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Yamasaki L, Kamada T, Ng CFS, Takane Y, Nakajima K, Yamaguchi K, Oka K, Honda Y, Kim Y, Hashizume M. Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area. Environ Epidemiol 2024; 8:e292. [PMID: 38617431 PMCID: PMC11008645 DOI: 10.1097/ee9.0000000000000292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 01/02/2024] [Indexed: 04/16/2024] Open
Abstract
Background Air conditioners can prevent heat-related illness and mortality, but the increased use of air conditioners may enhance susceptibility to heat-related illnesses during large-scale power failures. Here, we examined the risks of heat-related illness ambulance transport (HIAT) and mortality associated with typhoon-related electricity reduction (ER) in the summer months in the Tokyo metropolitan area. Methods We conducted event study analyses to compare temperature-HIAT and mortality associations before and after the power outage (July to September 2019). To better understand the role of temperature during the power outage, we then examined whether the temperature-HIAT and mortality associations were modified by different power outage levels (0%, 10%, and 20% ER). We computed the ratios of relative risks to compare the risks associated with various ER values to the risks associated without ER. Results We analyzed the data of 14,912 HIAT cases and 74,064 deaths. Overall, 93,200 power outage cases were observed when the typhoon hit. Event study results showed that the incidence rate ratio was 2.01 (95% confidence interval [CI] = 1.42, 2.84) with effects enduring up to 6 days, and 1.11 (95% CI = 1.02, 1.22) for mortality on the first 3 days after the typhoon hit. Comparing 20% to 0% ER, the ratios of relative risks of heat exposure were 2.32 (95% CI = 1.41, 3.82) for HIAT and 0.95 (95% CI = 0.75, 1.22) for mortality. Conclusions A 20% ER was associated with a two-fold greater risk of HIAT because of summer heat during the power outage, but there was little evidence for the association with all-cause mortality.
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Affiliation(s)
- Lisa Yamasaki
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuma Kamada
- Osaka School of International Public Policy, Osaka University, Osaka, Japan
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuya Takane
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Ko Nakajima
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Kazuki Yamaguchi
- TEPCO Research Institute, Tokyo Electric Power Company Holdings, Inc, Yokohama, Japan
| | - Kazutaka Oka
- National Institute for Environmental Studies, Ibaraki, Japan
| | - Yasushi Honda
- National Institute for Environmental Studies, Ibaraki, Japan
| | - Yoonhee Kim
- 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
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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Kim Y, Oka K, Kawazu EC, Ng CFS, Seposo X, Ueda K, Hashizume M, Honda Y. Enhancing health resilience in Japan in a changing climate. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100970. [PMID: 38116496 PMCID: PMC10730320 DOI: 10.1016/j.lanwpc.2023.100970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 12/21/2023]
Abstract
Climate change poses significant threats to human health, propelling Japan to take decisive action through the Climate Change Adaptation Act of 2018. This Act has led to the implementation of climate change adaptation policies across various sectors, including healthcare. In this review, we synthesized existing scientific evidence on the impacts of climate change on health in Japan and outlined the adaptation strategies and measures implemented by the central and local governments. The country has prioritized tackling heat-related illness and mortality and undertaken various adaptation measures to mitigate these risks. However, it faces unique challenges due to its super-aged society. Ensuring effective and coordinated strategies to address the growing uncertainties in vulnerability to climate change and the complex intersectoral impacts of disasters remains a critical issue. To combat the additional health risks by climate change, a comprehensive approach embracing adaptation and mitigation policies in the health sector is crucial. Encouraging intersectoral communication and collaboration will be vital for developing coherent and effective strategies to safeguard public health in the face of climate change.
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Affiliation(s)
- Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kazutaka Oka
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Japan
| | | | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
| | - Xerxes Seposo
- Graduate School of Medicine, Hokkaido University, Japan
| | - Kayo Ueda
- Graduate School of Medicine, Hokkaido University, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Japan
| | - Yasushi Honda
- Center for Climate Change Adaptation, National Institute for Environmental Studies, Japan
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3
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Michikawa T, Sasaki J, Yamazaki S, Takami A, Asakura K, Imamura H, Ueda K, Saito S, Hoshi J, Yoshino A, Sugata S, Nitta H, Nishiwaki Y. A Case-Crossover Analysis of the Association between Exposure to Total PM 2.5 and Its Chemical Components and Emergency Ambulance Dispatches in Tokyo. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7319-7327. [PMID: 35608996 DOI: 10.1021/acs.est.1c08219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A limited number of studies have investigated the association between short-term exposure to PM2.5 components and morbidity. The present case-crossover study explored the association between exposure to total PM2.5 and its components and emergency ambulance dispatches, which is one of the indicators of morbidity, in the 23 Tokyo wards. Between 2016 and 2018 (mean mass concentrations of total PM2.5 13.5 μg/m3), we obtained data, from the Tokyo Fire Department, on the daily cases of ambulance dispatches. Fine particles were collected at a fixed monitoring site and were analyzed to estimate the daily mean concentrations of carbons and ions. We analyzed 1038301 cases of health-based all-cause ambulance dispatches by using a conditional logistic regression model. The average concentrations of total PM2.5 over one and the previous day were positively associated with the number of ambulance dispatches. In terms of PM2.5 components, the percentage increase per interquartile range (IQR) increase was 0.8% for elemental carbon (IQR = 0.8 μg/m3; 95% CI = 0.3-1.3%), 0.9% for sulfate (2.1 μg/m3; 0.5-1.4%), and 1.1% for ammonium (1.3 μg/m3; 0.4-1.8%) in the PM2.5-adjusted models. This is the first study to find an association between some specific components in PM2.5 and ambulance dispatches.
