Cold spell and mortality in 31 Chinese capital cities: Definitions, vulnerability and implications

Chen, Jin-Jian; Yang, Jun; Zhou, Maigeng; Yin, Peng; Wang, Boguang; Liu, Jiangmei; Chen, Zhaoyue; Song, Xiaofeng; Chen, Ou; Liu, Qiyong

doi:10.1016/j.envint.2019.04.049

Cited by 103 publications

(104 citation statements)

References 41 publications

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“…In terms of gender, we found similar impacts of cold spells among male and female patients, which corresponds with previous studies. 4 12 43 Our study has significant public health implications for local prevention of AECOPD, development of early warning systems and rational allocation of medical and health resources to mitigate the COPD burden caused by cold spells. We showed substantial effects of cold spells on the risk of AECOPD hospitalisations with a lagged effect of about 3 weeks, urging for effective and practical guidelines for preventions, particularly for patients with COPD during cold spells in China.…”

Section: Discussionmentioning

confidence: 97%

“…This finding is consistent with previous studies. 4 12 43 The reasons may point to reduced thermoregulatory ability, higher prevalence of chronic diseases 20 34 and impaired immunity 44 in the elderly. Note that ageing is one of the risk factors of COPD, and most patients in our study were over 64, giving more power to achieve statistical significance.…”

Section: Discussionmentioning

confidence: 99%

“…2 3 Over the last few years, the impacts of cold spells on human health have gained growing attention from the public. Many studies have reported positive relationships between cold spells and mortality, [4][5][6] while the impacts of cold spells on hospital visits or admissions are underexamined.…”

Section: Introductionmentioning

confidence: 99%

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Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China

et al. 2021

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ObjectivesOur work aimed at exploring the relationship between cold spells and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalisations in Beijing, China, and assessing the moderating effects of the intensities and the durations of cold spells, as well as identifying the vulnerable.DesignA time-series study.SettingWe obtained time-series data of AECOPD hospitalisations, meteorological variables and air quality index in Beijing, China during 2012–2016.ParticipantsAll AECOPD hospitalisations among permanent residents in Beijing, China during the cold seasons (November–March) of 2012–2016 were included (n=84 571).Primary and secondary outcome measuresA quasi-Poisson regression with a distributed lag model was fitted to investigate the short-term effects of cold spells on AECOPD hospitalisations by comparing the counts of AECOPD admissions during cold spell days with those during non-cold spell days.ResultsCold spells under different definitions were associated with increased risk of AECOPD hospitalisations, with the maximum cumulative relative risk (CRR) over 3 weeks (lag0–21). The cumulative effects at lag0–21 increased with the intensities and the durations of cold spells. Under the optimal definition, the most significant single-day relative risk (RR) was found on the days of cold spells (lag0) with an RR of 1.042 (95% CI 1.013 to 1.072), and the CRR at lag0–21 was 1.394 (95% CI 1.193 to 1.630). The elderly (aged ≥65) were more vulnerable to the effects of cold spells on AECOPD hospitalisations.ConclusionCold spells are associated with increased AECOPD hospitalisations in Beijing, with the cumulative effects increased with intensities and durations. The elderly are at particular risk of AECOPD hospitalisations triggered by cold spells.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China

et al. 2021

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“…where E 1 and E 2 are the estimates, ln(RR 1 ) and ln(RR 2 ), for the two subgroups; SE(E 1 ) and SE(E 2 ) are corresponding standard errors of E 1 and E 2 . 36 Sensitivity analyses were conducted by using 28-day maximum lag of temperature, 5 df for daily mean temperature, 8 df per year for time trend, and not control for relative humidity in the main model, respectively. In addition, the model included the linear terms of daily PM 2.5 , NO 2 , and SO 2 concentrations individually to explore the confounding effect of air pollutants.…”

Section: Discussionmentioning

confidence: 99%

<p>Temperature Variability and Hospital Admissions for Chronic Obstructive Pulmonary Disease: Analysis of Attributable Disease Burden and Vulnerable Subpopulation</p>

