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Weather, season, and daily stroke admissions in Hong Kong

International Journal of Biometeorology volume 56, pages 865–872 (2012)Cite this article

Abstract

Previous studies examining daily temperature and stroke incidence have given conflicting results. We undertook this retrospective study of all stroke admissions in those aged 35 years old and above to Hong Kong public hospitals from 1999 through 2006 in order to better understand the effects of meteorological conditions on stroke risk in a subtropical setting. We used Poisson Generalized Additive Models with daily hemorrhagic (HS) and ischemic stroke (IS) counts separately as outcomes, and daily mean temperature, humidity, solar radiation, rainfall, air pressure, pollutants, flu consultation rates, day of week, holidays, time trend and seasonality as predictors. Lagged effects of temperature, humidity and pollutants were also considered. A total of 23,457 HS and 107,505 IS admissions were analyzed. Mean daily temperature had a strong, consistent, negative linear association with HS admissions over the range (8.2–31.8°C) observed. A 1°C lower average temperature over the same day and previous 4 days (lags 0–4) being associated with a 2.7% (95% CI: 2.0–3.4%, P < .0.0001) higher admission rate after controlling for other variables. This association was stronger among older subjects and females. Higher lag 0–4 average change in air pressure from previous day was modestly associated with higher HS risk. The association between IS and temperature was weaker and apparent only below 22°C, with a 1°C lower average temperature (lags 0–13) below this threshold being associated with a 1.6% (95% CI:1.0–2.2%, P < 0.0001) higher IS admission rate. Pollutant levels were not associated with HS or IS. Future studies should examine HS and IS risk separately.

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Acknowledgments

The authors would like to thank the Editor and reviewers whose comments greatly improved the quality of the manuscript. This study was partially supported by the Health and Health Services Research Fund of the Hong Kong SAR government, grant no.06070451 and the Hong Kong Jockey Club Charities Trust Foundation.

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Affiliations

  1. Division of Biostatistics, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong

    William B. Goggins

  2. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong

    Jean Woo

  3. Division of Epidemiology, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong

    Suzanne Ho

  4. Division of Family Medicine and Primary Health Care, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong

    Emily Y. Y. Chan

  5. Faculty of Social Sciences, The University of Hong Kong, Shatin, Hong Kong

    P. H. Chau

Authors
  1. William B. Goggins
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  2. Jean Woo
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  3. Suzanne Ho
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  4. Emily Y. Y. Chan
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  5. P. H. Chau
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Correspondence to William B. Goggins.

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Goggins, W.B., Woo, J., Ho, S. et al. Weather, season, and daily stroke admissions in Hong Kong. Int J Biometeorol 56, 865–872 (2012). https://doi.org/10.1007/s00484-011-0491-9

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  • DOI: https://doi.org/10.1007/s00484-011-0491-9

Keywords

  • Stroke
  • Temperature
  • Generalized additive models
  • Humidity
  • Meteorology
  • Mortality
  • Incidence