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Affiliation(s)
- Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
- Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo160-8582, Japan
| | - Shin Yamazaki
- Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Akinori Takami
- Regional Environment Conservation Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
| | - Haruhiko Imamura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
- Environmental Health Sciences, Kyoto University Graduate School of Global Environmental Studies, Kyoto Daigaku Katsura, Nishikyo-ku, Kyoto 615-8540, Japan
| | - Shinji Saito
- Tokyo Metropolitan Research Institute for Environmental Protection, 1-7-5 Shinsuna, Koto-ku, Tokyo136-0075, Japan
| | - Junya Hoshi
- Tokyo Metropolitan Research Institute for Environmental Protection, 1-7-5 Shinsuna, Koto-ku, Tokyo136-0075, Japan
| | - Ayako Yoshino
- Regional Environment Conservation Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Seiji Sugata
- Regional Environment Conservation Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Hiroshi Nitta
- Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo143-8540, Japan
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4
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The effect of ambient temperature on in-hospital mortality: a study in Nanjing, China. Sci Rep 2022; 12:6304. [PMID: 35428808 PMCID: PMC9012784 DOI: 10.1038/s41598-022-10395-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/31/2022] [Indexed: 12/05/2022] Open
Abstract
To reduce the inpatient mortality and improve the quality of hospital management, we explore the relationship between temperatures and in-hospital mortality in a large sample across 10 years in Nanjing, Jiangsu. We collected 10 years’ data on patient deaths from a large research hospital. Distributed lag non-linear model (DLNM) was used to find the association between daily mean temperatures and in-hospital mortality. A total of 6160 in-hospital deaths were documented. Overall, peak RR appeared at 8 °C, with the range of 1 to 20 °C having a significantly high mortality risk. In the elderly (age ≥ 65 years), peak RR appeared at 5 °C, with range − 3 to 21 °C having a significantly high mortality risk. In males, peak RR appeared at 8 °C, with the range 0 to 24 °C having a significantly high mortality risk. Moderate cold (define as 2.5th percentile of daily mean temperatures to the MT), not extreme temperatures (≤ 2.5th percentile or ≥ 97.5th percentile of daily mean temperatures), increased the risk of death in hospital patients, especially in elderly and male in-hospital patients.
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5
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Min JY, Lee HS, Choi YS, Min KB. Association between income levels and prevalence of heat- and cold-related illnesses in Korean adults. BMC Public Health 2021; 21:1264. [PMID: 34187422 PMCID: PMC8243613 DOI: 10.1186/s12889-021-11227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Given that low income worsens health outcomes, income differences may affect health disparities in weather-related illnesses. The aim of this study was to investigate the association between income levels and prevalence of heat- and cold-related illnesses among Korean adults. METHODS The current study comprised 535,186 participants with all variables on income and health behaviors. Patients with temperature-related illnesses were defined as individuals with outpatient medical code of heat- and cold-related illnesses. We categorized individual income into three levels: "low" for the fourth quartile (0-25%), "middle" for the second and the third quartiles (25-75%), and "high" for the first quartile (75-100%). To examine income-related health disparities, Cox proportional hazard regression was performed. Hazard ratios (HRs) and 95% CI (confidence interval) for heat- and cold-related illnesses were provided. The model adjusted for age, sex, smoking status, alcohol drinking, exercise, body mass index, hypertension, hyperglycemia, and local income per capita. RESULTS A total of 5066 (0.95%) and 3302 (0.62%) cases identified patients with heat- and cold-related illnesses, respectively. Compared with high income patients, the adjusted HR for heat-related illnesses was significantly increased in the low income (adjusted HR = 1.103; 95% CI: 1.022-1.191). For cold-related illnesses, participants with low income were likely to have 1.217 times greater likelihood than those with high income (95% CI: 1.107-1.338), after adjusting for other covariates. In the stratified analysis of age (20-64 years and over 65 years) and sex, there was no difference in the likelihood of heat-related illnesses according to income levels. On the other hand, an HR for cold-related illnesses was higher in patients aged 20 to 64 years than in those aged over 65 years. Male with low income had also a higher HR for cold-related illnesses than female with low income. CONCLUSIONS Our results showed that heat- or cold-related illnesses were more prevalent in Koreans with low income than those with high income. Strategies for low-income subgroups were needed to reduce greater damage due to the influence of extreme temperature events and to implement effective adaptation.
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Affiliation(s)
- Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Hyeong-Seong Lee
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Yeon-Soo Choi
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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6
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Michikawa T, Yamazaki S, Ueda K, Yoshino A, Sugata S, Saito S, Hoshi J, Nitta H, Takami A. Effects of exposure to chemical components of fine particulate matter on mortality in Tokyo: A case-crossover study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:142489. [PMID: 33017765 DOI: 10.1016/j.scitotenv.2020.142489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Fine particulate matter (PM2.5) is composed of a variety of chemical components, and the dependency of the health effects of total PM2.5 on specific components is still under discussion. We hypothesised that specific PM2.5 components are responsible for the health effects, and investigated the association between PM2.5 components and mortality in 23 Tokyo wards. We obtained mortality data from the Ministry of Health, Labour and Welfare for the period from April 2013 to March 2017. At a monitoring site within the study area, we collected daily samples of PM2.5 on a filter, and determined the daily mean concentrations of total carbon (organic carbon and elemental carbon) and ions such as nitrate and sulphate. A case-crossover design was employed, and a conditional logistic regression model was used to estimate the strength of the association. Over the study period, we identified 280,460 total non-accidental deaths, and the average daily mean concentration of total PM2.5 was 16.0 (standard deviation = 8.9) μg/m3. We observed a positive association of total PM2.5 with total, cardiovascular, and respiratory mortality. After adjustment for total PM2.5 and its components associated with mortality in the single-component models, the percentage increase per interquartile range (2.3 μg/m3) increase in the average total carbon concentration of the case- and previous-day was 2.1% (95% confidence interval = 1.0 to 3.1%) for total mortality. Carbon elements were associated with respiratory but not cardiovascular mortality. Our results suggest that specific components of PM2.5 account for its adverse health effects.
