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Stickley A, Baburin A, Jasilionis D, Krumins J, Martikainen P, Kondo N, Shin JI, Oh H, Waldman K, Leinsalu M. Educational inequalities in hypothermia mortality in the Baltic countries and Finland in 2000-15. Eur J Public Health 2023:7140394. [PMID: 37094965 PMCID: PMC10393481 DOI: 10.1093/eurpub/ckad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Despite an increased focus on cold-related mortality in recent years, there has been comparatively little research specifically on hypothermia mortality and its associated factors. METHODS Educational inequalities in hypothermia mortality among individuals aged 30-74 in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in 2000-15 were examined using data from longitudinal mortality follow-up studies of population censuses (the Baltics) and from a longitudinal register-based population data file (Finland). RESULTS Age-standardized mortality rates (ASMRs) were much higher in the Baltic countries than in Finland across the study period. From 2000-07 to 2008-15, overall ASMRs declined in all countries except among Finnish women. Although a strong educational gradient was observed in hypothermia mortality in all countries in 2000-07, inequalities were larger in the Baltic countries. Between 2000-07 and 2008-15, ASMRs declined in all educational groups except for high-educated women in Finland and low-educated women in Lithuania; the changes however were not always statistically significant. The absolute mortality decline was often larger among the low educated resulting in narrowing absolute inequalities (excepting Lithuania), whereas a larger relative decline among the high educated (excepting Finnish women) resulted in a considerable widening of relative inequalities in hypothermia mortality by 2008-15. CONCLUSION Although some reduction was observed in absolute educational inequalities in hypothermia mortality in 2000-15, substantial and widening relative inequalities highlight the need for further action in combatting factors behind deaths from excessive cold in socioeconomically disadvantaged groups, including risky alcohol consumption and homelessness.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Rostock, Germany
- Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Juris Krumins
- Demography Unit, Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Kyle Waldman
- Department of Sociology, Harvard University, Cambridge, MA, USA
| | - Mall Leinsalu
- Stockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
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Simić M, Stavrakis AK, Stojanović GM. Portable Heating and Temperature-Monitoring System with a Textile Heater Embroidered on the Facemask. ACS OMEGA 2022; 7:47214-47224. [PMID: 36570303 PMCID: PMC9773964 DOI: 10.1021/acsomega.2c06431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Personal heating systems are getting increasing interest because of the need to reduce the negative impact of cold weather on the health of people and animals. Heating the air before inhalation is of great importance as it can reduce the probability of various diseases. In this paper, we present a textile-based heater composed of commercial conductive threads, embroidered on an ordinary protective facemask. We also present the design and implementation details of the temperature monitoring and controlling circuit. Air temperature inside the facemask was monitored by a thermocouple placed in close proximity to the nose (nostrils). Preliminary testing revealed that the difference among temperatures in repeated heating cycles is in the range of ±1.5 °C. The response time for temperature increase from 29.9 to 40.5 °C was about 4 min, while the recovery time from 40.5 to 31.3 °C was about 4.3 min. Safety for human use and wireless data transmission to an application installed on a mobile phone are also demonstrated.
