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Influence of weather on emergency transport events coded as stroke: population-based study in Japan

Abstract

Studying the relation between incidence of stroke and weather is difficult because it requires large-scale community-based data collection. Despite the lack of strong evidence that weather conditions influence stroke incidence, many clinicians feel that meteorological conditions influence the onset of stroke. This study examined whether emergency events related to stroke are influenced by meteorological factors and was based on computerized records of emergency medical transport services in a Japanese city during the period January 1992–December 2003. A total of 53,585 patients transported for an event coded as stroke were analyzed in relation to meteorological factors such as temperature, humidity, and barometric pressure. Poisson regression analysis was applied to clarify the influence of daily meteorological conditions on the daily incidence of emergency transport due to events coded as stroke. Ordinary least squares regression analysis was used to evaluate the influence of weather, defined as the combination of meteorological parameters, on the occurrence of emergency transport due to events coded as stroke. Daily mean ambient temperature and daily mean relative humidity showed a statistically significant negative effect on the incidence of the emergency transport events for both men and women (P<0.001). Daily mean barometric pressure was not significantly related to these events. The occurrence of a holiday was negatively related to the incidence (P<0.001). Dry weather and cool weather were likely to shift the circadian curve of the incidence upward. Thus, occurrence of emergency transport due to events coded as stroke is likely to be associated with weather conditions.

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References

  • Aylin P, Morris S, Wakefield J, Grossinho A, Jarup L, Elliott P (2001) Temperature, housing, deprivation and their relationship to excess winter mortality in Great Britain, 1986–1996. Int J Epidemiol 30:1100–1108

    PubMed  Article  CAS  Google Scholar 

  • Barer D, Ebrahim S, Smith C (1984) Factors affecting day to day incidence of stroke in Nottingham. Br Med J (Clin Res Ed) 89:662

    Article  Google Scholar 

  • Berginer VM, Goldsmith J, Batz U, Vardi H, Shapiro Y (1989) Clustering of strokes in association with meteorologic factors in the Negev Desert of Israel: 1981–1983. Stroke 20:65–69

    PubMed  CAS  Google Scholar 

  • Brennan PJ, Greenberg G, Miall WE, Thompson SG (1982) Seasonal variation in arterial blood pressure. Br Med J (Clin Res Ed) 285:919–923

    CAS  Google Scholar 

  • Cameron AC, Trivedi PK (1986) Econometric models based on count data: comparisons and applications of some estimators and tests. J Appl Econometrics 1:29–54

    Article  Google Scholar 

  • Cameron AC, Trivedi PK (1990) Regression-based tests for overdispersion in the Poisson model. J Econometrics 46:347–364

    Article  Google Scholar 

  • Chang CL, Shipley M, Marmot M, Poulter N (2004) Lower ambient temperature was associated with an increased risk of hospitalization for stroke and acute myocardial infarction in young women. J Clin Epidemiol 57:749–757

    PubMed  Article  Google Scholar 

  • Chen ZY, Chang SF, Su CL (1995) Weather and stroke in a subtropical area: Ilan, Taiwan. Stroke 26:569–572

    PubMed  CAS  Google Scholar 

  • Connor MD (2002) Does the weather influence stroke incidence? Stroke 33:1757–1758

    PubMed  Google Scholar 

  • Cook NS, Ubben D (1990) Fibrinogen as a major risk factor in cardiovascular disease. Trends Pharmacol Sci 11:444–451

    PubMed  Article  Google Scholar 

  • Danet S, Richard F, Montaye M, Beauchant S, Lemaire B, Graux C, Cottel D, Marécaux N, Amouyel P (1999) Unhealthy effects of atmospheric temperature and pressure on the occurrence of myocardial infarction and coronary deaths. A 10-year survey: the Lille-World Health Organization MONICA project (Monitoring trends and determinants in cardiovascular disease). Circulation 100:E1–E7

    PubMed  CAS  Google Scholar 

  • Ebi KL, Exuzides KA, Lau E, Kelsh M, Barnston A (2004) Weather changes associated with hospitalizations for cardiovascular diseases and stroke in California, 1983–1998. Int J Biometeorol 49:48–58 DOI 10.1007/s00484-004-0207-5

    PubMed  Article  CAS  Google Scholar 

  • Feigin VL, Nikitin YP, Bots ML, Vinogradova TE, Grobbee DE (2000) A population-based study of the associations of stroke occurrence with weather parameters in Siberia, Russia (1982–92). Eur J Neurol 7:171–178

    PubMed  Article  CAS  Google Scholar 

  • Field TS, Hill MD (2002) Weather, Chinook, and stroke occurrence. Stroke 33:1751–1758

    PubMed  Article  Google Scholar 

  • Haberman S, Capildeo R, Rose FC (1981) The seasonal variation in mortality from cerebrovascular disease. J Neurol Sci 52:25–36

    PubMed  Article  CAS  Google Scholar 

  • Jakovljević D (2004) Day of the week and ischemic stroke. Is it Monday high or Sunday low? Stroke 35:2089–2093

