Skip to main content
SpringerLink
Log in

Cold Spells and the Risk of Hospitalization for Asthma: New York, USA 1991–2006

  • Published:
Lung Aims and scope Submit manuscript

Abstract

Purpose

A study was conducted to investigate whether prolonged periods of very cold temperatures were associated with an increased risk of hospitalization for asthma.

Methods

Hospitalization admissions with a principal diagnosis of asthma were identified in New York State, USA, for the months November through April from 1991 to 2006. A cold spell was defined as three or more consecutive days where the daily mean of universal apparent temperature (UAT) within a week prior to admission was at the 10th percentile or less. The percentage change in asthma hospitalizations during and after a cold spell was compared to the average daily number of hospitalizations preceding the cold spell using time series analysis.

Results

The average temperature during winter cold spells (December through March) was −15 °C, compared to −6 and −2 °C for cold spells in November and April, respectively. Cold spells during the winter months were associated with a mean decline of 4.9 % in asthma admissions statewide (95 % CI −7.8, −1.9 %). After a cold spell, no statistically significant changes were apparent during the winter months, but asthma hospitalizations increased after cold spells in the transitional months of November (mean = 9.6, 95 % CI 5.5, 13.9 %) and April (mean = 5.0, 95 % CI 1.2, 9.0 %).

Conclusions

The results suggest that during prolonged periods of severe cold asthmatics may adhere to medical guidelines and limit their exposure, thereby preventing exacerbations. They may be less likely to alter their behavior in the more moderate months of November and April.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Estes TS (2011) Moving towards effective chronic illness management: asthma as an exemplar. Chron Respir Dis 8(3):163–170. doi:10.1177/1479972311412251

    Article  PubMed  Google Scholar 

  2. New York State Department of Health (NYSDOH) (2009) New York State Asthma Surveillance Summary Report. NYSDOH Public Health Information Group, Center for Community Health, Albany

    Google Scholar 

  3. Koenig JQ (1999) Air pollution and asthma. J Allergy Clin Immunol 104(4):717–722. doi:10.1016/S0091-6749(99)70280-0

    Article  CAS  PubMed  Google Scholar 

  4. Patel MM, Miller RL (2009) Air pollution and childhood asthma: recent advances and future directions. Curr Opin Pediatr 21(2):235–242. doi:10.1097/MOP.0b013e3283267726

    Article  PubMed Central  PubMed  Google Scholar 

  5. Wong GW, Lai CK (2004) Outdoor air pollution and asthma. Curr Opin Pulm Med 10(1):62–66

    Article  CAS  PubMed  Google Scholar 

  6. Hales S, Lewis S, Slater T, Crane J, Pearce N (1998) Prevalence of adult asthma symptoms in relation to climate in New Zealand. Environ Health Perspect 106(9):607–610

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Lin S, Luo M, Walker RJ, Liu X, Hwang SA, Chinery R (2009) Extreme high temperatures and hospital admissions for respiratory and cardiovascular diseases. Epidemiology 20(5):738–746. doi:10.1097/EDE.0b013e3181ad5522

    Article  PubMed  Google Scholar 

  8. Abe T, Tokuda Y, Ohde S, Ishimatsu S, Nakamura T, Birrer RB (2009) The relationship of short-term air pollution and weather to ED visits for asthma in Japan. Am J Emerg Med 27(2):153–159. doi:10.1016/j.ajem.2008.01.013

    Article  PubMed  Google Scholar 

  9. Gosai A, Salinger J, Dirks K (2009) Climate and respiratory disease in Auckland, New Zealand. Aust N Z J Public Health 33(3):521–526. doi:10.1111/j.1753-6405.2009.00447.x

    Article  PubMed  Google Scholar 

  10. Kim S, Kim Y, Lee MR, Kim J, Jung A, Park JS, Jang AS, Park SW, Uh ST, Choi JS, Kim YH, Buckley T, Park CS (2012) Winter season temperature drops and sulfur dioxide levels affect on exacerbation of refractory asthma in South Korea: a time-trend controlled case-crossover study using soonchunhyang asthma cohort data. J Asthma 49(7):679–687. doi:10.3109/02770903.2012.702839

