Ambient temperature and emergency department visits: Time-series analysis in 12 Chinese cities

被引:59
作者
Zhao, Qi [1 ]
Zhang, Yongming [2 ]
Zhang, Wenyi [3 ]
Li, Shanshan [1 ]
Chen, Gongbo [1 ]
Wu, Yanbin [4 ]
Qiu, Chen [5 ]
Ying, Kejing [6 ]
Tang, Huaping [7 ]
Huang, Jian-an [8 ]
Williams, Gail [1 ]
Huxley, Rachel [9 ]
Guo, Yuming [1 ]
机构
[1] Univ Queensland, Sch Publ Hlth, Div Epidemiol & Biostat, 288 Herston Rd, Brisbane, Qld 4006, Australia
[2] China Japan Friendship Hosp, Dept Resp & Crit Care Med, 2 East Yinghua Rd, Beijing 100029, Peoples R China
[3] Acad Mil Med Sci, Inst Dis Control & Prevent, 20 East Rd, Beijing 102206, Peoples R China
[4] Guangxi Med Univ, Affiliated Hosp 1, 6 Shuangyong Rd, Nanning 530021, Peoples R China
[5] Shenzhen Peoples Hosp, 1017 North Dongmen Rd, Shenzhen 518020, Guangdong, Peoples R China
[6] Zhejiang Univ, Sir Run Run Shaw Hosp, Resp & Crit Care Dept, 3 East Qingchun Rd, Hangzhou 310016, Zhejiang, Peoples R China
[7] Qingdao Municipal Hosp, 1 Jiaozhou Rd, Qingdao 266011, Shandong, Peoples R China
[8] Soochow Univ, Affiliated Hosp 1, 188 Shizi St, Suzhou 215006, Peoples R China
[9] Curtin Univ, Sch Publ Hlth, Kent St, Perth, WA 6102, Australia
基金
英国医学研究理事会;
关键词
Ambient temperature; Emergency department visits; Non-linear relationship; Multicity study; China; CLIMATE VARIABILITY; COARSE PARTICLES; MORTALITY; HEAT; ASSOCIATIONS; MORBIDITY; SHANGHAI; IMPACTS; HEALTH; RANGE;
D O I
10.1016/j.envpol.2017.02.010
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Background: The association between ambient temperature and mortality has been well documented worldwide. However, limited data are available on nonfatal health outcomes, such as emergency department visits (EDVs), particularly from China. Objectives: To examine the temperature-EDV association in 12 Chinese cities; and to assess the modification effects by region, gender and age. Methods: Daily meteorological data and non-accidental EDVs were collected during 2011-2014. Poisson regression with distributed lag non-linear model was applied to examine the temperature-lag-EDV association in each city. The effect estimates were pooled using multivariate meta-analysis at the national and regional level. Stratified analyses were performed by gender and age-groups. Sensitivity analyses adjusting for air pollution and relative humidity were conducted. Results: A total of 4,443,127 EDVs were collected from the 12 cities. Both cold and hot temperatures were associated with increased risk of EDVs, with minimum-mortality temperature located at 64th percentile of temperature. The effect of cold temperature appeared on day 2 and persisted until day 30, causing a cumulative relative risk (RR) of 1.80 (1.54, 2.11). The effect of hot temperature appeared immediately and lasted until day 3, with a cumulative RR of 1.15 (1.03,1.29). The effect of temperature on EDVs was similar in male and female but was attenuated with increasing age. The effect of cold temperature on EDVs was greater in southern areas of the country whereas the hot effect was greater in northern cities. The association was robust to a large range of sensitivity analyses. Conclusions: In China, there is a U-shaped association between temperature and risk of EDVs that is independent of air pollution and humidity. The temperature-EDV association varies with latitude and age-groups but is not affected by gender. Forecasting models for hospital emergency departments may be improved if temperature is included as an independent predictor. (C) 2017 Elsevier Ltd. All rights reserved.
引用
收藏
页码:310 / 316
页数:7
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