and lags 0-8 days, controlling for holiday and relative humidity. To evaluate the impact of different durations and thresholds of extreme cold weather, we considered 4 cold day and 12 cold wave definitions RESULTS: Our results showed an increase in circulatory disease deaths under several definitions. The number of older adults died of circulatory diseases totaled 92,119 during the study period. In the definitions of cold day, the maximum significant effect ranging from 1.08 (95% CI: 1.03,1.14) to 1.13 (95% CI: 1.04,1.24) and appeared on Lag5 or Lag6. In the definitions of cold wave, the maximum significant effect ranging from 1.07 (95% CI: 1.02, 1.12) to 1.14 (95% CI: 1.03, 1.25). The cold effect is mainly attributable to cold day rather than an added effect related to the duration. Our research confirmed that extreme cold weather had a stronger impact on women [maximum effects with an OR of 1.21 (95% CI: 1.08, 1.36) in P1, 1.19 (95% CI: 1.05, 1.36) in M12)], and the effect gradient increased with age. CONCLUSIONS Our findings support the evidence on the impact of extreme cold weather on circulatory disease mortality and provide a basis for policymakers to select target groups to develop policies and reduce the public health burden.
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Affiliation(s)
- Jipei Du
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Liangliang Cui
- Jinan Municipal Center for Disease Control and Prevention; Jinan Municipal Center for Disease Control and Prevention Affiliated to Shandong University, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Yiwen Ma
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Xianhui Zhang
- Jinan Municipal Center for Disease Control and Prevention; Jinan Municipal Center for Disease Control and Prevention Affiliated to Shandong University, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China
| | - Jinli Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Nan Chu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Shiman Ruan
- Jinan Municipal Center for Disease Control and Prevention; Jinan Municipal Center for Disease Control and Prevention Affiliated to Shandong University, 2 Weiliu Road, Huaiyin District, Jinan, 250021, China.
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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12
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He Y, Zhang X, Gao J, Gao H, Cheng J, Xu Z, Pan R, Yi W, Song J, Liu X, Tang C, Song S, Su H. The impact of cold spells on schizophrenia admissions and the synergistic effect with the air quality index. ENVIRONMENTAL RESEARCH 2022; 212:113243. [PMID: 35398316 DOI: 10.1016/j.envres.2022.113243] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/20/2022] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Under current global climate conditions, there are insufficient studies on the health influences of cold spells, especially on mental health. This study aimed to examine the effect of cold spells on schizophrenia admissions and to analyze the potential interaction effect with the air quality index (AQI). METHODS Daily data on schizophrenia admissions and climatic variables in Hefei were collected from 2013 to 2019. Based on 20 definitions, the impacts of cold spells were quantified separately to find the most appropriate definition for the region, and meta-regression was used to explore the different effect sizes of the different days in a cold spell event. In addition, the potential interaction effect was tested by introducing a categorical variable, CSH, reflecting the cold spell and AQI level. RESULTS The cold spell defined by temperature below the 6th centile while lasting for at least three days produced the optimum model fit performance. In general, the risk of schizophrenia admissions increased on cold spell days. The largest single-day effect occurred on the 12th day with RR = 1.081 (95% CI: 1.044, 1.118). In a single cold spell event, the effect of the 3rd and subsequent days of a cold spell (RR = 1.082, 95% CI: 1.036, 1.130) was higher than that on the 2nd day (RR = 1.054, 95% CI: 1.024, 1.085). Similarly, the effect of the 2nd day was also higher than that of the 1st day (RR = 1.027, 95% CI: 1.012, 1.042). We found a synergistic effect between cold spells and high AQI in the male group, and the relative excess risk due to interaction (RERI) was 0.018 (95% CI: 0.005-0.030). CONCLUSIONS This study suggested that the impacts of cold spells should be considered based on the definition of the most appropriate for the region when formulating targeted measures of schizophrenia. The discovery of the synergistic effect was referred to help the selection of the timing of precautions for susceptible people.
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Affiliation(s)
- Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xulai Zhang
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Jiaojiao Gao
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hua Gao
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Huang Y, Yang J, Chen J, Shi H, Lu X. Association between ambient temperature and age-specific mortality from the elderly: Epidemiological evidence from the Chinese prefecture with most serious aging. ENVIRONMENTAL RESEARCH 2022; 211:113103. [PMID: 35278469 DOI: 10.1016/j.envres.2022.113103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 05/16/2023]
Abstract
Older people are main susceptible group affected by non-optimal temperature. The aim of the study was to determine how mortality of older people with different ages are affected by temperatures. For this study, we collected data of all-cause death of 256,037 people aged between 65 and 104 years of age from a prefecture located in the north subtropical area with most serious aging rate in 2000, 2010 and 2020 in China. A distributed lag nonlinear model under different age groups was used to estimate non-optimal temperature associations to mortality. The results revealed: (1) With increasing age, older people were more likely to die during moderate low temperature, the proportion of attributable fraction of moderate low temperature in all temperature gradually increased with age. (2) Moderate low temperature could be divided into two parts, the lower part caused most death at age 65-79 and the higher part was not so dangerous, while for age 80+, preventive actions should be taken for both parts. (3) A leveling-off and deceleration phenomenon was observed at age 95-99 for low temperature, but not 100-104, it may be virtually a consequence of "harvesting effect" in that susceptible and common people have died before age 95, it was coincidence with mortality deceleration at extreme old ages found by demographic scholars over the past 200 years. (4) Heat wave had much higher relative risk than cold spell compared with moderate high and low temperature because of steeper slope of relative risk at the period of moderate-extreme conversion of high temperature, the older people should pay more attention to weather with moderate-extreme conversion of high temperature. Furthermore, our findings could help improve the understanding of non-optimal temperature on health of older people and support the development of response strategies for different seasons at different ages.
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Affiliation(s)
- Yi Huang
- School of Geographic Sciences, Nantong University, Nantong, 226000, China.
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jianwei Chen
- School of Geographic Sciences, Nantong University, Nantong, 226000, China
| | - Hujing Shi
- School of Geographic Sciences, Nantong University, Nantong, 226000, China
| | - Xianjing Lu
- School of Geographic Sciences, Nantong University, Nantong, 226000, China
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Ni W, Schneider A, Wolf K, Zhang S, Chen K, Koenig W, Peters A, Breitner S. Short-term effects of cold spells on plasma viscosity: Results from the KORA cohort study in Augsburg, Germany. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 302:119071. [PMID: 35231540 DOI: 10.1016/j.envpol.2022.119071] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/11/2022] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
As the underlying mechanisms of the adverse effects of cold spells on cardiac events are not well understood, we explored the effects of cold spells on plasma viscosity, a blood parameter linked to cardiovascular disease. This cross-sectional study involved 3622 participants from the KORA S1 Study (1984-1985), performed in Augsburg, Germany. Exposure data was obtained from the Bavarian State Office for the Environment. Cold spells were defined as two or more consecutive days with daily mean temperatures below the 3rd, 5th, or 10th percentile of the distribution. The effects of cold spells on plasma viscosity were explored by generalized additive models with distributed lag nonlinear models (DLNM). We estimated cumulative effects at lags 0-1, 0-6, 0-13, 0-20, and 0-27 days separately. Cold spells (mean temperature <3rd, <5th or <10th percentile) were significantly associated with an increase in plasma viscosity with a lag of 0-1 days [%change of geometric mean (95% confidence interval): 1.35 (0.06-2.68), 1.35 (0.06-2.68), and 2.49 (0.34-4.69), respectively], and a lag of 0-27 days [18.81 (8.97-29.54), 17.85 (8.29-28.25), and 7.41 (3.35-11.0), respectively]. For the analysis with mean temperature <3rd or 10th percentile, we also observed significant associations at lag 0-20 days [8.34 (0.43-16.88), and 4.96 (1.68, 8.35), respectively]. We found that cold spells had significant immediate and longer lagged effects on plasma viscosity. This finding supports the complex interplay of multiple mechanisms of cold on adverse cardiac events and enriches the knowledge about how cold exposure acts on the human body.
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Affiliation(s)
- Wenli Ni
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, 06520, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Wolfgang Koenig
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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15
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Sun Q, Sun Z, Chen C, Yan M, Zhong Y, Huang Z, He L, Li T. Health risks and economic losses from cold spells in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 821:153478. [PMID: 35093380 DOI: 10.1016/j.scitotenv.2022.153478] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cold significantly increases the risk of mortality. However, the health risks associated with cold spells, persistent and extreme cold temperature events, have yet to be investigated in detail. METHODS Meteorological and mortality data was collated from 280 counties in China from 2013 through 2019. GLM (Generalized Linear Models) was used to calculate county-level exposure-response relationships for nine different cold spell definitions. Next, we estimated the exposure-response associations between cold spells and mortality in national, Southern, and Northern China. Based on exposure-response relationships, along with the population and mortality data, we then calculated the number of excess deaths due to the cold spell of 2839 counties across China in 2018. Then, we calculated the loss of VSL (value of a statistical life) in each province. RESULTS We identified that P5day7 was the cold spell definition that was associated with the highest health in China. Compared with non-cold spell days, the risk of non-accidental mortality, circulatory mortality, and respiratory mortality, on cold spell days increased by 17.4% (95% confidence interval [CI]: 15.8%, 19.0%), 20.8% (95%CI: 18.8%, 23.0%), and 22.7% (95%CI: 19.5%, 25.9%) respectively at lag 7 day in the South. In the North, the risk increased by 13.0% (95% CI: 11.0%, 15.0%), 13.8% (95% CI: 11.4%, 16.2%), and 21.0% (95% CI: 16.6%, 25.6%), respectively. The number of related deaths in China were 57,783, 29,827, and 10,922. The corresponding VSLs were 229,195, 118,322, and 43,315 million CNY (Chinese Yuan), thus accounting for 0.25%, 0.13%, and 0.05% of national GDP (Gross Domestic Product). CONCLUSION Cold spells have caused a severe epidemiological and economic burden in China. South China should pay more attention to the health risks associated with cold spells.
