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Gao D, Friedman S, Hosler AS, Sheridan S, Zhang W, Yu F, Lin S. Ambient heat and diabetes hospitalizations: Does the timing of heat exposure matter? THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169011. [PMID: 38040382 DOI: 10.1016/j.scitotenv.2023.169011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Although ambient heat exposure is linked with diabetes mortality, the impacts of heat exposure on diabetes-related hospitalizations remain controversial. Previous research did not examine the timing of heat-diabetes associations and relation with comorbidities/risk factors. OBJECTIVE We examined the association between heat exposure and diabetes-related hospitalizations in the transitional and summer months and identified populations vulnerable to heat. METHODS We conducted a time-stratified case-crossover study. Data on diabetes hospital admissions (primary diagnosis of type 1 and type 2 diabetes, 2013-2020) were collected by the New York State (NYS) Department of Health under the state legislative mandate. We treated temperature and air pollutants as continuous variables and defined the heat exposure as per interquartile range (IQR, a measure between the 25th and 75th percentiles) increase of daily mean temperature. Conditional logistic regressions were performed to quantify the heat-diabetes associations after controlling for air pollutants and time variant variables. Multiplicative-scale interactions between heat and demographics/comorbidities/risk factors on diabetes hospitalizations were investigated. RESULTS Each IQR increase in temperature was associated with significantly increased risks for diabetes admissions that occurred immediately and lasted for an entire week during multi-day lags in the transitional month of May (ranges of excess risk: 3.1 %-4.8 %) but not in the summer (June-August) (ranges of excess risk: -0.3 %-1.3 %). The significant increases in the excess risk of diabetes were also found among diabetes patients with complications of neuronopathy (excess risk: 27.7 %) and hypoglycemia (excess risk: 19.1 %). Furthermore, the modification effects on the heat-diabetes association were significantly stronger in females, Medicaid enrollees, non-compliant patients, and individuals with comorbidities of atherosclerotic heart disease and old myocardial infarction. CONCLUSIONS Ambient heat exposure significantly increased the burden of hospital admissions for diabetes in transitional rather than summer months indicating the importance of exposure timing. Vulnerability to heat varied by demographics and heart comorbidity.
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Affiliation(s)
- Donghong Gao
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, USA
| | | | - Akiko S Hosler
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, USA
| | - Scott Sheridan
- Department of Geography, Kent State University, Kent, OH, USA
| | - Wangjian Zhang
- Department of Medical Statistics, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fangqun Yu
- Atmospheric Sciences Research Center, University at Albany, Albany, NY, USA
| | - Shao Lin
- Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, USA; Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, USA.
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2
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Lo Y, Vosper E, Higgins JP, Howard G. Heat impacts on human health in the Western Pacific Region: an umbrella review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 42:100952. [PMID: 38022710 PMCID: PMC10652124 DOI: 10.1016/j.lanwpc.2023.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
Background High temperatures and heatwaves are occurring more frequently and lasting longer because of climate change. A synthesis of existing evidence of heat-related health impacts in the Western Pacific Region (WPR) is lacking. This review addresses this gap. Methods The Scopus and PubMed databases were searched for reviews about heat impacts on mortality, cardiovascular morbidity, respiratory morbidity, dehydration and heat stroke, adverse birth outcomes, and sleep disturbance. The last search was conducted in February 2023 and only publications written in English were included. Primary studies and reviews that did not include specific WPR data were excluded. Data were extracted from 29 reviews. Findings There is strong evidence of heat-related mortality in the WPR, with the evidence concentrating on high-income countries and China. Associations between heat and cardiovascular or respiratory morbidity are not robust. There is evidence of heat-related dehydration and stroke, and preterm and still births in high-income countries in the WPR. Some evidence of sleep disturbance from heat is found for Australia, Japan and China. Interpretation Mortality is by far the most studied and robust health outcome of heat. Future research should focus on morbidity, and lower income countries in continental Asia and Pacific Island States, where there is little review-level evidence. Funding Funded by the World Health Organization WPR Office.
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Affiliation(s)
- Y.T.Eunice Lo
- Cabot Institute for the Environment, University of Bristol, UK
- Elizabeth Blackwell Institute for Health Research, University of Bristol, UK
| | - Emily Vosper
- Cabot Institute for the Environment, University of Bristol, UK
- School of Geographical Sciences, University of Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Guy Howard
- Cabot Institute for the Environment, University of Bristol, UK
- School of Civil, Aerospace and Design Engineering, University of Bristol, UK
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3
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Jingesi M, Lan S, Hu J, Dai M, Huang S, Chen S, Liu N, Lv Z, Ji J, Li X, Wang P, Cheng J, Peng J, Yin P. Association between thermal stress and cardiovascular mortality in the subtropics. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:2093-2106. [PMID: 37878088 DOI: 10.1007/s00484-023-02565-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 09/13/2023] [Accepted: 10/15/2023] [Indexed: 10/26/2023]
Abstract
Hazardous thermal conditions resulting from climate change may play a role in cardiovascular disease development. We chose the Universal Thermal Climate Index (UTCI) as the exposure metric to evaluate the relationship between thermal conditions and cardiovascular mortality in Shenzhen, China. We applied quasi-Poisson regression non-linear distributed lag models to evaluate the exposure-response associations. The findings suggest that cardiovascular mortality risks were significantly increased under heat and cold stress, and the adverse effects of cold stress were stronger than heat stress. Referencing the 50th percentile of UTCI (25.4°C), the cumulative risk of cardiovascular mortality was 75% (RRlag0-21 =1.75, 95%CI: 1.32, 2.32) higher in the 1st percentile (3.5°C), and 40% (RRlag0-21=1.40, 95%CI: 1.09, 1.80) higher in the 99th percentile (34.1°C). We observed that individuals older than 65 years were more vulnerable to both cold and heat stress, and females were identified as more susceptible to heat stress than males. Moreover, increased mortality risks of hypertensive disease and cerebrovascular disease were observed under cold stress, while heat stress was related to higher risks of mortality for hypertensive disease and ischemic heart disease. We also observed a stronger relationship between cold stress and ischemic heart disease mortality during the cold season, as well as a significant impact of heat stress on cerebrovascular disease mortality in the warm season when compared to the analysis of the entire year. These results confirm the significant relationship between thermal stress and cardiovascular mortality, with age and sex as potential effect modifiers of this association. Providing affordable air conditioning equipment, increasing the amount of vegetation, and establishing comprehensive early warning systems that take human thermoregulation into account could all help to safeguard the well-being of the public, particularly vulnerable populations, in the event of future extreme weather.