    PubMed  Article  Google Scholar 

  • Jakovljević D, Salomaa V, Sivenius J, Tamminen M, Sarti C, Salmi K, Kaarsalo E, Narva V, Immonen-Raiha P, Torppa J, Tuomilehto J (1996) Seasonal variation in the occurrence of stroke in a Finnish adult population. The FINMONICA stroke register. Finnish monitoring trends and determinants in cardiovascular disease. Stroke 27:1774–1779

    PubMed  Google Scholar 

  • Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, Murata M, Kuroda T, Schwartz JE, Shimada K (2003) Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives. A prospective study. Circulation 107:1401–1406

    PubMed  Article  Google Scholar 

  • Kelly-Hayes M, Wolf PA, Kase CS, Brand FN, McGuirk JM, D’Agostino RB (1995) Temporal patterns of stroke onset. The Framingham Study. Stroke 26:1343–1347

    PubMed  CAS  Google Scholar 

  • Lanska DJ, Hoffmann RG (1999) Seasonal variation in stroke mortality rates. Neurology 52:984–990

    PubMed  CAS  Google Scholar 

  • Lejeune JP, Vinchon M, Amouyel P, Escartin T, Escartin D, Christiaens JL (1994) Association of occurrence of aneurysmal bleeding with meteorologic variations in the north of France. Stroke 25:338–341

    PubMed  CAS  Google Scholar 

  • Marler JR, Price TR, Clark GL, Muller JE, Robertson T, Mohr JP, Hier DB, Wolf PA, Caplan LR, Foulkes MA (1989) Morning increase in onset of ischemic stroke. Stroke 20:473–476

    PubMed  CAS  Google Scholar 

  • Ohshige K (2004) Circadian pattern of ambulance use for children in a Japanese city. Acad Emerg Med 11:316–318

    PubMed  Google Scholar 

  • Ohwaki K, Yano E, Murakami H, Nagashima H, Nakagomi T (2004) Meteorological factors and the onset of hypertensive intracerebral hemorrhage. Int J Biometeorol 49:86–90 DOI 10.1007/s00484-004-0219-1

    PubMed  Article  Google Scholar 

  • Rothwell PM, Wroe SJ, Slattery J, Warlow CP (1996) Is stroke incidence related to season or temperature? The Oxfordshire Community Stroke Project. Lancet 347:934–936

    PubMed  Article  CAS  Google Scholar 

  • Shinkawa A, Ueda K, Hasuo Y, Kiyohara Y, Fujishima M (1990) Seasonal variation in stroke incidence in Hisayama, Japan. Stroke 21:1262–1267

    PubMed  CAS  Google Scholar 

  • Sloan MA, Price TR, Foulkes MA, Marler JR, Mohr JP, Hier DB, Wolf PA, Caplan LR (1992) Circadian rhythmicity of stroke onset. Intracerebral and subarachnoid hemorrhage. Stroke 23:1420–1426

    PubMed  CAS  Google Scholar 

  • Stergiou GS, Vemmos KN, Pliarchopoulou KM, Synetos AG, Roussias LG, Mountokalakis TD (2002) Parallel morning and evening surge in stroke onset, blood pressure, and physical activity. Stroke 33:1480–1486

    PubMed  Article  Google Scholar 

  • Stout RW, Crawford V (1991) Seasonal variations in fibrinogen concentrations among elderly people. Lancet 338:9–13

    PubMed  Article  CAS  Google Scholar 

  • Wang H, Sekine M, Chen X, Kagamimori S (2002) A study of weekly and seasonal variation of stroke onset. Int J Biometeorol 47:13–20 DOI 10.1007/s00484-002-0147-x

    PubMed  Article  Google Scholar 

  • Wang Y, Levi CR, Attia JR, D’Este CA, Spratt N, Fisher J (2003) Seasonal variation in stroke in the Hunter region, Australia. A 5-year hospital-based study, 1995–2000. Stroke 34:1144–1150

    PubMed  Article  Google Scholar 

  • White WB (2001) Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate. Blood Press Monit 6:63–72

    PubMed  Article  CAS  Google Scholar 

  • Willich SN, Löwel H, Lewis M, Hörmann A, Arntz HR, Keil U (1994) Weekly variation of acute myocardial infarction. Increased Monday risk in the working population. Circulation 90:87–93

    PubMed  CAS  Google Scholar 

  • Woodhouse PR, Khaw KT, Plummer M (1993) Seasonal variation of blood pressure and its relationship to ambient temperature in an elderly population. J Hypertens 11:1267–1274

    PubMed  Article  CAS  Google Scholar 

  • Woodhouse PR, Khaw KT, Plummer M, Foley A, Meade TW (1994) Seasonal variations of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease. Lancet 343:435–439

    PubMed  Article  CAS  Google Scholar 

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Acknowledgements

The research described herein was supported in part by Terumo Corporation, Tokyo, Japan. We sincerely thank the staff of the Yokohama Fire Bureau for their cooperation.

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Correspondence to Kenji Ohshige.

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Ohshige, K., Hori, Y., Tochikubo, O. et al. Influence of weather on emergency transport events coded as stroke: population-based study in Japan. Int J Biometeorol 50, 305 (2006). https://doi.org/10.1007/s00484-005-0018-3

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  • DOI: https://doi.org/10.1007/s00484-005-0018-3

Keywords

  • Weather
  • Stroke
  • Emergency transport event
  • Population-based study