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Aydin-Ghormoz H, Adeyeye T, Muscatiello N, Nayak S, Savadatti S, Insaf TZ. Identifying Risk Factors for Hospitalization with Behavioral Health Disorders and Concurrent Temperature-Related Illness in New York State. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16411. [PMID: 36554292 PMCID: PMC9779268 DOI: 10.3390/ijerph192416411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Extreme temperature events are linked to increased emergency department visits, hospitalizations, and mortality for individuals with behavioral health disorders (BHD). This study aims to characterize risk factors for concurrent temperature-related illness among BHD hospitalizations in New York State. Using data from the NYS Statewide and Planning Research and Cooperative System between 2005-2019, multivariate log binomial regression models were used in a population of BHD hospitalizations to estimate risk ratios (RR) for a concurrent heat-related (HRI) or cold-related illness (CRI). Dementia (RR 1.65; 95% CI:1.49, 1.83) and schizophrenia (RR 1.38; 95% CI:1.19, 1.60) were associated with an increased risk for HRI among BHD hospitalizations, while alcohol dependence (RR 2.10; 95% CI:1.99, 2.22), dementia (RR 1.52; 95% CI:1.44, 1.60), schizophrenia (RR 1.41; 95% CI:1.31, 1.52), and non-dependent drug/alcohol use (RR 1.20; 95% CI:1.15, 1.26) were associated with an increased risk of CRI among BHD hospitalizations. Risk factors for concurrent HRI among BHD hospitalizations include increasing age, male gender, non-Hispanic Black race, and medium hospital size. Risk factors for concurrent CRI among BHD hospitalizations include increasing age, male gender, non-Hispanic Black race, insurance payor, the presence of respiratory disease, and rural hospital location. This study adds to the literature by identifying dementia, schizophrenia, substance-use disorders, including alcohol dependence and non-dependent substance-use, and other sociodemographic factors as risk factors for a concurrent CRI in BHD hospitalizations.
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Affiliation(s)
- Heather Aydin-Ghormoz
- Center for Environmental Health, New York State Department of Health, Albany, NY 12208, USA
- School of Public Health, University at Albany, Rensselaer, NY 12144, USA
| | - Temilayo Adeyeye
- Center for Environmental Health, New York State Department of Health, Albany, NY 12208, USA
- School of Public Health, University at Albany, Rensselaer, NY 12144, USA
| | - Neil Muscatiello
- Center for Environmental Health, New York State Department of Health, Albany, NY 12208, USA
| | - Seema Nayak
- Center for Environmental Health, New York State Department of Health, Albany, NY 12208, USA
| | - Sanghamitra Savadatti
- Center for Environmental Health, New York State Department of Health, Albany, NY 12208, USA
- School of Public Health, University at Albany, Rensselaer, NY 12144, USA
| | - Tabassum Z. Insaf
- Center for Environmental Health, New York State Department of Health, Albany, NY 12208, USA
- School of Public Health, University at Albany, Rensselaer, NY 12144, USA
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Petkova EP, Dimitrova LK, Sera F, Gasparrini A. Mortality attributable to heat and cold among the elderly in Sofia, Bulgaria. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:865-872. [PMID: 33416949 DOI: 10.1007/s00484-020-02064-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 05/21/2023]
Abstract
Although a number of epidemiological studies have examined the effects of non-optimal temperatures on mortality in Europe, evidence about the mortality risks associated with exposures to hot and cold temperatures in Bulgaria is scarce. This study provides evidence about mortality attributable to non-optimal temperatures in adults aged 65 and over in Sofia, Bulgaria, between 2000 and 2017. We quantified the relationship between the daily mean temperature and mortality in the total elderly adult population aged 65 and over, among males and females aged 65 and over, as well as individuals aged 65-84 and 85 years or older. We used a distributed lag non-linear model with a 25-day lag to fully capture the effects of both cold and hot temperatures and calculated the fractions of mortality attributable to mild and extreme hot and cold temperatures. Cold temperatures had a greater impact on mortality than hot temperatures during the studied period. Most of the temperature-attributable mortality was due to moderate cold, followed by moderate heat, extreme cold, and extreme heat. The total mortality attributable to non-optimal temperatures was greater among females compared to males and among individuals aged 85 and over compared to those aged 65 to 84. The findings of this study can serve as a foundation for future research and policy development aimed at characterizing and reducing the risks from temperature exposures among vulnerable populations in the country, climate adaptation planning and improved public health preparedness, and response to non-optimal temperatures.