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Affiliation(s)
- Maidina Jingesi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Shuhua Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Mengyi Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Siyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ning Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jiajia Ji
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Rd, Shenzhen, 518020, Guangdong, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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Guan Q, Zhu C, Zhang G, Wang J, Xiang H, Chen Y, Cui H. Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 337:122579. [PMID: 37741540 DOI: 10.1016/j.envpol.2023.122579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
The prevalence of type 2 diabetes (T2D) is higher in urban than in rural areas. Limited information is available on the association between T2D and Land urbanization (LU) while LU influences not only greenness and Particulate Matter 2.5 (PM2.5) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM2.5, or conscious physical activity mediated any of the observed associations. This study encompassed 27,633 adult participants from Shandong Province who completed the sixth National Health Service Survey in 2018. Ambient LU exposure was estimated by spatial characteristics, including the existing impervious surface area (ISA), road density (RD), and annual night light (NL). Exposures were estimated using satellite images and OpenStreetMap, with 1000 m used as the main analysis buffer. Two-level logistic regression models were used to investigate the association between the LU metrics and T2D. Additionally, we explored potential mechanisms of the association through mediation analysis. The prevalence of T2D among participants was 5.14%, with average exposures to ISA_1000m of 1.441 km2, RD_1000m of 3.856 km/km2, and NL_1000m of 9.821 nW/cm2/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA_1000m, RD_1000m, and NL_1000m, the adjusted OR (95% CI) for the T2D prevalence were 1.29 (1.19-1.4), 1.25 (1.15-1.36), and 1.25 (1.15-1.36), respectively]. This relationship persisted in several sensitivity analyses including use of different buffer sizes. We observed stronger associations among participants younger than 65 years or in men. Greenness mediated a 20.78%-65.36% of the estimated associations, conscious physical activity mediated a 10.35%-15.85%, while PM2.5 mediated insignificantly. These results suggest a deleterious association between higher levels of LU and T2D among adult residents in a developing country. Greenness and conscious physical activity mediate the association.
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Affiliation(s)
- Qing Guan
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Chunyang Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Guo Zhang
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan 430072, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.
| | - Yujia Chen
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Hao Cui
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
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Park H, Lee SM, Kim WJ, Chae Y. Analysis of compound health impacts of heatwave and COVID-19 in Korea from May to September in 2020. Sci Rep 2023; 13:14880. [PMID: 37689740 PMCID: PMC10492780 DOI: 10.1038/s41598-023-41880-1] [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: 01/30/2023] [Accepted: 09/01/2023] [Indexed: 09/11/2023] Open
Abstract
The number of non-accidental deaths and heat-related illnesses due to the co-occurrence of heatwaves and COVID-19 has been identified to estimate compound health impacts between two risks. We have analyzed data from historical years (2013-2019) to calculate the baseline values of the number of non-accidental deaths and heat-related illness patients from May to September using a quasi-Poisson generalized linear model and compared them to data from 2020 in Korea. We also assessed the relative risk and absolute cumulative number of non-accidental deaths and heat-related illnesses in the summer of 2020 in Seoul, Daegu, and Gyeongnam region of Korea. In the Summer of 2020, Korea experienced 0.8% of non-accidental excess deaths, with the highest in August, and 46% of reduction was observed in heat-related throughout the study period, except in Daegu, where excess of heat-related illness occurred in August. The relative risk (RR) of non-accidental deaths at 33.1 °C, was 1.00 (CI 0.99-1.01) and 1.04 (CI 1.02-1.07) in 2013-2019 and 2020, respectively. The RR of heat-related illness at 33.1 °C, was 1.44 (CI 1.42-1.45) and 1.59 (CI 1.54-1.64) in 2013-2019 and 2020, respectively. The absolute cumulative trends of non-accidental deaths and heat-related illnesses were similar in the three regions, indicating increased non-accidental deaths and decreased heat-related illnesses at similar temperatures in 2020. During the COVID-19 pandemic, the fear of infection by the virus and the limited access to healthcare services led to changes in health-seeking behaviors. These results indicate social distancing could have had adverse impacts on other health conditions. A comprehensive health risk assessment is important when facing simultaneous risks, such as heatwaves and pandemics, in the implementation of effective countermeasures.
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Affiliation(s)
- Haemin Park
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Sang-Min Lee
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Woo Joong Kim
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea
| | - Yeora Chae
- Korea Environment Institute, 370 Sicheong-Daero, Sejong, 30147, Republic of Korea.
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6
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Lin SY, Ng CFS, Kim Y, Htay ZW, Cao AQ, Pan R, Hashizume M. Ambient temperature and nervous system diseases-related mortality in Japan from 2010 to 2019: A time-stratified case-crossover analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 867:161464. [PMID: 36621488 DOI: 10.1016/j.scitotenv.2023.161464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/16/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Despite the substantial disease burden caused by nervous system diseases, few studies have examined the association between ambient temperature and nervous system diseases, especially during cold seasons. Evidence for specific disease subgroups such as Alzheimer's and Parkinson's is also lacking. OBJECTIVES This study examined the association between short-term changes in ambient temperature and nervous system diseases-related mortality in ten Japanese prefectures from 1 January 2010 to 31 December 2019. METHODS A two-stage analysis based on a time-stratified case-crossover study design was conducted. A conditional quasi-Poisson regression model with a distributed lag non-linear model for temperature was applied followed by a multivariate random-effects meta-analysis to obtain average associations. Mortality due to all and cause-specific nervous system diseases (major neurodegenerative diseases, Alzheimer's, and Parkinson's) were analyzed, with consideration for sex and age (0-84 and 85+ years old) subgroups. RESULTS We analyzed 162,315 death cases due to nervous system diseases. Cold was associated with all categories of nervous system diseases-related mortality, but not heat. The estimated relative risks for cold, obtained by comparing the 2.5th percentile of daily mean temperature distribution to the minimum mortality temperature (MMT), were 1.43 (95 % CI: 1.28-1.60), 1.37 (95 % CI: 1.17-1.59), 1.53 (95 % CI: 1.07-2.01), and 1.54 (95 % CI: 1.13-2.10) for all nervous system diseases, major neurodegenerative diseases, Alzheimer's, and Parkinson's, respectively. These associations were also observed in the sex and age subgroups in general but without evidence of effect modification. Heat (the 97.5th percentile of daily mean temperature distribution vs. MMT) was associated with Parkinson's disease-related mortality among those aged 85 years and over. DISCUSSION Cold was associated with an increased risk of nervous system disease-related mortality. The effect of heat was not observed, except for mortality among the elderly aged 85 years and older with Parkinson's disease.