Zhan¹,

Tian²,

Chen³

et al. 2020

COPD

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Chronic obstructive pulmonary disease (COPD) is a major cause of chronic diseases causing considerable social and economic burden globally. Despite substantial evidence on temperature-COPD association, few studies have investigated the acute effect of temperature variability (TV), a potential trigger of exacerbation of COPD disease, and it remains unknown what fraction of the disease burden of COPD is attributable to TV. Patients and Methods: Based on 71,070 COPD hospitalizations during 2013-2015 in Guangzhou, China, we conducted a time-series analysis using quasi-Poisson regression to assess the association between TV and hospital admission for COPD after adjusting for daily mean temperature. Short-term TV was captured by the standard deviation of hourly or daily temperatures across various exposure days. We also provided the fraction (total number) of COPD attributable to TV. Stratified analyses by admission route, sex, age, occupation, marital status and season were performed to identify vulnerable subpopulations. Results: We found a linear relationship between TV and COPD hospitalization, with a 1° C increase in hourly TV and daily TV associated with 4.3% (95%CI: 2.2-6.4) and 4.0% (2.3-5.8) increases in COPD, respectively. The greater relative risks of TV identified males, people aged 0-64 years, blue collar, and divorced/widowed people as vulnerable population. There were 12.0% (8500 cases) of COPD hospitalization attributable to hourly TV during the study period. Daily TV produced similar estimates of relative effects (relative risk) but grater estimates of absolute effects (attributable fraction) than hourly TV. Conclusion: We concluded that TV was an independent risk factor of COPD morbidity, especially among the susceptible subgroups. These findings would be helpful to guide the development of targeted public intervention.

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“…Populations in this region are poorly acclimatized to cold weather and so not well prepared to endure severe cold surges. The Elderly population is especially vulnerable to long persistent cold surges (Chen et al., 2019). Adaptation measures at household and community levels to such cold events are poor with, for example, a lack of efficient heater and poor insulation, especially in old buildings, which may amplify the vulnerability of the population (Wang et al., 2016).…”

Section: Introductionmentioning

confidence: 99%

Widespread Persistent Extreme Cold Events Over South‐East China: Mechanisms, Trends, and Attribution

et al. 2020

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Winter widespread persistent extreme cold events (WiPECEs) have important socioeconomic impacts in China (Peng & Bueh, 2011). In the past few decades, these events have caused great destruction to health, agriculture, and social amenities (Peng & Bueh, 2011; Zhang & Qian, 2011; Qian et al., 2017). For example, the 2008 and 2016 cold surges in eastern China caused heavy freezing rain and icy conditions that led to power outage in many regions as a result of damaged electricity transmission lines (Sun & Zhao, 2010). The impact of extreme cold events on winter wheat yields is also significant (Powell & Reinhard, 2016). Health impacts of cold temperatures are well known (Chen et al., 2017; Luo et al., 2018; Ma et al., 2013). Wu et al. (2013) showed, for four subtropical cities in China, that longer exposure to cold events had larger impact than similar duration hot events. A case study for Shanghai from Ma et al. (2011) indicated that during a cold spell hospital admission related to cardiovascular and respiratory problems increased by 32%-38%, versus an increase of 2%-8% during a similar duration heat wave. Chen et al. (2017) found an association between extreme low temperature and hemorrhagic stroke admission. Cold effects are also linked to a significant increase of patients with fracture (Du et al., 2013). A large part of the research community has focused much attention on the variability and spatial distributions of trends in extreme hot temperature events in China as a result on the ongoing anthropogenic warming, while less effort have been devoted to widespread persistent extreme cold temperature events (Qian et al., 2017; Zhou et al., 2009). Most of these studies and the references therein focused on case studies without reference to the climatology of such events. Although Peng and Bueh (2011) examined the extensive and persistent extreme cold events for the period 1951-2009, these authors only used a station observational dataset and did not examine the large-scale circulation features of their classified extreme cold events. Recently, Liao et al. (2020) highlighted the different dynamical configuration for the events of 2008 and 2016. Zuo et al. (2015) also indicated that cold surges were more likely to be persistent during February. The recently released European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis version 5 (ERA5, Hersbach, 2018) data set opens a further opportunity to examine WiPECE over China. In addition, the sixth phase of the Coupled Model Intercomparison Project (CMIP6) also provides updated climate

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Cold spell and mortality in 31 Chinese capital cities: Definitions, vulnerability and implications

Cited by 103 publications

References 41 publications

Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China

Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China

<p>Temperature Variability and Hospital Admissions for Chronic Obstructive Pulmonary Disease: Analysis of Attributable Disease Burden and Vulnerable Subpopulation</p>

Widespread Persistent Extreme Cold Events Over South‐East China: Mechanisms, Trends, and Attribution

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