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Strobl K, Irfan SA, Masood H, Latif N, Kurmi O. Association between PM10 exposure and risk of myocardial infarction in adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0301374. [PMID: 38691568 PMCID: PMC11062553 DOI: 10.1371/journal.pone.0301374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 03/11/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Air pollution has several negative health effects. Particulate matter (PM) is a pollutant that is often linked to health adversities. PM2.5 (PM with an aerodynamic diameter of ≤2.5μm) exposure has been associated with negative cardiovascular (CV) outcomes. However, the impact of PM10 (PM with an aerodynamic diameter of ≤10μm) exposure is often overlooked due to its limited ability to pass the alveolar barrier. This study aims to assess the association between PM10 exposure and risk of myocardial infarction (MI) amongst adults (≥18 years of age) as this has been poorly studied. METHODS The study protocol was published on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023409796) on March 31, 2023. Literature searches were conducted on 4 databases (Ovid Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science) on January 17, 2023, for studies looking at associations between PM and MI. English studies from all time periods were assessed. Studies selected for review were time-series, case-crossover, and cohort studies which investigated the risk of MI as an outcome upon PM10 exposure. The quality of evidence was assessed using Cochrane's Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data for different risk outcomes (risk ratio (RR), odds ratio (OR), hazard ratio (HR)) and 3 lags was meta-analyzed using an inverse variance statistical analysis using a random effects model. The pooled effect sizes and the 95% confidence intervals (CIs) were reported in forest plots. RESULTS Among the 1,099 studies identified, 41 were included for review and 23 were deemed eligible for meta-analysis. Our analysis revealed that there is an increased risk (OR = 1.01; 95% CI:1.00-1.02) of MI with a 10 μg/m3 increase in PM10 after a lag 0 and lag 1 delay. CONCLUSIONS Our findings indicate that PM10 exposure is associated with an increased risk of MI. This can aid in informing environmental policy-making, personal-level preventative measures, and global public health action.
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Affiliation(s)
- Kleiton Strobl
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Syed Asad Irfan
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Hassan Masood
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Noor Latif
- Faculty of Science, McMaster University, Hamilton, Canada
| | - Om Kurmi
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Faculty Research Centre for Healthcare and Communities, Coventry University, Coventry, United Kingdom
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Abrignani MG, Lombardo A, Braschi A, Renda N, Abrignani V. Climatic influences on cardiovascular diseases. World J Cardiol 2022; 14:152-169. [PMID: 35432772 PMCID: PMC8968453 DOI: 10.4330/wjc.v14.i3.152] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/23/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
Classical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ''U'' shape. Exposure to cold, heat and heat waves is associated with an increased risk of acute coronary syndromes. Other climatic variables, such as humidity, atmospheric pressure, sunlight hours, wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and non-fatal cardiovascular diseases incidence. Main limitation of these studies is the unavailability of data on individual exposure to weather parameters. Effects of weather may vary depending on other factors, such as population disease profile and age structure. Climatic stress may increase direct and indirect risks to human health via different, complex pathophysiological pathways and exogenous and endogenous mechanisms. These data have attracted growing interest because of the recent earth's climate change, with consequent increasing ambient temperatures and climatic fluctuations. This review evaluates the evidence base for cardiac health consequences of climate conditions, and it also explores potential further implications.
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Affiliation(s)
- Maurizio Giuseppe Abrignani
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy.
| | - Alberto Lombardo
- Operative Unit of Cardiology, Department of Medicine, S. Antonio Abate Hospital of Trapani, ASP Trapani, Trapani 91100, Italy
| | - Annabella Braschi
- Department of Internal Medicine, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90100, Italy
| | - Nicolò Renda
- Department of Mental Health, ASP Trapani, Trapani 91100, Italy
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Atmospheric features and risk of ST-elevation myocardial infarction in Porto (Portugal): A temperate Mediterranean (Csb) city. Rev Port Cardiol 2021; 41:51-58. [DOI: 10.1016/j.repc.2020.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/30/2020] [Accepted: 11/18/2020] [Indexed: 11/20/2022] Open
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Xu Z, Tong S, Ho HC, Lin H, Pan H, Cheng J. Associations of heat and cold with hospitalizations and post-discharge deaths due to acute myocardial infarction: what is the role of pre-existing diabetes? Int J Epidemiol 2021; 51:134-143. [PMID: 34387661 DOI: 10.1093/ije/dyab155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The existing evidence suggests that pre-existing diabetes may modify the association between heat and hospitalizations for acute myocardial infarction (AMI). METHODS This study included patients who were hospitalized for AMI from 1 January 2005 to 31 December 2013 in Brisbane, Australia, and also included those who died within 2 months after discharge. A time-stratified case-crossover design with conditional logistic regression was used to quantify the associations of heat and cold with hospitalizations and post-discharge deaths due to AMI in patients with and without pre-existing diabetes. Stratified analyses were conducted to explore whether age, sex and suburb-level green space and suburb-level socio-economic status modified the temperature-AMI relationship. Heat and cold were defined as the temperature above/below which the odds of hospitalizations/deaths due to AMI started to increase significantly. RESULTS There were 14 991 hospitalizations for AMI and 1811 died from AMI within 2 months after discharge during the study period. Significant association between heat and hospitalizations for AMI was observed only in those with pre-existing diabetes (odds ratio: 1.19, 95% confidence interval: 1.00-1.41) [heat (26.3°C) vs minimum morbidity temperature (22.2°C)]. Cold was associated with increased odds of hospitalizations for AMI in both diabetes and non-diabetes groups. Significant association between cold and post-discharge deaths from AMI was observed in both diabetes and non-diabetes groups. CONCLUSIONS Individuals with diabetes are more susceptible to hospitalizations due to AMI caused by heat and cold.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China.,School of Geography and Remote Sensing, Guangzhou University, Guangzhou, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Haifeng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
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Harvey NC, Lorentzon M, Kanis JA, McCloskey E, Johansson H. Incidence of myocardial infarction and associated mortality varies by latitude and season: findings from a Swedish Registry Study. J Public Health (Oxf) 2021; 42:e440-e448. [PMID: 31774530 DOI: 10.1093/pubmed/fdz131] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We investigated whether the incidence of death following myocardial infarction (MI) varied by season and latitude in the Swedish population. METHODS We studied deaths following MI from January 1987 to December 2009, using the Swedish National Cause of Death Register. County of residence was used to determine latitude and population density. An extension of Poisson regression was used to study the relationship between risk of death following MI with age, latitude, time (from 1987), population density and calendar days. RESULTS Over the study period, there was a secular decrease in the incidence of MI-related death. In men, MI-related death incidence increased by 1.3% [95% confidence interval (CI) = 1.1-1.5] per degree of latitude (northwards). In women, MI-related death incidence increased by 0.6% (95% CI = 0.4-0.9) per degree of latitude. There was seasonal variation in the risk of MI-related death with peak values in the late winter and a nadir in the summer months in both the north and the south of Sweden. Findings were similar with incident MI as the outcome. CONCLUSIONS The incidence of MI-related death varied markedly by season and latitude in Sweden, with summer months and more southerly latitude associated with lower rates than winter months and more northerly latitude.
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Affiliation(s)
- Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK
| | - Mattias Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Sweden.,Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.,Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
| | - Eugene McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.,Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | - Helena Johansson
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.,Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
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Shin J, Oh J, Kang IS, Ha E, Pyun WB. Effect of Short-Term Exposure to Fine Particulate Matter and Temperature on Acute Myocardial Infarction in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4822. [PMID: 33946492 PMCID: PMC8124364 DOI: 10.3390/ijerph18094822] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Previous studies have suggested that the short-term ambient air pollution and temperature are associated with myocardial infarction. In this study, we aimed to conduct a time-series analysis to assess the impact of fine particulate matter (PM2.5) and temperature on acute myocardial infarction (AMI) among adults over 20 years of age in Korea by using the data from the Korean National Health Information Database (KNHID). METHODS The daily data of 192,567 AMI cases in Seoul were collected from the nationwide, population-based KNHID from 2005 to 2014. The monitoring data of ambient PM2.5 from the Seoul Research Institute of Public Health and Environment were also collected. A generalized additive model (GAM) that allowed for a quasi-Poisson distribution was used to analyze the effects of PM2.5 and temperature on the incidence of AMI. RESULTS The models with PM2.5 lag structures of lag 0 and 2-day averages of lag 0 and 1 (lag 01) showed significant associations with AMI (Relative risk [RR]: 1.011, CI: 1.003-1.020 for lag 0, RR: 1.010, CI: 1.000-1.020 for lag 01) after adjusting the covariates. Stratification analysis conducted in the cold season (October-April) and the warm season (May-September) showed a significant lag 0 effect for AMI cases in the cold season only. CONCLUSIONS In conclusion, acute exposure to PM2.5 was significantly associated with AMI morbidity at lag 0 in Seoul, Korea. This increased risk was also observed at low temperatures.
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Affiliation(s)
- Jiyoung Shin
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (J.S.); (J.O.)
