Environmental Science and Pollution Research

, Volume 22, Issue 12, pp 9378–9399 | Cite as

Inverted U-shape relationships of the weather as biometeorological and hospital admissions due to carcinoma in situ and benign neoplasm in Germany in 2009–2011

  • Ivy Shiue
  • David R. Perkins
  • Nick Bearman
Research Article


We aimed to understand the relationships of the weather as biometeorological and hospital admissions due to carcinoma in situ and benign neoplasms, which have been less paid attention to, in a national setting in recent years. 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 D00-D48 in situ neoplasms, benign neoplasms and neoplasms of uncertain or unknown behaviour 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). For most subtypes, peaks of admissions were observed in spring and late autumn. There could be four groups of phenomenon among these admissions. To be specific, D06, D16, D21, D24–25, D35 and D39 peaked when PET was at 0 °C. D46 peaked when PET was at 5–10 °C. D03, D04 and D33 had linear relationships. Other admissions peaked when PET was between 0 and 5 °C. All admissions were in common with a drop when PET reached 10 °C or higher. More medical resources could have been needed on days when PETs were at 0–10 °C than on other days. Adaptation to such weather change for medical professionals and the general public would seem to be imperative.


Hospital admission Weather Biometeorology Cancer Neoplasm Carcinoma 



IS is supported by the Global Platform for Research Leaders scheme and EU FP-7 project, Data without Boundaries (grant number: n°262608). The authors would also like to thank Mr. Rafael Beier and other German colleagues at Statistisches Bundesamt for their professional assistance in coordinating and checking data and hosting the research visit for the purpose of data analysis.