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Affiliation(s)
- Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143-8540, Japan; Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Shin Yamazaki
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Kayo Ueda
- Environmental Health Sciences, Kyoto University Graduate School of Global Environmental Studies, Kyoto Daigaku Katsura, Nishikyo-ku, Kyoto 615-8540, Japan.
| | - Ayako Yoshino
- Centre for Regional Environmental Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Seiji Sugata
- Centre for Regional Environmental Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Shinji Saito
- Tokyo Metropolitan Research Institute for Environmental Protection, 1-7-5 Shinsuna, Koto-ku, Tokyo 136-0075, Japan.
| | - Junya Hoshi
- Tokyo Metropolitan Research Institute for Environmental Protection, 1-7-5 Shinsuna, Koto-ku, Tokyo 136-0075, Japan.
| | - Hiroshi Nitta
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
| | - Akinori Takami
- Centre for Regional Environmental Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
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7
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Zhang W, Du G, Xiong L, Liu T, Zheng Z, Yuan Q, Yang J, Wu Y, Zhu R, Hu G. Extreme temperatures and cardiovascular mortality: assessing effect modification by subgroups in Ganzhou, China. Glob Health Action 2021; 14:1965305. [PMID: 34482804 PMCID: PMC8425637 DOI: 10.1080/16549716.2021.1965305] [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] [Indexed: 11/25/2022] Open
Abstract
Background Many people die from cardiovascular diseases each year, and extreme temperatures are regarded as a risk factor for cardiovascular deaths. However, the relationship between temperature and cardiovascular deaths varies in different regions because of population density, demographic inequality, and economic situation, and the evidence in Ganzhou, China is limited and inconclusive. Objective This study aimed to assess extreme temperature-related cardiovascular mortality and identify the potential vulnerable people. Methods After controlling other meteorological measures, air pollution, seasonality, relative humidity, day of the week, and public holidays, we examined temperature-related cardiovascular mortality along 21 lag days by Poisson in Ganzhou, China. Results A J-shaped relationship was observed between mean temperature and cardiovascular mortality. Extremely low temperatures substantially increased the relative risks (RR) of cardiovascular mortality. The effect of cold temperature was delayed by 2–6 days and persisted for 4–10 days. However, the risk of cardiovascular mortality related to extremely high temperatures was not significant (p > 0.05). Subgroup analysis indicated that extremely low temperatures had a stronger association with cardiovascular mortality in people with cerebrovascular diseases (RR: 1.282, 95% confidence interval [CI]: 1.020–1.611), males (RR: 1.492, 95% CI: 1.175–1.896), married people (RR: 1.590, 95% CI: 1.224–2.064), and people above the age of 65 years (RR: 1.641, 95% CI: 1.106–2.434) than in people with ischemic heart disease, females, unmarried people, and the elderly (≥65 years old), respectively. Conclusions The type of cardiovascular disease, sex, age, and marital status modified the effects of extremely low temperatures on the risk of cardiovascular mortality. These findings may help local governments to establish warning systems and precautionary measures to reduce temperature-related cardiovascular mortality.
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Affiliation(s)
- Wei Zhang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gang Du
- Ganzhou Center For Disease Control And Prevention, Ganzhou, Jiangxi, China
| | - Liang Xiong
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Tingting Liu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zuobing Zheng
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Qiong Yuan
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jiahui Yang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yangna Wu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Rongfei Zhu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Gonghua Hu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.,Department of Occupational Health and Occupational Medicine, School of Public Health and Health Management, Gannan Medical University, Ganzhou, Jiangxi, China
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8
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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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9
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Michikawa T, Yamazaki S, Shimizu A, Nitta H, Kato K, Nishiwaki Y, Morokuma S. Exposure to Asian dust within a few days of delivery is associated with placental abruption in Japan: a case-crossover study. BJOG 2019; 127:335-342. [PMID: 31654606 DOI: 10.1111/1471-0528.15999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Asian dust is a natural phenomenon in which dust particles are transported from desert areas in China and Mongolia to East Asia. Short-term exposure to Asian dust has been associated with cardiovascular disease through mechanisms such as systemic inflammation. Because inflammation is a potential trigger of placental abruption, exposure may also lead to abruption. We examined whether exposure to Asian dust was associated with abruption. DESIGN A bi-directional, time-stratified case-crossover design. SETTING AND POPULATION From the Japan Perinatal Registry Network database, we identified 3014 patients who delivered singleton births in hospitals in nine Japanese prefectures from 2009 to 2014 with a diagnosis of placental abruption. METHODS Asian dust levels were measured at Light Detection and Ranging monitoring stations, and these measurements were used to define the Asian dust days. As there was no information on the onset day of abruption, we assumed this day was the day before delivery (lag1). MAIN OUTCOME MEASURES Placental abruption. RESULTS During the study period, the Asian dust days ranged from 15 to 71 days, depending on the prefecture. The adjusted odds ratio of placental abruption associated with exposure to Asian dust was 1.4 (95% confidence interval = 1.0, 2.0) for cumulative lags of 1-2 days. Even after adjustment for co-pollutant exposures, this association did not change substantially. CONCLUSIONS In this Japanese multi-area study, exposure to Asian dust was associated with an increased risk of placental abruption. TWEETABLE ABSTRACT Exposure to environmental factors such as Asian dust may be a trigger of placental abruption.
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Affiliation(s)
- T Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan.,Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - S Yamazaki
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - A Shimizu
- Centre for Regional Environmental Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - H Nitta
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - K Kato
- Department of Obstetrics and Gynaecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - S Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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10
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Liu J, Ma Y, Wang Y, Li S, Liu S, He X, Li L, Guo L, Niu J, Luo B, Zhang K. The Impact of Cold and Heat on Years of Life Lost in a Northwestern Chinese City with Temperate Continental Climate. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193529. [PMID: 31547211 PMCID: PMC6801473 DOI: 10.3390/ijerph16193529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 12/16/2022]
Abstract
Cold spells and heat waves in a changing climate are well known as great public-health concerns due to their adverse effects on human health. However, very few studies have quantified health impacts of heat and cold in the region of Northwestern China. The purpose of the present study was to evaluate the effects of cold and heat on years of life lost (YLL) in Lanzhou, a city with temperate continental climate. We compiled a daily dataset including deaths, weather variables, and air pollutants in Lanzhou, China, from 2014–2017. We used a distributed lag non-linear model to estimate single-day and cumulative effects of heat and cold on daily YLL. Results indicated that both cold and heat were associated with increased YLL for registered residents in Lanzhou. Estimated heat effects appeared immediately in the first two days, while estimated cold effects lasted over a longer period (up to 30 days). Cold significantly increased the YLL of all residents except for males and those with respiratory diseases (≥65 years). Our results showed that both heat and cold had more pronounced effects on cardiovascular diseases compared to respiratory diseases. Males might be more vulnerable to heat, while females might suffer more YLL from cold. The effects of cold or heat on the elderly might appear earlier and last longer than those for other age groups.
