Abstract
Cardiovascular disease (CVD) has become a severe public health and social issue in China. However, in northwest China, evidence on the association between ambient temperature and CVD hospitalisations in suburban farmers is somewhat limited. We collected CVD hospitalisations and meteorological data (2012–2015) in Zhangye suburbs and assessed the temperature-related risk and burden of admission by fitting a distributed lag nonlinear model to probe the relationship between ambient temperature and CVD hospitalisations among farmers in suburban northwest China. The results show that 23,921 cases of CVD admissions were recorded from 2012 to 2015. There was a “U-shaped” association between temperature and hospitalisations. Compared with the minimum admissions temperature (MAT) at 15.3 °C, the cumulative relative risk (RR) over lag 0–21 days was 1.369 (95% CI 0.980–1.911) for extreme cold temperature (1st percentile, –15 °C), 1.353 (95% CI 1.063–1.720) for moderate cold (5th percentile, –11 °C), 1.415 (95% CI 1.117–1.792) for extreme heat (99th percentile, 26 °C), and 1.241 (95% CI 1.053–1.464) for moderate heat (95th percentile, 24 °C). Female farmers were more susceptible to low and high temperatures than male farmers. Farmers aged ≥ 65 years old were more sensitive to low temperatures, while farmers aged < 65 years old were more sensitive to high temperatures. A total of 13.4% (3,208 cases) of the hospitalisation burden for CVD were attributed to temperature exposure, with the moderate range of temperatures accounting for the most significant proportion (12.2%). Ambient temperature, primarily moderate temperatures, might be an essential factor for cardiovascular-related hospitalisations among farmers in suburban northwest China.
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References
An R, Ji M, Zhang S (2018) Global warming and obesity: a systematic review. Obes Rev 19(2):150–163. https://doi.org/10.1111/obr.12624
Bai L, Li Q, Wang J, Lavigne E, Gasparrini A, Copes R, Yagouti A, Burnett RT, Goldberg MS, Cakmak S, Chen H (2018) Increased coronary heart disease and stroke hospitalisations from ambient temperatures in Ontario. Heart 104(8):673. https://doi.org/10.1136/heartjnl-2017-311821
Chen R, Yin P, Meng X, Liu C, Wang L, Xu X, Ross JA, Tse LA, Zhao Z, Kan H, Zhou M (2017) Fine particulate air pollution and daily mortality. A nationwide analysis in 272 Chinese cities. Am J Respir Crit Care Med 196(1):73–81. https://doi.org/10.1164/rccm.201609-1862OC
Cheng X, Su H (2010) Effects of climatic temperature stress on cardiovascular diseases. Eur J Intern Med 21(3):164–167. https://doi.org/10.1016/j.ejim.2010.03.001
Cui L, Geng X, Ding T, Tang J, Xu J, Zhai J (2019) Impact of ambient temperature on hospital admissions for cardiovascular disease in Hefei City China. Int J Biometeorol 63(6):723–734. https://doi.org/10.1007/s00484-019-01687-0
Dagenais GR, Leong DP, Rangarajan S, Lanas F, Lopez-Jaramillo P, Gupta R, Diaz R, Avezum A, Oliveira GBF, Wielgosz A, Parambath SR, Mony P, Alhabib KF, Temizhan A, Ismail N, Chifamba J, Yeates K, Khatib R, Rahman O, Zatonska K, Kazmi K, Wei L, Zhu J, Rosengren A, Vijayakumar K, Kaur M, Mohan V, Yusufali A, Kelishadi R, Teo KK, Joseph P, Yusuf S (2020) Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): a prospective cohort study. Lancet 395(10226):785–794. https://doi.org/10.1016/S0140-6736(19)32007-0