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Affiliation(s)
- Szu Yu Lin
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Zin Wai Htay
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Alton Quan Cao
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rui Pan
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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7
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Yan M, Xie Y, Zhu H, Ban J, Gong J, Li T. Cardiovascular mortality risks during the 2017 exceptional heatwaves in China. ENVIRONMENT INTERNATIONAL 2023; 172:107767. [PMID: 36716635 DOI: 10.1016/j.envint.2023.107767] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/11/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Climate change has made disastrous heatwaves more frequent. Heatwave-related health impacts are much more devastating for more intense heatwaves. In the summer of 2017, exceptional heatwaves occurred in many regions, including China. This study aims to evaluate the cardiovascular mortality risk associated with the 2017 exceptional heatwaves and compare the mortality risk of the severe heatwaves with those in other years. Using daily data for a spectrum of cardiovascular mortality and temperature for 102 Chinese counties (2014-2017), we estimated the association between heatwave and mortality by generalized linear mixed-effects models. Compared with matched non-heatwave days, mortality risks on heatwaves days in 2017 increased 27.8% (95% CI, 14.8-42.3%), 26.7% (8.0-48.5%), 30.1% (10.2-53.7%), 27.3% (1.4-59.9%), 32.2% (3.4-68.4%), and 25.2% (1.0-57.7%) for total circulatory diseases, cerebrovascular disease, ischemic heart disease (IHD), acute IHD, chronic IHD, and myocardial infarction. The 2017 exceptional heatwaves impacted ischemic heart disease mortality and myocardial infarction mortality more than heatwaves in 2014-2016. Here we show that the severe heatwaves in 2017 posed catastrophic death threats for those under-studied cardiovascular diseases.
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Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China; Future Cities Lab, Beihang University, China
| | - Huanhuan Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology and State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, 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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8
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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9
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Dang TN, Vy NTT, Thuong DTH, Phung D, Van Dung D, Le An P. Main and added effects of heatwaves on hospitalizations for mental and behavioral disorders in a tropical megacity of Vietnam. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:59094-59103. [PMID: 35378653 DOI: 10.1007/s11356-022-19898-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
Vietnam is highly vulnerable to climate change-related extreme weather events such as heatwaves. This study assesses the association between heatwaves and hospitalizations due to mental and behavioral disorders (MBDs) in Ho Chi Minh City (HCMC). We collected daily MBD hospital admissions data at the HCMC Mental Health Hospital from 2017 to 2019. Heatwaves effects were characterized into the main effect (i.e., the intensity of temperature during heatwaves) and the added effect (i.e., the duration of heatwaves). Time series Poisson regression coupled with a distributed lag linear model (DLM) was used to quantify the 14-day lags effect of heatwaves. Confounders including long-term trend, seasonality, days of the week, holidays, and relative humidity were included in the model. Heatwaves increased all-cause MBD hospitalization by 62% (95%Cl, 36-93%) for the main effect and by 8% (95% Cl, - 3% to 19%) for the added effect. Noticeably, the group aged 18-60 years old was affected by the main effect of the heatwave, while the group aged 61 years and older was affected by the added effect of the heatwave. The effects of heatwaves differed among groups of MBD hospitalizations. The mental and behavioral disorder group due to psychoactive substance use was significantly affected by the main effect of heatwaves (RR:2.21; 95%Cl:1.55-3.15). The group of schizophrenia, schizotypal and delusional disorders were highly vulnerable towards both the main and the added effect of heatwaves with RR = 1.50 (95%CI, 1.20-1.86) and RR = 1.14 (95%CI, 1.01-1.30), respectively.
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Affiliation(s)
- Tran Ngoc Dang
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam.
| | - Nguyen Thi Tuong Vy
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Do Thi Hoai Thuong
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane, Australia
| | - Do Van Dung
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Pham Le An
- Family Medicine Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam.
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10
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Strathearn M, Osborne NJ, Selvey LA. Impact of low-intensity heat events on mortality and morbidity in regions with hot, humid summers: a scoping literature review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1013-1029. [PMID: 35059818 PMCID: PMC9042961 DOI: 10.1007/s00484-022-02243-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 05/05/2023]
Abstract
The objective of this study is to determine the impacts of low-intensity heat on human health in regions with hot, humid summers. Current literature has highlighted an increase in mortality and morbidity rates during significant heat events. While the impacts on high-intensity events are established, the impacts on low-intensity events, particularly in regions with hot, humid summers, are less clear. A scoping review was conducted searching three databases (PubMed, EMBASE, Web of Science) using key terms based on the inclusion criteria. We included papers that investigated the direct human health impacts of low-intensity heat events (single day or heatwaves) in regions with hot, humid summers in middle- and high-income countries. We excluded papers written in languages other than English. Of the 600 publications identified, 33 met the inclusion criteria. Findings suggest that low-intensity heatwaves can increase all-cause non-accidental, cardiovascular-, respiratory- and diabetes-related mortality, in regions experiencing hot, humid summers. Impacts of low-intensity heatwaves on morbidity are less clear, with research predominantly focusing on hospitalisation rates with a range of outcomes. Few studies investigating the impact of low-intensity heat events on emergency department presentations and ambulance dispatches were found. However, the data from a limited number of studies suggest that both of these outcome measures increase during low-intensity heat events. Low-intensity heat events may increase mortality. There is insufficient evidence of a causal effect of low-intensity heat events on increasing morbidity for a firm conclusion. Further research on the impact of low-intensity heat on morbidity and mortality using consistent parameters is warranted.