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Affiliation(s)
- Jiangtao Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Yueling Ma
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Yuhong Wang
- Lanzhou Municipal Center for Disease Control, Lanzhou 730000, Gansu, China.
| | - Sheng Li
- Lanzhou Municipal Center for Disease Control, Lanzhou 730000, Gansu, China.
| | - Shuyu Liu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, Gansu, China.
| | - Xiaotao He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Lanyu Li
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Lei Guo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Jingping Niu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China.
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
- Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
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11
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Smith ET, Sheridan SC. The influence of extreme cold events on mortality in the United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 647:342-351. [PMID: 30081371 DOI: 10.1016/j.scitotenv.2018.07.466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
Many studies have analyzed the effects of extreme heat on human mortality, however fewer studies have focused on the effects of cold related mortality due to the complicated nature of the lagged response. This study utilized a Distributed Lag Non-Linear Model with a 30-day lag to determine the cumulative effects of extreme cold events (ECEs) on mortality across 32 cities in the United States for the period of 1975-2010. ECEs were divided into specific categories based on duration, magnitude, and timing of occurrence. Mortality was divided into all-age mortality as well as mortality of individuals >64 years old. The findings suggest a strong relationship between a city's latitude as well as the timing of an ECE with mortality. Early season ECEs result in a much higher relative risk of increased mortality, particularly in cities with higher mean winter temperatures, while the RR of mortality of individuals >64 was consistently higher for each city. This study suggests early season ECEs should receive enhanced preparedness efforts as individuals may be particularly vulnerable when not acclimatized to extreme cold.
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Affiliation(s)
- Erik T Smith
- Kent State University, PO Box 5190, Kent, OH 44242, United States of America.
| | - Scott C Sheridan
- Kent State University, PO Box 5190, Kent, OH 44242, United States of America
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12
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Kotani K, Ueda K, Seposo X, Ono M, Honda A, Takano H. [Effect of City-Specific Characteristics on Association between Heat and Ambulance Dispatches]. Nihon Eiseigaku Zasshi 2019; 74:n/a. [PMID: 31875633 DOI: 10.1265/jjh.19007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In this multicity study, we aimed to elucidate the city-specific factors affecting the association of high ambient temperature with ambulance dispatches due to acute illnesses. METHODS We used the data of ambulance dispatches in 27 cities in Japan with more than 500,000 population excluding Tokyo, from May to September from 2012 to 2015. We included patients 20 years and older (≥20 years) and stratified them into three age groups (20-59, 60-79, and ≥80 years). We explored the city-specific pattern of the daily relative temperature (in temperature percentiles) and the risk of ambulance dispatches for each age group using a distributed lag nonlinear model and estimated the city-specific relative risks of ambulance dispatches at the 95/99 percentile temperature compared with the 77.6 percentile temperature defined as the reference temperature (Tref). Then, the estimates were combined by performing meta-analyses for each age group. We also applied meta-regression models to explore whether the city-specific characteristics modified the association of temperature with ambulance dispatches. RESULTS The relative risks of the 95th percentile with respect to Tref were 1.14 (95% confidence interval (CI): 1.12, 1.16), 1.16 (95% CI: 1.13, 1.20), 1.13 (95% CI: 1.10, 1.16), and 1.13 (95% CI: 1.00, 1.16), for all-age (≥20) and age-stratified groups (20-59, 60-79, and ≥80 years), respectively. We observed a higher relative risk for the ≥20 years age group in the cities with higher proportions of single-elderly, single-mother, and single-father households. We also found that the relative risk for the 20-59 years age group was higher in the cities with a higher proportion of blue-collar workers. CONCLUSIONS The present study provides insights into city-specific characteristics modifying heat-related health effects.
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Affiliation(s)
- Kazuya Kotani
- Department of Environmental Engineering, Kyoto University
| | - Kayo Ueda
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
| | - Xerxes Seposo
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
| | - Masaji Ono
- National Institute for Environmental Studies
| | - Akiko Honda
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
| | - Hirohisa Takano
- Department of Environmental Engineering, Kyoto University
- Kyoto University Graduate School of Global Environmental Studies
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13
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Michikawa T, Ueda K, Takami A, Sugata S, Yoshino A, Nitta H, Yamazaki S. Japanese Nationwide Study on the Association Between Short-term Exposure to Particulate Matter and Mortality. J Epidemiol 2018; 29:471-477. [PMID: 30369511 PMCID: PMC6859079 DOI: 10.2188/jea.je20180122] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background From around 2012, the use of automated equipment for fine particulate matter (PM2.5) measurement with equivalence to a reference method has become popular nationwide in Japan. This enabled us to perform a national health effect assessment employing PM2.5 concentrations based on the standardized measurement method. We evaluated the association between non-accidental mortality and short-term exposure to PM2.5 and coarse particulate matter (PM), with the latter estimated as the difference between suspended particulate matter and PM2.5, for the fiscal years 2012–2014. Methods This was a time-stratified case-crossover study in 100 highly-populated Japanese cities. Mortality data was obtained from the Ministry of Health, Labour and Welfare. City-specific estimates of PM-mortality association were calculated by applying a conditional logistic regression analysis, and combined with a random-effects meta-analysis. Results The respective averages of daily mean concentration were 14.6 µg/m3 for PM2.5 and 6.4 µg/m3 for coarse PM. A 10 µg/m3 increase in PM2.5 concentrations for the average of the day of death and the previous day was associated with an increase of 1.3% (95% confidence interval (CI), 0.9–1.6%) in total non-accidental mortality. For cause-specific mortality, PM2.5 was positively associated with cardiovascular and respiratory mortality. After adjustment for PM2.5, we observed a 1.4% (95% CI, 0.2–2.6%) increase in total mortality with a 10 µg/m3 increase in coarse PM. Conclusion The study revealed that short-term exposure to PM2.5 had adverse effects on total non-accidental, cardiovascular, and respiratory mortality in Japan. Coarse PM exposure also increased the risk of total mortality.