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Affiliation(s)
- Elisaveta P Petkova
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA.
| | - Lyudmila K Dimitrova
- Department of Computer and Information Technology, Prof. Asen Zlatarov University, Burgas, Bulgaria
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
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Min JY, Choi YS, Lee HS, Lee S, Min KB. Increased cold injuries and the effect of body mass index in patients with peripheral vascular disease. BMC Public Health 2021; 21:294. [PMID: 33579232 PMCID: PMC7881551 DOI: 10.1186/s12889-020-09789-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023] Open
Abstract
Background Exposure to extremely or moderate low temperatures is associated with increased morbidity and mortality risk. Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. Given that cold temperature causes constriction of the small arteries and veins in the skin, patients who suffer from peripheral circulation problems, like PVD, may be vulnerable to cold injuries. This study aimed to investigate the association between PVD and cold-induced injuries in the winter among Korean adults. We further analyzed the association stratified by body mass index (BMI) classification. Methods We used the 2002–2015 National Health Insurance Service-National Sample Cohort data and included a total of 535,186 adults as the study population. Patients with underlying PVD were identified by ICD-10 code I73. Cold-related illnesses were defined by ICD-10 codes (T690, T691, T698, T699, T330 ~ T339, T340 ~ T349, and T350 ~ T357). Body mass index (BMI) was categorized into underweight, normal weight, overweight, and obese. Results A total of 23.21% (n = 124,224) were PVD patients, and 0.59% (n = 3154) had cold-induced injuries. PVD patients were more likely to be diagnosed with cold injuries, but it was valid only in the underweight or normal weight groups. After adjusting for age, sex, income, cigarette smoking, alcohol consumption, regular exercise, high blood pressure, and hyperglycemia, PVD patients had a significantly increased odds ratio (OR) for cold injuries [adjusted OR = 1.11; 95% confidence intervals (95% CI): 1.01–1.21]. Increased OR for cold injuries in PVD patients was also observed in adults (adjusted OR = 1.14; 95% CI: 1.03–1.25 in Model 2), but not in the elderly. When we classified study subjects into the four BMI groups, the adjusted OR of cold injuries in PVD patients was significant in the underweight group (OR = 1.83; 95% CI, 1.26–2.66) and normal weight group (OR = 1.15; 95% CI, 1.03–1.27), not in those with overweight and obese. In adults, a consistent result was found in adults in the underweight group (OR = 1.63; 95% CI, 1.08–2.47 in Model 2) and normal weight group (OR = 1.19; 95% CI, 1.07–1.33 in Model 2). In the elderly, the adjusted OR for cold injuries was only significant in the underweight group (OR = 3.37; 95% CI, 1.08–10.53 in Model 2). Conclusions We found a significant association between PVD and cold-induced injuries in the general population. BMI modified the association. Thus, the association observed appears to be clinically applicable to PVD patients being low to normal BMI.
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Affiliation(s)
- Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Yeon-Soo Choi
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Hyeong-Seong Lee
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Sohyae Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Seoul, 110-799, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Seoul, 110-799, Republic of Korea.
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Hachim MY, Hachim IY, Naeem K, Hannawi H, Al Salmi I, Hannawi S. Higher Temperatures, Higher Solar Radiation, and Less Humidity Is Associated With Poor Clinical and Laboratory Outcomes in COVID-19 Patients. Front Public Health 2021; 9:618828. [PMID: 33816417 PMCID: PMC8017282 DOI: 10.3389/fpubh.2021.618828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 02/03/2021] [Indexed: 02/05/2023] Open
Abstract
Background: The COVID-19 pandemic varies between countries, with suggestions that weather might contribute to the transmission mode, disease presentation, severity, and clinical outcomes. Yet the exact link between climate and COVID-19 is still not well-explored. Objectives: This study aimed to evaluate the effect of hot geographical region weather [like United Arab Emirates (UAE)] on COVID-19 clinical profile and outcomes. Temperature, wind speed, cloud cover, precipitation, and other weather-related variables were studied concerning COVID-19 patients outcomes and laboratory results. Methodology: A total of 434 COVID-19 positive patients admitted between January and June 2020, were recruited from Al Kuwait Hospital, Dubai, UAE. Temperature, wind speed, cloud cover, and precipitation rate were retrieved from history+ for the day when COVID-19 patients presented to the hospital. These weather parameters were correlated with COVID-19 clinical and laboratory parameters. Results: Our results showed that patients needed admission in days with higher temperatures, higher solar radiation, and less humidity were associated with higher deaths. This association can be linked to the association of these weather parameters with age at diagnosis; higher C-reactive protein (CRP), neutrophil count, white cell count (WCC), aspartate aminotransferase (AST), and alkaline phosphatase (ALP); and lower lymphocyte count, estimated glomerular filtration rate (eGFR), hemoglobin (Hb), Na, and albumin, all of which are considered poor prognostic factors for COVID-19. Conclusion: Our study highlighted the importance of weather-related variables on the dynamics of mortality and clinical outcomes of COVID-19. The hot weather might makes some people, especially those with comorbidities or older ages, develop aggressive inflammation that ends up with complications and mortality.