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Affiliation(s)
- Melanie Strathearn
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Nicholas J Osborne
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Linda A Selvey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia.
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11
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Song X, Jiang L, Zhang D, Wang X, Ma Y, Hu Y, Tang J, Li X, Huang W, Meng Y, Shi A, Feng Y, Zhang Y. Impact of short-term exposure to extreme temperatures on diabetes mellitus morbidity and mortality? A systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:58035-58049. [PMID: 34105073 DOI: 10.1007/s11356-021-14568-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/20/2021] [Indexed: 05/27/2023]
Abstract
The relationship between diabetes mellitus and short-term exposure to extreme temperatures remains controversial. A systematic review and meta-analysis were performed to assess the association between extreme temperatures and diabetes mellitus morbidity and mortality. PubMed, Embase, the Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched since inception to January 1, 2019, and updated on November 17, 2020. The results were combined using random effects model and reported as relative risk (RR) with 95% confidence interval (CI). In total, 32 studies met the inclusion criteria. (1) Both heat and cold exposures have impact on diabetes. (2) For heat exposure, the subgroup analysis revealed that the effect on diabetes mortality (RR=1.139, 95% CI: 1.089-1.192) was higher than morbidity (RR=1.012, 95% CI: 1.004-1.019). (3) With the increase of definition threshold, the impact of heat exposure on diabetes rose. (4) A stronger association between heat exposure and diabetes was observed in the elderly (≥ 60 years old) (RR=1.040, 95% CI: 1.017-1.064). In conclusion, short-term exposure to both heat and cold temperatures has impact on diabetes. The elderly is the vulnerable population of diabetes exposure to heat temperature. Developing definitions of heatwaves at the regional level are suggested.
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Affiliation(s)
- Xuping Song
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Liangzhen Jiang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Dongdong Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xinyi Wang
- Second Clinical College, Lanzhou University, Lanzhou, 730000, China
| | - Yan Ma
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yue Hu
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Jing Tang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiayang Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Wenqiang Huang
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Yuan Meng
- Laboratory of Cancer Biology, Key Lab of Biotherapy in Zhejiang, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, 310000, China
| | - Anchen Shi
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiao Tong University, Shaanxi, 710061, China
| | - Yan Feng
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yan Zhang
- Gansu Province Hospital Rehabilitation Center, 53 Dingxi Road, Chengguan District, Lanzhou, 730000, Gansu, China.
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12
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Ma Y, Zhou L, Chen K. Burden of cause-specific mortality attributable to heat and cold: A multicity time-series study in Jiangsu Province, China. ENVIRONMENT INTERNATIONAL 2020; 144:105994. [PMID: 32745780 DOI: 10.1016/j.envint.2020.105994] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/12/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Previous epidemiological studies primarily examined the temperature-related mortality burden of all-cause or cardiovascular diseases (CVD) and respiratory diseases. However, evidence on the heat- and cold-attributable mortality burden from other specific causes is limited. This paper aimed to systematically examine the association of heat and cold with a comprehensive spectrum of plausible temperature-related diseases, and to estimate the mortality burdens attributable to heat and cold. In the time-series study of 11 cities in Jiangsu, China, distributed lag non-linear models were applied to estimate city-specific temperature-mortality associations, and then meta-analysis was conducted to pool the estimates. A total of 1,368,648 cases of death were included in this study. Both extreme heat and cold were associated with increased mortality risks from all-cause, CVD, respiratory diseases, nervous diseases, and external causes. Short-term exposures to heat and cold were associated with excess burden of mortality for several specific diseases, accounting for 16.38% (95% eCI, 7.27-22.31%) for myocardial infarction (MI), 12.41% (95% eCI, 8.81-15.07%) for stroke, 27.97% (95% eCI, 18.42-33.35%) for hypertensive heart disease, 25.18% (95% eCI, 18.42-29.63%) for chronic obstructive pulmonary disease, and 28.46% (95% eCI: 4.93-33.57%) for Alzheimer's and dementia. Diabetes was only associated with extreme heat, with 4.61% (95% eCI, 0.13-7.13%) of diabetes mortality attributable to heat. In total, 11.98% (95% eCI, 10.46-13.08%) of mortality was attributable to heat and cold, with 3.49% (95% eCI, 2.87-4.00%) attributable to heat and 8.48% (95% eCI, 7.31-9.49%) attributable to cold, and about 64% of this overall temperature-related mortality burden was found in 6 aforementioned specific causes and about 10% of mortality burden in external causes. Extreme heat and/or cold are associated with increased risks of mortality from a wide range of causes, including previously identified causes in cardiorespiratory diseases and under-studied causes such as diabetes and Alzheimer's and dementia. Future research is needed to confirm the substantial mortality burden of heat and cold.
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Affiliation(s)
- Yiqun Ma
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA.
| | - Lian Zhou
- College of Applied Meteorology, Nanjing University of Information Science and Technology, Nanjing, China; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Jänicke B, Kim KR, Cho C. A simple high-resolution heat-stress forecast for Seoul, Korea: coupling climate information with an operational numerical weather prediction model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:1197-1205. [PMID: 32166440 DOI: 10.1007/s00484-020-01893-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 01/30/2020] [Accepted: 03/03/2020] [Indexed: 06/10/2023]
Abstract
To provide a simple high-resolution heat-stress forecast for Seoul, Korea, we coupled a high-resolution climate simulation (25 m grid spacing) for an average heat day with the operational forecasting model (5 km grid spacing). Thereby, we accounted for the meso-scale weather conditions and local-scale air temperature induced by land cover and the urban heat island effect. Moreover, we estimated the impacts of heat events using heat-related mortality rate. Applying the simple high-resolution heat-stress forecast for July and August 2016, we detected a substantial spatial variability in maximum air temperature and heat-related mortality rate in Seoul. The evaluation of simulated maximum air temperature compared to observations revealed a small deviation (MB = 0.11 K, RMSD = 1.40 K). Despite the limitation of using average conditions, it was an efficient way to identify particularly affected areas, neighbourhoods, and districts for releasing more location-specific heat-stress warnings.