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Affiliation(s)
- Takehiro Michikawa
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies.,Department of Environmental and Occupational Health, School of Medicine, Toho University
| | - Kayo Ueda
- Environmental Health Sciences, Kyoto University Graduate School of Global Environmental Studies.,Department of Environmental Engineering, Graduate School of Engineering, Kyoto University
| | - Akinori Takami
- Centre for Regional Environmental Research, National Institute for Environmental Studies
| | - Seiji Sugata
- Centre for Regional Environmental Research, National Institute for Environmental Studies
| | - Ayako Yoshino
- Centre for Regional Environmental Research, National Institute for Environmental Studies
| | - Hiroshi Nitta
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies
| | - Shin Yamazaki
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies
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Abstract
BACKGROUND Placental abruption is an emergency obstetric complication. Although the etiology of abruption is not fully understood, acute stimuli, such as ischemia and/or inflammation, are associated with rupture of the decidual artery, resulting in placental separation. Ischemia and inflammation are acute biologic effects of air pollution. Using a case-crossover design, we tested the hypothesis that a short-term increase in exposure to air pollutants is a potential trigger of placental abruption. METHODS We received data for western Japan (Kyushu-Okinawa Districts) from the Japan Perinatal Registry Network database. From 2005 to 2010, 821 singleton pregnant women with placental abruption were identified. We assigned daily concentrations of air pollutants, including nitrogen dioxide (NO2), suspended particulate matter, ozone, and sulfur dioxide (SO2), from the nearest monitoring station to the respective delivery hospital of each woman. Because information on the onset day of abruption was not obtained, we assumed the case day to be 1 day before the day of delivery. RESULTS Exposure to NO2 at 2 days' lag was associated with placental abruption (temperature adjusted odds ratio per 10 ppb increase = 1.4; 95% confidence interval = 1.1, 1.8). The association patterns were similar, when we restricted to participants who delivered by emergency cesarean (1.4, 1.1, 1.9), or who delivered after 35 weeks of gestation (1.4, 1.0, 2.0). There was no association with suspended particulate matter, ozone, or SO2. CONCLUSIONS We observed an association between NO2 exposure at 2 days before the day of delivery and placental abruption in pregnant Japanese women.
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15
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Acute Effects of Ambient PM 2.5 on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020307. [PMID: 29425190 PMCID: PMC5858376 DOI: 10.3390/ijerph15020307] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/07/2018] [Accepted: 02/09/2018] [Indexed: 12/23/2022]
Abstract
Short-term health effects of ambient PM2.5 have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM2.5 on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes. We utilized daily emergency ambulance dispatches (EAD) data from eight Japanese cities (2007–2011). Statistical analyses included two stages: (1) City-level generalized linear model with Poisson distribution; (2) Random-effects meta-analysis in pooling city-specific effect estimates. Lag patterns were explored using (1) unconstrained-distributed lags (lag 0 to lag 7) and (2) average lags (lag: 0–1, 0–3, 0–5, 0–7). In all-cause EAD, significant increases were observed in both shorter lag (lag 0: 1.24% (95% CI: 0.92, 1.56)) and average lag 0–1 (0.64% (95% CI: 0.23, 1.06)). Increases of 1.88% and 1.48% in respiratory and neuropsychological EAD outcomes, respectively, were observed at lag 0 per 10 µg/m3 increase in PM2.5. While respiratory outcomes demonstrated significant average effects, no significant effect was observed for cardiovascular outcomes. Meanwhile, an inverse association was observed in cerebrovascular outcomes. In this study, we observed that effects of PM2.5 on all-cause, respiratory and neuropsychological EAD were acute, with average effects not exceeding 3 days prior to EAD onset.
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Moghadamnia MT, Ardalan A, Mesdaghinia A, Keshtkar A, Naddafi K, Yekaninejad MS. Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis. PeerJ 2017; 5:e3574. [PMID: 28791197 PMCID: PMC5546177 DOI: 10.7717/peerj.3574] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 06/23/2017] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Our study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis. MATERIAL AND METHODS A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression. RESULT After screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]). CONCLUSION Our findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
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Affiliation(s)
- Mohammad Taghi Moghadamnia
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ardalan
- Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Harvard Humanitarian Initiative, Harvard University, Cambridge, United States of America
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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17
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Gao H, Lan L, Yang C, Wang J, Zhao Y. The Threshold Temperature and Lag Effects on Daily Excess Mortality in Harbin, China: A Time Series Analysis. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:85-95. [PMID: 28432370 PMCID: PMC6679615 DOI: 10.15171/ijoem.2017.979] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/17/2017] [Indexed: 01/08/2023]
Abstract
Background: A large number of studies have reported the relationship between ambient temperature and mortality. However, few studies have focused on the effects of high temperatures on cardio-cerebrovascular diseases mortality (CCVDM) and their acute events (ACCVDM). Objective: To assess the threshold temperature and time lag effects on daily excess mortality in Harbin, China. Methods: A generalized additive model (GAM) with a Poisson distribution was used to investigate the relative risk of mortality for each 1 °C increase above the threshold temperature and their time lag effects in Harbin, China. Results: High temperature threshold was 26 °C in Harbin. Heat effects were immediate and lasted for 0–6 and 0–4 days for CCVDM and ACCVDM, respectively. The acute cardiovascular disease mortality (ACVDM) seemed to be more sensitive to temperature than cardiovascular disease mortality (CVDM) with higher death risk and shorter time lag effects. The lag effects lasted longer for cerebrovascular disease mortality (CBDM) than CVDM; so did ACBDM compared to ACVDM. Conclusion: Hot temperatures increased CCVDM and ACCVDM in Harbin, China. Public health intervention strategies for hot temperatures adaptation should be concerned.
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Affiliation(s)
- Hanlu Gao
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China.,Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China
| | - Li Lan
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China
| | - Chao Yang
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China.
| | - Jian Wang
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, China
| | - Yashuang Zhao
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China.