- Inflammation-Cancer Microenvironment Research Center, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Jongmin Oh
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (J.S.); (J.O.)
| | - In-Sook Kang
- Department of Internal Medicine, Division of Cardiology, College of Medicine, Ewha Womans University, Seoul 07804, Korea;
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (J.S.); (J.O.)
- Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Wook-Bum Pyun
- Department of Internal Medicine, Division of Cardiology, College of Medicine, Ewha Womans University, Seoul 07804, Korea;
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Fonseca-Rodríguez O, Sheridan SC, Lundevaller EH, Schumann B. Effect of extreme hot and cold weather on cause-specific hospitalizations in Sweden: A time series analysis. ENVIRONMENTAL RESEARCH 2021; 193:110535. [PMID: 33271141 DOI: 10.1016/j.envres.2020.110535] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
Considering that several meteorological variables can contribute to weather vulnerability, the estimation of their synergetic effects on health is particularly useful. The spatial synoptic classification (SSC) has been used in biometeorological applications to estimate the effect of the entire suite of weather conditions on human morbidity and mortality. In this study, we assessed the relationships between extremely hot and dry (dry tropical plus, DT+) and hot and moist (moist tropical plus, MT+) weather types in summer and extremely cold and dry (dry polar plus, DP+) and cold and moist (moist polar, MP+) weather types in winter and cardiovascular and respiratory hospitalizations by age and sex. Time-series quasi-Poisson regression with distributed lags was used to assess the relationship between oppressive weather types and daily hospitalizations over 14 subsequent days in the extended summer (May to August) and 28 subsequent days during the extended winter (November to March) over 24 years in 4 Swedish locations from 1991 to 2014. In summer, exposure to hot weather types appeared to reduce cardiovascular hospitalizations while increased the risk of hospitalizations for respiratory diseases, mainly related to MT+. In winter, the effect of cold weather on both cause-specific hospitalizations was small; however, MP+ was related to a delayed increase in cardiovascular hospitalizations, whilst MP+ and DP + increased the risk of hospitalizations due to respiratory diseases. This study provides useful information for the staff of hospitals and elderly care centers who can help to implement protective measures for patients and residents. Also, our results could be helpful for vulnerable people who can adopt protective measures to reduce health risks.
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Affiliation(s)
- Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, 901 85, Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden.
| | - Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH, 44242, USA.
| | | | - Barbara Schumann
- Department of Epidemiology and Global Health, Umeå University, 901 85, Umeå, Sweden; Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden.
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Abed Al Ahad M, Sullivan F, Demšar U, Melhem M, Kulu H. The effect of air-pollution and weather exposure on mortality and hospital admission and implications for further research: A systematic scoping review. PLoS One 2020; 15:e0241415. [PMID: 33119678 PMCID: PMC7595412 DOI: 10.1371/journal.pone.0241415] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Air-pollution and weather exposure beyond certain thresholds have serious effects on public health. Yet, there is lack of information on wider aspects including the role of some effect modifiers and the interaction between air-pollution and weather. This article aims at a comprehensive review and narrative summary of literature on the association of air-pollution and weather with mortality and hospital admissions; and to highlight literature gaps that require further research. METHODS We conducted a scoping literature review. The search on two databases (PubMed and Web-of-Science) from 2012 to 2020 using three conceptual categories of "environmental factors", "health outcomes", and "Geographical region" revealed a total of 951 records. The narrative synthesis included all original studies with time-series, cohort, or case cross-over design; with ambient air-pollution and/or weather exposure; and mortality and/or hospital admission outcomes. RESULTS The final review included 112 articles from which 70 involved mortality, 30 hospital admission, and 12 studies included both outcomes. Air-pollution was shown to act consistently as risk factor for all-causes, cardiovascular, respiratory, cerebrovascular and cancer mortality and hospital admissions. Hot and cold temperature was a risk factor for wide range of cardiovascular, respiratory, and psychiatric illness; yet, in few studies, the increase in temperature reduced the risk of hospital admissions for pulmonary embolism, angina pectoris, chest, and ischemic heart diseases. The role of effect modification in the included studies was investigated in terms of gender, age, and season but not in terms of ethnicity. CONCLUSION Air-pollution and weather exposure beyond certain thresholds affect human health negatively. Effect modification of important socio-demographics such as ethnicity and the interaction between air-pollution and weather is often missed in the literature. Our findings highlight the need of further research in the area of health behaviour and mortality in relation to air-pollution and weather, to guide effective environmental health precautionary measures planning.
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Affiliation(s)
- Mary Abed Al Ahad
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
| | - Frank Sullivan
- School of Medicine, University of St Andrews, Scotland, United Kingdom
| | - Urška Demšar
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
| | - Maya Melhem
- Department of Landscape Design and Ecosystem Management, American University of Beirut, Beirut, Lebanon
| | - Hill Kulu
- School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom
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Shire J, Vaidyanathan A, Lackovic M, Bunn T. Association Between Work-Related Hyperthermia Emergency Department Visits and Ambient Heat in Five Southeastern States, 2010-2012-A Case-Crossover Study. GEOHEALTH 2020; 4:e2019GH000241. [PMID: 32821873 PMCID: PMC7429406 DOI: 10.1029/2019gh000241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/10/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
The objective of this study is to assess ambient temperatures' and extreme heat events' contribution to work-related emergency department (ED) visits for hyperthermia in the southeastern United States to inform prevention. Through a collaborative network and established data framework, work-related ED hyperthermia visits in five participating southeastern U.S. states were analyzed using a time stratified case-crossover design. For exposure metrics, day- and location-specific measures of ambient temperatures and county-specific identification of extreme heat events were used. From 2010 to 2012, 5,017 work-related hyperthermia ED visits were seen; 2,298 (~46%) of these visits occurred on days when the daily maximum heat index was at temperatures the Occupational Safety and Health Administration designates as having "lower" or "moderate" heat risk. A 14% increase in risk of ED visit was seen for a 1°F increase in average daily mean temperature, modeled as linear predictor across all temperatures. A 54% increase in risk was seen for work-related hyperthermia ED visits during extreme heat events (two or more consecutive days of unusually high temperatures) when controlling for average daily mean temperature. Despite ambient heat being a well-known risk to workers' health, this study's findings indicate ambient heat contributed to work-related ED hyperthermia visits in these five states. Used alone, existing OSHA heat-risk levels for ambient temperatures did not appear to successfully communicate workers' risk for hyperthermia in this study. Findings should inform future heat-alert communications and policies, heat prevention efforts, and heat-illness prevention research for workers in the southeastern United States.
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Affiliation(s)
- Jeffrey Shire
- National Institute for Occupational Safety and HealthCenters for Disease Control and PreventionCincinnatiOHUSA
| | - Ambarish Vaidyanathan
- National Center for Environmental HealthCenters for Disease Control and PreventionAtlantaGAUSA
| | | | - Terry Bunn
- Kentucky Injury Prevention and Research Center, Department of Preventive Medicine and Environmental HealthUniversity of Kentucky College of Public HealthLexingtonKYUSA
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Bergmann S, Li B, Pilot E, Chen R, Wang B, Yang J. Effect modification of the short-term effects of air pollution on morbidity by season: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 716:136985. [PMID: 32044481 DOI: 10.1016/j.scitotenv.2020.136985] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/15/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
Studies of the health effects of air pollution have traditionally controlled for ambient temperature as a confounder, and vice versa. However, season might be an important factor contributing to adverse health effects of air pollution. Given the current inconsistencies in results of previous studies on the effect modification of air pollution on morbidity by season, a systematic review and meta-analysis was conducted to synthesize the current evidence on effects of season on air pollution and morbidity. The electronic databases including PubMed, Web of Science, Embase, CNKI, and Wanfang were used to identify papers published up to the 30st of November in 2019. We identified 4284 articles, after screening, eighty papers met the inclusion criteria. Significant effect modification of CO, O3, SO2 and NO2 on morbidity by season was observed, with corresponding ratio of relative risk of 1.0009 (95% CI: 1.0001-1.0018), 1.0080 (95% CI: 1.0021-1.0138), 0.9828 (95% CI: 0.9697-0.9962) and 0.9896 (95% CI: 0.9824-0.9968), respectively. Season significantly modified the effect of CO on pneumonia, the effect of SO2 on cardiovascular disease, the effect of PM10 on stroke, and the effect of O3 on stroke, asthma and pneumonia. The effect modifications of air pollution by season were similar among males and females, while the effect estimates seem to be higher among children under 18 years old and the elderly aged 75 or over. Further research is needed to better understand the mechanisms underlying the seasonal variance of the effect of air pollutants on morbidity.
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Affiliation(s)
- Stéphanie Bergmann
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Bixia Li
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Eva Pilot
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Renchao Chen
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou, 511443, China.