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Affiliation(s)
- Britta Jänicke
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, Jeju-do, 63568, Republic of Korea.
| | - Kyu Rang Kim
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, Jeju-do, 63568, Republic of Korea
| | - Changbum Cho
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, Jeju-do, 63568, Republic of Korea
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14
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Lian T, Fu Y, Sun M, Yin M, Zhang Y, Huang L, Huang J, Xu Z, Mao C, Ni J, Liu G. Effect of temperature on accidental human mortality: A time-series analysis in Shenzhen, Guangdong Province in China. Sci Rep 2020; 10:8410. [PMID: 32439880 PMCID: PMC7242478 DOI: 10.1038/s41598-020-65344-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 05/01/2020] [Indexed: 12/16/2022] Open
Abstract
Health-risk assessments of temperature are central to determine total non-accidental human mortality; however, few studies have investigated the effect of temperature on accidental human mortality. We performed a time-series study combined with a distributed lag non-linear model (DLNM) to quantify the non-linear and delayed effects of daily mean temperature on accidental human mortality between 2013 and 2017 in Shenzhen, China. The threshold for effects of temperature on accidental human mortality occurred between 5.6 °C and 18.5 °C. Cold exposures, but not hot exposures, were significantly associated with accidental human mortality. All of the observed groups were susceptible to cold effects, with the strongest effects presented in females (relative risk [RR]: 3.14, 95% confidence interval (CI) [1.44-6.84]), followed by poorly educated people (RR: 2.63, 95% CI [1.59-4.36]), males (RR: 1.79, 95% CI [1.10-2.92]), and well-educated people (RR: 1.20, 95% CI [0.58-2.51]). Pooled estimates for cold effects at a lag of 0-21 days (d) were also stronger than hot effects at a lag of 0-2 d. Our results indicate that low temperatures increased the risk of accidental human mortality. Females and poorly educated people were more susceptible to the low temperatures. These findings imply that interventions which target vulnerable populations during cold days should be developed to reduce accidental human mortality risk.
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Affiliation(s)
- Tingyu Lian
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Longzhu Avenue Nanshan District, Shenzhen, 518000, Guangdong, China
| | - Mingwei Sun
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Mingjuan Yin
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Yan Zhang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Lingfeng Huang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Jingxiao Huang
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China
| | - Ziqian Xu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Longzhu Avenue Nanshan District, Shenzhen, 518000, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Jindong Ni
- Department of Epidemiology and Biostatistics, Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Key Laboratory of Precision Public Health, Guangdong Medical University, 1 Xincheng Avenue Songshanhu District, Dongguan, 523000, Guangdong, China.
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Road, Longzhu Avenue Nanshan District, Shenzhen, 518000, Guangdong, China.
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15
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Chae SM, Kim D. Research Trends in Agenda-setting for Climate Change Adaptation Policy in the Public Health Sector in Korea. J Prev Med Public Health 2020; 53:3-14. [PMID: 32023669 PMCID: PMC7002993 DOI: 10.3961/jpmph.19.326] [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: 11/27/2019] [Accepted: 01/10/2020] [Indexed: 11/18/2022] Open
Abstract
Many studies have been conducted to assess the health effects of climate change in Korea. However, there has been a lack of consideration regarding how the results of these studies can be applied to relevant policies. The current study aims to examine research trends at the agenda-setting stage and to review future ways in which health-related adaptation to climate change can be addressed within national public health policy. A systematic review of previous studies of the health effects of climate change in Korea was conducted. Many studies have evaluated the effect of ambient temperature on health. A large number of studies have examined the effects on deaths and cardio-cerebrovascular diseases, but a limitation of these studies is that it is difficult to apply their findings to climate change adaptation policy in the health sector. Many infectious disease studies were also identified, but these mainly focused on malaria. Regarding climate change-related factors other than ambient temperature, studies of the health effects of these factors (with the exception of air pollution) are limited. In Korea, it can be concluded that studies conducted as part of the agenda-setting stage are insufficient, both because studies on the health effects of climate change have not ventured beyond defining the problem and because health adaptation to climate change has not been set as an important agenda item. In the future, the sharing and development of relevant databases is necessary. In addition, the priority of agenda items should be determined as part of a government initiative.
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Affiliation(s)
- Su-Mi Chae
- Center for Research on Future Disease Response, Korea Institute for Health and Social Affairs, Sejong, Korea
| | - Daeeun Kim
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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16
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Lim YH, Lee KS, Bae HJ, Kim D, Yoo H, Park S, Hong YC. Estimation of heat-related deaths during heat wave episodes in South Korea (2006-2017). INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1621-1629. [PMID: 31385090 DOI: 10.1007/s00484-019-01774-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/30/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
In 2016, South Korea experienced extremely high temperatures and the Korea Centre for Disease Control and Prevention (KCDC) reported 17 heat-caused deaths during these heat waves, most due to heat stroke. Because the reported number of heat-caused deaths is only part of the total deaths associated with heat waves, we aimed to estimate attributable deaths during heat wave episodes. We linked mortality to meteorological data in 16 regions in South Korea and estimated relative risk at or above threshold of maximum temperature during summer using generalized linear regression models after controlling for confounders. We computed overall, age-, sex-, and cause-specific attributable deaths from 2006 to 2017. With a 1.5% increase in all-cause mortality per 1 °C increase in concurrent days' maximum temperature during summer, this study estimates a total of 1440 all-cause deaths associated with heat waves during the 2006-2017 study period in South Korea. We estimate that 343 deaths in 2016 can be ascribed to heat waves, which is approximately 20 times more than the number reported by the KCDC (17 heat-caused deaths). This study addresses attributable heat wave deaths in South Korea and illustrates that the reports of medically classified heat-caused deaths seriously underestimate the number of deaths attributable to heat waves. Our findings may enable the implementation and reinforcement of government- and individual-level management strategies for heat waves.