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18
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Zhang Y, Feng R, Wu R, Zhong P, Tan X, Wu K, Ma L. Global climate change: impact of heat waves under different definitions on daily mortality in Wuhan, China. Glob Health Res Policy 2017; 2:10. [PMID: 29202078 PMCID: PMC5683448 DOI: 10.1186/s41256-017-0030-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background There was no consistent definition for heat wave worldwide, while a limited number of studies have compared the mortality effect of heat wave as defined differently. This paper aimed to provide epidemiological evidence for policy makers to determine the most appropriate definition for local heat wave warning systems. Methods We developed 45 heat wave definitions (HWs) combining temperature indicators and temperature thresholds with durations. We then assessed the impact of heat waves under various definitions on non-accidental mortality in hot season (May–September) in Wuhan, China during 2003–2010. Results Heat waves defined by HW14 (daily mean temperature ≥ 99.0th percentile and duration ≥ 3 days) had the best predictive ability in assessing the mortality effects of heat wave with the relative risk of 1.63 (95% CI: 1.43, 1.89) for total mortality. The group-specific mortality risk using official heat wave definition of Chinese Meteorological Administration was much smaller than that using HW14. We also found that women, and the elderly (age ≥ 65) were more susceptible to heat wave effects which were stronger and longer lasting. Conclusion These findings suggest that region specific heat wave definitions are crucial and necessary for developing efficient local heat warning systems and for providing evidence for policy makers to protect the vulnerable population. Electronic supplementary material The online version of this article (doi:10.1186/s41256-017-0030-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Renjie Feng
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Ran Wu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Peirong Zhong
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Xiaodong Tan
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
| | - Kai Wu
- Jiang'an District Center for Disease Control and Prevention, 3 Chezhan Road, Jiang'an District, Wuhan, 430014 China
| | - Lu Ma
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071 China
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Tasmin S, Ueda K, Stickley A, Yasumoto S, Phung VLH, Oishi M, Yasukouchi S, Uehara Y, Michikawa T, Nitta H. Short-term exposure to ambient particulate matter and emergency ambulance dispatch for acute illness in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 566-567:528-535. [PMID: 27235903 DOI: 10.1016/j.scitotenv.2016.05.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/02/2016] [Accepted: 05/08/2016] [Indexed: 06/05/2023]
Abstract
Short-term exposure to air pollution may be linked to negative health outcomes that require an emergency medical response. However, few studies have been undertaken on this phenomenon to date. The aim of this study therefore was to examine the association between short-term exposure to ambient suspended particulate matter (SPM) and emergency ambulance dispatches (EADs) for acute illness in Japan. Daily EAD data, daily mean SPM and meteorological data were obtained for four prefectures in the Kanto region of Japan for the period from 2007 to 2011. The area-specific association between daily EAD for acute illness and SPM was explored using generalized linear models while controlling for ambient temperature, relative humidity, seasonality, long-term trends, day of the week and public holidays. Stratified analyses were conducted to evaluate the modifying effects of age, sex and medical conditions. Area-specific estimates were combined using meta-analyses. For the total study period the mean level of SPM was 23.7μg/m(3). In general, higher SPM was associated with a significant increase in EAD for acute illness [estimated pooled relative risk (RR): 1.008, 95% CI: 1.007 to 1.010 per 10μg/m(3) increase in SPM at lag 0-1]. The effects of SPM on EAD for acute illness were significantly greater for moderate/mild medical conditions (e.g. cases that resulted in <3weeks hospitalization or no hospitalization) when compared to severe medical conditions (e.g. critical cases, and cases that led to >3weeks hospitalization or which resulted in death). Using EAD data, this study has shown the adverse health effects of ambient air pollution. This highlights the importance of reducing the level of air pollution in order to maintain population health and well-being.
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Affiliation(s)
- Saira Tasmin
- Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan.
| | - Kayo Ueda
- Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan
| | - Andrew Stickley
- Stockholm Center on Health and Social Change (Scohost), Södertörn University, 141 89 Huddinge, Sweden
| | - Shinya Yasumoto
- Kinugasa Research Organization, Ritsumeikan University, Japan
| | - Vera Ling Hui Phung
- Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan
| | - Mizuki Oishi
- Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan
| | - Shusuke Yasukouchi
- Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan
| | - Yamato Uehara
- Department of Environmental Engineering, Graduate School Engineering, Kyoto University, Kyoto, Japan
| | - Takehiro Michikawa
- Center for Environmental Health Sciences, National Institute for Environmental Studies (NIES), Japan
| | - Hiroshi Nitta
- Center for Environmental Health Sciences, National Institute for Environmental Studies (NIES), Japan
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Ng CFS, Stickley A, Konishi S, Watanabe C. Ambient air pollution and suicide in Tokyo, 2001-2011. J Affect Disord 2016; 201:194-202. [PMID: 27240312 DOI: 10.1016/j.jad.2016.05.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 04/07/2016] [Accepted: 05/09/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Some evidence suggests an association may exist between the level of air pollution and suicide mortality. However, this relation has been little studied to date. The current study examined the association in Tokyo, Japan. METHODS Suicide mortality data for Tokyo for the 11-year period 2001-2011 were obtained together with data on four air pollutants: fine particulate matter (PM2.5), suspended particulate matter (SPM), sulphur dioxide (SO2) and nitrogen dioxide (NO2). A time-stratified case-crossover study design was used to examine the daily association between the level of air pollution and suicide mortality. RESULTS During the study period there were 29,939 suicide deaths. In stratified analyses an interquartile range (IQR) increase in the same-day concentration of NO2 was linked to increased suicide mortality among those aged under 30 (percentage change: 6.73%, 95% CI: 0.69-13.12%). An IQR increase in PM2.5 and SO2 was associated with a 10.55% (95% CI: 2.05-19.75%) and 11.47% (95% CI: 3.60-19.93%) increase, respectively, in suicide mortality among widowed individuals for mean exposure on the first four days (average lags 0-3). Positive associations were observed for the air pollutants in the summer although associations were reversed in autumn. LIMITATIONS We relied on monitoring data to approximate individual exposure to air pollutants. CONCLUSIONS Higher levels of air pollution are associated with increased suicide mortality in some population subgroups in Tokyo. Further research is needed to elucidate the mechanisms linking air pollutants and suicide in this setting.