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Stieb DM, Zheng C, Salama D, BerjawI R, Emode M, Hocking R, Lyrette N, Matz C, Lavigne E, Shin HH. Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity. Environ Health 2020; 19:47. [PMID: 32357902 PMCID: PMC7195719 DOI: 10.1186/s12940-020-00601-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/20/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Nitrogen dioxide (NO2) is a pervasive urban pollutant originating primarily from vehicle emissions. Ischemic heart disease (IHD) is associated with a considerable public health burden worldwide, but whether NO2 exposure is causally related to IHD morbidity remains in question. Our objective was to determine whether short term exposure to outdoor NO2 is causally associated with IHD-related morbidity based on a synthesis of findings from case-crossover and time-series studies. METHODS MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts between reviewers were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined using Leave One Out analysis and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill. RESULTS Thirty-eight case-crossover studies and 48 time-series studies were included in our analysis. NO2 was significantly associated with IHD morbidity (pooled odds ratio from case-crossover studies: 1.074 95% CI 1.052-1.097; pooled relative risk from time-series studies: 1.022 95% CI 1.016-1.029 per 10 ppb). Pooled estimates for case-crossover studies from Europe and North America were significantly lower than for studies conducted elsewhere. The high degree of heterogeneity among studies was only partially accounted for in meta-regression. There was evidence of publication bias, particularly for case-crossover studies. For both case-crossover and time-series studies, pooled estimates based on multi-pollutant models were smaller than those from single pollutant models, and those based on older populations were larger than those based on younger populations, but these differences were not statistically significant. CONCLUSIONS We concluded that there is a likely causal relationship between short term NO2 exposure and IHD-related morbidity, but important uncertainties remain, particularly related to the contribution of co-pollutants or other concomitant exposures, and the lack of supporting evidence from toxicological and controlled human studies.
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Affiliation(s)
- David M. Stieb
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC V6C 1A1 Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Carine Zheng
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Dina Salama
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Rania BerjawI
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Monica Emode
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Robyn Hocking
- Learning, Knowledge and Library Services, Health Canada, Ottawa, Canada
| | - Ninon Lyrette
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Carlyn Matz
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Hwashin H. Shin
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC V6C 1A1 Canada
- Department of Mathematics and Statistics, Queen’s University, Kingston, Canada
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Cheng J, Bambrick H, Tong S, Su H, Xu Z, Hu W. Winter temperature and myocardial infarction in Brisbane, Australia: Spatial and temporal analyses. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 715:136860. [PMID: 32040995 DOI: 10.1016/j.scitotenv.2020.136860] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
Myocardial infarction (MI) incidence often peaks in winter, but it remains unclear how winter temperature affects MI temporally and spatially. We examined the short-term effects of winter temperature on the risk of MI and explored spatial associations of winter MI hospitalizations with temperature and socioeconomic status (area-based index) in Brisbane, Australia. We used a distributed lag non-linear model to fit the association at the city level between population-weighted daily mean temperature and daily MI hospitalizations during 11 winters of 2005-2015. For each winter, a Bayesian spatial conditional autoregressive model was fitted to examine the associations at postal code level of MI hospitalisations with temperature and socioeconomic status measured as the Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD). Area-specific winter temperature was categorised into three levels: cold (<25th percentile of average winter temperature across postal areas), mild (25th-75th percentile) and warm (>75th percentile). This study included 4978 MI hospitalizations. At the city level, each 1 °C drop in temperature below a threshold of 15.6 °C was associated with a relative risk (RR) of 1.016 (95% confidence interval (CI): 1.008-1.024) for MI hospitalizations on the same day. Low temperature had a much delayed and transient effect on women but an immediate and longer-lasting effect on men. Winter MI incidence rate varied spatially in Brisbane, with a higher incidence rate in warmer areas (RR for mild areas: 1.214, 95%CI: 1.116-1.320; RR for warm areas: 1.251, 95%CI: 1.127-1.389; cold areas as the reference) and in areas with lower socioeconomic levels (RR: 0.900, 95%CI: 0.886-0.914 for each decile increase in IRSAD). This study provides compelling evidence that short-term winter temperature drops were associated with an elevated risk of MI in the subtropical region with a mild winter. Particular attention also needs to be paid to people living in relatively warm and socioeconomically disadvantaged communities in winter.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia; Shanghai Children's Medical Center, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Anhui Medical University, Hefei, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhiwei Xu
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
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Cui L, Geng X, Ding T, Tang J, Xu J, Zhai J. Impact of ambient temperature on hospital admissions for cardiovascular disease in Hefei City, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:723-734. [PMID: 30852664 DOI: 10.1007/s00484-019-01687-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/30/2019] [Accepted: 02/04/2019] [Indexed: 05/21/2023]
Abstract
Many studies have quantified the hospitalization risk for cardiovascular disease (CVD) caused by temperature, but the results of most studies are not consistent. In this study, we evaluate the effect of temperature on CVD hospitalizations. We use a quasi-Poisson regression with a distributed-lag nonlinear model (DLNM) to evaluate the effect of temperature on CVD hospitalizations between July 1, 2015, and October 31, 2017, in Hefei City, China. We found that the cold effect and heat effect of temperature can impact CVD hospital admissions. Compared with the 25th percentile of temperature (10.3 °C), the cumulative relative risk (RR) of extremely low temperature (first percentile of temperature, 0.075 °C) over lags 0-27 days was 0.616 (95% CI 0.423-0.891), and the cumulative RR of moderate low temperature (10th percentile of temperature, 5.16 °C) was 1.081 (95% CI 1.019-1.147) over lags 0-7 days. Compared with the 75th percentile of temperature (25.6 °C), the cumulative RR of extremely high temperature (99th percentile of temperature, 33.7 °C) was 1.078 (95% CI 0.752-1.547) over lags 0-27 days, and the cumulative RR of moderate-high temperature (90th percentile of temperature, 29.0 °C) was 1.015 (95% CI 0.988-1.043) over lag 0 day. In the subgroup, the < 65-year group and male were more susceptible to low temperature; however, the ≥ 65-year group and female were more vulnerable to high temperature. The high temperature's impact on CVD hospital admissions was found to be more obvious in female and the ≥ 65-year group compared to male and the < 65-year group. However, the < 65-year group and men are more sensitive to low temperature.
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Affiliation(s)
- Longjiang Cui
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Xiya Geng
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Tao Ding
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jing Tang
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jixiang Xu
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China
| | - Jinxia Zhai
- Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
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Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101696. [PMID: 31091805 PMCID: PMC6573000 DOI: 10.3390/ijerph16101696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/03/2019] [Accepted: 05/10/2019] [Indexed: 01/13/2023]
Abstract
Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.
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Lin YK, Maharani AT, Chang FT, Wang YC. Mortality and morbidity associated with ambient temperatures in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 651:210-217. [PMID: 30227291 DOI: 10.1016/j.scitotenv.2018.09.161] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 05/03/2023]
Abstract
BACKGROUND This study evaluated integrated risks of all-cause mortality, emergency room visits (ERVs), and outpatient visits associated with ambient temperature in all cities and counties of Taiwan. In addition, the modifying effects of socio-economic and environmental factors on temperature-health associations were also evaluated. METHODS A distributed lag non-linear model was applied to estimate the cumulative relative risks (RRs) with confidence intervals of all-cause mortality, ERVs, and outpatient visits associated with extreme temperature events. Random-effect meta-analysis was used to estimate the pooled RR of all-cause mortality, ERVs, and outpatient visits influenced by socio-economic and environmental factors. RESULTS Temperature-related risks varied with study area and health outcome. Meta-analysis showed greater all-cause mortality risk occurred in low temperatures than in high temperatures. Integrated RR of all-cause mortality was 1.71 (95% confidence interval [CI]:1.43-2.04) in the 5th percentile temperature and 1.10 (95% CI: 1.05-1.15) in the 95th percentile temperature, while the lowest mortality risk was in the 60th percentile temperature (22.2 °C). Risk for ERVs increased when temperature increased (RR was 1.21 [95% CI: 1.17-1.26] in 95th percentile temperature), but risk of outpatient visits increased at low temperatures (RR was 1.06 [95% CI: 1.01-1.12] in the 5th percentile temperature). Certain socio-economic factors significantly modified low-temperature-related mortality risks, including number of employed populations, elders living alone from lower-income families, and public and medical services. CONCLUSIONS This study found that mortality and outpatient visits were higher at low temperature, while ERVs risk was higher at high temperature. Future plans for public health and emerging medical services responding to extreme temperatures should consider regional and integrated evaluations of temperature-related health risks and modifying factors.
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Affiliation(s)
- Yu-Kai Lin
- Department of Health and Welfare, University of Taipei, College of City Management, 101, Sec. 2, Zhongcheng Road, Taipei 111, Taiwan
| | - Aussie Tahta Maharani
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Fang-Tzu Chang
- Department of Health and Welfare, University of Taipei, College of City Management, 101, Sec. 2, Zhongcheng Road, Taipei 111, Taiwan; Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli 320, Taiwan.