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Affiliation(s)
- Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehakro, Jongno-Gu, Seoul, 110-799, Republic of Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Shin Lee
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehakro, Jongno-Gu, Seoul, 110-799, Republic of Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Joo Bae
- Korea Environment Institute, Sejong, Republic of Korea
| | - Dowoo Kim
- National Disaster Management Research Institute, Ulsan, Republic of Korea
| | - Hyosoon Yoo
- Korea Centre for Disease Control and Prevention, Osong, Cheongju, Republic of Korea
| | - Sungwoo Park
- Korea Centre for Disease Control and Prevention, Osong, Cheongju, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehakro, Jongno-Gu, Seoul, 110-799, Republic of Korea.
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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17
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Kim Y, Kim H, Gasparrini A, Armstrong B, Honda Y, Chung Y, Ng CFS, Tobias A, Íñiguez C, Lavigne E, Sera F, Vicedo-Cabrera AM, Ragettli MS, Scovronick N, Acquaotta F, Chen BY, Guo YLL, Seposo X, Dang TN, de Sousa Zanotti Stagliorio Coelho M, Saldiva PHN, Kosheleva A, Zanobetti A, Schwartz J, Bell ML, Hashizume M. Suicide and Ambient Temperature: A Multi-Country Multi-City Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:117007. [PMID: 31769300 PMCID: PMC6927501 DOI: 10.1289/ehp4898] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Previous literature suggests that higher ambient temperature may play a role in increasing the risk of suicide. However, no multi-country study has explored the shape of the association and the role of moderate and extreme heat across different locations. OBJECTIVES We examined the short-term temperature-suicide relationship using daily time-series data collected for 341 locations in 12 countries for periods ranging from 4 to 40 y. METHODS We conducted a two-stage meta-analysis. First, we performed location-specific time-stratified case-crossover analyses to examine the temperature-suicide association for each location. Then, we used a multivariate meta-regression to combine the location-specific lag-cumulative nonlinear associations across all locations and by country. RESULTS A total of 1,320,148 suicides were included in this study. Higher ambient temperature was associated with an increased risk of suicide in general, and we observed a nonlinear association (inverted J-shaped curve) with the highest risk at 27°C. The relative risk (RR) for the highest risk was 1.33 (95% CI: 1.30, 1.36) compared with the risk at the first percentile. Country-specific results showed that the nonlinear associations were more obvious in northeast Asia (Japan, South Korea, and Taiwan). The temperature with the highest risk of suicide ranged from the 87th to 88th percentiles in the northeast Asian countries, whereas this value was the 99th percentile in Western countries (Canada, Spain, Switzerland, the UK, and the United States) and South Africa, where nearly linear associations were estimated. The country-specific RRs ranged from 1.31 (95% CI: 1.19, 1.44) in the United States to 1.65 (95% CI: 1.40, 1.93) in Taiwan, excluding countries where the results were substantially uncertain. DISCUSSION Our findings showed that the risk of suicide increased with increasing ambient temperature in many countries, but to varying extents and not necessarily linearly. This temperature-suicide association should be interpreted cautiously, and further evidence of the relationship and modifying factors is needed. https://doi.org/10.1289/EHP4898.
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Affiliation(s)
- Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ben Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yeonseung Chung
- Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana M. Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Martina S. Ragettli
- Department of Epidemiology and Public Health, Environmental Exposures and Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Noah Scovronick
- Department of Environmental Health, Emory Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Bing-Yu Chen
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Xerxes Seposo
- Department of Environmental Engineering, Kyoto University, Kyoto, Japan
| | - Tran Ngoc Dang
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | - Anna Kosheleva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michelle L. Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Masahiro Hashizume
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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18
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Cheng J, Xu Z, Bambrick H, Su H, Tong S, Hu W. Impacts of exposure to ambient temperature on burden of disease: a systematic review of epidemiological evidence. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1099-1115. [PMID: 31011886 DOI: 10.1007/s00484-019-01716-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 05/21/2023]
Abstract
Ambient temperature is an important determinant of mortality and morbidity, making it necessary to assess temperature-related burden of disease (BD) for the planning of public health policies and adaptive responses. To systematically review existing epidemiological evidence on temperature-related BD, we searched three databases (PubMed, Web of Science, and Scopus) on 1 September 2018. We identified 97 studies from 56 counties for this review, of which 75 reported the fraction or number of health outcomes (include deaths and diseases) attributable to temperature, and 22 reported disability-adjusted life years (include years of life lost and years lost due to disability) related to temperature. Non-optimum temperatures (i.e., heat and cold) were responsible for > 2.5% of mortality in all included high-income countries/regions, and > 3.0% of mortality in all included middle-income countries. Cold was mostly reported to be the primary source of mortality burden from non-optimum temperatures, but the relative role of three different temperature exposures (i.e., heat, cold, and temperature variability) in affecting morbidity and mortality remains unclear so far. Under the warming climate scenario, almost all projections assuming no population adaptation suggested future increase in heat-related but decrease in cold-related BD. However, some studies emphasized the great uncertainty in future pattern of temperature-related BD, largely depending on the scenarios of climate, population adaptation, and demography. We also identified important discrepancies and limitations in current research methodologies employed to measure temperature exposures and model temperature-health relationship, and calculate the past and project future temperature-related BD. Overall, exposure to non-optimum ambient temperatures has become and will continue to be a considerable contributor to the global and national BD, but future research is still needed to develop a stronger methodological framework for assessing and comparing temperature-related BD across different settings.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
- School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, 4059, Australia.
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Jänicke B, Holtmann A, Kim KR, Kang M, Fehrenbach U, Scherer D. Quantification and evaluation of intra-urban heat-stress variability in Seoul, Korea. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1-12. [PMID: 30460432 DOI: 10.1007/s00484-018-1631-2] [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: 10/11/2017] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 06/09/2023]
Abstract
This study quantifies heat-stress hazard (air temperature), vulnerability (heat vulnerability index and age score), and risk (heat-related mortality) on the district scale in Seoul, Korea, for a comprehensive heat-stress impact assessment. Moreover, the heat-stress impact assessment is evaluated by checking the spatial consistency between heat-stress hazard, vulnerability, and risk, which was rarely done before. We applied numerical and geo-empirical models to simulate the spatial pattern of heat-stress hazard. For heat-stress vulnerability, we used demographic and socioeconomic factors. Heat-related mortality was estimated based on an event-based heat-stress risk analysis. Results are that heat-stress hazard, vulnerability, and risk are spatially variable in Seoul. The highest heat-stress hazard was detected in the districts Mapo, Yeongdeungpo, and Yangcheon, the highest vulnerability in Jongno and the highest risk in Jongno and Yangcheon. The different components (heat-stress hazard, vulnerability, and risk) and variables (heat vulnerability index and percentage of seniors) showed different spatial patterns. Knowledge about the causes of higher heat-stress risk, either the hazard or vulnerability, is helpful to design tailored adaptation measures that focus on the reduction of thermal loads or on the preparation of the vulnerable population. The evaluation showed that heat-stress vulnerability and hazard explain the spatial pattern of risk only partly. This highlights the need to evaluate heat-stress impact assessment systems to produce reliable urban heat-stress maps.