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Affiliation(s)
- Mahmood Yaseen Hachim
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- *Correspondence: Mahmood Yaseen Hachim
| | - Ibrahim Y. Hachim
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Kashif Naeem
- Ministry of Health and Prevention (United Arab Emirates), Dubai, United Arab Emirates
| | - Haifa Hannawi
- Ministry of Health and Prevention (United Arab Emirates), Dubai, United Arab Emirates
| | | | - Suad Hannawi
- Ministry of Health and Prevention (United Arab Emirates), Dubai, United Arab Emirates
- Suad Hannawi
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Mollayeva T, Hurst M, Chan V, Escobar M, Sutton M, Colantonio A. Pre-injury health status and excess mortality in persons with traumatic brain injury: A decade-long historical cohort study. Prev Med 2020; 139:106213. [PMID: 32693173 PMCID: PMC7494568 DOI: 10.1016/j.ypmed.2020.106213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/15/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022]
Abstract
An increasing number of patients are able to survive traumatic brain injuries (TBIs) with advanced resuscitation. However, the role of their pre-injury health status in mortality in the following years is not known. Here, we followed 77,088 consecutive patients (59% male) who survived the TBI event in Ontario, Canada for more than a decade, and examined the relationships between their pre-injury health status and mortality rates in excess to the expected mortality calculated using sex- and age-specific life tables. There were 5792 deaths over the studied period, 3163 (6.95%) deaths in male and 2629 (8.33%) in female patients. The average excess mortality rate over the follow-up period of 14 years was 1.81 (95% confidence interval = 1.76-1.86). Analyses of follow-up time windows showed different patterns for the average excess rate of mortality following TBI, with the greatest rates observed in year one after injury. Among identified pre-injury comorbidity factors, 33 were associated with excess mortality rates. These rates were comparable between sexes. Additional analyses in the validation dataset confirmed that these findings were unlikely a result of TBI misclassification or unmeasured confounding. Thus, detection and subsequent management of pre-injury health status should be an integral component of any strategy to reduce excess mortality in TBI patients. The complexity of pre-injury comorbidity calls for integration of multidisciplinary health services to meet TBI patients' needs and prevent adverse outcomes.
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Affiliation(s)
- Tatyana Mollayeva
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada.