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Liu X, Kong D, Fu J, Zhang Y, Liu Y, Zhao Y, Lian H, Zhao X, Yang J, Fan Z. Association between extreme temperature and acute myocardial infarction hospital admissions in Beijing, China: 2013-2016. PLoS One 2018; 13:e0204706. [PMID: 30332423 PMCID: PMC6192570 DOI: 10.1371/journal.pone.0204706] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022] Open
Abstract
Over the past few decades, a growing body of epidemiological studies found the effects of temperature on cardiovascular disease, including the risk for acute myocardial infarction (AMI). Our study aimed to investigate whether there is an association between extremely temperature and acute myocardial infarction hospital admission in Beijng, China. We obtained 81029 AMI cases and daily temperature data from January 1, 2013 to December 31, 2016. We employed a time series design and modeled distributed lag nonlinear model (DLNM) to analyze effects of temperature on daily AMI cases. Compared with the 10th percentile temperature measured by daily mean temperature (Tmean), daily minimum temperature (Tmin) and daily minimum apparent temperature (ATmin), the cumulative relative risks (CRR) at 1st percentile of Tmean, Tmin and ATmin for AMI hospitalization were 1.15(95% CI: 1.02, 1.30), 1.24(95% CI: 1.11, 1.38) and 1.41(95% CI: 1.18, 1.68), respectively. Moderate low temperature (10th vs 25th) also had adverse impact on AMI events. The susceptive groups were males and people 65 years and older. No associations were found between high temperature and AMI risk. The main limitation of the study is temperature exposure was not individualized. These findings on cold-associated AMI hospitalization helps characterize the public health burden of cold and target interventions to reduce temperature induced AMI occurrence.
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Affiliation(s)
- Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dehui Kong
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongqiao Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yakun Zhao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Lian
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyi Zhao
- Department of Physical Medicine and Rehabilitation, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail:
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Sun Z, Chen C, Xu D, Li T. Effects of ambient temperature on myocardial infarction: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 241:1106-1114. [PMID: 30029319 DOI: 10.1016/j.envpol.2018.06.045] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 05/03/2023]
Abstract
Previous studies have suggested that ambient temperature is associated with the mortality and morbidity of myocardial infarction (MI) although consistency among these investigations is lacking. We performed a meta-analysis to investigate the relationship between ambient temperature and MI. The PubMed, Web of Science, and China National Knowledge Infrastructure databases were searched back to August 31, 2017. The pooled estimates for different temperature exposures were calculated using a random-effects model. The Cochran's Q test and coefficient of inconsistency (I2) were used to evaluate heterogeneity, and the Egger's test was used to assess publication bias. The exposure-response relationship of temperature-MI mortality or hospitalization was modeled using random-effects meta-regression. A total of 30 papers were included in the review, and 23 studies were included in the meta-analysis. The pooled estimates for the relationship between temperature and the relative risk of MI hospitalization was 1.016 (95% confidence interval [CI]: 1.004-1.028) for a 1 °C increase and 1.014 (95% CI: 1.004-1.024) for a 1 °C decrease. The pooled estimate of MI mortality was 1.639 (95% CI: 1.087-2.470) for a heat wave. The heterogeneity was significant for heat exposure, cold exposure, and heat wave exposure. The Egger's test revealed potential publication bias for cold exposure and heat exposure, whereas there was no publication bias for heat wave exposure. An increase in latitude was associated with a decreased risk of MI hospitalization due to cold exposure. The association of heat exposure and heat wave were immediate, and the association of cold exposure were delayed. Consequently, cold exposure, heat exposure, and exposure to heat waves were associated with an increased risk of MI. Further research studies are required to understand the relationship between temperature and MI in different climate areas and extreme weather conditions.
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Affiliation(s)
- Zhiying Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China
| | - Chen Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China
| | - Dandan Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, China.
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Lam HCY, Chan JCN, Luk AOY, Chan EYY, Goggins WB. Short-term association between ambient temperature and acute myocardial infarction hospitalizations for diabetes mellitus patients: A time series study. PLoS Med 2018; 15:e1002612. [PMID: 30016318 PMCID: PMC6049878 DOI: 10.1371/journal.pmed.1002612] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/14/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is the leading cause of death among people with diabetes mellitus (DM) and has been found to occur more frequently with extreme temperatures. With the increasing prevalence of DM and the rising global mean temperature, the number of heat-related AMI cases among DM patients may increase. This study compares excess risk of AMI during periods of extreme temperatures between patients with DM and without DM. METHODS Distributed lag nonlinear models (DLNMs) were used to estimate the short-term association between daily mean temperature and AMI admissions (International Classification of Diseases 9th revision [ICD-9] code: 410.00-410.99), stratified by DM status (ICD-9: 250.00-250.99), to all public hospitals in Hong Kong from 2002 to 2011, adjusting for other meteorological variables and air pollutants. Analyses were also stratified by season, age group, gender, and admission type (first admissions and readmissions). The admissions data and meteorological data were obtained from the Hong Kong Hospital Authority (HA) and the Hong Kong Observatory (HKO). FINDINGS A total of 53,769 AMI admissions were included in the study. AMI admissions among DM patients were linearly and negatively associated with temperature in the cold season (cumulative relative risk [cumRR] [95% confidence interval] in lag 0-22 days (12 °C versus 24 °C) = 2.10 [1.62-2.72]), while those among patients without DM only started increasing when temperatures dropped below 22 °C with a weaker association (cumRR = 1.43 [1.21-1.69]). In the hot season, AMI hospitalizations among DM patients started increasing when the temperature dropped below or rose above 28.8 °C (cumRR in lag 0-4 days [30.4 versus 28.8 °C] = 1.14 [1.00-1.31]), while those among patients without DM showed no association with temperature. The differences in sensitivity to temperature between patients with DM and without DM were most apparent in the group <75 years old and among first-admission cases in the cold season. The main limitation of this study was the unavailability of data on individual exposure to ambient temperature. CONCLUSIONS DM patients had a higher increased risk of AMI admissions than non-DM patients during extreme temperatures. AMI admissions risks among DM patients rise sharply in both high and low temperatures, with a stronger effect in low temperatures, while AMI risk among non-DM patients only increased mildly in low temperatures. Targeted health protection guidelines should be provided to warn DM patients and physicians about the dangers of extreme temperatures. Further studies to project the impacts of AMI risks on DM patients by climate change are warranted.
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Affiliation(s)
- Holly Ching Yu Lam
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - Juliana Chung Ngor Chan
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - Andrea On Yan Luk
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - Emily Ying Yang Chan
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR
- * E-mail:
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Ha S, Nguyen K, Liu D, Männistö T, Nobles C, Sherman S, Mendola P. Ambient temperature and risk of cardiovascular events at labor and delivery: A case-crossover study. ENVIRONMENTAL RESEARCH 2017; 159:622-628. [PMID: 28926807 PMCID: PMC5624535 DOI: 10.1016/j.envres.2017.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 09/06/2017] [Accepted: 09/09/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Extreme ambient temperatures are linked to cardiac events in the general population, but this relationship is unclear among pregnant women. We estimated the associations and attributable risk between ambient temperature and the risk of cardiovascular event at labor/delivery, and investigated whether these associations vary by maternal race/ethnicity. METHODS We identified 680 women with singleton deliveries affected by cardiovascular events across 12 US sites (2002-2008). Average daily temperature during the week before, delivery day, and each of the seven days before delivery was estimated for each woman. In a case-crossover analysis, exposures during these hazard periods were compared to two control periods before and after delivery using conditional logistic regression adjusted for other environmental factors. RESULTS During the cold season (October-April), 1°C lower during the week prior to delivery was associated with a 4% (95% CI: 1-7%) increased risk of having a labor/delivery affected by cardiovascular events including cardiac arrest and stroke. During the warm season (May-September), 1°C higher during the week prior was associated with a 7% (95% CI: 3-12%) increased risk. These risks translated to 13.4 and 23.9 excess events per 100,000 singleton deliveries during the cold and warm season, respectively. During the warm season, the risks were more pronounced on days closer to delivery and Black women appeared to be more susceptible to the same temperature increase. CONCLUSION Small changes in temperature appear to affect the risk of having cardiovascular events at labor/delivery. Black women had a differentially higher warm season risk. These findings merit further investigation.
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Affiliation(s)
- Sandie Ha
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA; School of Social Sciences, Humanties and Arts, University of California, Merced, CA, USA
| | - Kelly Nguyen
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA; San Diego State University, San Diego, CA, USA; Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Danping Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, NICHD, Rockville, MD, USA
| | - Tuija Männistö
- Northern Finland Laboratory Centre NordLab, Oulu, Finland; Department of Clinical Chemistry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; National Institute for Health and Welfare, Oulu, Finland
| | - Carrie Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA
| | | | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, NICHD, 6710B Rockledge Drive Room 3119, MSC 7004 Bethesda, Rockville, MD, USA.