Conflict of interest



  1. Ansari A, Burch GE (1969) Influence of hot environments on the cardiovascular system: a clinical study of 23 cardiac patients at rest. Arch Intern Med 123:371–378CrossRefGoogle Scholar
  2. Augustsson A, Stierner U, Rosdahl I, Suurküla M (1992) Regional distribution of melanocytic naevi in relation to sun exposure, and site-specific counts predicting total number of naevi. Acta Derm Venereol 72:123–127Google Scholar
  3. Bean WB, Mills CA (1938) Coronary occlusion, heart failure, and environmental temperatures. Am Heart J 16:701–713CrossRefGoogle Scholar
  4. Bhaskaran K, Hajat S, Haines A, Herrett E, Wilkinson P, Smeeth L (2009) Effects of ambient temperature on the incidence of myocardial infarction. Heart 95:1760–1769CrossRefGoogle Scholar
  5. Dobrosavljevic D, Brasanac D, Apostolovic M, Medenica L (2009) Changes in common melanocytic naevi after intense sun exposure: digital dermoscopic study with a 1-year follow-up. Clin Exp Dermatol 34:672–678CrossRefGoogle Scholar
  6. Epstein SE, Stampfer M, Beiser D, Goldstein RE, Braunwald E (1969) Effects of a reduction in environmental temperature on the circulatory response to exercise in man—implications concerning angina pectoris. N Engl J Med 280:7–11CrossRefGoogle Scholar
  7. Evans SE, Ingram DL (1977) The effect of ambient temperature upon the secretion of thyroxine in the young pig. J Physiol 264:511–521CrossRefGoogle Scholar
  8. Green AC, Wallingford SC, McBride P (2011) Childhood exposure to ultraviolet radiation and harmful skin effects: epidemiological evidence. Prog Biophys Mol Biol 107:349–355CrossRefGoogle Scholar
  9. Hanna JM (1999) Climate, altitude, and blood pressure. Hum Biol 71:553Google Scholar
  10. Harrison SL, MacLennan R, Speare R, Wronski I (1994) Sun exposure and melanocytic naevi in young Australian children. Lancet 344:1529–1532CrossRefGoogle Scholar
  11. Höppe P (1999) The physiological equivalent temperature—a universal index for the biometeorological assessment of the thermal environment. Int J Biometeorol 43:71–75CrossRefGoogle Scholar
  12. Höppe P, von Mackensen S, Nowak D, Piel E (2002) Prevalence of weather sensitivity in Germany. Dtsch Med Wochenschr 127:15–20CrossRefGoogle Scholar
  13. Ibidapo II, Sofola OA (1989) The effects of prolonged exposure to lowered ambient temperature on thyroid activity in mature female rats. Q J Exp Physiol 74:207–209CrossRefGoogle Scholar
  14. Klein A, Kulcsár M, Krízsik V, Mátics R, Rudas P, Török J, Huszenicza G (2006) Effects of environmental temperature on thyroid hormones in the barn owl (Tyto alba). Acta Vet Hung 54:321–331CrossRefGoogle Scholar
  15. Kokolus KM, Capitano ML, Lee CT, Eng JW, Waight JD, Hylander BL, Sexton S, Hong CC, Gordon CJ, Abrams SI, Repasky EA (2013) Baseline tumor growth and immune control in laboratory mice are significantly influenced by subthermoneutral housing temperature. Proc Natl Acad Sci U S A 110:20176–20181CrossRefGoogle Scholar
  16. Kristbjornsdottir A, Rafnsson V (2012) Incidence of cancer among residents of high temperature geothermal areas in Iceland: a census based study 1981 to 2010. Environ Health 11:73CrossRefGoogle Scholar
  17. Matzarakis A, Mayer H (1996) Another kind of environmental stress: thermal stress. WHO Newsletter 18:7–10Google Scholar
  18. Matzarakis A, Rutz F, Mayer H (2007) Modelling radiation fluxes in simple and complex environments - Application of the RayMan model. Int J Biometeorol 51: 323–334Google Scholar
  19. Milo-Cotter O, Setter I, Uriel N, Kaluski E, Vered Z, Golik A, Cotter G (2006) The daily incidence of acute heart failure is correlated with low minimal night temperature: cold immersion pulmonary edema revisited? J Card Fail 12:114–119Google Scholar
  20. Modesti PA (2013) Season, temperature and blood pressure: a complex interaction. Eur J Intern Med 24:604–607CrossRefGoogle Scholar
  21. Nguyen TD, Siskind V, Green L, Frost C, Green A (1997) Ultraviolet radiation, melanocytic naevi and their dose-response relationship. Br J Dermatol 137:91–95CrossRefGoogle Scholar
  22. Oloufa MM, Bogart R, McKenzie FF (1951) Effect of environmental temperature and the thyroid gland on fertility in the male rabbit. Fertil Steril 2:223–229Google Scholar
  23. Reed HL, Quesada M, Hesslink RL Jr, D'Alesandro MM, Hays MT, Christopherson RJ, Turner BV, Young BA (1994) Changes in serum triiodothyronine kinetics and hepatic type I 5'-deiodinase activity of cold-exposed swine. Am J Physiol 266:E786–E795Google Scholar
  24. Rowe NH, Grammer FC, Watson FR, Nickerson NH (1970) A study of environmental influence upon salivary gland neoplasia in rats. Cancer 26:436–444CrossRefGoogle Scholar
  25. Sabetghadam S, Ahmadi-Givi F (2014) Relationship of extinction coefficient, air pollution, and meteorological parameters in an urban area during 2007 to 2009. Environ Sci Pollut Res Int 21:538–547CrossRefGoogle Scholar
  26. Schubert C, Welsch U (1976) Temperature dependent changes in the thyroid gland of Mertensiella caucasica (Urodela, Amphibia). Cell Tissue Res 165:467–475CrossRefGoogle Scholar
  27. Shiue I, Matzarakis A (2011) When stroke epidemiology meets weather and climate: a heat exposure index from human biometeorology. Int J Stroke 6:176CrossRefGoogle Scholar
  28. Shiue I, Muthers S, Bearman N (2014) The role of cold stress in predicting extra cardiovascular and respiratory admissions. Int J Cardiol 172:e109–10CrossRefGoogle Scholar
  29. Sinha AK, Choubey BJ (1981) Seasonal changes in the thyroid gland of Indian spiny tailed, sand lizard, Uromastix hardwickii (Gray) male. Z Mikrosk Anat Forsch 95:72–80Google Scholar
  30. Talmage RV, Doty SB, Yates CW (1962) The effect of temperature on the uptake of radioiodine by the thyroid gland of the frog, Rana pipiens. Gen Comp Endocrinol 2:266–272CrossRefGoogle Scholar
  31. Turbiner S, Shklar G, Cataldo E (1970) The effect of cold stress on chemical carcinogenesis of rat salivary glands. Oral Surg Oral Med Oral Pathol 29:130–137CrossRefGoogle Scholar
  32. World Health Organisation (WHO). International Classification of Diseases (ICD) Version 10. 2009. (Accessed on 1 July, 2014)

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.School of Energy, Geoscience, Infrastructure & SocietyHeriot-Watt UniversityRiccarton, EdinburghUK
  2. 2.Owens Institute of Behavioral ResearchUniversity of GeorgiaAthensUSA
  3. 3.Department of GeographyUniversity of North Carolina at GreensboroGreensboroUSA
  4. 4.School of Environmental SciencesUniversity of LiverpoolLiverpoolUK

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