Di Cesare M, Bennett JE, Best N, Stevens GA, Danaei G, Ezzati M (2013) The contributions of risk factor trends to cardiometabolic mortality decline in 26 industrialized countries. Int J Epidemiol 42(3):838–848. https://doi.org/10.1093/ije/dyt063
Doherty RM, Heal MR, O’Connor FM (2017) Climate change impacts on human health over Europe through its effect on air quality. Environ Health 16(1):118. https://doi.org/10.1186/s12940-017-0325-2
Gasparrini A, Armstrong B (2010) Time series analysis on the health effects of temperature: advancements and limitations. Environ Res 110(6):633–638. https://doi.org/10.1016/j.envres.2010.06.005
Gasparrini A, Leone M (2014) Attributable risk from distributed lag models. BMC Med Res Methodol 14(1):55. https://doi.org/10.1186/1471-2288-14-55
Gasparrini A, Guo Y, Hashizume M, Lavigne E, Zanobetti A, Schwartz J, Tobias A, Tong S, Rocklöv J, Forsberg B, Leone M, De Sario M, Bell ML, Guo Y-LL, Wu C-f, Kan H, Yi S-M, De Sousa ZanottiStagliorio Coelho M, Saldiva PHN, Honda Y, Kim H, Armstrong B (2015) Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Lancet 386(9991):369–375. https://doi.org/10.1016/S0140-6736(14)62114-0
Goggins WB, Chan EYY (2017) A study of the short-term associations between hospital admissions and mortality from heart failure and meteorological variables in Hong Kong: weather and heart failure in Hong Kong. Int J Cardiol 228:537–542. https://doi.org/10.1016/j.ijcard.2016.11.106
Goggins WB, Chan EYY, Yang C-Y (2013) Weather, pollution, and acute myocardial infarction in Hong Kong and Taiwan. Int J Cardiol 168(1):243–249. https://doi.org/10.1016/j.ijcard.2012.09.087
Gronlund CJ, Zanobetti A, Schwartz JD, Wellenius GA, O’Neill MS (2014) Heat, heat waves, and hospital admissions among the elderly in the United States, 1992–2006. Environ Health Perspect 122(11):1187–1192. https://doi.org/10.1289/ehp.1206132
Guo Y, Barnett Adrian G, Pan X, Yu W, Tong S (2011) The impact of temperature on mortality in Tianjin, China: a case-crossover design with a distributed lag nonlinear model. Environ Health Perspect 119(12):1719–1725. https://doi.org/10.1289/ehp.1103598
Guo Y, Punnasiri K, Tong S (2012) Effects of temperature on mortality in Chiang Mai city, Thailand: a time series study. Environ Health 11(1):36. https://doi.org/10.1186/1476-069X-11-36
Hurtado-Díaz M, Cruz JC, Texcalac-Sangrador JL, Félix-Arellano EE, Gutiérrez-Ávila I, Briseño-Pérez AA, Saavedra-Lara N, Tobías A, Riojas-Rodríguez H (2019) Short-term effects of ambient temperature on non-external and cardiovascular mortality among older adults of metropolitan areas of Mexico. Int J Biometeorol 63(12):1641–1650. https://doi.org/10.1007/s00484-019-01778-y
Kampmann B, Bröde P, Fiala D (2012) Physiological responses to temperature and humidity compared to the assessment by UTCI. WGBT and PHS Int J Biometeorol 56(3):505–513. https://doi.org/10.1007/s00484-011-0410-0
Keatinge W, Coleshaw S, Easton J, Cotter F, Mattock M, Chelliah R (1986) Increased platelet and red cell counts blood viscosity and plasma cholesterol levels during heat stress and mortality from coronary and cerebral thrombosis. Am JMed 81(5):795–800. https://doi.org/10.1016/0002-9343(86)90348-7
Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R (1984) Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: factors in mortality from coronary and cerebral thrombosis in winter. Br Med J (clin Res Ed) 289(6456):1405–1408. https://doi.org/10.1136/bmj.289.6456.1405