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Affiliation(s)
- Qinghua Sun
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiying Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yu Zhong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zihao Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lihua He
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Lei J, Chen R, Yin P, Meng X, Zhang L, Liu C, Qiu Y, Ji JS, Kan H, Zhou M. Association between Cold Spells and Mortality Risk and Burden: A Nationwide Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:27006. [PMID: 35157500 PMCID: PMC8843087 DOI: 10.1289/ehp9284] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Few multicity studies have evaluated the association between cold spells and mortality risk and burden. OBJECTIVES We aimed to estimate the association between cold spells and cause-specific mortality and to evaluate the mortality burden in China. METHODS We conducted a time-series analysis with a nationally representative Disease Surveillance Points System database during the cool seasons spanning from 2013 to 2015 in 272 Chinese cities. We used 12 cold-spell definitions and overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative association of cold spells over lags of 0-28 d. We controlled for the nonlinear and lagged effects of cold temperature over 0-28 d to evaluate the added effect estimates of cold spell. We also quantified the nationwide mortality burden and pooled the estimated association at national and different climatic levels with meta-regression models. RESULTS For the cold-spell definition of daily mean temperatures of ≤5th percentile of city-specific daily mean temperature and duration of ≥4 consecutive d, the relative risks (i.e., risk ratios) associated with cold spells were 1.39 [95% confidence interval (CI): 1.15, 1.69] for non-accidental mortality, 1.66 (95% CI: 1.20, 2.31) for coronary heart disease mortality, 1.49 (95% CI: 1.12, 1.97) for stroke mortality, and 1.26 (95% CI: 0.85, 1.87) for chronic obstructive pulmonary disease mortality. Cold spells showed a maximal lagged association of 28 d with the risks peaked at 10-15 d. A statistically significant attributable fraction (AF) of non-accidental mortality [2.10% (95% CI: 0.94%, 3.04%)] was estimated. The risks were higher in the temperate continental and the temperate monsoon zones than in the subtropical monsoon zone. The elderly population was especially vulnerable to cold spells. DISCUSSION Our study provides evidence for the significant relative risks of non-accidental, cardiovascular, and respiratory mortality associated with cold spells. The findings on vulnerable populations and differential risks in different climatic zones may help establish region-specific forecasting systems against the hazardous impact of cold spells. https://doi.org/10.1289/EHP9284.
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Affiliation(s)
- Jian Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence (IRDR ICoE) on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lina Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yang Qiu
- Department of Environmental Sciences and Engineering, School of Architecture and Environmental Sciences, Sichuan University, Chengdu, China
| | - John S. Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission (NHC) Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
- Integrated Research on Disaster Risk International Center of Excellence (IRDR ICoE) on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Meng C, Ke F, Xiao Y, Huang S, Duan Y, Liu G, Yu S, Fu Y, Peng J, Cheng J, Yin P. Effect of Cold Spells and Their Different Definitions on Mortality in Shenzhen, China. Front Public Health 2022; 9:817079. [PMID: 35141195 PMCID: PMC8818748 DOI: 10.3389/fpubh.2021.817079] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
A high premium has been put on researching the effects of cold spells because of their adverse influence on people's daily lives and health. The study aimed to find the most appropriate definition of the cold spell in Shenzhen and quantify the impact of cold spells on mortality. Based on the daily mortality data in Shenzhen from 2013 to 2017 and the meteorological and pollutant data from the same period, we quantified the effect of cold spells using eight different definitions in the framework of a distributed lag non-linear model with a quasi-Poisson distribution. In Shenzhen, low temperatures increase the risk of death more significantly than high temperatures (using the optimal temperature as the cut-off value). Comparing the quasi-Akaike information criterion value, attribution fraction (b-AF), and attribution number (b-AN) for all causes of deaths and non-accidental deaths, the optimal definition of the cold spell was defined as the threshold was 3rd percentile of the daily average temperature and duration for 3 or more consecutive days (all causes: b-AF = 2.31% [1.01–3.50%], b-AN = 650; non-accidental: b-AF = 1.92% [0.57–3.17%], b-AN = 471). For cardiovascular deaths, the best definition was the temperature threshold as the 3rd percentile of the daily average temperature with a duration of 4 consecutive days (cardiovascular: b-AF = 1.37% [0.05–2.51%], b-AN = 142). Based on the best definition in the model, mortality risk increased in cold spells, with a statistically significant lag effect occurring as early as the 4th day and the effect of a single day lasting for 6 days. The maximum cumulative effect occurred on the 14th day (all-cause: RR = 1.54 [95% CI, 1.20–1.98]; non-accidental: RR = 1.43 [95% CI, 1.11–1.84]; cardiovascular: RR = 1.58 [95% CI, 1.00–2.48]). The elderly and females were more susceptible to cold spells. Cold spells and their definitions were associated with an increased risk of death. The findings of this research provide information for establishing an early warning system, developing preventive measures, and protecting susceptible populations.
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Affiliation(s)
- Chengzhen Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Ke
- Children's Health Care Hospital, Wuhan, China
| | - Yao Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
- *Correspondence: Ji Peng
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Jinquan Cheng
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ping Yin
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Zhai L, Ma X, Wang J, Luan G, Zhang H. Effects of ambient temperature on cardiovascular disease: a time-series analysis of 229288 deaths during 2009-2017 in Qingdao, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:181-190. [PMID: 32196376 DOI: 10.1080/09603123.2020.1744532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/14/2020] [Indexed: 06/10/2023]
Abstract
The association between ambient temperature and cardiovascular mortality varied by regions, populations, and climates. We estimated the relative risk (RR) of cardiovascular mortality using 229,288 death cases of cardiovascular disease in Qingdao China from 1 January 2009, to 31 December 2017. A distributed lag non-linear model was used. The temperature showed a negative association with the cardiovascular mortality. The RR of cardiovascular death at -4.8 °C was 2.05 (95% CI: 1.55, 2.69). The high temperature had acute and short-term effects with the maximum risk occurring 0 day of exposure. The low temperature had the greatest effect on the 4th lag day. The cold temperature effect was stronger for males than females. The estimates of temperature-related cardiovascular mortality risk were higher in people age ≥75 years. Our study showed that the cold and hot ambient temperature had a relationship with the risk of cardiovascular mortality.
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Affiliation(s)
- Long Zhai
- Department of Occupational Health, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Department of Occupational Health, Qingdao Institute of Prevention Medicine, Qingdao, China
| | - Xiaojia Ma
- Department of Social Prevention and Control, Qingdao Mental Health Center, Qingdao, China
| | - Junhui Wang
- Department of Second Supervisory Section, Shibei District Health Supervision Institute, Qingdao, China
| | - Guijie Luan
- Department of Planned Immunization, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Hua Zhang
- Department of Chronic Noncommunicable Diseases, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Department of Chronic Noncommunicable Diseases, Qingdao Institute of Prevention Medicine, Qingdao, China
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Yatim ANM, Latif MT, Sofwan NM, Ahamad F, Khan MF, Mahiyuddin WRW, Sahani M. The association between temperature and cause-specific mortality in the Klang Valley, Malaysia. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:60209-60220. [PMID: 34156627 DOI: 10.1007/s11356-021-14962-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/13/2021] [Indexed: 06/13/2023]
Abstract
This study aims to examine the relationship between daily temperature and mortality in the Klang Valley, Malaysia, over the period 2006-2015. A quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM) was used to estimate the association between the mean temperature and mortality categories (natural n=69,542, cardiovascular n= 15,581, and respiratory disease n=10,119). Particulate matter with an aerodynamic diameter below 10 μm (PM10) and surface ozone (O3) was adjusted as a potential confounding factor. The relative risk (RR) of natural mortality associated with extreme cold temperature (1st percentile of temperature, 25.2 °C) over lags 0-28 days was 1.26 (95% confidence interval (CI): 1.00, 1.60), compared with the minimum mortality temperature (28.2 °C). The relative risk associated with extremely hot temperature (99th percentile of temperature, 30.2 °C) over lags 0-3 days was 1.09 (95% CI: 1.02, 1.17). Heat effects were immediate whereas cold effects were delayed and lasted longer. People with respiratory diseases, the elderly, and women were the most vulnerable groups when it came to the effects of extremely high temperatures. Extreme temperatures did not dramatically change the temperature-mortality risk estimates made before and after adjustments for air pollutant (PM10 and O3) levels.
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Affiliation(s)
- Ahmad Norazhar Mohd Yatim
- Space Science Centre (ANGKASA), Institute of Climate Change, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Talib Latif
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia.
| | - Nurzawani Md Sofwan
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
- Department of Environmental Health, Faculty of Health Sciences, Universiti Teknologi Mara, Sarawak Branch, Samarahan Campus, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Fatimah Ahamad
- AQ Expert Solutions, Jalan Dato Muda Linggi, 70100, Seremban, Negeri Sembilan, Malaysia
| | - Md Firoz Khan
- Department of Chemistry, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Climate Change Unit, Environmental Health Research Center, Institute for Medical Research, Level 2, Block C6, National Institute of Health, Jalan Setia Murni U13/52, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Mazrura Sahani
- Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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20
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Denpetkul T, Phosri A. Daily ambient temperature and mortality in Thailand: Estimated effects, attributable risks, and effect modifications by greenness. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148373. [PMID: 34126499 DOI: 10.1016/j.scitotenv.2021.148373] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In recent years, many previous studies have examined the association between ambient temperature and mortality in different parts of the world. However, very few studies have explored the mortality burden attributable to temperature, especially those in developing countries. This study aimed to quantify the burden of mortality attributable to non-optimum temperature in Thailand and explore whether greenness, using normalized difference vegetation index (NDVI) as indicator, alleviates the mortality contributed by non-optimum ambient temperature. METHODS Daily number of mortality (i.e., all-cause, cardiovascular and respiratory diseases) and daily meteorological data were obtained over 65 provinces in Thailand during 2010 to 2017. The two-stage statistical approach was applied to estimate the association between temperature and mortality. First, the time-stratified case-crossover analysis was performed to examine province-specific temperature-mortality association. Second, province-specific association was pooled to derive national estimates using multivariate meta-regression. Mortality burden attributable to temperature was then estimated, and the association between attributed mortality and NDVI was explored using multivariate meta-regression models. RESULTS A total of 2,891,407 all-cause of death was included over the study period, in which 403,450 and 264,672 deaths were accounted for cardiovascular and respiratory diseases, respectively. The temperature-mortality association at cumulative lag 0-7 days was non-linear with J-shaped curve for all-cause and respiratory mortality, whereas V-shaped curve was observed for cardiovascular mortality. Using minimum mortality temperature (MMT) as optimum temperature, 3.72% (95% empirical CI: 2.18, 5.21) of all-cause, 2.92% (0.55, 5.10) of cardiovascular and 3.00% (0.27, 5.49) of respiratory mortality were attributable to non-optimum temperature (both hot and cold effects). Higher level of NDVI was associated with alleviated impacts of non-optimum temperature, especially hot temperature. CONCLUSION Exposure to non-optimum temperature was associated with increased risks of mortality in Thailand. This finding is useful for planning the public health interventions to reduce health effects of non-optimum ambient temperature.