    Article  CAS  PubMed  Google Scholar 

  11. Pönkä A (1991) Asthma and low level air pollution in Helsinki. Arch Environ Health 46(5):262–270

    Article  PubMed  Google Scholar 

  12. Steadman RG (1984) A universal scale of apparent temperature. J Climate Appl Meteorol 23(12):1674–1687

    Article  Google Scholar 

  13. Kysely J, Pokorna L, Kyncl J, Kriz B (2009) Excess cardiovascular mortality associated with cold spells in the Czech Republic. BMC Public Health 9:19. doi:10.1186/1471-2458-9-19

    Article  PubMed Central  PubMed  Google Scholar 

  14. Chinery R, Walker R (2009) Development of Exposure Characterization Regions for Priority Ambient Air Pollutants. Hum Ecol Risk Assess 15(5):876–889. doi:10.1080/10807030903152842

    Article  CAS  Google Scholar 

  15. Environmental Protection Agency (2013) Ground Level Ozone. http://www.epa.gov/airquality/ozonepollution. Accessed 12-2-2013

  16. Gu C (2002) Smoothing Spline ANOVA Models. Springer, New York

    Book  Google Scholar 

  17. Guo Y, Jiang F, Peng L, Zhang J, Geng F, Xu J, Zhen C, Shen X, Tong S (2012) The association between cold spells and pediatric outpatient visits for asthma in Shanghai. China. PLoS One 7(7):e42232. doi:10.1371/journal.pone.0042232

    Article  CAS  PubMed  Google Scholar 

  18. Kaminsky DA, Bates JH, Irvin CG (2000) Effects of cool, dry air stimulation on peripheral lung mechanics in asthma. Am J Respir Crit Care Med 162(1):179–186

    Article  CAS  PubMed  Google Scholar 

  19. Koskela HO (2007) Cold air-provoked respiratory symptoms: the mechanisms and management. Int J Circumpolar Health 66(2):91–100. doi:10.3402/ijch.v66i2.18237

    Article  PubMed  Google Scholar 

  20. Li M, Li Q, Yang G, Kolosov VP, Perelman JM, Zhou XD (2011) Cold temperature induces mucin hypersecretion from normal human bronchial epithelial cells in vitro through a transient receptor potential melastatin 8 (TRPM8)-mediated mechanism. J Allergy Clin Immunol 128(3):626–634. doi:10.1016/j.jaci.2011.04.032

    Article  CAS  PubMed  Google Scholar 

  21. Butcher JD (2006) Exercise-induced asthma in the competitive cold weather athlete. Curr Sports Med Rep 5(6):284–288. doi:10.1097/01.CSMR.0000306431.39285.0b

    Article  PubMed  Google Scholar 

  22. Carlsen KH (2012) Sports in extreme conditions: the impact of exercise in cold temperatures on asthma and bronchial hyper-responsiveness in athletes. Br J Sports Med 46(11):796–799. doi:10.1136/bjsports-2012-091292

    Article  PubMed  Google Scholar 

  23. Uçok K, Dane S, Gökbel H, Akar S (2004) Prevalence of exercise-induced bronchospasm in long distance runners trained in cold weather. Lung 182(5):265–270. doi:10.1007/s00408-004-2503-6

    Article  PubMed  Google Scholar 

  24. Busse WW, Lemanske RF Jr (2007) Expert Panel Report 3: moving forward to improve asthma care. J Allergy Clin Immunol 120(5):1012–1014. doi:10.1016/j.jaci.2007.09.016

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by Grant # 5U01EH000396 from the National Center for Environmental Health, Centers for Disease Control and Prevention (CDCP), Atlanta, Georgia, USA. The content is solely the responsibility of the authors and does not necessarily represent the official view of CDCP.

Conflict of interest

The authors declare that they have no actual or potential conflicts of interest.

Ethical Standards

The study was approved for human subjects protection by the Institutional Review Board of the New York State Department of Health, Albany, NY, USA, and adheres to all current laws of the USA.

Author information

Authors and Affiliations

  1. Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA

    Edward F. Fitzgerald & Shao Lin

  2. Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Empire State Plaza, Corning Tower, Room 1143, Albany, NY, 12237, USA

    Cristian Pantea & Shao Lin

Authors
  1. Edward F. Fitzgerald
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristian Pantea
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shao Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edward F. Fitzgerald.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fitzgerald, E.F., Pantea, C. & Lin, S. Cold Spells and the Risk of Hospitalization for Asthma: New York, USA 1991–2006. Lung 192, 947–954 (2014). https://doi.org/10.1007/s00408-014-9645-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-014-9645-y

Keywords

Search

Navigation