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Affiliation(s)
- Britta Jänicke
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea.
| | - Achim Holtmann
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
| | - Kyu Rang Kim
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea
| | - Misun Kang
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea
| | - Ute Fehrenbach
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
| | - Dieter Scherer
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
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de Sousa TCM, Amancio F, Hacon SDS, Barcellos C. [Climate-sensitive diseases in Brazil and the world: systematic reviewEnfermedades sensibles al clima en Brasil y el mundo: revisión sistemática]. Rev Panam Salud Publica 2018; 42:e85. [PMID: 31093113 PMCID: PMC6385874 DOI: 10.26633/rpsp.2018.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/12/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To survey the literature regarding climate-sensitive diseases (CSD) and the impacts of climate changes on health. METHOD This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The Lilacs, SciELO, Scopus, and PubMed databases were searched in July 2017 without temporal restrictions for articles published in in Portuguese, English and Spanish. The following search strategy was used in all databases: (climate) AND (disease) AND (sensitive). RESULTS The systematic review included 106 articles, most of which focused on dengue, malaria, and respiratory and cardiovascular diseases. The most commonly studied climate variables were temperature and precipitation. The studies revealed a relationship between the incidence of certain diseases, especially cardiovascular and respiratory diseases, dengue, malaria, and arboviral diseases, and climate conditions in different regions of the world. This relationship was analyzed considering both past data on the incidence of diseases and climate variables and projections regarding the future incidence of diseases according to expected climate variations. A greater number of studies was performed by authors originating from developed countries. The world regions most often studied were China, the United States, Australia, and Brazil. CONCLUSIONS Despite the increase in the number of published articles on this theme, a greater number of climate and environmental variables must be studied, with expansion of studies to additional regions in the world.
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Affiliation(s)
| | - Flavia Amancio
- Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro (RJ), Brasil
| | - Sandra de Sousa Hacon
- Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública (ENSP), Rio de Janeiro (RJ), Brasil
| | - Christovam Barcellos
- Fundação Oswaldo Cruz (Fiocruz), Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Rio de Janeiro (RJ), Brasil
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Cheng J, Xu Z, Bambrick H, Su H, Tong S, Hu W. Heatwave and elderly mortality: An evaluation of death burden and health costs considering short-term mortality displacement. ENVIRONMENT INTERNATIONAL 2018; 115:334-342. [PMID: 29627746 DOI: 10.1016/j.envint.2018.03.041] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/27/2018] [Accepted: 03/27/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND A heatwave can be a devastating natural disaster to human health, and elderly people are particularly vulnerable. With the continuing rise in earth's surface temperature alongside the world's aging population, research on the mortality burden of heatwave for the older population remains relatively sparse. The potential magnitude of benefits of averting such deaths may be considerable. OBJECTIVES This paper examined the short-term mortality displacement (or "harvesting") of heatwave, characterized the heatwave-mortality relationship, and estimated death burden and health costs attributable to heatwave among the elderly in Australia. METHODS We collected daily data on the temperature and deaths of people aged ≥75 years in the five largest cities of Australia (Sydney, Melbourne, Brisbane, Perth and Adelaide), totaling 368,767 deaths in different periods between 1988 and 2011. A total of 15-tiered heatwave definitions, based on intensity (95th to 99th percentiles of temperature distribution) and duration (two or more consecutive days), were used to quantify heatwave effects, using time-series regression and random-effects meta-analysis. We calculated attributable deaths for each city and by different types of heatwave. Potential economic benefits in monetary terms were also estimated, considering that heat-related deaths are avoidable. RESULTS Among the Australian elderly population, we found significant associations between heatwave and deaths, with raised mortality immediately in the first few days followed by lower-than-expected mortality. In general, heatwave was associated with an average death increase of 28% (95% confidence interval: 15% to 42%), and greater increases were mostly observed for more intense heatwaves across multiple megacities. During the study period, there were dozens to hundreds of deaths attributable to heatwave for each city, equating to an economic loss of several million Australian dollars every year. Although the estimated attributable deaths varied by heatwave intensity and duration, the pattern was not consistent across cities. CONCLUSIONS Heatwave caused harvesting effects on mortality in the elderly population of Australia, and contributed to a substantial amount of death burden and indirect financial costs. To lessen the health impacts of heatwave in the affected regions, effective heatwave early warning systems and interventions targeted at the elderly population could be beneficial, both now and in the future.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hong Su
- School of Public Health, Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, China
| | - Shilu Tong
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia; School of Public Health, Institute of Environment and Human Health, Anhui Medical University, Hefei, China; Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
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Lee S, Lee H, Myung W, Kim EJ, Kim H. Mental disease-related emergency admissions attributable to hot temperatures. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 616-617:688-694. [PMID: 29126638 DOI: 10.1016/j.scitotenv.2017.10.260] [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: 06/26/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The association between high temperature and mental disease has been the focus of several studies worldwide. However, no studies have focused on the mental disease burden attributable to hot temperature. Here, we aim to quantify the risk attributed to hot temperatures based on the exposure-lag-response relationship between temperature and mental diseases. METHOD From data on daily temperature and emergency admissions (EA) for mental diseases collected from 6 major cities (Seoul, Incheon, Daejeon, Daegu, Busan, and Gwangju in South Korea) over a period of 11years (2003-2013), we estimated temperature-disease associations using a distributed lag non-linear model, and we pooled the data by city through multivariate meta-analysis. Cumulative relative risk and attributable risks were calculated for extreme hot temperatures, defined as the 99th percentile relative to the 50th percentile of temperatures. RESULTS The strongest association between mental disease and high temperature was seen within a period of 0-4days of high temperature exposure. Our results reveal that 14.6% of EA for mental disease were due to extreme hot temperatures, and the elderly were more susceptible (19.1%). Specific mental diseases, including anxiety, dementia, schizophrenia, and depression, also showed significant risk attributed to hot temperatures. Of all EA for anxiety, 31.6% were attributed to extremely hot temperatures. CONCLUSIONS High temperature was responsible for an attributable risk for mental disease, and the burden was higher in the elderly. This finding has important implications for designing appropriate public health policies to minimize the impact of high temperature on mental health.
