Abstract
This study evaluated the risk of outpatient visits for respiratory diseases, asthma, and chronic airway obstruction not elsewhere classified (CAO) associated with ambient temperatures and extreme temperature events from 2000 to 2008 in Taiwan. Based on geographical and socioeconomics characteristics, this study divided the whole island into seven areas. A distributed lag non-linear model was used to estimate the area-disease-specific cumulative relative risk (RR), and random-effect meta-analysis was used to estimate the pooled RR of outpatient visits, from lag 0 to lag 7 days, associated with daily temperature, and added effects of prolonged extreme heat and cold for population of all ages, the elderly and younger than 65 years. Pooled analyses showed that younger population had higher outpatient visits for exposing to low temperature of 18 °C, with cumulative 8-day RRs of 1.36 (95 % confidence interval (CI) 1.31–1.42) for respiratory diseases, 1.10 (95 % CI 1.03–1.18) for asthma, and 1.12 (95 % CI 1.02–1.22) for CAO. The elderly was more vulnerable to high temperature of 30 °C with the cumulative 8-day RR of 1.08 (95 % CI 1.03–1.13) for CAO. Elevated outpatient visits for all respiratory diseases and asthma were associated with extreme heat lasting for 6 to 8 days. On the contrary, the extreme cold lasting more than 8 days had significant negative association with outpatient visits of all respiratory diseases. In summary, elderly patients of respiratory diseases and CAO are vulnerable to high temperature. Cold temperature is associated with all types of respiratory diseases for younger patients.
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Acknowledgments
We appreciate the authorities of Taiwan National Health Research Institute, Taiwan Environmental Protection Administration, and Taiwan Central Weather Bureau for providing research data. Interpretations and conclusions herein do not represent those of these agencies.
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The authors declare that this study involves no conflict of interest.
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Both authors were involved in designing the study, analyzing the data, and finalizing the manuscript. Both have read and approved the final version of the manuscript.
Funding
This study was supported by National Science Council (NSC 100-2621-M-039-001, NSC 102-2621-M-033-001, and MOST 103-2621-M-033-001) of Taiwan and China Medical University Hospital (grant number 1MS1) and Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW103-TDU-B-212-113002).
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Supplementary Fig. S1
Probability density function of average temperature in study areas (PDF 9 kb)
Supplementary Fig. S2
Pooled risks for outpatient visits for respiratory diseases, asthma, and chronic airway obstruction not elsewhere classified associated with consecutive extreme temperatures (97th and 5th percentile temperatures) lasting for 3–5 days, for 6–8 days, and >8 days and their first extreme temperature events (First 97th and First 5th) of the year by random effect meta-analysis. (PDF 32 kb)
Supplementary Fig. S3
Pooled cumulative 6-day (lag 0 to lag 5) risk estimates for age-specific outpatient visits for respiratory diseases, asthma, and chronic airway obstruction not elsewhere classified associated with an interquartile increase of PM10, NO2 and O3 by random-effect meta-analysis. (PDF 32 kb)
Supplementary Table S1
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Supplementary Table S2
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Supplementary Table S3
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Supplementary Table S4
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Wang, YC., Lin, YK. Temperature effects on outpatient visits of respiratory diseases, asthma, and chronic airway obstruction in Taiwan. Int J Biometeorol 59, 815–825 (2015). https://doi.org/10.1007/s00484-014-0899-0
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DOI: https://doi.org/10.1007/s00484-014-0899-0