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Affiliation(s)
- Chris Fook Sheng Ng
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Andrew Stickley
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Shoko Konishi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Chiho Watanabe
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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The Short-Term Effect of Ambient Temperature on Mortality in Wuhan, China: A Time-Series Study Using a Distributed Lag Non-Linear Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070722. [PMID: 27438847 PMCID: PMC4962263 DOI: 10.3390/ijerph13070722] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/06/2016] [Accepted: 07/14/2016] [Indexed: 01/03/2023]
Abstract
Less evidence concerning the association between ambient temperature and mortality is available in developing countries/regions, especially inland areas of China, and few previous studies have compared the predictive ability of different temperature indictors (minimum, mean, and maximum temperature) on mortality. We assessed the effects of temperature on daily mortality from 2003 to 2010 in Jiang'an District of Wuhan, the largest city in central China. Quasi-Poisson generalized linear models combined with both non-threshold and double-threshold distributed lag non-linear models (DLNM) were used to examine the associations between different temperature indictors and cause-specific mortality. We found a U-shaped relationship between temperature and mortality in Wuhan. Double-threshold DLNM with mean temperature performed best in predicting temperature-mortality relationship. Cold effect was delayed, whereas hot effect was acute, both of which lasted for several days. For cold effects over lag 0-21 days, a 1 °C decrease in mean temperature below the cold thresholds was associated with a 2.39% (95% CI: 1.71, 3.08) increase in non-accidental mortality, 3.65% (95% CI: 2.62, 4.69) increase in cardiovascular mortality, 3.87% (95% CI: 1.57, 6.22) increase in respiratory mortality, 3.13% (95% CI: 1.88, 4.38) increase in stroke mortality, and 21.57% (95% CI: 12.59, 31.26) increase in ischemic heart disease (IHD) mortality. For hot effects over lag 0-7 days, a 1 °C increase in mean temperature above the hot thresholds was associated with a 25.18% (95% CI: 18.74, 31.96) increase in non-accidental mortality, 34.10% (95% CI: 25.63, 43.16) increase in cardiovascular mortality, 24.27% (95% CI: 7.55, 43.59) increase in respiratory mortality, 59.1% (95% CI: 41.81, 78.5) increase in stroke mortality, and 17.00% (95% CI: 7.91, 26.87) increase in IHD mortality. This study suggested that both low and high temperature were associated with increased mortality in Wuhan, and that mean temperature had better predictive ability than minimum and maximum temperature in the association between temperature and mortality.
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Carmona R, Díaz J, Mirón IJ, Ortíz C, León I, Linares C. Geographical variation in relative risks associated with cold waves in Spain: The need for a cold wave prevention plan. ENVIRONMENT INTERNATIONAL 2016; 88:103-111. [PMID: 26735348 DOI: 10.1016/j.envint.2015.12.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/17/2015] [Accepted: 12/19/2015] [Indexed: 05/18/2023]
Abstract
In general, there are few studies that analyse the impact of low temperatures on mortality and fewer still that use cold-wave-definition thresholds based on epidemiological and non-climatological criteria. Such a threshold definition, which took into account population features such as socio-economic and demographic characteristics, made it possible for a specific threshold temperature to be obtained for each of Spain's 52 provincial capitals in this study. Using generalised linear models with the Poisson regression link, and controlling for trend, autocorrelations and seasonalities of the series, and influenza epidemics, we obtained the impact of low temperatures on mortality in each provincial capital by calculating the relative risks (RRs) and attributable risks (ARs) for natural as well as circulatory and respiratory causes. The study showed higher minimum temperature thresholds in coastal areas, and an overall impact of cold on mortality in Spain due to natural causes RR=1.13 (95% CI: 1.11-1.16), circulatory causes RR=1.18 (95% CI: 1.15-1.22) and respiratory causes RR=1.24 (95% CI: 1.20-1.29) slightly greater than that obtained to date for heat. From a public health standpoint, there is a need for specific cold wave prevention plans at a regional level which would enable mortality attributable to low temperatures to be reduced. These plans have shown themselves to be effective in decreasing heat-related mortality, and we feel that they are essential for reducing cold-related effects on morbidity and mortality.
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Affiliation(s)
- R Carmona
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
| | - J Díaz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - I J Mirón
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority (Consejería de Sanidad y Asuntos Sociales de Castilla-La Mancha), Torrijos, Toledo, Spain
| | - C Ortíz
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - I León
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - C Linares
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
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The daily incidence of out-of-hospital cardiac arrest unexpectedly increases around New Year's Day in Japan. Resuscitation 2015; 96:156-62. [DOI: 10.1016/j.resuscitation.2015.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 11/24/2022]
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Otsuki H, Murakami Y, Fujino K, Matsumura K, Eguchi Y. Analysis of seasonal differences in emergency department attendance in Shiga Prefecture, Japan between 2007 and 2010. Acute Med Surg 2015; 3:74-80. [PMID: 29123756 DOI: 10.1002/ams2.140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 04/28/2015] [Indexed: 11/12/2022] Open
Abstract
Aim Emergency department overcrowding is problematic. Some emergency departments have established a triage system to prevent overcrowding; however, effective management of a triage system requires knowledge of factors that influence emergency department attendance. Therefore, we investigated the effect of ambient temperature on emergency department attendance, as well as the types of patients that may have been affected. Methods Data on emergency department attendance at Shiga University of Medical Science Hospital (Otsu, Japan) were retrospectively collected from 1 April, 2007 to 31 March, 2010. Attendance was classified into eight categories based on a combination of symptoms (trauma or non-trauma), transport (by ambulance or walk-in), and severity (serious or non-serious). Results A total of 7,755 patients (4,120 [53.1%] men and 3,635 [46.9%] women) attended the emergency department during the study period. Statistically significant seasonal differences were observed in emergency department attendance in walk-in and non-serious groups of both trauma and non-trauma patients (P < 0.01), with the smallest differences occurring during winter. In a linear regression model, the mean ambient temperature had a positive correlation with emergency department attendance only in the walk-in and non-serious group of non-trauma patients during the summer (y = 0.092 × [mean ambient temperature] - 0.565). Conclusion In the walk-in and non-serious group of non-trauma patients, emergency department attendance significantly increased with the increase in mean ambient temperature during summer. In emergency department triage systems, it may be more effective to evaluate non-trauma and walk-in patients during summer, especially on hot days.