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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: 111] [Impact Index Per Article: 13.9] [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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Mohammadi R, Khodakarim S, Alipour A, Bitaraf E, Soori H. Association between Air Temperature and Acute Myocardial Infarction Hospitalizations in Tehran, Iran: A Time-Stratified Case-Crossover. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:143-152. [PMID: 28689211 PMCID: PMC6679627 DOI: 10.15171/ijoem.2017.1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/18/2017] [Indexed: 11/24/2022]
Abstract
Background: Although the effect of temperature on the incidence of acute myocardial infarction (AMI) has been extensively documented, no study has previously investigated the association between temperature and AMI in the Middle Eastern countries. Objective: To examine the association between daily mean temperature and AMI admission rates in Tehran, Iran. Methods: Data on daily number of admissions of patients with AMI to Tehran hospitals between March 21, 2013 and March 19, 2016, were retrieved from the Iranian Myocardial Infarction Registry (IMIR). Over the same period, data on daily mean temperature and relative humidity were measured at Mehrabad International Airport weather station of the Islamic Republic of Iran Meteorological Organization. Time-stratified case-crossover design was employed to investigate the short-term association between the daily mean temperature and the number of daily admissions of patients with AMI, after adjusting for public holidays, relative humidity, and air pollution. Results: An interquartile range (IQR) increase in daily mean temperature was associated with 15.1% (95% CI 1.3 to 30.8%) and 13% (95% CI 1.9% to 25.4%) increase in the risk of AMI hospitalizations during the entire year, and in the warm months of the year, respectively. There were no significant associations between IQR increase in the two-day cumulative average up to the six-day cumulative average of the daily mean temperature and AMI during the entire year, and warm or cold months of the year. Conclusion: An increase in temperature would increase the rate of AMI hospitalization.
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Affiliation(s)
- Rasool Mohammadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Alipour
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Bitaraf
- IT Office, Ministry of Health & Medical Education, Tehran, Iran
| | - Hamid Soori
- Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Fisher JA, Jiang C, Soneja SI, Mitchell C, Puett RC, Sapkota A. Summertime extreme heat events and increased risk of acute myocardial infarction hospitalizations. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:276-280. [PMID: 28176761 DOI: 10.1038/jes.2016.83] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Abstract
Few studies have examined the association between exposure to extreme heat events and risk of acute myocardial infarction (AMI) or demonstrated which populations are most vulnerable to the effects of extreme heat. We defined extreme heat events as days when the daily maximum temperature (TMAX) exceeded the location- and calendar day-specific 95th percentile of the distribution of daily TMAX during the 30-year baseline period (1960-1989). We used a time-stratified case-crossover design to analyze the association between exposure to extreme heat events and risk of hospitalization for AMI in the summer months (June-August) with 0, 1, or 2 lag days. There were a total of 32,670 AMI hospitalizations during the summer months in Maryland between 2000 and 2012. Overall, extreme heat events on the day of hospitalization were associated with an increased risk of AMI (lag 0 OR=1.11; 95% CI: 1.05-1.17). Results considering lag periods immediately before hospitalization were comparable, but effect estimates varied among several population subgroups. As extreme weather events are expected to become more frequent and intense in response to our changing climate, community-specific adaptation strategies are needed to account for the differential susceptibility across ethnic subgroups and geographic areas.
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Affiliation(s)
- Jared A Fisher
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Sutyajeet I Soneja
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Clifford Mitchell
- Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USA
| | - Robin C Puett
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA
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Ogbomo AS, Gronlund CJ, O'Neill MS, Konen T, Cameron L, Wahl R. Vulnerability to extreme-heat-associated hospitalization in three counties in Michigan, USA, 2000-2009. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:833-843. [PMID: 27796569 PMCID: PMC5410403 DOI: 10.1007/s00484-016-1261-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 05/27/2023]
Abstract
With climate change, extreme heat (EH) events are increasing, so it is important to understand who is vulnerable to heat-associated morbidity. We determined the association between EH and hospitalizations for all natural causes; cardiovascular, respiratory, and renal diseases; diabetes mellitus; and acute myocardial infarction in Michigan, USA, at different intensities and durations. We assessed confounding by ozone and how individual characteristics and health insurance payer (a proxy for income) modified these associations. We obtained Michigan Inpatient Database, National Climatic Data Center, and US Environmental Protection Agency ozone data for May-September, 2000-2009 for three Michigan counties. We employed a case-crossover design and modeled EH as an indicator for temperature above the 95th, 97th, or 99th percentile thresholds for 1, 2, 3, or 4 days. We examined effect modification by patient age, race, sex, and health insurance payer and pooled the county results. Among non-whites, the pooled odds ratio for hospitalization on EH (97th percentile threshold) vs. non-EH days for renal diseases was 1.37 (95 % CI = 1.13-1.66), which increased with increasing EH intensity, but was null among whites (OR = 1.00, 95 % CI = 0.81, 1.25). We observed a null association between EH and cardiovascular hospitalization. EH (99th percentile threshold) was associated with myocardial infarction hospitalizations. Confounding by ozone was minimal. EH was associated with hospitalizations for renal disease among non-whites. This information on vulnerability to heat-associated morbidity helps characterize the public health burden of EH and target interventions including patient education.
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Affiliation(s)
- Adesuwa S Ogbomo
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Carina J Gronlund
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109,, USA.
| | - Marie S O'Neill
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109,, USA
| | - Tess Konen
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Lorraine Cameron
- Division of Environmental Health, Michigan Department of Health and Human Services, 333 South Grand Ave, Lansing, MI, 48913, USA
| | - Robert Wahl
- Lifecourse Epidemiology and Genomics Division, Michigan Department of Health and Human Services, 333 South Grand Ave, Lansing, MI, 48913, USA
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Ponjoan A, Blanch J, Alves-Cabratosa L, Martí-Lluch R, Comas-Cufí M, Parramon D, del Mar Garcia-Gil M, Ramos R, Petersen I. Effects of extreme temperatures on cardiovascular emergency hospitalizations in a Mediterranean region: a self-controlled case series study. Environ Health 2017; 16:32. [PMID: 28376798 PMCID: PMC5379535 DOI: 10.1186/s12940-017-0238-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/20/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Cold spells and heatwaves increase mortality. However little is known about the effect of heatwaves or cold spells on cardiovascular morbidity. This study aims to assess the effect of cold spells and heatwaves on cardiovascular diseases in a Mediterranean region (Catalonia, Southern Europe). METHODS We conducted a population-based retrospective study. Data were obtained from the System for the Development of Research in Primary Care and from the Catalan Meteorological Service. The outcome was first emergency hospitalizations due to coronary heart disease, stroke, or heart failure. Exposures were: cold spells; cold spells and 3 or 7 subsequent days; and heatwaves. Incidence rate ratios (IRR) and 95% confidence intervals were calculated using the self-controlled case series method. We accounted for age, time trends, and air pollutants; results were shown by age groups, gender or cardiovascular event type. RESULTS There were 22,611 cardiovascular hospitalizations in winter and 17,017 in summer between 2006 and 2013. The overall incidence of cardiovascular hospitalizations significantly increased during cold spells (IRR = 1.120; CI 95%: 1.10-1.30) and the effect was even stronger in the 7 days subsequent to the cold spell (IRR = 1.29; CI 95%: 1.22-1.36). Conversely, cardiovascular hospitalizations did not increase during heatwaves, neither in the overall nor in the stratified analysis. CONCLUSIONS Cold spells but not heatwaves, increased the incidence of emergency cardiovascular hospitalizations in Catalonia. The effect of cold spells was greater when including the 7 subsequent days. Such knowledge might be useful to develop strategies to reduce the impact of extreme temperature episodes on human health.
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Affiliation(s)
- Anna Ponjoan
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Girona Biomedical Research Institute (IDIBGi), c/ del Dr. Castany, s/n, Salt, Girona, 17190 Catalonia Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra Spain
| | - Jordi Blanch
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Lia Alves-Cabratosa
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Ruth Martí-Lluch
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Girona Biomedical Research Institute (IDIBGi), c/ del Dr. Castany, s/n, Salt, Girona, 17190 Catalonia Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Bellaterra Spain
| | - Marc Comas-Cufí
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Dídac Parramon
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Centre d’Atenció Primària Santa Clara, Gerència d’Àmbit d’Atenció Primària Girona, Institut Català de la Salut, Girona, Spain
| | - María del Mar Garcia-Gil
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
| | - Rafel Ramos
- Vascular Health Research Group (ISV-Girona), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), c/ Maluquer Salvador, 11 baixos, Girona, 17002 Catalonia Spain
- Department of Medical Sciences, School of Medicine, Campus Salut, University of Girona, Girona, Spain
| | - Irene Petersen
- Department of Primary Care and Population Health, University College of London, London, UK
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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Relationship between ambient temperature and frequency and severity of cardiovascular emergencies: A prospective observational study based on out-of-hospital care data. Int J Cardiol 2017; 228:553-557. [DOI: 10.1016/j.ijcard.2016.11.155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/06/2016] [Indexed: 11/21/2022]
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Basu R, May Wu X, Malig BJ, Broadwin R, Gold EB, Qi L, Derby C, Jackson EA, Green RS. Estimating the associations of apparent temperature and inflammatory, hemostatic, and lipid markers in a cohort of midlife women. ENVIRONMENTAL RESEARCH 2017; 152:322-327. [PMID: 27835857 PMCID: PMC5135618 DOI: 10.1016/j.envres.2016.10.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/29/2016] [Accepted: 10/21/2016] [Indexed: 05/04/2023]
Abstract
Associations between temperature and cardiovascular (CVD) mortality have been reported, but the underlying biological mechanisms remain uncertain. We explored the association between apparent temperature and serum biomarkers for CVD. Using linear mixed effects models, we examined the relationships between residence-proximate apparent temperature (same day and 1, 7, and 30 days prior) and several inflammatory, hemostatic, and lipid biomarkers for midlife women from 1999 through 2004. Our study population consisted of 2,306 women with mean age of 51 years (± 3 years) enrolled in Study of Women's Health Across the Nation (SWAN) in Chicago, Illinois; Detroit, Michigan; Los Angeles and Oakland, California; Newark, New Jersey; and Pittsburgh, Pennsylvania. Mean daily apparent temperature was calculated using temperature and relative humidity data provided by the National Climatic Data Center and the US Environmental Protection Agency, while daily data for fine particles, ozone, carbon monoxide, and nitrogen dioxide from the US Environmental Protection Agency Air Quality Data Mart were considered as confounders. All analyses were stratified by warm and cold seasons. More significant (p < 0.10) negative associations were found during the warm season for various lag times, including hs-CRP, fibrinogen, tissue plasminogen activator antigen (tPA-ag), tissue plasminogen activator antigen (PAI-1), Factor VIIc, high-density lipoprotein (HDL), and total cholesterol. During the cold season, significant negative associations for fibrinogen and HDL, but significant positive associations for tPA-ag, PAI-1, and triglycerides were observed for various lag times. With the exception of ozone, pollutants did not confound these associations. Apparent temperature was associated with several serum biomarkers of CVD risk in midlife women, shedding light on potential mechanisms.