| | - Mackenzie Hurst
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada
| | - Vincy Chan
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Mitchell Sutton
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada
| | - Angela Colantonio
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada; ICES Institute for Clinical Evaluative Sciences, Canada; Occupational Science & Occupational Therapy, University of Toronto, Canada
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8
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Zhang S, Yang Y, Xie X, Li H, Han R, Hou J, Sun J, Qian ZM, Wu S, Huang C, Howard SW, Tian F, Deng W, Lin H. The effect of temperature on cause-specific mental disorders in three subtropical cities: A case-crossover study in China. ENVIRONMENT INTERNATIONAL 2020; 143:105938. [PMID: 32688157 DOI: 10.1016/j.envint.2020.105938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Little is known about the association between ambient temperature and cause-specific mental disorders, especially in subtropical areas. OBJECTIVE To investigate the effect of ambient temperature on mental disorders in subtropical cities. METHOD Daily morbidity data for mental disorders in three Chinese cities (Shenzhen, Zhaoqing, and Huizhou) were collected from medical record systems of local psychiatric specialist hospitals, covering patients of all ages. Case-crossover design combined with a distributed lag nonlinear model (DLNM) was used to assess the nonlinear and delayed effects of temperatures on five specific mental disorders (affective disorders, anxiety, depressive disorders, schizophrenia, and organic mental disorders), with analyses stratified by gender and age. The temperature of minimum effect was used as the reference value to calculate estimates. RESULTS We observed inversed J-shaped exposure-response curves between temperature and mental morbidity and observed that low temperatures had a significant and prolonged effect on most types of mental disorders in the three cities. For example, the effect of the cold (2.5th percentile) on anxiety was consistently observed in the three cities with an odds ratio (OR) of 1.29 (95% CI: 1.06-1.57) in Zhaoqing, 1.26 (95% CI: 1.18-1.34) in Shenzhen, and 1.45 (95% CI: 1.17-1.81) in Huizhou. Low temperature was also associated with an increased risk of depressive disorders and schizophrenia. For the high temperature exposure (97.5th percentile), we only observed a significant, harmful effect on anxiety [OR = 1.30 (95% CI: 1.08, 1.58) in Shenzhen, OR = 1.16 (95% CI: 1.00, 1.34) in Zhaoqing], affective disorders [OR = 1.32 (95% CI: 1.08, 1.62) in Shenzhen], and schizophrenia [OR = 1.24 (95% CI: 1.03, 1.48) in Zhaoqing, OR = 1.03 (95% CI: 1.00, 1.06) in Huizhou]. CONCLUSIONS Our study suggests that both low and high temperatures might be important drivers of morbidity from mental disorders, and low temperature may have a more general and wide-spread effect on this cause-specific morbidity than high temperature.
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Affiliation(s)
- Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - XinHui Xie
- Brain Function and Psychosomatic Medicine Institute, The Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Huan Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Rong Han
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Jiesheng Hou
- The Third People's Hospital of Zhaoqing, Guangdong, China
| | - Jia Sun
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, China
| | - Cunrui Huang
- Health Management and Policy, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Steven W Howard
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Fei Tian
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - WenFeng Deng
- Brain Function and Psychosomatic Medicine Institute, The Second People's Hospital of Huizhou, Huizhou, Guangdong, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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9
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Dickinson GM, Maya GX, Lo Y, Jarvis HC. Hypothermia-related Deaths: A 10-year Retrospective Study of Two Major Metropolitan Cities in the United States. J Forensic Sci 2020; 65:2013-2018. [PMID: 32717145 DOI: 10.1111/1556-4029.14518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/10/2020] [Accepted: 06/29/2020] [Indexed: 11/27/2022]
Abstract
Hypothermia-related deaths affect vulnerable populations and are preventable. They account for the vast majority of weather-related deaths in the United States. The postmortem diagnosis of hypothermia can be challenging, as there are no pathognomonic signs. The electronic databases of the New York City Office of Chief Medical Examiner and Harris County Institute of Forensic Sciences were searched for all fatalities where the primary cause of death included hypothermia, between January 2009 and July 2019. There were 139 hypothermia deaths in New York City (NYC) with an average annualized rate of 1.7 per million. During this same time, there were 50 hypothermia deaths in Houston with an average annualized rate of 2.4 per million. Males were more likely to die of hypothermia compared to females in both cities. The rate ratio (RR) in NYC was 3.55 (95% CI 2.40, 5.25), while the RR in Houston was 2.83 (95% CI 1.50, 5.32). Age- and sex-specific standardized hypothermia mortality rates were 18.2 (95% CI 15.1, 21.2) per million in NYC and 30.1 (95% CI 21.7, 38.6) per million in Houston. The comparative hypothermia death ratio was 1.66 (95% CI 1.19, 2.30), indicating hypothermia mortality in Houston was 66% higher than in NYC. There was no correlation between zip code poverty rates and hypothermia-related deaths. The most consistent autopsy finding was Wischnewski spots (56.6%), and ethanol was the most common toxicological finding (36.5%). Local agencies can use this data to target these higher-risk populations and offer appropriate interventions to try to prevent these deaths.