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Affiliation(s)
- Thammanitchpol Denpetkul
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
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21
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Chen Y, Kong D, Fu J, Zhang Y, Zhao Y, Liu Y, Chang Z, Liu Y, Liu X, Xu K, Jiang C, Fan Z. Increased hospital admissions for asthma from short-term exposure to cold spells in Beijing, China. Int J Hyg Environ Health 2021; 238:113839. [PMID: 34507107 DOI: 10.1016/j.ijheh.2021.113839] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a paucity of studies investigating extreme cold events and asthma exacerbations. This study examined whether an association exists between cold spells and daily hospital admissions for asthma in Beijing, China from 2012 to 2016. METHODS Daily hospital admissions for asthma, meteorological variables and air quality data were collected during 2012-2016 in Beijing. A cold spell was defined as a period of at least two consecutive days with the daily mean temperature below or at the 5th percentile (-7 °C) in cold seasons (November to March) during the study period. We applied a time-series design using quasi-Poisson regression combined with a distributed lag model to estimate the risk of asthma hospital admissions associated with cold spells. Stratified analyses by gender and age groups were conducted to identify the potential susceptible subpopulations to cold spells. We also explored the effect modification by air quality by dividing the daily air quality index (AQI) into two levels (high and low) based on the median value. RESULTS Cold spells increased the risk of asthma hospital admissions, with the maximum cumulative relative risk (CRR) over three weeks (Lag0-21) in the total population. The highest single-day relative risk (RR) was found on the days of cold spells (Lag0) with the RR = 1.059 (95% CI: 1.008-1.113), and the CRR at Lag0-21 was 1.333 (95% CI: 1.049-1.693). Across different gender and age groups, younger people (<65 years) were more sensitive to cold spells. No significant effect modification by AQI was detected. CONCLUSION Short-term exposure to cold spells is associated with an increased risk of hospital admissions for asthma in Beijing. During the cold spells, younger people aged <65 years were at particular risk for asthma exacerbations. Our results suggest that extreme cold events have a significant impact on asthma.
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Affiliation(s)
- Yuxiong Chen
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Dehui Kong
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Jia Fu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yongqiao Zhang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yakun Zhao
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yanbo Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zhen'ge Chang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yijie Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xiaole Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Kaifeng Xu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Chengyu Jiang
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Department of Biochemistry, Peking Union Medical College, Beijing, 100005, China
| | - Zhongjie Fan
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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22
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Ma C, Yang J, Nakayama SF, Iwai-Shimada M, Jung CR, Sun XL, Honda Y. Cold Spells and Cause-Specific Mortality in 47 Japanese Prefectures: A Systematic Evaluation. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:67001. [PMID: 34128690 PMCID: PMC8204943 DOI: 10.1289/ehp7109] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Many studies have investigated the devastating health effects of heat waves, but less is known about health risks related to cold spells, despite evidence that extreme cold may contribute to a larger proportion of deaths. OBJECTIVES We aimed to systematically investigate the association between cold spells and mortality in Japan. METHODS Daily data for weather conditions and 12 common causes of death during the 1972-2015 cold seasons (November-March) were obtained from 47 Japanese prefectures. Cold spells were defined as ≥2 consecutive days with daily mean temperatures ≤5th percentile for the cold season in each prefecture. Quasi-Poisson regression was combined with a distributed lag model to estimate prefecture-specific associations, and pooled associations at the national level were obtained through random-effects meta-analysis. The potential influence of cold spell characteristics (intensity, duration, and timing in season) on associations between cold spells and mortality was examined using a similar two-stage approach. Temporal trends were investigated using a meta-regression model. RESULTS A total of 18,139,498 deaths were recorded during study period. Mortality was significantly higher during cold spell days vs. other days for all selected causes of death. Mortality due to age-related physical debilitation was more strongly associated with cold spells than with other causes of death. Associations between cold spells and mortality from all causes and several more specific outcomes were stronger for longer and more intense cold spells and for cold spells earlier in the cold season. However, although all outcomes were positively associated with cold spell duration, findings for cold spell intensity and seasonal timing were heterogeneous across the outcomes. Associations between cold spells and mortality due to cerebrovascular disease, cerebral infarction, and age-related physical debility decreased in magnitude over time, whereas temporal trends were relatively flat for all-cause mortality and other outcomes. DISCUSSION Our findings may have implications for establishing tailored public health strategies to prevent avoidable cold spell-related health consequences. https://doi.org/10.1289/EHP7109.
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Affiliation(s)
- Chaochen Ma
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, Guangdong, China
| | - Shoji F. Nakayama
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Miyuki Iwai-Shimada
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Chau-Ren Jung
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Xian-Liang Sun
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Qi X, Wang Z, Xia X, Xue J, Gu Y, Han S, Yao Q, Cai Z, Wang X, Wang L, Leng SX, Li X. The effects of heatwaves and cold spells on patients admitted with acute ischemic stroke. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:309. [PMID: 33708936 PMCID: PMC7944308 DOI: 10.21037/atm-20-4256] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background This study aimed to explore the effects of heatwaves and cold spells on blood pressure, thrombus formation, and systemic inflammation at admission in patients with ischemic stroke. Methods Data of patients with ischemic stroke who were admitted to the Second Hospital of Tianjin Medical University between May 2014 and March 2019 were reviewed, along with meteorological data from the same time period. A total of 806 clinically confirmed patients with ischemic stroke (34–97 years old) were included in the final analysis. Heatwaves and cold spells were defined as ≥2 consecutive days with average temperature >95th percentile (May–August) and <5th percentile (November–March), respectively. Coagulation parameters, inflammation indices, blood pressure, and neurological impairment were evaluated within 24 hours of admission. General linear and logistic regression models were created to investigate the relationships of heatwaves and cold spells with the examination results of patients with ischemic stroke at admission. Results After adjustment for potential environmental confounders, heatwaves were positively associated with high systolic blood pressure (SBP) (β=8.693, P=0.019), diastolic blood pressure (DBP) (β=3.665, P=0.040), reduced thrombin time (TT) (β=−0.642, P=0.027), and activated partial thromboplastin time (APTT) (β=−1.572, P=0.027) in ischemic stroke patients at admission. Cold spells were positively associated with high SBP (β=5.277, P=0.028), DBP (β=4.672, P=0.012), fibrinogen (β=0.315, P=0.011), globulin (β=1.523, P=0.011), and reduced TT (β=−0.784, P<0.001) and APTT (β=−1.062, P=0.024). Cold spells were also associated with a higher risk of respiratory infection [odds ratio (OR) =2.677, P=0.001]. Conclusions Exposure to heatwaves or cold spells was associated with blood pressure and coagulation at admission in patients with ischemic stroke. Cold spells also resulted in higher levels of inflammation. These findings suggest that changes in coagulation, blood pressure, and inflammation may be the potential biological mechanisms underlying the cerebrovascular effects of exposure to extreme temperatures.
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Affiliation(s)
- Xuemei Qi
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhongyan Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Juanjuan Xue
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yumeng Gu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Suqin Han
- Tianjin Environmental Meteorology Center, Tianjin, China
| | - Qing Yao
- Tianjin Environmental Meteorology Center, Tianjin, China
| | - Ziying Cai
- Tianjin Environmental Meteorology Center, Tianjin, China
| | - Xiaojia Wang
- Tianjin Environmental Meteorology Center, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
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24
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Liu Y, Chen Y, Kong D, Liu X, Fu J, Zhang Y, Zhao Y, Chang Z, Zhao X, Xu K, Jiang C, Fan Z. Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China. BMJ Open 2021; 11:e039745. [PMID: 33408200 PMCID: PMC7789453 DOI: 10.1136/bmjopen-2020-039745] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/10/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Our work aimed at exploring the relationship between cold spells and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalisations in Beijing, China, and assessing the moderating effects of the intensities and the durations of cold spells, as well as identifying the vulnerable. DESIGN A time-series study. SETTING We obtained time-series data of AECOPD hospitalisations, meteorological variables and air quality index in Beijing, China during 2012-2016. PARTICIPANTS All AECOPD hospitalisations among permanent residents in Beijing, China during the cold seasons (November-March) of 2012-2016 were included (n=84 571). PRIMARY AND SECONDARY OUTCOME MEASURES A quasi-Poisson regression with a distributed lag model was fitted to investigate the short-term effects of cold spells on AECOPD hospitalisations by comparing the counts of AECOPD admissions during cold spell days with those during non-cold spell days. RESULTS Cold spells under different definitions were associated with increased risk of AECOPD hospitalisations, with the maximum cumulative relative risk (CRR) over 3 weeks (lag0-21). The cumulative effects at lag0-21 increased with the intensities and the durations of cold spells. Under the optimal definition, the most significant single-day relative risk (RR) was found on the days of cold spells (lag0) with an RR of 1.042 (95% CI 1.013 to 1.072), and the CRR at lag0-21 was 1.394 (95% CI 1.193 to 1.630). The elderly (aged ≥65) were more vulnerable to the effects of cold spells on AECOPD hospitalisations. CONCLUSION Cold spells are associated with increased AECOPD hospitalisations in Beijing, with the cumulative effects increased with intensities and durations. The elderly are at particular risk of AECOPD hospitalisations triggered by cold spells.