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Affiliation(s)
- Rupa Basu
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Oakland, CA, USA.
| | - Xiangmei May Wu
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Oakland, CA, USA
| | - Brian J Malig
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Oakland, CA, USA
| | - Rachel Broadwin
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Oakland, CA, USA
| | - Ellen B Gold
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA
| | - Carol Derby
- Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Rochelle S Green
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Oakland, CA, USA
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Shiue I, Perkins DR, Bearman N. Hospital admissions of hypertension, angina, myocardial infarction and ischemic heart disease peaked at physiologically equivalent temperature 0°C in Germany in 2009-2011. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:298-306. [PMID: 26286805 DOI: 10.1007/s11356-015-5224-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/11/2015] [Indexed: 06/04/2023]
Abstract
We aimed to understand and to provide evidence on relationships of the weather as biometeorological and hospital admissions due to hypertension, angina, myocardial infarction and ischemic heart disease in a national setting in recent years that might help indicate when to expect more admissions for health professionals and the general public. This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I11 hypertensive heart disease, I13 hypertensive heart and renal disease, I15 secondary hypertension, I20 angina pectoris, I21 acute myocardial infarction and I25 chronic ischemic heart disease by International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations that covered 13 German States including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure were obtained and generated into physiologically equivalent temperature (PET). Two-way fractional-polynomial prediction was plotted with 95% confidence intervals. Hospital admissions of hypertension, angina, myocardial infarction, heart disease peaked in winter and early spring when PETs were around 0°C. Admissions had an apparent drop when PETs reached 10°C. More medical resources could have been needed on days when PETs were around 0°C than on other days. While adaptation to such weather change for health professionals and the general public would seem to be imperative, future research with a longitudinal monitoring would still be needed.
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Affiliation(s)
- Ivy Shiue
- Department of Healthcare, Northumbria University, Newcastle upon Tyne, England, NE7 7XA, UK.
- Owens Institute of Behavioral Research, University of Georgia, Athens, GA, USA.
| | - David R Perkins
- Department of Geography, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Nick Bearman
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
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Sadeghi M, Ahmadi A, Baradaran A, Masoudipoor N, Frouzandeh S. Modeling of the relationship between the environmental air pollution, clinical risk factors, and hospital mortality due to myocardial infarction in Isfahan, Iran. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2015; 20:757-62. [PMID: 26664423 PMCID: PMC4652309 DOI: 10.4103/1735-1995.168382] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: This study aimed to determine the relationship between the environmental factor, clinical risk factors, and individual variables with mortality due to acute myocardial infarction (MI) in Isfahan. Materials and Methods: This cross-sectional study was performed between April 2012 and March 2013. The data on the patients’ mortality due to MI in Isfahan were obtained from the MI National Registry. The international classification system (ICD10: I21-I22) was used to diagnose MI. The air quality indicators and environmental variables were used to measure the air pollution. Multilevel logistic regression in the Stata software was used to determine the factors associated with mortality in patients and odds ratios (ORs) were calculated. Results: Six hundred eleven patients with MI were studied during 1-year. 444 (72.2%) patients were male and the rest were female. 4.7% of the patients died due to MI. The mean age at MI incidence was 62.2 ± 13 years. Of the air pollution parameters, PM10 had the maximum mean concentration (49.113 ppm), followed by NOX, NO, NO2, CO, SO2, and O3. The adjusted OR of mortality was derived 2.07 (95% CI: 1.5-2.85) for right bundle branch block, 1.5 (95% CI: 1.3-1.7) for ST-segment elevation MI, 1.84 (95% CI: 1.13-3) for age, 1.06 (95% CI: 1.01-1.20) for CO, 1.1 (95% CI: 1.03-1.30) for O3, and 1.04 (95% CI: 1.01-1.4) for SO2, all of which were considered as the risk factors of mortality. However, OR of mortality was 0.79 for precipitation (95% CI: 0.74-0.84) and 0.52 for angioplasty (95% CI: 0.4-0.68) were considered as protective factors of mortality. The individual characteristics including age, history of MI in the immediate family, hypertension, and diabetes were significantly associated with mortality from MI. The indices of air pollution including SO2, CO, O3, and environmental factors such as the precipitation and temperature were the determinants of mortality in patients with MI. Conclusion: With regards to the factors associated with mortality from MI reported in this study, air pollution and environmental factors, in addition to the risk factors and predictive factors, should be particularly addressed to control the mortality from MI.
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Affiliation(s)
- Mehraban Sadeghi
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, School of Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Azar Baradaran
- Department of Clinical Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Neda Masoudipoor
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Soleiman Frouzandeh
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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30
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Kwon BY, Lee E, Lee S, Heo S, Jo K, Kim J, Park MS. Vulnerabilities to Temperature Effects on Acute Myocardial Infarction Hospital Admissions in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:14571-88. [PMID: 26580643 PMCID: PMC4661668 DOI: 10.3390/ijerph121114571] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 01/03/2023]
Abstract
Most previous studies have focused on the association between acute myocardial function (AMI) and temperature by gender and age. Recently, however, concern has also arisen about those most susceptible to the effects of temperature according to socioeconomic status (SES). The objective of this study was to determine the effect of heat and cold on hospital admissions for AMI by subpopulations (gender, age, living area, and individual SES) in South Korea. The Korea National Health Insurance (KNHI) database was used to examine the effect of heat and cold on hospital admissions for AMI during 2004-2012. We analyzed the increase in AMI hospital admissions both above and below a threshold temperature using Poisson generalized additive models (GAMs) for hot, cold, and warm weather. The Medicaid group, the lowest SES group, had a significantly higher RR of 1.37 (95% CI: 1.07-1.76) for heat and 1.11 (95% CI: 1.04-1.20) for cold among subgroups, while also showing distinctly higher risk curves than NHI for both hot and cold weather. In additions, females, older age group, and those living in urban areas had higher risks from hot and cold temperatures than males, younger age group, and those living in rural areas.
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Affiliation(s)
- Bo Yeon Kwon
- Department of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Eunil Lee
- Department of Preventive Medicine, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Suji Lee
- Department of Preventive Medicine, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Seulkee Heo
- Department of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Kyunghee Jo
- Graduate School of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Jinsun Kim
- Graduate School of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea.
| | - Man Sik Park
- Department of Statistics, College of Natural Science, Sungshin Women's University, 249-1, Dongseon-dong 3-ga, Seongbuk-gu, Seoul 02844, Korea.
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Liu C, Yavar Z, Sun Q. Cardiovascular response to thermoregulatory challenges. Am J Physiol Heart Circ Physiol 2015; 309:H1793-812. [PMID: 26432837 DOI: 10.1152/ajpheart.00199.2015] [Citation(s) in RCA: 206] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 09/28/2015] [Indexed: 01/05/2023]
Abstract
A growing number of extreme climate events are occurring in the setting of ongoing climate change, with an increase in both the intensity and frequency. It has been shown that ambient temperature challenges have a direct and highly varied impact on cardiovascular health. With a rapidly growing amount of literature on this issue, we aim to review the recent publications regarding the impact of cold and heat on human populations with regard to cardiovascular disease (CVD) mortality/morbidity while also examining lag effects, vulnerable subgroups, and relevant mechanisms. Although the relative risk of morbidity/mortality associated with extreme temperature varied greatly across different studies, both cold and hot temperatures were associated with a positive mean excess of cardiovascular deaths or hospital admissions. Cause-specific study of CVD morbidity/mortality indicated that the sensitivity to temperature was disease-specific, with different patterns for acute and chronic ischemic heart disease. Vulnerability to temperature-related mortality was associated with some characteristics of the populations, including sex, age, location, socioeconomic condition, and comorbidities such as cardiac diseases, kidney diseases, diabetes, and hypertension. Temperature-induced damage is thought to be related to enhanced sympathetic reactivity followed by activation of the sympathetic nervous system, renin-angiotensin system, as well as dehydration and a systemic inflammatory response. Future research should focus on multidisciplinary adaptation strategies that incorporate epidemiology, climatology, indoor/building environments, energy usage, labor legislative perfection, and human thermal comfort models. Studies on the underlying mechanism by which temperature challenge induces pathophysiological response and CVD await profound and lasting investigation.