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Affiliation(s)
- Hideki Otsuki
- Department of Critical and Intensive Care Medicine Shiga University of Medical Science Otsu Shiga Japan
| | - Yoshitaka Murakami
- Department of Social Medicine Division of Medical Statistics Toho University Tokyo Japan
| | - Kazunori Fujino
- Department of Critical and Intensive Care Medicine Shiga University of Medical Science Otsu Shiga Japan
| | - Kazuhiro Matsumura
- Department of Critical and Intensive Care Medicine Shiga University of Medical Science Otsu Shiga Japan
| | - Yutaka Eguchi
- Department of Critical and Intensive Care Medicine Shiga University of Medical Science Otsu Shiga Japan
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Michikawa T, Ueda K, Takeuchi A, Tamura K, Kinoshita M, Ichinose T, Nitta H. Coarse particulate matter and emergency ambulance dispatches in Fukuoka, Japan: a time-stratified case-crossover study. Environ Health Prev Med 2014; 20:130-6. [PMID: 25533085 DOI: 10.1007/s12199-014-0439-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/11/2014] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES There is no conclusive evidence of adverse health effects caused by short-term exposure to coarse particulate matter, so in this case-crossover study we looked for an association between exposure and emergency ambulance dispatches (as a proxy of acute health outcomes). METHODS We used data on emergency ambulance dispatches in Fukuoka City, Japan between 2005 and 2010. After excluding ambulance dispatches related to external injuries and pregnancy/childbirth, we analyzed data on 176,123 dispatches. Citywide daily mean concentrations of suspended particulate matter (SPM) and fine particulate matter (PM2.5) were calculated from ambient monitoring data, and the differences between concentrations of SPM and PM2.5 were used as an exposure surrogate of coarse particulate matter. Using a conditional logistic regression model, we estimated the ambient temperature and relative humidity adjusted odds ratios (ORs) per 10 μg/m(3) increase in coarse particulate matter. RESULTS The average daily concentration of coarse particulate matter over the study period was 9.9 μg/m(3), representing 33% of the total concentration of SPM. Elevated concentrations of coarse particulate matter were associated with an increase in respiratory disease-related emergency ambulance dispatches for adults aged 65 years or older (9,716 dispatches, OR for lag0-1 = 1.065, 95% confidence interval = 1.023-1.109). After additional adjustment for exposure to PM2.5, we observed a statistically non-significant increased risk (OR = 1.035, 0.986-1.086). CONCLUSIONS We found weak evidence of adverse effects of short-term exposure to coarse particulate matter on human health.
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Affiliation(s)
- Takehiro Michikawa
- Center for Environmental Health Sciences, National Institute for Environmental Studies, Onogawa 16-2, Tsukuba, Ibaraki, 305-8506, Japan,
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Michikawa T, Ueda K, Takeuchi A, Kinoshita M, Hayashi H, Ichinose T, Nitta H. Impact of short-term exposure to fine particulate matter on emergency ambulance dispatches in Japan. J Epidemiol Community Health 2014; 69:86-91. [DOI: 10.1136/jech-2014-203961] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Jie Y, Houjin H, Mengxue Y, Wei Q, Jie X. A time series analysis of meteorological factors and hospital outpatient admissions for cardiovascular disease in the Northern district of Guizhou Province, China. ACTA ACUST UNITED AC 2014; 47:689-96. [PMID: 25003542 PMCID: PMC4165296 DOI: 10.1590/1414-431x2014424] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 04/02/2014] [Indexed: 11/21/2022]
Abstract
Findings on the effects of weather on health, especially the effects of ambient
temperature on overall morbidity, remain inconsistent. We conducted a time series
study to examine the acute effects of meteorological factors (mainly air temperature)
on daily hospital outpatient admissions for cardiovascular disease (CVD) in Zunyi
City, China, from January 1, 2007 to November 30, 2009. We used the generalized
additive model with penalized splines to analyze hospital outpatient admissions,
climatic parameters, and covariate data. Results show that, in Zunyi, air temperature
was associated with hospital outpatient admission for CVD. When air temperature was
less than 10°C, hospital outpatient admissions for CVD increased 1.07-fold with each
increase of 1°C, and when air temperature was more than 10°C, an increase in air
temperature by 1°C was associated with a 0.99-fold decrease in hospital outpatient
admissions for CVD over the previous year. Our analyses provided statistically
significant evidence that in China meteorological factors have adverse effects on the
health of the general population. Further research with consistent methodology is
needed to clarify the magnitude of these effects and to show which populations and
individuals are vulnerable.
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Affiliation(s)
- Y Jie
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - H Houjin
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Y Mengxue
- Department of Endocrinology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Q Wei
- Department of Physiology, Zunyi Medical University, Guizhou, China
| | - X Jie
- School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
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Gronlund CJ. Racial and socioeconomic disparities in heat-related health effects and their mechanisms: a review. CURR EPIDEMIOL REP 2014; 1:165-173. [PMID: 25512891 DOI: 10.1007/s40471-014-0014-4] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adaptation to increasing extreme heat in a changing climate requires a precise understanding of who is most vulnerable to the health effects of extreme heat. The evidence for race, ethnicity, income, education and occupation, at the individual and area levels, as indicators of vulnerability is reviewed. The evidence for the social, behavioral and technological mechanisms by which racial and socioeconomic disparities in vulnerability exist is also reviewed. These characteristics include cardiorespiratory, renal and endocrine comorbidities; cognitive, mental or physical disabilities; medication use; housing characteristics; neighborhood characteristics such as urban heat islands, crime and safety; social isolation; and individual behaviors such as air conditioning use, opening windows and using fans and use of cooler public spaces. Pre-existing and future research identifying these more proximal indicators of vulnerability will provide information that is more generalizable across locations and time to aid in identifying who to target for prevention of heat-associated morbidity and mortality.
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Affiliation(s)
- Carina J Gronlund
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, 734-615-9215
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