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Affiliation(s)
- Yanbo Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiong Chen
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Dehui Kong
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaole Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Fu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yongqiao Zhang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhen'ge Chang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyi Zhao
- Department of Physiotherapy, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Kaifeng Xu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Chengyu Jiang
- Department of Biochemistry, The State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhongjie Fan
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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25
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Chen S, Xiao Y, Zhou M, Zhou C, Yu M, Huang B, Xu Y, Liu T, Hu J, Xu X, Lin L, Hu R, Hou Z, Li J, Jin D, Qin M, Zhao Q, Gong W, Yin P, Xu Y, Xiao J, Zeng W, Li X, Guo L, Zhang Y, Huang C, Ma W. Comparison of life loss per death attributable to ambient temperature among various development regions: a nationwide study in 364 locations in China. Environ Health 2020; 19:98. [PMID: 32933549 PMCID: PMC7491140 DOI: 10.1186/s12940-020-00653-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/08/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Several studies have investigated the associations between ambient temperature and years of life lost (YLLs), but few focused on the difference of life loss attributable to temperature among different socioeconomic development levels. OBJECTIVES We investigated the disparity in temperature-YLL rate relationships and life loss per death attributable to nonoptimal temperature in regions with various development levels. METHODS Three hundred sixty-four Chinese counties or districts were classified into 92 high-development regions (HDRs) and 272 low-development regions (LDRs) according to socioeconomic factors of each location using K-means clustering approach. We used distributed lag non-linear models (DLNM) and multivariate meta-analysis to estimate the temperature-YLL rate relationships. We calculated attributable fraction (AF) of YLL and temperature-related average life loss per death to compare mortality burden of temperature between HDRs and LDRs. Stratified analyses were conducted by region, age, sex and cause of death. RESULTS We found that non-optimal temperatures increased YLL rates in both HDRs and LDRs, but all subgroups in LDRs were more vulnerable. The disparity of cold effects between HDRs and LDRs was significant, while the difference in heat effect was insignificant. The overall AF of non-optimal temperature in LDRs [AF = 12.2, 95% empirical confidence interval (eCI):11.0-13.5%] was higher than that in HDRs (AF = 8.9, 95% eCI: 8.3-9.5%). Subgroups analyses found that most groups in LDRs had greater AFs than that in HDRs. The average life loss per death due to non-optimal temperature in LDRs (1.91 years, 95% eCI: 1.72-2.10) was also higher than that in HDRs (1.32 years, 95% eCI: 1.23-1.41). Most of AFs and life loss per death were caused by moderate cold in both HDRs and LDRs. CONCLUSIONS Mortality burden caused by temperature was more significant in LDRs than that in HDRs, which means that more attention should be paid to vulnerable populations in LDRs in planning adaptive strategies.
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Affiliation(s)
- Siqi Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Yize Xiao
- Yunnan Center for Disease Control and Prevention, Kunming, 650022 China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050 China
| | - Chunliang Zhou
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Yanjun Xu
- 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, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Ruying Hu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Junhua Li
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Donghui Jin
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Mingfang Qin
- Yunnan Center for Disease Control and Prevention, Kunming, 650022 China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062 China
| | - Weiwei Gong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051 Zhejiang China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050 China
| | - Yiqing Xu
- Department of environment and health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001 China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No.160, Qunxian Road, Panyu District, Guangzhou, 511430 Guangdong China
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Iranpour S, Khodakarim S, Shahsavani A, Khosravi A, Etemad K. Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran. Epidemiol Health 2020; 42:e2020053. [PMID: 32777886 PMCID: PMC7871149 DOI: 10.4178/epih.e2020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/18/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). METHODS Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. RESULTS We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. CONCLUSIONS A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
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Affiliation(s)
- Sohrab Iranpour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Shahsavani
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chak Ho H, Chan TC, Xu Z, Huang C, Li C. Individual- and community-level shifts in mortality patterns during the January 2016 East Asia cold wave associated with a super El Niño event: Empirical evidence in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 711:135050. [PMID: 31810701 DOI: 10.1016/j.scitotenv.2019.135050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Despite the fact that cold weather has been widely documented as a major factor that can elevate the mortality in a subtropical population due to a lack of adaptability, the disastrous impacts from a major cold event in East Asia caused by a super El Niño event in January 2016 have passed largely unreported. In order to minimize the catastrophic risk from such events given ongoing concerns about climate change, as also noted in the Sendai Framework for Disaster Risk Reduction 2015-2030 (SFDRR), it is important to evaluate the individual- and community-level shifts in mortality patterns during such cold waves, in order to develop health protocols for surveillance and disaster planning. This study evaluated the impacts of the 2016 cold wave on mortality patterns in Hong Kong because this city has been highlighted as a city with severe negative impacts from the disaster by social media. Based on a sensitivity analysis, we found significantly higher daily mortality for up to ten weeks during this cold wave compared to the same calendar days between 2007 and 2015. We also found that the short-term impact of the cold wave was prolonged and fatal, with the potential to increase the mortality across the city for up to five weeks compared to the pre-disaster period. An examination of the individual- and community-level shifts in mortality patterns reveals that the unmarried and economically inactive were most vulnerable during the 2016 cold wave, and respiratory diseases were the greatest medical problems, while age and gender effects as well as cardiovascular diseases did not enhance the fatal effect. The excessive mortality was citywide, and not limited to particular locations or specific characteristics of a community within the city. Based on the results, disaster education as well as social and health services should be provided to all local people for an extended period in order to minimize the fatal and prolonged effects of future cold waves.
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Affiliation(s)
- Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong.
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Changchang Li
- Department of Sexually Transmitted Disease Prevention and Control, Dermatology Hospital of Southern Medical University, China.
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Du Z, Lin S, Marks T, Zhang W, Deng T, Yu S, Hao Y. Weather effects on hand, foot, and mouth disease at individual level: a case-crossover study. BMC Infect Dis 2019; 19:1029. [PMID: 31796004 PMCID: PMC6891988 DOI: 10.1186/s12879-019-4645-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) raises an urgent public health issue in the Asia-Pacific region, especially in China. The associations between weather factors and HFMD have been widely studied but with inconsistent results. Moreover, previous studies utilizing ecological design could not rule out the bias of exposure misclassification and unobserved confounders. METHODS We used case-crossover analysis to assess the associations of weather factors on HFMD. Individual HFMD cases from 2009 to 2012 in Guangdong were collected and cases located within 10 km of the meteorological monitoring sites were included. Lag effects were examined through the previous 7 days. In addition, we explored the variability by changing the distance within 20 km and 30 km. RESULTS We observed associations between HFMD and weather factors, including temperature and relative humidity. An approximately U-shaped relationship was observed for the associations of temperature on HFMD across the same day and the previous 7 days, while an approximately exponential-shaped was seen for relative humidity. Statistically significant increases in rates of HFMD were associated with each 10-unit increases in temperature [Excess rate (ER): 7.7%; 95% Confidence Interval (CI): 3.9, 11.7%] and relative humidity (ER: 1.9%; 95% CI: 0.7, 3.0%) on lag days 0-6, when assessing within 10 km of the monitoring sites. Potential thresholds for temperature (30.0 °C) and relative humidity (70.3%) detected showed associations with HFMD. The associations remained robust for 20 km and 30 km. CONCLUSIONS Our study found that temperature and relative humidity are significantly associated with the increased rates of HFMD. Thresholds and lag effects were observed between weather factors and HFMD. Our findings are useful for planning on targeted prevention and control of HFMD.
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Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, 12144 USA
| | - Tia Marks
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, 12144 USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, 12144 USA
| | - Te Deng
- Healthcare Department, Nanshan Maternity & Child Healthcare Hospital of Shenzhen, Shenzhen, 518000 China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, 102206 China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080 China
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Gholampour R, Darand M, Halabian AH. Impacts of cold and hot temperatures on mortality rate in Isfahan, Iran. J Therm Biol 2019; 86:102453. [DOI: 10.1016/j.jtherbio.2019.102453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/23/2019] [Accepted: 10/31/2019] [Indexed: 12/16/2022]
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Development of the Adjusted Wind Chill Equivalent Temperature (AWCET) for cold mortality assessment across a subtropical city: validation and comparison with a spatially-controlled time-stratified approach. BMC Public Health 2019; 19:1290. [PMID: 31615481 PMCID: PMC6794828 DOI: 10.1186/s12889-019-7612-5] [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: 06/21/2019] [Accepted: 09/11/2019] [Indexed: 12/03/2022] Open
Abstract
Background Global warming has reduced the adaptability of the people living in subtropical regions to cope up with cold stress due to lengthening of hot days and shortening of transition period from hot to cold weather. However, existing studies on measuring cold stress are based on biometeorological indices designed for temperate regions. This may overestimate the impact of wind chill on mortality risk in subtropical cities. Methods This study developed an Adjusted Wind Chill Equivalent Temperature (AWCET) index. A spatially-controlled time-stratified approach was applied to evaluate the ability of AWCET for estimating cold mortality in subtropical cities, based on a mortality dataset (2008–2012) in Hong Kong. Results The use of AWCET could indicate increase in all-cause, cardiovascular, respiratory, and cancer-related mortality risk during the days with average temperature < = 1st [11.0 °C], <= 3rd [12.6 °C] and < = 5th [13.4 °C] percentiles. The results were stable and consistent based on both log-linear and curve-linear relationships between AWCET and mortality risk. AWCET was also compared with the New Wind Chill Equivalent Temperature (NWCET) designed for temperate regions, and has found that higher magnitude of mortality risk would be found when using AWCET for assessing all-cause and cause-specific mortality in Hong Kong, for days with average temperature < = 1st, <= 3rd and < = 5th percentiles. Conclusions AWCET is validated to be effective to access cold mortality in the context of subtropical cities. The use of AWCET may enhance the cold weather warning system in subtropical cities, as a supplementary tool to help demonstrating small administrative-level perceived temperature with volunteered geographic information.