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Affiliation(s)
- Cuiqing Liu
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou, China; and
| | - Zubin Yavar
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Qinghua Sun
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
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Luo C, Zhu X, Yao C, Hou L, Zhang J, Cao J, Wang A. Short-term exposure to particulate air pollution and risk of myocardial infarction: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:14651-62. [PMID: 26298338 DOI: 10.1007/s11356-015-5188-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 08/10/2015] [Indexed: 05/20/2023]
Abstract
A growing number of studies have associated short-term exposure to ambient particulate matter air pollution (PM) and risk of specific cardiovascular events, just as myocardial infarction (MI). However, the results of the recent studies were inconsistent; therefore, a systematic review and meta-analysis was performed. To synthetically quantify the association between short-term exposure to PM and risk of MI, a meta-analysis was conducted to combine the estimates of effect for a relationship between short-term exposure to PM10, PM2.5 (particulate matter ≤ 10 μm, 2.5 μm in diameter) and risk of MI. Electronic database searches for all relevant published studies were updated in January 2015. And, a random-effects model was performed to estimate pooled relative risk (RR) and 95 % confidence intervals (95 % CI). Thirty-one published observational epidemiological studies were identified. Risk of MI was significantly associated with per 10 μg/m(3) increment in PM10 (OR = 1.005; 95 % CI 1.001-1.008) and PM2.5 (OR = 1.022; 95 % CI 1.015-1.030). The risk of PM2.5 exposure was relatively greater than PM10. In the subgroup analysis by study design, location, quality score, and lag exposure, the results were basically consistent with the former overall results in PM2.5 but slightly changed in PM10. Short-term exposure to particulate matter (PM2.5, PM10) was a risk factor for MI, and the results further confirmed the discovery in the previous meta-analysis.
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Affiliation(s)
- Chunmiao Luo
- Department of Cardiology Medical, The Second People's Hospital of Hefei, Heping Road, Hefei, Anhui, China
| | - Xiaoxia Zhu
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Cijiang Yao
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Lijuan Hou
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Jian Zhang
- Department of Occupational and Environmental, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Jiyu Cao
- The Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Meishan Road, Hefei, Anhui, China
| | - Ailing Wang
- Department of Cardiology Medical, the First Affiliated Hospital of Anhui Medical University, Jixi Road, Hefei, Anhui, China.
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Wang X, Kindzierski W, Kaul P. Air Pollution and Acute Myocardial Infarction Hospital Admission in Alberta, Canada: A Three-Step Procedure Case-Crossover Study. PLoS One 2015; 10:e0132769. [PMID: 26167938 PMCID: PMC4500548 DOI: 10.1371/journal.pone.0132769] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 06/18/2015] [Indexed: 01/26/2023] Open
Abstract
Adverse associations between air pollution and myocardial infarction (MI) are widely reported in medical literature. However, inconsistency and sensitivity of the findings are still big concerns. An exploratory investigation was undertaken to examine associations between air pollutants and risk of acute MI (AMI) hospitalization in Alberta, Canada. A time stratified case-crossover design was used to assess the transient effect of five air pollutants (carbon monoxide (CO), nitrogen dioxide (NO2), nitric oxide (NO), ozone (O3) and particulate matter with an aerodynamic diameter ≤2.5 (PM2.5)) on the risk of AMI hospitalization over the period 1999–2009. Subgroups were predefined to see if any susceptible group of individuals existed. A three-step procedure, including univariate analysis, multivariate analysis, and bootstrap model averaging, was used. The multivariate analysis was used in an effort to address adjustment uncertainty; whereas the bootstrap technique was used as a way to account for regression model uncertainty. There were 25,894 AMI hospital admissions during the 11-year period. Estimating health effects that are properly adjusted for all possible confounding factors and accounting for model uncertainty are important for making interpretations of air pollution–health effect associations. The most robust findings included: (1) only 1-day lag NO2 concentrations (6-, 12- or 24-hour average), but not those of CO, NO, O3 or PM2.5, were associated with an elevated risk of AMI hospitalization; (2) evidence was suggested for an effect of elevated risk of hospitalization for NSTEMI (Non-ST Segment Elevation Myocardial Infarction), but not for STEMI (ST segment elevation myocardial infarction); and (3) susceptible subgroups included elders (age ≥65) and elders with hypertension. As this was only an exploratory study there is a need to replicate these findings with other methodologies and datasets.
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Affiliation(s)
- Xiaoming Wang
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Warren Kindzierski
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- * E-mail:
| | - Padma Kaul
- Canadian Vigour Centre, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Bai L, Woodward A, Chen B, Liu Q. Temperature, hospital admissions and emergency room visits in Lhasa, Tibet: a time-series analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 490:838-48. [PMID: 24907619 DOI: 10.1016/j.scitotenv.2014.05.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/30/2014] [Accepted: 05/06/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND Tibet of China, with an average altitude of over 4000 m, has experienced noticeable changes in its climate over the last 50 years. The association between temperature and morbidity (most commonly represented by hospital admissions) has been documented mainly in developed countries. Little is known about patterns in China; nor have the health effects of temperature variations been closely studied in highland areas, worldwide. OBJECTIVE We investigated the temperature-morbidity association in Lhasa, the capital city of Tibet, using sex- and age-specific hospitalizations, excluding those due to external causes. METHODS A distributed lag non-linear model (DLNM) was applied to assess the nonlinear and delayed effects of temperature on morbidity (including total emergency room visits, total and cause-specific hospital admissions, sex- and age-specific non-external admissions). RESULTS High temperatures are associated with increases in morbidity, to a greater extent than low temperatures. Lag effects of high and low temperatures were cause-specific. The relative risks (RR) of high temperature for total emergency room visits and non-external hospitalizations were 1.162 (95% CI: 1.002-1.349) and 1.161 (95% CI: 1.007-1.339) respectively, for lag 0-14 days. The strongest cumulative effect of heat for lag 0-27 days was on admissions for infectious diseases (RR: 2.067, 95% CI: 1.026-4.027). Acute heat effects at lag 0 were related with increases of renal (RR: 1.478, 95% CI: 1.005-2.174) and respiratory diseases (RR: 1.119, 95% CI: 1.010-1.240), whereas immediate cold effects increased admission for digestive diseases (RR: 1.132, 95% CI: 1.002-1.282). Those ≥65 years of age and males were more vulnerable to high temperatures. CONCLUSION We provide a first look at the temperature-morbidity relationship in Tibet. Exposure to both hot and cold temperatures resulted in increased admissions to hospital, but the immediate causes varied. We suggest that initiatives should be taken to reduce the adverse effects of temperature extremes in Tibet.
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Affiliation(s)
- Li Bai
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China.
| | - Alistair Woodward
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Bin Chen
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China.
| | - Qiyong Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China; Shandong University Climate Change and Health Center, 44 Wenhua Road, Jinan, Shangdong 250012, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, PR China.
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Wichmann J, Sjöberg K, Tang L, Haeger-Eugensson M, Rosengren A, Andersson EM, Barregard L, Sallsten G. The effect of secondary inorganic aerosols, soot and the geographical origin of air mass on acute myocardial infarction hospitalisations in Gothenburg, Sweden during 1985-2010: a case-crossover study. Environ Health 2014; 13:61. [PMID: 25069830 PMCID: PMC4131776 DOI: 10.1186/1476-069x-13-61] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 07/14/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND The relative importance of different sources of air pollution for cardiovascular disease is unclear. The aims were to compare the associations between acute myocardial infarction (AMI) hospitalisations in Gothenburg, Sweden and 1) the long-range transported (LRT) particle fraction, 2) the remaining particle fraction, 3) geographical air mass origin, and 4) influence of local dispersion during 1985-2010. METHODS A case-crossover design was applied using lag0 (the exposure the same day as hospitalisation), lag1 (exposure one day prior hospitalisation) and 2-day cumulative average exposure (CA2) (mean of lag0 and lag1). The LRT fractions included PMion (sum of sulphate, nitrate and ammonium) and soot measured at a rural site. The difference between urban PM10 (particulate matter with an aerodynamic diameter smaller than 10 μm) and rural PMion was a proxy for locally generated PM10 (PMrest). The daily geographical origin of air mass was estimated as well as days with limited or effective local dispersion. The entire year was considered, as well as warm and cold periods, and different time periods. RESULTS In total 28 215 AMI hospitalisations occurred during 26 years. PM10, PMion, PMrest and soot did not influence AMI for the entire year. In the cold period, the association was somewhat stronger for PMrest than for urban PM10; the strongest associations were observed during 1990-2000 between AMI and CA2 of PMrest (6.6% per inter-quartile range (IQR), 95% confidence interval 2.1 to 11.4%) and PM10 (4.1%, 95% CI 0.2% - 8.2%). Regarding the geographical air mass origins there were few associations. Days with limited local dispersion showed an association with AMI in the cold period of 2001-2010 (6.7%, 95% CI 0.0% - 13.0%). CONCLUSIONS In the cold period, locally generated PM and days with limited local dispersion affected AMI hospitalisations, indicating importance of local emissions from e.g. traffic.