Liu X, Kong D, Fu J, Zhang Y, Liu Y, Zhao Y, Lian H, Zhao X, Yang J, Fan Z (2018) Association between extreme temperature and acute myocardial infarction hospital admissions in Beijing, China: 2013–2016. PLoS ONE 13(10):e0204706–e0204706. https://doi.org/10.1371/journal.pone.0204706
Luo K, Li R, Wang Z, Zhang R, Xu Q (2017) Effect modification of the association between temperature variability and daily cardiovascular mortality by air pollutants in three Chinese cities. Environ Pollut 230:989–999. https://doi.org/10.1016/j.envpol.2017.07.045
Luo Y, Li H, Huang F, Van Halm-Lutterodt N, Qin X, Wang A, Guo J, Tao L, Li X, Liu M, Zheng D, Chen S, Zhang F, Yang X, Tan P, Wang W, Xie X, Guo X (2018) The cold effect of ambient temperature on ischemic and hemorrhagic stroke hospital admissions: a large database study in Beijing, China between years 2013 and 2014—utilizing a distributed lag non-linear analysis. Environ Pollut 232:90–96. https://doi.org/10.1016/j.envpol.2017.09.021
Ma W, Chen R, Kan H (2014) Temperature-related mortality in 17 large Chinese cities: how heat and cold affect mortality in China. Environ Res 134:127–133. https://doi.org/10.1016/j.envres.2014.07.007
Madaniyazi L, Zhou Y, Li S, Williams G, Jaakkola JJK, Liang X, Liu Y, Wu S, Guo Y (2016) Outdoor temperature, heart rate and blood pressure in Chinese adults: effect modification by individual characteristics. Sci Rep 6(1):21003. https://doi.org/10.1038/srep21003
National Center for Cardiovascular Diseases of China (2018) Report on cardiovascular diseases in china 2018. Encyclopedia of China Publishing House, Beijing
NOAA (2020) Climate at a glance: global time series. National Centers for Environmental Information. https://www.ncdc.noaa.gov/cag/. Accessed 7 Apr 2020
Ostro B, Rauch S, Green R, Malig B, Basu R (2010) The effects of temperature and use of air conditioning on hospitalizations. Am J Epidemiol 172(9):1053–1061. https://doi.org/10.1093/aje/kwq231
Phung D, Thai PK, Guo Y, Morawska L, Rutherford S, Chu C (2016) Ambient temperature and risk of cardiovascular hospitalization: an updated systematic review and meta-analysis. Sci Total Environ 550:1084–1102. https://doi.org/10.1016/j.scitotenv.2016.01.154
Radisauskas R, Vaiciulis V, Ustinaviciene R, Bernotiene G (2013) The effect of atmospheric temperature and pressure on the occurrence of acute myocardial infarction in Kaunas. Medicina (kaunas) 49:447–452. https://doi.org/10.3390/medicina49100070
Schwartz J, Samet JM, Patz JA (2004) Hospital admissions for heart disease: the effects of temperature and humidity. Epidemiology 15(6):755–761. https://doi.org/10.1097/01.ede.0000134875.15919.0f
Tang J, Xiao C-c, Li Y-r, Zhang J-q, Zhai H-y, Geng X-y, Ding R, Zhai J-x (2018) Effects of diurnal temperature range on mortality in Hefei city. China Int J Biometeorol 62(5):851–860. https://doi.org/10.1007/s00484-017-1486-y
The Eurowinter Group (1997) Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe. The Eurowinter Group Lancet 349(9062):1341–1346
The Writing Committee of the Report on Cardiovascular Health and Diseases in China (2021) Key points of Report on Cardiovascular Health and Diseases in China 2020. Chinese Journal of Cardiovascular Research 19(7):582–590. https://doi.org/10.3969/j.issn.1672-5301.2021.07.002
Tian L, Qiu H, Sun S, Lin H (2016) Emergency cardiovascular hospitalization risk attributable to cold temperatures in Hong Kong. Circ Cardiovasc Qual Outcomes 9(2):135–142. https://doi.org/10.1161/CIRCOUTCOMES.115.002410