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Affiliation(s)
- Suji Lee
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea
| | - Hwanhee Lee
- Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea
| | - Woojae Myung
- School of Medicine, Samsung Medical Center, Department of Psychiatry, Gangnam-gu, Seoul 06351, South Korea
| | - E Jin Kim
- Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea
| | - Ho Kim
- Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea; Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea.
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Trend of Outbreak of Thermal Illness Patients Based on Temperature 2002–2013 in Korea. CLIMATE 2017. [DOI: 10.3390/cli5040094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cheng J, Xu Z, Bambrick H, Su H, Tong S, Hu W. The mortality burden of hourly temperature variability in five capital cities, Australia: Time-series and meta-regression analysis. ENVIRONMENT INTERNATIONAL 2017; 109:10-19. [PMID: 28923460 DOI: 10.1016/j.envint.2017.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/06/2017] [Accepted: 09/10/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Unstable weather, such as intra- and inter-day temperature variability, can impair the health and shorten the survival time of population around the world. Climate change will cause Earth's surface temperature rise, but has unclear effects on temperature variability, making it urgent to understand the characteristics of the burden of temperature variability on mortality, regionally and nationally. OBJECTIVES This paper aims to quantify the mortality risk of exposure to short-term temperature variability, estimate the resulting death toll and explore how the strength of temperature variability effects will vary as a function of city-level characteristics. METHODS Ten-year (2000-2009) time-series data on temperature and mortality were collected for five largest Australia's cities (Sydney, Melbourne, Brisbane, Perth and Adelaide), collectively registering 708,751 deaths in different climates. Short-term temperature variability was captured and represented as the hourly temperature standard deviation within two days. Three-stage analyses were used to assess the burden of temperature variability on mortality. First, we modelled temperature variability-mortality relation and estimated the relative risk of death for each city, using a time-series quasi-Poisson regression model. Second, we used meta-analysis to pool the city-specific estimates, and meta-regression to explore if some city-level factors will modify the population vulnerability to temperature variability. Finally, we calculated the city-specific deaths attributable to temperature variability, and applied such estimates to the whole of Australia as a reflection of the nation-wide death burden associated with temperature variability. RESULTS We found evidence of significant associations between temperature variability and mortality in all cities assessed. Deaths associated with each 1°C rise in temperature variability elevated by 0.28% (95% confidence interval (CI): 0.05%, 0.52%) in Melbourne to 1.00% (95%CI: 0.52%, 1.48%) in Brisbane, with a pooled estimate of 0.51% (95%CI: 0.33%, 0.69%) for Australia. Subtropical and temperate regions showed no apparent difference in temperature variability impacts. Meta-regression analyses indicated that the mortality risk could be influenced by city-specific factors: latitude, mean temperature, population density and the prevalence of several chronic diseases. Taking account of contributions from the entire time-series, temperature variability was estimated to account for 0.99% to 3.24% of deaths across cities, with a nation-wide attributable fraction of 1.67% (9.59 deaths per 100, 000 population per year). CONCLUSIONS Hourly temperature variability may be an important risk factor of weather-related deaths and led to a sizeable mortality burden. This study underscores the need for developing specific and effective interventions in Australia to lessen the health consequences of temperature variability.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Zhiwei Xu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, China
| | - Shilu Tong
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
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Abstract
BACKGROUND The objective of the present study was to estimate the current and projected burden of disease from high ambient temperature using population-based data sources of nationwide mortality and morbidity in Korea. METHODS Disability-adjusted life years (DALY) were estimated using noninjury-related deaths, and cerebrovascular and cardiovascular diseases from recently released nationwide health and mortality databases. Years of life lost and years lost due to disability were measured based on the point prevalence and number of deaths during the study period. Future DALY attributable to heat waves were estimated from projected populations, and temperature predictions for the years 2030 and 2050 were under Representative Concentration Pathways (RCP) 4.5 and 8.5 with summertime temperatures above threshold. RESULTS Relative risks (RR) of total mortality and of cardiovascular disease were 1.02 (95% CI, 1.01, 1.02) and 1.08 (95% CI, 1.06, 1.09) for each 1°C increase in temperature above threshold, respectively. The morbidity of heat-related disease was RR 1.67 (95% CI, 1.64, 1.68) for each 1°C increase in temperature above threshold. DALY for all-cause death were 0.49 DALY/1000 in 2011, 0.71 (0.71) DALY/1000 in 2030 and 0.77 (1.72) DALY/1000 in 2050 based on RCP 4.5 (RCP 8.5). DALY for cardio- and cerebrovascular diseases were 1.24 DALY/1000 in 2011, 1.63 (1.82) DALY/1000 in 2030, and 1.76 (3.66) DALY/1000 in 2050 based on RCP 4.5 (RCP 8.5). CONCLUSIONS Future excess mortality due to high ambient temperature is expected to be profound in Korea. Efforts to mitigate climate change can provide substantial health benefits via reducing heat-related mortality.
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Tian L, Qiu H, Sun S, Lin H. Emergency Cardiovascular Hospitalization Risk Attributable to Cold Temperatures in Hong Kong. Circ Cardiovasc Qual Outcomes 2016; 9:135-42. [DOI: 10.1161/circoutcomes.115.002410] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 01/27/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Linwei Tian
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Hong Qiu
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Shengzhi Sun
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
| | - Hualiang Lin
- From the School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China (L.T., H.Q., S.S.); and Division of Environmental Health, Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China (H.L.)
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