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Xiao J, Huang M, Zhang W, Rosenblum A, Ma W, Meng X, Lin S. The immediate and lasting impact of Hurricane Sandy on pregnancy complications in eight affected counties of New York State. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 678:755-760. [PMID: 31085491 DOI: 10.1016/j.scitotenv.2019.04.436] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND The frequency and intensity of hurricane have increased greatly. However, whether hurricane exposure is associated with an increased risk of pregnancy complications is less known. OBJECTIVE To assess the immediate impact and lasting impact of Hurricane Sandy (Sandy) on pregnancy complications. METHODS Using time-series study, we estimated the relative risks (RRs) of emergency department (ED) visits for pregnancy complications in eight affected counties in New York State, based on data of 2005-2014. The immediate impact was estimated by comparing the ED visits of pregnancy complications during the Sandy period to the non-Sandy periods. For the lasting impact of Sandy, we estimated the RRs by contrasting the ED visits in the following 12 months after Sandy with the same months of other years. RESULTS We found that ED visits for overall pregnancy complications increased 6.3% (95% confidence interval (CI): 2.2%, 10.5%) during the Sandy month. ED visits increased for threatened abortion (9.9%, 95% CI: 4.4%, 15.7%), threatened labor (10.1%, 95% CI: 1.9%, 18.9%), early onset of delivery (115.9%, 95% CI: 6.9%, 336.3%), renal disease (73.2%, 95% CI: 0.3%, 199.4%), and diabetes (42.3%, 95% CI: 15.0%, 76.0%). Gestational hypertension and renal disease were elevated 7-8 months after Sandy. The ED visits of mental illness increased gradually after Sandy and peaked eight months later with visits increasing 33.2%. CONCLUSIONS This study suggests that hurricanes may impact pregnancy health immediately and that some negative health may last for months thereafter.
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Affiliation(s)
- Jianpeng Xiao
- Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Miaoling Huang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA
| | | | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Xiaojing Meng
- Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.
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Ho HC, Wong MS. Urban environmental influences on the temperature-mortality relationship associated mental disorders and cardiorespiratory diseases during normal summer days in a subtropical city. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:24272-24285. [PMID: 31230236 DOI: 10.1007/s11356-019-05594-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Abstract
Temperature is associated with mortality risk across cities. However, there is lack of study investigating the summer effect on mortality associated with mental/behavioral disorders, especially in cities with subtropical climate. In addition, summer mortality in subtropical cities is different from tropical cities, and previous studies have not investigated the urban environmental inequality on heat mortality associated with mental/behavioral disorders. A register-based study was developed to estimate the temperature effects on decedents on days with 50th percentile of average daily temperature between 2007 and 2014 in Hong Kong (n = 133,359). Poisson regression was firstly applied to estimate the incidence rate ratio (IRR) from the summer temperature effects on all-cause mortality, cardiovascular mortality, respiratory mortality, and mortality associated with mental/behavioral disorders. For a 1 °C increase in average temperature on days with temperature ≥ 24.51 °C, IRRs of mortality associated with mental and behavioral disorders on lag 0 and lag 1 days were 1.033 [1.004, 1.062] and 1.030 [1.002, 1.060], while temperature effects on cardiovascular mortality and respiratory mortality during normal summer days (not extreme heat events) were not significant. A further investigation with linear regression has shown that decedents with mental/behavioral disorders on higher temperature days resided in areas with lower percentage of sky view, lower percentage of vegetation cover, higher level of neighborhood-level PM2.5, higher level of neighborhood-level NO, and higher level of neighborhood-level black carbon (BC). In order to develop protocols for community healthcare based on the "Leaving no one behind" scheme documented in the 2016 Sustainable Development Goals report of the United Nations, it is necessary to include heat effects on mental/behavioral disorders, especially people with dementia, for community planning and healthcare development.
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Affiliation(s)
- Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
- Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
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Pourshaikhian M, Moghadamnia MT, Yekaninejad MS, Ghanbari A, Rashti AS, Afraz Kamachli S. The effects of meteorological variables on ambulance attendance for cardiovascular diseases in Rasht, Iran. J Therm Biol 2019; 83:150-156. [PMID: 31331513 DOI: 10.1016/j.jtherbio.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/13/2019] [Accepted: 05/05/2019] [Indexed: 11/19/2022]
Abstract
Climate change has a devastating effect on human societies, including their economic, cultural and health conditions. Our objective was to investigate the association between meteorological variables and ambulance attendance in the event of cardiovascular diseases using time-series analyses. We used a time series analysis to investigate the relationship between meteorological variables and ambulance attendance in the event of cardiovascular diseases from 2010 to 2015. To examine the effect of high temperatures on ambulance attendance, we investigated the relative risk of the daily volume of high temperature attendance, the 99th temperature percentile compared to the 75th temperature percentile. Upon examining the effect of cold temperatures on ambulance attendance, or the relative risk of the daily volume of attendance with low temperatures, the 1st temperature percentile compared to the 25th temperature percentile. In 1826 days, from March 21, 2010 to March 19, 2015, there were 7051 emergency calls for cardiovascular diseases. Significant variations were identified in the monthly (P < 0.001) and seasonal (P < 0.001) distributions. The highest seasonal incidence occurred in the winter and lowest was observed in the summer. With regard to association between cold temperature and calls for ambulance attendance in the event of cardiovascular diseases according to lag days, our findings showed a significant increase in lag 7 ((RR, 1.026; 95% CI, 1.003 to 1.050), lag 8 (RR, 1.023; 95% CI, 1.005to 1.041) and lag 9 (RR, 1.019; 95% CI, 1.002 to 1.036) respectively. These results suggest that the demand for an ambulance for cardiovascular diseases was higher in the cold weather and that humidity can increase this demand in the warm seasons.
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Affiliation(s)
- Majid Pourshaikhian
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mohammad Taghi Moghadamnia
- Department of Medical-Surgical Nursing, Nursing and Midwifery School, Guilan University of Medical Sciences, Rasht, Iran.
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Ghanbari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Saadat Rashti
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Chen J, Yang J, Zhou M, Yin P, Wang B, Liu J, Chen Z, Song X, Ou CQ, Liu Q. Cold spell and mortality in 31 Chinese capital cities: Definitions, vulnerability and implications. ENVIRONMENT INTERNATIONAL 2019; 128:271-278. [PMID: 31071590 DOI: 10.1016/j.envint.2019.04.049] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 03/26/2019] [Accepted: 04/20/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND In the context of global warming, most researches have been conducted on health influences of heat waves, with limited understanding of health impacts of cold spells, especially for developing countries. METHODS We collected daily mortality and meteorological data for 31 capital cities across China during the maximum period of 2007-2013. A quasi-Poisson regression model combined with a distributed lag non-linear model was used to estimate the short-term effects of cold spells on mortality in cold seasons (November to March). 19 definitions of cold spell were clearly compared, including three definitions from the China Meteorological Administration (CMA) and 16 definitions by combining two temperature indicators (daily minimum and mean temperature), two temperature thresholds (3rd and 5th percentile) and four durations of at least 2-5 days. Then, a random effect meta-analysis was applied to pool the effect estimates at national level. Furthermore, a stratified analysis was constructed to identify the vulnerable subpopulations to cold spells. RESULTS The definition, in which daily mean temperature falls below 5th percentile for at least two consecutive days, produced the optimum model fit performance. Generally, the mortality risk increased to the maximum after 3-6 days' exposure to cold spell and then leveled off in the next 3 weeks. The pooled relative risks (RR) of non-accidental mortality for cold spells were 1.03 (95% CI: 1.01-1.05), 1.27 (1.19-1.35) and 1.55 (1.40-1.70) at lag 0, lag 0-14 and lag 0-27 days, respectively. The greatest effect estimates of cold spells were found among total respiratory diseases and COPD, with RR of 1.88 (1.65-2.11) and 1.88 (1.58-2.19), respectively. The elderly, less-educated individuals and residents in southern China were more vulnerable to cold spells. CONCLUSION There are remarkable mortality effects of cold spells, with effect estimates varying with the definition of cold spell and subpopulations. Using the official definition of cold spells may fail to capture the mortality risk associated with cold spells. These findings may facilitate the development of cold alert warning system and preventive actions to the vulnerable populations.
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Affiliation(s)
- Jinjian Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China; Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Zhaoyue Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Xiuping Song
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China.
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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Chan EYY, Ho JY, Hung HHY, Liu S, Lam HCY. Health impact of climate change in cities of middle-income countries: the case of China. Br Med Bull 2019; 130:5-24. [PMID: 31070715 PMCID: PMC6587073 DOI: 10.1093/bmb/ldz011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/31/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized. SOURCES OF DATA Sources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database. AREAS OF AGREEMENT The impact of temperature on mortality outcomes was the most extensively studied, with the strongest cause-specific mortality risks between temperature and cardiovascular and respiratory mortality. The geographical focuses of the studies indicated variations in health risks and impacts of different climate change phenomena across the country. AREAS OF CONTROVERSY While rainfall-related studies predominantly focus on its impact on infectious and vector-borne diseases, consistent associations were not often found. GROWING POINTS Mental health outcomes of climate change had been gaining increasing attention, particularly in the context of extreme weather events. The number of projection studies on the long-term impact had been growing. AREAS TIMELY FOR DEVELOPING RESEARCH The lack of studies on the health implications of rising sea levels and on comorbidity and injury outcomes warrants immediate attention. Evidence is needed to understand health impacts on vulnerable populations living in growing urbanized cities and urban enclaves, in particular migrant workers. Location-specific climate-health outcome thresholds (such as temperature-mortality threshold) will be needed to support evidence-based clinical management plans and health impact mitigation strategies to protect vulnerable communities.