Tobías A, Armstrong B, Gasparrini A (2017) Brief report: investigating uncertainty in the minimum mortality temperature: methods and application to 52 Spanish cities. Epidemiology 28(1):72–76. https://doi.org/10.1097/EDE.0000000000000567
Wang Q, Gao C, Wang H, Lang L, Yue T, Lin H (2013) Ischemic stroke hospital admission associated with ambient temperature in Jinan. China Plos One 8(11):e80381–e80381. https://doi.org/10.1371/journal.pone.0080381
Wang B, Chai G, Sha Y, Zha Q, Su Y, Gao Y (2021) Impact of ambient temperature on cardiovascular disease hospital admissions in farmers in China’s Western suburbs. Sci Total Environ 761:143254. https://doi.org/10.1016/j.scitotenv.2020.143254
Watts N, Amann M, Ayeb-Karlsson S, Belesova K, Bouley T, Boykoff M, Byass P, Cai W, Campbell-Lendrum D, Chambers J, Cox P, Daly M, Dasandi N, Davies M, Depledge M, Depoux A, Dominguez-Salas P, Drummond P, Ekins P, Costello A (2018) The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. The Lancet 391391(10120):581–630. https://doi.org/10.1016/S0140-6736(17)32464-9
Webb L, Bambrick H, Tait P, Green D, Alexander L (2014) Effect of ambient temperature on Australian northern territory public hospital admissions for cardiovascular disease among indigenous and non-indigenous populations. Int J Environ Res Public Health 11:1942–1959. https://doi.org/10.3390/ijerph110201942
WHO (2017) Cardiovascular diseases (CVDs). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Accessed 5 Apr 2020
Xiong J, Lan L, Lian Z, Lin Y (2017) Effect of different temperatures on hospital admissions for cardiovascular and cerebrovascular diseases: a case study. Indoor Built Environ 26(1):69–77. https://doi.org/10.1177/1420326x15604492
Yang L, Qian F, Song D-X, Zheng K-J (2016) Research on urban heat-island effect. Procedia Engineering 169:11–18. https://doi.org/10.1016/j.proeng.2016.10.002
Zhai G, Zhang K, Chai G (2021) Lag effect of ambient temperature on the cardiovascular disease hospital admission in Jiuquan, China. Air Qual Atmos Health 14(2):181–189. https://doi.org/10.1007/s11869-020-00924-5
Zhangye City Bureau of Statistics (2016) Statistical bulletin on national economic and social development of Zhangye City in 2015. Zhangye City Bureau of Statistics. http://www.zhangye.gov.cn/tjj/ztzl/tjsj/201806/t20180625_22097.html. Accessed 1 Oct 2021
Zhao Q, Zhao Y, Li S, Zhang Y, Wang Q, Zhang H, Qiao H, Li W, Huxley R, Williams G, Zhang Y, Guo Y (2018) Impact of ambient temperature on clinical visits for cardio-respiratory diseases in rural villages in northwest China. Sci Total Environ 612:379–385. https://doi.org/10.1016/j.scitotenv.2017.08.244
Zhou N, Cui Z, Yang S, Han X, Chen G, Zhou Z, Zhai C, Ma M, Li L, Cai M, Li Y, Ao L, Shu W, Liu J, Cao J (2014) Air pollution and decreased semen quality: a comparative study of Chongqing urban and rural areas. Environ Pollut 187:145–152. https://doi.org/10.1016/j.envpol.2013.12.030
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This work was supported by the National Natural Science Foundation of China (No. 71472079) and the Key Project of China Ministry of Education for Philosophy and Social Science (No. 16JZD023).
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Wang, B., Chai, G., Sha, Y. et al. Association between ambient temperature and cardiovascular disease hospitalisations among farmers in suburban northwest China. Int J Biometeorol 66, 1317–1327 (2022). https://doi.org/10.1007/s00484-022-02278-2
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DOI: https://doi.org/10.1007/s00484-022-02278-2