Temperature effects on outpatient visits of respiratory diseases, asthma, and chronic airway obstruction in Taiwan

Abstract

This study evaluated the risk of outpatient visits for respiratory diseases, asthma, and chronic airway obstruction not elsewhere classified (CAO) associated with ambient temperatures and extreme temperature events from 2000 to 2008 in Taiwan. Based on geographical and socioeconomics characteristics, this study divided the whole island into seven areas. A distributed lag non-linear model was used to estimate the area-disease-specific cumulative relative risk (RR), and random-effect meta-analysis was used to estimate the pooled RR of outpatient visits, from lag 0 to lag 7 days, associated with daily temperature, and added effects of prolonged extreme heat and cold for population of all ages, the elderly and younger than 65 years. Pooled analyses showed that younger population had higher outpatient visits for exposing to low temperature of 18 °C, with cumulative 8-day RRs of 1.36 (95% confidence interval (CI) 1.31-1.42) for respiratory diseases, 1.10 (95% CI 1.03-1.18) for asthma, and 1.12 (95% CI 1.02-1.22) for CAO. The elderly was more vulnerable to high temperature of 30 °C with the cumulative 8-day RR of 1.08 (95% CI 1.03-1.13) for CAO. Elevated outpatient visits for all respiratory diseases and asthma were associated with extreme heat lasting for 6 to 8 days. On the contrary, the extreme cold lasting more than 8 days had significant negative association with outpatient visits of all respiratory diseases. In summary, elderly patients of respiratory diseases and CAO are vulnerable to high temperature. Cold temperature is associated with all types of respiratory diseases for younger patients.

The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study

“…This is consistent with the results of previous studies from Taiwan and Japan that stronger associations were found between ambient temperatures and asthma admissions among adults compared with the elderly (age >65 years) and children (age <15 years), respectively 8 16. Although the Korean study reported a stronger association between asthma admissions and low temperatures among children (<15) than in the older age groups,5 the study did not compare associations between young children (<5) and older children (5–14).…”

“…The nature of associations reported from past studies of asthma morbidity and temperatures have not been consistent, likely due to differences in climate, study design and statistical methodology. Some studies have found positive associations between temperatures and asthma admissions,23 24 some have reported negative associations,2 5 7 8 16 19 25 26 while a few have reported significant associations with high and low temperatures 6 27. The seasonal differences in associations of RH with asthma hospitalisations observed in this study, negative association in the cold season and positive in the hot season, have not been commonly reported in previous studies.…”

“…Thus age is a possible effect modifier of the asthma–temperature association. Several studies have reported on associations in different age groups 5 8 16. However, only one study from Korea compared associations among children, adults and the elderly from the same population,5 and reported a higher risk for children under 15 than for adults or the elderly at low temperatures, but did not report on differences between age groups for other environmental variables.…”

“…However, only one study from Korea compared associations among children, adults and the elderly from the same population,5 and reported a higher risk for children under 15 than for adults or the elderly at low temperatures, but did not report on differences between age groups for other environmental variables. Other studies have only compared the associations between either children and adults,16 or the elderly and non-elderly 8…”

<p>Effects of Ambient Temperature on Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Results from a Time-Series Analysis of 143318 Hospitalizations</p>

“…[11][12][13] However, research conducted in Taiwan from 2000 to 2008 has reported a U-shaped association. 14 Furthermore, previous studies on temperature and COPD have been conducted mostly in the developed regions rather than the developing ones. Therefore, high-quality evidence and large population-based study from China are certainly lacking.…”