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Affiliation(s)
- Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA, USA
| | - Janice Y Ho
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Heidi H Y Hung
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sida Liu
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly C Y Lam
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Gao J, Yu F, Xu Z, Duan J, Cheng Q, Bai L, Zhang Y, Wei Q, Yi W, Pan R, Su H. The association between cold spells and admissions of ischemic stroke in Hefei, China: Modified by gender and age. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 669:140-147. [PMID: 30878922 DOI: 10.1016/j.scitotenv.2019.02.452] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Some studies have discovered that low ambient temperatures were associated with increased risk of the incidence of ischemic stroke. Although the frequency of extreme weather events is increasing, few studies have studied the effects of cold wave on ischemic stroke. OBJECTIVE The purpose of this study was to explore the association between cold waves and ischemic stroke onset and further to explore how this association was modified by cold spell characteristics and individual-level factors. METHODS A Poisson regression with a distributed lag nonlinear model was used to investigate the association between cold spells under 9 different definitions and daily admissions of ischemic stroke in 2013-2015 in Hefei. RESULTS By comparing the attribution risk and the results of the sensitivity analysis of different models, the local optimal cold spell was defined as the day between November to March when daily mean temperature was less than 10th for 2 or more consecutive days (backward attributable risk fraction (b-AF) = 4.19%, 95% empirical confidence intervals (eCI): 0.87%, 6.66%, backward attributable number (b-AN) = 278). On the basis of optimal model, the single-day effect of cold waves on ischemic stroke occurred on 5th day after exposure and continued until 17th day, and the maximum effect appeared on the 5th day with relative risk (RR) = 1.050 (95% confidence interval (CI) = 1.008, 1.094). The significant cumulative effect lasted from day 9 after exposure to cold spells to day 21. The maximum cumulative effect was observed on the 21st day with RR = 2.378 (95% CI = 1.304, 4.337). The female and the young and middle-aged people were susceptible to the local cold waves. CONCLUSION This study suggests that cold spell is a risk factor for ischemic stroke in Hefei, and there is a certain lag effect. Targeted measures should be taken to protect susceptible populations during cold spell days, including women and young and middle-aged people.
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Affiliation(s)
- Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Feng Yu
- Anhui Provincial Hospital, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Qiang Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Lijun Bai
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Yanwu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Disease, China.
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Wu T, Ma Y, Wu X, Bai M, Peng Y, Cai W, Wang Y, Zhao J, Zhang Z. Association between particulate matter air pollution and cardiovascular disease mortality in Lanzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:15262-15272. [PMID: 30929170 DOI: 10.1007/s11356-019-04742-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/28/2019] [Indexed: 05/22/2023]
Abstract
Ambient particulate matter (PM) pollution has been linked to elevated mortality, especially from cardiovascular diseases. However, evidence on the effects of particulate matter pollution on cardiovascular mortality is still limited in Lanzhou, China. This research aimed to examine the associations of daily mean concentrations of ambient air pollutants (PM2.5, PMC, and PM10) and cardiovascular mortality due to overall and cause-specific diseases in Lanzhou. Data representing daily cardiovascular mortality rates, meteorological factors (daily average temperature, daily average humidity, and atmospheric pressure), and air pollutants (PM2.5, PM10, SO2, NO2) were collected from January 1, 2014, to December 31, 2017, in Lanzhou. A quasi-Poisson regression model combined with a distributed lag non-linear model (DLNM) was used to estimate the associations. Stratified analyses were also performed by different cause-specific diseases, including cerebrovascular disease (CD), ischemic heart disease (IHD), heart rhythm disturbances (HRD), and heart failure (HF). The results showed that elevated concentration of PM2.5, PMC, and PM10 had different effects on mortality of different cardiovascular diseases. Only cerebrovascular disease showed a significant positive association with elevated PM2.5. Positive associations were identified between PMC and daily mortality rates from total cardiovascular diseases, cerebrovascular diseases, and ischemic heart diseases. Besides, increased concentration of PM10 was correlated with increased death of cerebrovascular diseases and ischemic heart diseases. For cerebrovascular disease, each 10 μg/m3 increase in PM2.5 at lag4 was associated with increments of 1.22% (95% CI 0.11-2.35%). The largest significant effects for PMC on cardiovascular diseases and ischemic heart diseases were both observed at lag0, and a 10 μg/m3 increment in concentration of PMC was associated with 0.47% (95% CI 0.06-0.88%) and 0.85% (95% CI 0.18-1.52%) increases in cardiovascular mortality and ischemic heart diseases. In addition, it exhibited a lag effect on cerebrovascular mortality as well, which was most significant at lag6d, and an increase of 10 μg/m3 in PMC was associated with a 0.76% (95% CI 0.16-1.37%) increase in cerebrovascular mortality. The estimates of percentage change in daily mortality rates per 10 μg/m3 increase in PM10 were 0.52% (95% CI 0.05-1.02%) for cerebrovascular disease at lag6 and 0.53% (95% CI 0.01-1.05%) for ischemic heart disease at lag0, respectively. Our study suggests that elevated concentration of atmospheric PM (PM2.5, PMC, and PM10) in Lanzhou is associated with increased mortality of cardiovascular diseases and that the health effect of elevated concentration of PM2.5 is more significant than that of PMC and PM10.
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Affiliation(s)
- Tingting Wu
- The First Clinical Medical College of Lanzhou University, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
- Department of Ultrasound in Children, The Second Hospital of Lanzhou University, No. 82, Cuiying Gate, Chengguan District, 730030, Lanzhou, China
| | - Yuan Ma
- The First Clinical Medical College of Lanzhou University, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
| | - Xuan Wu
- Disease Control and Prevention Center in Chengguan District, No. 121, Qingyang Road, Lanzhou, 730000, China
| | - Ming Bai
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, China
| | - Yu Peng
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, China
| | - Weiting Cai
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
- Heart Center, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, China
| | - Yongxiang Wang
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
| | - Jing Zhao
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China
| | - Zheng Zhang
- Gansu Key Laboratory of Cardiovascular Disease, No. 1, Donggang West Road, Chengguan District, 730000, Lanzhou, China.
- Heart Center, The First Hospital of Lanzhou University, No. 1, Donggang West Road, Chengguan District, Lanzhou, 730000, China.
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Khajavi A, Khalili D, Azizi F, Hadaegh F. Impact of temperature and air pollution on cardiovascular disease and death in Iran: A 15-year follow-up of Tehran Lipid and Glucose Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 661:243-250. [PMID: 30677672 DOI: 10.1016/j.scitotenv.2019.01.182] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
In this, the first study to be conducted in the Middle East and North Africa (MENA) on the subject, we examined the impact of temperature and air pollution on cardiovascular disease (CVD) and all-cause mortality. The Tehran Lipid and Glucose Study followed 9731 participants, aged ≥30years (men=4409), during the period 1999-2014, reporting 1350 CVDs (men=796) and 725 deaths (men=447). Air pollution level was measured using the air quality index (AQI). Data were analyzed using the distributed lag nonlinear model, with 30°C temperature and AQI=50 minimum risk values, as the relative risks' (RR) reference values. Although for the whole sample, no significant effect of air pollution was observed on CVD, for the under 60year olds, two significant peaks occurred in AQI=180 at lags 2 and 6days (RR=1.94, 95% CI: 1.02-3.67 and 2.06, 95% CI: 1.09-3.88, respectively). Temperature had no significant effect on CVD, yet the closest case to significance happened at 36°C and lag 5days (RR=1.43, 95% CI: 0.97-2.11), for ages ≥60y. The largest significant effects of air pollution on death, occurred in AQI=180 and lag 1day (RR=2.40, 95% CI: 1.0.-5.59 and 3.29, 95% CI: 1.15-9.36, for the whole sample and the <60year olds, respectively). Interestingly, for those aged over 60years, the peak belonged to AQI=180 and lag 7days (RR=2.16, 95% CI: 1.11-4.19). Regarding the effect of temperature on death among the whole sample, the highest risk was for 6°C and lag 0 (RR=3.91, 95% CI: 1.12-13.61). For the ≥60year olds, it occurred in 9+ and lag 0 (RR=6.81, 95% CI: 1.69-27.44), though notably, the peak went to -3°C and lag 3 (RR=5.69, 95% CI: 1.12-28.87), for those aged <60years. Overall, the effect of low temperature on death had the highest risk, for the over 60-year-olds, without any lag. Moreover, the <60-year-olds were the most vulnerable group to air pollution with a one day lag, in terms of mortality risk.
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Affiliation(s)
- Alireza Khajavi
- Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Liang Z, Wang P, Zhao Q, Wang BQ, Ma Y, Lin H, Xiao J, Zhou JY. Effect of the 2008 cold spell on preterm births in two subtropical cities of Guangdong Province, Southern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 642:307-313. [PMID: 29902628 DOI: 10.1016/j.scitotenv.2018.06.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/05/2018] [Accepted: 06/02/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND A few studies have reported that low temperatures were associated with an increased risk of preterm birth. However, the effect of extreme weather events, such as cold spell, on preterm birth has not been studied in China. OBJECTIVE This study was conducted to evaluate the impact of the 2008 cold spell on preterm birth in two subtropical cities of Guangdong Province. METHODS Data of daily preterm birth, air pollution and meteorological variables from 2006 to 2010 were collected in Dongguan and Shenzhen. A Poisson regression with a distributed lag nonlinear model was used to investigate the association between the 2008 cold spell and daily rate of preterm birth for each city. RESULTS During the 2008 cold spell, total vaginal preterm births were increased by 22.44% and 21.25% in Dongguan and Shenzhen, respectively. The effect of the cold spell on preterm births lasted for more than 1 week, the lag0-6 days cumulative relative risk (RR) is 1.32 (95% CI: 1.10-1.58) and 1.40 (95% CI: 1.18-1.68) in Dongguan and Shenzhen, respectively. The effects were found to be more pronounced for the pregnant women with 34-36 gestation weeks, maternal age < 35 years group. CONCLUSION This study demonstrates that cold spell could increase the risk of preterm births in Dongguan and Shenzhen, and the effect lasts for more than 1 week. Specific measures should be considered to protect the pregnant women, especially the vulnerable subgroups.