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Affiliation(s)
- Janine Wichmann
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Medicinaregatan 16A, Gothenburg, Sweden
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Karin Sjöberg
- IVL Swedish Environmental Research Institute, Gothenburg, Sweden
| | - Lin Tang
- IVL Swedish Environmental Research Institute, Gothenburg, Sweden
| | | | - Annika Rosengren
- Department of Emergency and Cardiovascular Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Emergency and Cardiovascular Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva M Andersson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Medicinaregatan 16A, Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Medicinaregatan 16A, Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Medicinaregatan 16A, Gothenburg, Sweden
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Bai L, Woodward A, Liu Q. Temperature and mortality on the roof of the world: a time-series analysis in three Tibetan counties, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 485-486:41-48. [PMID: 24704955 DOI: 10.1016/j.scitotenv.2014.02.094] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 02/06/2014] [Accepted: 02/21/2014] [Indexed: 05/17/2023]
Abstract
BACKGROUND Tibet, with an average altitude of more than 4,000 meters, is warming faster than anywhere else in China. However, there have been no studies in Tibet of the relation between ambient temperature and mortality. METHODS We examined mean temperature and daily mortality in three Tibetan counties (Chengguan, Jiangzi and Naidong) using a distributed lag non-linear model (DLNM) based on 5,610 deaths that occurred in 2008-2012. We separately investigated hot and cold effects on non-accidental deaths, cardiovascular deaths, out-of-hospital deaths and vulnerability factors including age, sex and education. RESULTS In all three counties, the effect of heat tended to be immediate, while the impact of cold lasted longer. The effects were consistent but modest in size and not statistically significant except for cumulative cold effects in Jiangzi (lag=0-14, RR=2.251, 95% CI=1.054-4.849). Those who were more vulnerable to temperature extremes tended to be men, the elderly (over 65 years) and illiterate persons. We found stronger temperature effects on cardiovascular deaths than on all-cause mortality, and we also observed an increase in out-of-hospital mortality in one county. CONCLUSIONS This is the first study to investigate the temperature-mortality relationship in Tibet, and the findings may guide public health programs and other interventions to protect the population against extreme temperatures in a developing Tibet.
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Affiliation(s)
- Li Bai
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China.
| | - Alistair Woodward
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Qiyong Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China; Shandong University Climate Change and Health Center, 44 WenHua Road, JiNan, Shangdong 250012, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, PR China.
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Bailly V, Le Ray I, Bardonnaud N, Pillot P, Martin L, Pastori J, Balssa L, Guichard G, Bittard H, Kleinclauss F. [Meteo-U-rology: climate impact on urological emergencies]. Prog Urol 2014; 24:535-9. [PMID: 24975786 DOI: 10.1016/j.purol.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/10/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES The aim of this study was to analyze the weather influence on the onset of renal colic (RC), acute urinary retention (AUR) and testicular torsion (TT). MATERIALS AND METHODS We correlated the daily number of RC, AUR and TT cases admitted to our urology department and weather conditions between 2005 and 2009 on day-to-day basis. Eight hundred and seventy-six RC, 453 AUR and 50 TT were analyzed. Information on temperature, atmospheric pressure, relative humidity, vapor pressure, wind force, evapotranspiration and sunshine level were collected from the national meteorological office (Meteo-France) in Besançon, France. We performed a univariate and a multivariate Stepwise method in linear regression using Akaike Information Criterion. RESULTS We reported a statistically significant increased risk of renal colic at higher vapor pressure. Likewise, temperature seemed to be a risk factor for occurrence of renal colics. We determined an increased daily rate when maximal daily temperature rises above 20 Celsius degrees (P = 0.05). Furthermore, we observed a positive link between mean (P = 0.05) and minimal (P = 0.08) daily temperature and urolithiasis. Contrarywise AUR was more frequent when the mean temperature falls below zero Celsius degree. We also demonstrated a non-significant influence of temperature on TT, with 3 fold higher events during cold period. Much more mystic, we noted a higher AUR rate on new moon days, and fewer renal colic on full moon. CONCLUSIONS Further investigations are necessary to understand the mechanisms underlying the relationship between urologic diseases and climate. But our findings could help us justify healthy living messages.
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Affiliation(s)
- V Bailly
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - I Le Ray
- Inserm 803, centre d'investigation, clinique plurithématique, CHU de Dijon, 21000 Dijon, France
| | - N Bardonnaud
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - P Pillot
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - L Martin
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - J Pastori
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - L Balssa
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - G Guichard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - H Bittard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France
| | - F Kleinclauss
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, UFR SMP, 25000 Besançon, France; Inserm UMR 1098, 25000 Besançon, France.
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QIAN YUANYU, LIU JIE, MA JINLING, MENG QINGYI, PENG CHAOYING. Effect of initial temperature changes on myocardial enzyme levels and cardiac function in acute myocardial infarction. Exp Ther Med 2014; 8:243-247. [PMID: 24944629 PMCID: PMC4061241 DOI: 10.3892/etm.2014.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 01/30/2014] [Indexed: 11/15/2022] Open
Abstract
In the present study, the effect of initial body temperature changes on myocardial enzyme levels and cardiac function in acute myocardial infarction (AMI) patients was investigated. A total of 315 AMI patients were enrolled and the mean temperature was calculated based on their body temperature within 24 h of admission to hospital. The patients were divided into four groups according to their normal body temperature: Group A, <36.5°C; group B, ≥36.5°C and <37.0°C; group C, ≥37.0°C and <37.5°C and group D, ≥37.5°C. The levels of percutaneous coronary intervention, myocardial enzymes and troponin T (TNT), as well as cardiac ultrasound images, were analyzed. Statistically significant differences in the quantity of creatine kinase at 12 and 24 h following admission were identified between group A and groups C and D (P<0.01). A significant difference in TNT at 12 h following admission was observed between groups A and D (P<0.05), however, this difference was not observed with groups B and C. The difference in TNT between the groups at 24 h following admission was not statistically significant (P>0.05). Significant differences in lactate dehydrogenase at 12 and 24 h following admission were observed between groups A and D (P<0.05), however, differences were not observed with groups B and C (P>0.05). Significant differences in glutamic-oxaloacetic transaminase at 12 and 24 h following admission were observed between groups A and D (P<0.05), however, differences were not observed in groups B and C (P>0.05). However, no significant differences were identified in cardiac function index between all the groups. Therefore, the results of the present study indicated that AMI patients with low initial body temperatures exhibited decreased levels of myocardial enzymes and TNT. Thus, the observation of an initially low body temperature may be used as a protective factor for AMI and may improve the existing clinical program.
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The effects of heat stress and its effect modifiers on stroke hospitalizations in Allegheny County, Pennsylvania. Int Arch Occup Environ Health 2013; 87:557-65. [PMID: 23897226 DOI: 10.1007/s00420-013-0897-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 07/17/2013] [Indexed: 01/07/2023]
Abstract
PURPOSE Heat has been known to increase the risk of many health endpoints. However, few studies have examined its effects on stroke. The objective of this case-crossover study is to investigate the effects of high heat and its effect modifiers on the risk of stroke hospitalization in Allegheny County, Pennsylvania. METHODS We obtained data on first stroke hospitalizations among adults ages 65 and older and daily meteorological information during warm seasons (May-September) from 1994 to 2000 in Allegheny County, Pennsylvania. Using conditional multiple logistic regressions, the effects of heat days (any day with a temperature greater than the 95th percentile) and heat wave days (at least two continuous heat days) on the risk of stroke hospitalization were investigated. The potential interactions between high heat and age, type of stroke, and gender were also examined. RESULTS Heat day and heat wave at lag-2 day were significantly associated with an increased risk for stroke hospitalization (OR 1.121, 95 % CI 1.013-1.242; OR 1.173, 95 % CI 1.047-1.315, respectively) after adjusting for important covariates. In addition, having two or more heat wave days within the 4 day window prior to the event was also significantly associated with an increased risk (OR 1.119, 95 % CI 1.004, 1.246) compared to having no heat wave days during the period. The effect of high heat on stroke was more significant for ischemic stroke, men, and subjects ages 80 years or older. CONCLUSIONS Our study suggests that high heat may have adverse effects on stroke and that some subgroups may be particularly susceptible to heat.
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