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Affiliation(s)
- Gregory M Dickinson
- Pathology Department, Montefiore Medical Center, 111 E 210th Street, Bronx, NY, 10467-2490
| | - Gene X Maya
- Office of the Chief Medical Examiner - Northern District, 10850 Pyramid Place, Suite 121, Manassas, VA, 20110
| | - Yungtai Lo
- Albert Enstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Block, Room 311, Bronx, NY, 10461
| | - Hannah C Jarvis
- Harris County Institute of Forensic Sciences, 1861 Old Spanish Trail, Houston, TX, 77030
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10
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The Association between Air Temperature and Mortality in Two Brazilian Health Regions. CLIMATE 2020. [DOI: 10.3390/cli8010016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Air temperature, both cold and hot, has impacts on mortality and morbidities, which are exacerbated by poor health service and protection responses, particularly in under-developed countries. This study was designed to analyze the effects of air temperature on the risk of deaths for all and specific causes in two regions of Brazil (Florianopolis and Recife), between 2005 and 2014. The association between temperature and mortality was performed through the fitting of a quasi-Poisson non-linear lag distributed model. The association between air temperature and mortality was identified for both regions. The results showed that temperature exerted influence on both general mortality indicators and specific causes, with hot and cold temperatures bringing different impacts to the studied regions. Cerebrovascular and cardiovascular deaths were more sensitive to cold temperatures for Florianopolis and Recife, respectively. Based on the application of the very-well documented state-of-the-art methodology, it was possible to conclude that there was evidence that extreme air temperature influenced general and specific deaths. These results highlighted the importance of consolidating evidence and research in tropical countries such as Brazil as a way of understanding climate change and its impacts on health indicators.
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11
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Zhang P, Wiens K, Wang R, Luong L, Ansara D, Gower S, Bassil K, Hwang SW. Cold Weather Conditions and Risk of Hypothermia Among People Experiencing Homelessness: Implications for Prevention Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183259. [PMID: 31491874 PMCID: PMC6765826 DOI: 10.3390/ijerph16183259] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 01/02/2023]
Abstract
Hypothermia is a preventable condition that disproportionately affects individuals who experience homelessness, yet limited data exist to inform the response to cold weather. To fill this gap, we examined the association between meteorological conditions and the risk of hypothermia among homeless individuals. Hypothermic events were identified from emergency department charts and coroner's records between 2004 and 2015 in Toronto, Canada. A time-stratified case-crossover design with conditional logistic regression was used to assess the relationship between the meteorological conditions (minimum temperature and precipitation) and the risk of hypothermia. There were 97 hypothermic events identified: 79 injuries and 18 deaths. The odds of experiencing a hypothermic event increased 1.64-fold (95% CI: 1.30-2.07) with every 5 °C decrease in the minimum daily temperature and 1.10-fold (95% CI: 1.03-1.17) with every 1 mm increase in precipitation. The risk of hypothermia among individuals experiencing homelessness increased with declining temperature; however, most cases occurred during periods of low and moderate cold stress. 72% occurred when the minimum daily temperatures were warmer than -15 °C. These findings highlight the importance of providing a seasonal cold weather response to prevent hypothermia, complemented by an alert-based response on extremely cold days.
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Affiliation(s)
- Paige Zhang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
| | - Kathryn Wiens
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada.
| | - Ri Wang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
| | - Linh Luong
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
| | - Donna Ansara
- Toronto Public Health, 277 Victoria St, Toronto, ON M5B 1W2, Canada.
| | - Stephanie Gower
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada.
- Toronto Public Health, 277 Victoria St, Toronto, ON M5B 1W2, Canada.
| | - Kate Bassil
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada.
- Toronto Public Health, 277 Victoria St, Toronto, ON M5B 1W2, Canada.
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada.
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