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Affiliation(s)
- Zhijiang Liang
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China; Department of Public Health, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Peng Wang
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Qingguo Zhao
- Department of Epidemiology, Family Planning Research Institute of Guangdong Province, Guangzhou 510600, China
| | - Bei-Qi Wang
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yuanzhu Ma
- Department of Public Health, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jianpeng Xiao
- Department of Occupational Health and Occupational Medicine, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Ji-Yuan Zhou
- State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Zhan ZY, Yu YM, Qian J, Song YF, Chen PY, Ou CQ. Effects of ambient temperature on ambulance emergency call-outs in the subtropical city of Shenzhen, China. PLoS One 2018; 13:e0207187. [PMID: 30419000 PMCID: PMC6231653 DOI: 10.1371/journal.pone.0207187] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 10/26/2018] [Indexed: 12/17/2022] Open
Abstract
The associations between meteorological factors and mortality have been well documented worldwide, but limited evidence is available for the non-fatal health impacts of ambient temperature, particularly there are few population-based investigations on the impacts of emergency ambulance dispatches in Asia. In this study, based on 809,906 ambulance emergency call-outs (AECOs) for the total population from 2010-2016 in the subtropical city of Shenzhen, China, a Poisson regression combined with a distributed lag nonlinear model was used to simultaneously assess the nonlinear and lag effects of daily mean temperature on AECOs. Stratified analyses by age and sex were performed to identify vulnerable subpopulations. A U-shaped relationship was found between temperature and AECOs. Cold effects were delayed and persisted for 3-4 weeks, with a cumulative relative risk (RR) and 95% confidence interval (CI) of 1.23 (1.10-1.38) and 1.25 (1.16-1.35) over lag 0-28 when comparing the 1st and 5th percentile of the temperature distribution to the optimal (i.e. minimum AECOs) temperature, respectively. Hot effects were immediate and diminished quickly in 5 days, with an increase of 19% (RR = 1.19, 95%CI: 1.14-1.23) and 21% (RR = 1.21, 95%CI: 1.16-1.26) in AECOs over lag 0-5 when comparing the 95th and 99th percentile of temperature to the optimal temperature. Children and the elderly were more vulnerable to cold effects. The youth and middle-aged people suffered more from high temperature. The effects of temperature were similar between males and females. In summary, significant increases were observed in the frequency of AECOs during cold and hot days, and the weather-associated increases in AECOs are different among age groups. This information has valuable implications in ambulance demand prediction and service provision planning.
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Affiliation(s)
- Zhi-Ying Zhan
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yi-Min Yu
- Shenzhen Center for Prehospital Care, Shenzhen, China
- The People's Hospital of Longhua, Shenzhen, China
| | - Jun Qian
- Department of Mathematics and Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - Yun-Feng Song
- Intensive Care Unit, Guangdong No.2 Provincial People’s Hospital, Guangzhou, China
| | - Ping-Yan Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
- * E-mail:
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Lee W, Choi HM, Lee JY, Kim DH, Honda Y, Kim H. Temporal changes in mortality impacts of heat wave and cold spell in Korea and Japan. ENVIRONMENT INTERNATIONAL 2018; 116:136-146. [PMID: 29679776 DOI: 10.1016/j.envint.2018.04.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 05/27/2023]
Abstract
Investigating how well people adapt to heat waves and cold spells has been an important issue under climate change. Also, most of previous studies focused only on the mortality risks for heat waves or cold spells for certain time period not considering its temporal changes and increasing frequencies. This study investigated the change in risks of mortality from heat waves and cold spells over time, and estimated the temporal changes in mortality burden attributed to heat waves and cold spells in Korea and Japan. We collected time-series data covering mortality and weather variables from 53 communities in the two countries from 1992 to 2015. Two-stage time-series regression with a time-varying distributed lag model and meta-analysis was used to assess the impacts of heat waves and cold spells by period (1990s, 2000s, and 2010s). In total population, the risks of heat waves have decreased over time; however their mortality burden increased in the 2010s compared to the 2000s with increasing frequency. On the other hand, the risk and health burden of cold spells have increased over the decades. Our findings showed that the future mortality burden of heat waves and cold spells might not decrease, when considering their changes in risks and frequencies.
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Affiliation(s)
- Whanhee Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hayon Michelle Choi
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jae Young Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Da Hye Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.
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Huang Y, Rosenberg M, Wang Y. Is extreme climate or moderate climate more conducive to longevity in China? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:971-977. [PMID: 29455295 DOI: 10.1007/s00484-018-1499-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 12/05/2017] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
Climate is closely related to human longevity. In China, there are many climate types. According to national population censuses from 1982 to 2000, most provinces with a high ratio of centenarians are located in western and northwestern China far from the sea; these areas are characterized by a dry, cold climate, very high altitude, very high daily temperature range, strong winds, and partial hypoxia. Meanwhile, provinces with a high ratio of nonagenarians from 1982 to 2000 are located in southern China near the sea. Previous studies have attributed the high ratio of centenarians in western and northwestern China to the extreme local climate. However, centenarians in these areas decreased greatly in 2010, whereas residents in southern China frequently reached 90 to 100 years old in 2010. This study aims to explain this strange phenomenon and find whether extreme climate in Tibetan plateau and northwestern China or moderate climate in southern China is more conducive to longevity. The study found that mortality rate in Tibetan plateau is much higher than southern China, then a population evolution experiment was proposed to compare longevity indicators between low mortality rate and high mortality rate and shows that longevity indicators will decrease in the near future and increase above their original levels after several decades when the mortality rate is decreased. Results of this study show individuals in northwestern China do not live as long as those in eastern and southern China. A moderate climate is more conducive to longevity than extreme climate in China. The longevity of a region should be judged by long-term longevity indicators.
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Affiliation(s)
- Yi Huang
- School of Geographic Science, Nantong University, Nantong, 226000, China.
- Department of Geography and Planning, Queen's University, Kingston, K7L 3N6, Canada.
| | - Mark Rosenberg
- Department of Geography and Planning, Queen's University, Kingston, K7L 3N6, Canada
| | - Yingli Wang
- School of Geographic Science, Nantong University, Nantong, 226000, China
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Zhang Y, Yu C, Peng M, Zhang L. The burden of ambient temperature on years of life lost: A multi-community analysis in Hubei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 621:1491-1498. [PMID: 29054637 DOI: 10.1016/j.scitotenv.2017.10.079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/07/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Compared with death rates, years of life lost (YLL) has been widely used as a more informative indicator to quantify the burden of premature death. In the context of global climate change, existing evidence linking ambient temperatures and YLL was very scarce across the globe. METHODS Daily mortality and meteorological data during 2009-2012 were obtained from 12 communities across Hubei Province in central China. A two-stage approach was used for statistical analysis. At the first stage, a generalized linear regression combined with distributed lag non-linear model was applied to estimate community-specific temperature-YLL associations. A second-stage multivariable meta-analysis was then conducted to pool the community-specific estimates of temperature-related effects on YLL. RESULTS A pooled J- or U-shaped association was observed between ambient temperature and YLL due to different mortality categories. Heat effects occurred immediately and only persisted for several days, whereas cold effects were delayed and much longer-lasting. At the provincial level, heat effect (per 1°C increase from 75th to 99th percentile of temperature) at lag 0-2days and cold effect (per 1°C decrease from 25th to 1st percentile of temperature) at lag 0-21days was associated with an increase of 1.91% (95% CI: 0.83, 3.00) and 5.09% (2.79, 7.40) in YLL due to non-accidental deaths, respectively. Much greater effect estimates of cold than heat were also observed for other mortality-specific YLLs (except for respiratory mortality). Heat effects on YLL were higher for males and the youth, while cold effects were greater for females and the elderly. Additionally, relatively stronger associations between heat, cold and YLL were consistently observed in low-educated persons. CONCLUSIONS This multi-community study strengthened the evidence that both cold and hot temperatures were associated with increased years of life lost. Our findings may have important implications for better understanding the burden of premature death related to temperature extremes.
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Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road,Wuchang District, Wuhan 430071, China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road,Wuchang District, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuchang District, Wuhan 430072, China.
| | - Minjin Peng
- Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Lan Zhang
- Office of Chronic Disease, Hubei Provincial Center for Disease Control and Prevention, 6 Zhuodaoquan Road, Wuhan 430079, China
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Luan G, Yin P, Wang L, Zhou M. The temperature-mortality relationship: an analysis from 31 Chinese provincial capital cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:192-201. [PMID: 29562755 DOI: 10.1080/09603123.2018.1453056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 02/22/2018] [Indexed: 06/08/2023]
Abstract
We aim to explore the Minimum Mortality Temperature (MMT) of different cities and regions, and that provides evidence for developing reasonable heat wave definition in China. The death data of 31 Chinese provincial capital cities from seven geographical regions during 2008-2013 was included in this study. In the first stage, a DLNM (Distributed Lag Non-linear Model) was used to estimate the association between mean temperature and mortality in a single city, then we pooled them with a multivariate meta-analysis to estimate the region-specific effects. The range of MMT was from 17.4 °C (Shijiazhuang) to 28.4 °C (Haikou), and the regional MMT increased as the original latitude decreased. Different cities and regions have their own specialized MMT due to geography and demographic characteristics. These findings indicate that the government deserves to adjust measures to local conditions to develop public health policies.
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Affiliation(s)
- Guijie Luan
- a Shandong Center for Disease Control and Prevention , Jinan , China
| | - Peng Yin
- b National Center for Chronic and Noncommunicable Disease Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Lijun Wang
- b National Center for Chronic and Noncommunicable Disease Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Maigeng Zhou
- b National Center for Chronic and Noncommunicable Disease Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , China
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Rasi H, Kuivila H, Pölkki T, Bloigu R, Rintamäki H, Tourula M. A descriptive quantitative study of 7- and 8-year-old children's outdoor recreation, cold exposure and symptoms in winter in Northern Finland. Int J Circumpolar Health 2018; 76:1298883. [PMID: 28346080 PMCID: PMC5405444 DOI: 10.1080/22423982.2017.1298883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: In Finland, children spend a lot of time outdoors in winter. Outdoor recreation in winter has a wide variety of effects on children’s well-being. Although children are a subgroup that is vulnerable to cold exposure, remarkably little research has been done on the subject. Objective: The aim of this study was to describe children’s outdoor recreation, cold exposure and symptoms in winter in Northern Finland. Design: This was a descriptive quantitative study. The participants consisted of 30 children aged 7–8 years who were living in the provinces of Lapland and Northern Ostrobothnia in Finland. Data were collected by using electronic data-logging thermometers fixed on children’s outerwear for a month. The thermometers recorded the environmental temperature every five minutes and from that temperature data, we were able to discern the exact amount and duration of children’s outdoor recreation. In addition, information on the children’s cold symptoms was collected with structured daily entries. Results: Cold weather was not an obstacle to children’s outdoor activities in Finland. However, the duration of outdoor recreation shortened when the outdoor air temperature decreased. There were no significant differences between boys and girls in terms of time spent outdoors. Remarkably, every child reported symptoms associated with cold. Almost half of the children reported experiencing respiratory symptoms and some children also experienced cold pain and numbness. Conclusions: The results of this study illustrate the many and varied effects that cold exposure can have on children’s health and well-being. In order to prevent negative health effects of cold exposure on children, structured prevention strategies are needed: therefore, children’s exposure to cold should be studied more. Future research should also bring out more the positive health effects of outdoor recreation on children’s growth and development.
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Affiliation(s)
- Hanna Rasi
- a Nursing and Health Administration Science Research Unit , Oulu University , Oulu , Finland
| | - Heli Kuivila
- b Nursing and Health Administration Science Research Unit , University of Oulu , Oulu , Finland
| | - Tarja Pölkki
- c Clinical Nursing Science , Oulu University Hospital, Children and Women , Oulu , Finland
| | - Risto Bloigu
- d Medical Informatics and Statistics Research Group , University of Oulu , Aapistie , Oulu , Finland
| | - Hannu Rintamäki
- e Finnish Institute of Occupational Health , Aapistie , Oulu , Finland.,f Research Unit of Biomedicine, University of Oulu , Oulu , Finland
| | - Marjo Tourula
- g Arctic Health, Faculty of Medicine and Thule Institute, University of Oulu , Aapistie , Oulu , Finland
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Wang C, Zhang Z, Zhou M, Wang P, Yin P, Ye W, Zhang L. Different response of human mortality to extreme temperatures (MoET) between rural and urban areas: A multi-scale study across China. Health Place 2018; 50:119-129. [PMID: 29432981 DOI: 10.1016/j.healthplace.2018.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/19/2018] [Accepted: 01/30/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The environmental variation in mortality due to extreme temperatures has been well-documented by many studies. Mortality to extreme temperatures (MoET) was recognized to vary geographically, either by countries within a region or by areas within a country. However, so far, little attention has been paid to rural residents, with even lesser attention on the potential rural-urban differences. The aim of our study was to offer a quite comprehensive analysis on the differences in temperature-mortality relationship between rural and urban areas across China. METHOD A distributed lag nonlinear model was built to describe the temperature-mortality relationship, based on the mortality data and meteorological variable of 75 communities in China from 2007 to 2012. Subsequently, a meta-analysis was applied to compare the differences in the temperature-mortality relationship between rural and urban areas at various levels. RESULTS Distinct responses regarding MoET between rural and urban areas were observed at different spatial scales. At regional level, more U-shaped curves were observed for temperature-mortality relationships in urban areas, while more J-shaped curves were observed in rural areas. At national scale, we found that the cold effect was stronger in rural areas (RR: rural 1.69 vs. urban 1.51), while heat effect was stronger in urban areas (RR: rural 1.01 vs. urban 1.12). Moreover, the modifying influence of air pollution on temperature-mortality relationship was found to be very limited. CONCLUSION The difference in response of MoET between rural and urban areas was noticeable, cold effect is more significant in China both in rural and urban areas. Additionally, urban areas in southern China and rural areas in northern China suffered more from extreme temperature events. Our findings suggest that differences in rural-urban responses to MoET should be taken seriously when intervention measures for reducing the risks to residents' health were adopted.
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Affiliation(s)
- Chenzhi Wang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
| | - Zhao Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China.
| | - Pin Wang
- Institute of Remote Sensing and Earth Sciences, Hangzhou Normal University, No.1378, Wenyi West Street, Hangzhou 311121, China.
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China.
| | - Wan Ye
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
| | - Lingyan Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
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Gumabay EMS, Ramirez RC, Dimaya JMM, Beltran MM. Adversity of prolonged extreme cold exposure among adult clients diagnosed with coronary artery diseases: a primer for recommending community health nursing intervention. Nurs Open 2018; 5:62-69. [PMID: 29344396 PMCID: PMC5762701 DOI: 10.1002/nop2.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/15/2017] [Indexed: 01/31/2023] Open
Abstract
Aim This research study explored the lived experiences of adults diagnosed with Coronary Artery Disease (CAD) when exposed to a prolonged period of extreme cold. Design This research study utilized descriptive qualitative research design. Methods Face-to-face interview sessions with audio recording were conducted. There were 30 informants who participated in the study. Descriptive phenomenology with Colaizzi's method of data analysis was used. Results Results revealed three themes, namely: (i) elucidating cold exposure; (ii) challenges of cold exposure; and (iii) translating adverse exposure to self-management. The results further revealed the significance of nursing health care especially to health promotion, disease prevention and health restoration especially in community setting. Conclusion In conclusion, manifestations of CAD are triggered when exposed to a prolonged period of extremely low environmental temperature.
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Affiliation(s)
- Eladio Martin S. Gumabay
- Center for Health Research and DevelopmentUniversity of Saint LouisTuguegarao CityCagayan ValleyPhilippines
| | | | | | - Mae M. Beltran
- University of Saint LouisTuguegarao CityCagayan ValleyPhilippines
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48
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Paschalidou AK, Kassomenos PA, McGregor GR. Analysis of the synoptic winter mortality climatology in five regions of England: Searching for evidence of weather signals. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 598:432-444. [PMID: 28448935 DOI: 10.1016/j.scitotenv.2017.03.276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/29/2017] [Accepted: 03/30/2017] [Indexed: 06/07/2023]
Abstract
Although heat-related mortality has received considerable research attention, the impact of cold weather on public health is less well-developed, probably due to the fact that physiological responses to cold weather can vary substantially among individuals, age groups, diseases etc., depending on a number of behavioral and physiological factors. In the current work we use the classification techniques provided by the COST-733 software to link synoptic circulation patterns with excess cold-related mortality in 5 regions of England. We conclude that, regardless of the classification scheme used, the most hazardous conditions for public health in England are associated with the prevalence of the Easterly type of weather, favoring advection of cold air from continental Europe. It is noteworthy that there has been observed little-to-no regional variation with regards to the classification results among the 5 regions, suggestive of a spatially homogenous response of mortality to the atmospheric patterns identified. In general, the 10 different groupings of days used reveal that excess winter mortality is linked with the lowest daily minimum/maximum temperatures in the area. However it is not uncommon to observe high mortality rates during days with higher, in relative terms, temperatures, when rapidly changing weather results in an increase of mortality. Such a finding confirms the complexity of cold-related mortality and highlights the importance of synoptic climatology in understanding of the phenomenon.
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Affiliation(s)
- A K Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, GR-68200, Greece.
| | - P A Kassomenos
- Laboratory of Meteorology, Department of Physics, University of Ioannina, GR-45110, Greece
| | - G R McGregor
- Department of Geography, Durham University, Durham, United Kingdom
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Luo K, Li R, Wang Z, Zhang R, Xu Q. Effect modification of the association between temperature variability and daily cardiovascular mortality by air pollutants in three Chinese cities. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 230:989-999. [PMID: 28763936 DOI: 10.1016/j.envpol.2017.07.045] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 06/07/2023]
Abstract
There is limited evidence showing the mortality effects of temperature variability (TV) on cardiovascular diseases. The joint effects between TV and air pollutants are also less well-established. This study aims to assess the effect modification of TV-cardiovascular mortality by air pollutants in three Chinese cities (Beijing, Nanjing and Chengdu). Data of daily mortality, air pollutants and meteorological factors from 2008 to 2011 was collected from each city. TV was calculated as the standard deviation of daily maximum and minimum temperatures over exposure days. The city-specific effect estimates of TV on cardiovascular mortality were calculated using a quasi-Poisson regression model, adjusting for potential confounders (e.g., seasonality and temperature). An interaction term of TV and a three-level air pollutants stratum indicator was included in the models. Effect modifications by air pollutants were assessed by comparing the estimates of TV's effect between pollutant stratums and calculating the corresponding 95% confidential interval of the differences. Multivariate meta-analysis was conducted to obtain the pooled estimates. The data showed that TV was associated with increased risk of cardiovascular mortality, especially for longer TV exposure days (0-8 days, TV08). This association was still observed after adjusting for air pollutants on current day or the previous two days. Stronger estimates were observed in females, but no significant difference between males and females was detected, indicating the absence of evidence of effect modification by gender. Estimates of TV-cardiovascular mortality varied across two season periods (warm and cool season) and age groups, but the evidence of effect modification by age and seasons was absent. Regarding the effect modification of TV-cardiovascular mortality association by air pollutants, a significant effect modification was identified for PM10, but not for NO2 and SO2 in the whole population for all TV exposure days. This finding also persisted in subgroups, specifically in females and the elderly.
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Affiliation(s)
- Kai Luo
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Runkui Li
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Science, Beijing 100101, China
| | - Zongshuang Wang
- Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Ruiming Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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50
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Huang Y, Rosenberg M, Hou L, Hu M. Relationships among Environment, Climate, and Longevity in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101195. [PMID: 28991186 PMCID: PMC5664696 DOI: 10.3390/ijerph14101195] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 11/16/2022]
Abstract
Human longevity is influenced by environment and nutrition. We considered environmental and nutritional factors relating to longevity in Chinese cities. We found higher 85+/65+ distribution ratios, indicating enhanced longevity, in the coastal and southern regions of China. These areas also featured higher humidity, low standard deviation of monthly temperature, higher levels of selenium (Se) distribution in soil, and greater sea fish consumption. Moderate climate is more conducive to longevity, however, there is no significant difference in longevity between different sub-climatic types within moderate climate; the relation between humidity and longevity is not always positive, the relation between altitude and longevity is not always negative. Nutritional factors like Se and omega-3 fatty acids contained in sea fish were crucial to longevity. In contrast, the consumption of meat and freshwater fish were less related to longevity. Taken together, humidity, altitude, and per capita sea fish consumption, when evaluated via geographically weighted regression, explained 66% and 68% of longevity among Chinese individuals in 2000 and 2010, respectively. Other factors require further discussion.
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Affiliation(s)
- Yi Huang
- School of Geographic Science, Nantong University, Nantong 226007, China.
- Department of Geography and Planning, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Mark Rosenberg
- Department of Geography and Planning, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Lingli Hou
- School of Geographic Science, Nantong University, Nantong 226007, China.
| | - Mengjin Hu
- School of Geographic Science, Nantong University, Nantong 226007, China.
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