Association between ambient temperature and childhood respiratory hospital visits in Beijing, China: a time-series study (2013–2017)

Fang, Jiakun; Song, Jing; Wu, Rongshan; Xie, Yunfei; Xu, Xin; Zeng, Yueping; Zhu, Yutong; Wang, Tong; Yuan, Ningman; Xu, Hongbing; Song, Xiaoming; Zhang, Qinghong; Xu, Baoping; Huang, Wei

doi:10.1007/s11356-021-12817-w

Research Article
Published: 08 February 2021

Association between ambient temperature and childhood respiratory hospital visits in Beijing, China: a time-series study (2013–2017)

Jiakun Fang¹^na1,
Jing Song²^na1,
Rongshan Wu^1,3,
Yunfei Xie¹,
Xin Xu²,
Yueping Zeng²,
Yutong Zhu¹,
Tong Wang¹,
Ningman Yuan¹,
Hongbing Xu¹,
Xiaoming Song¹,
Qinghong Zhang⁴,
Baoping Xu² &
Wei Huang^1,5

Environmental Science and Pollution Research volume 28, pages 29445–29454 (2021)Cite this article

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Abstract

Little is known on the potential impact of temperature on respiratory morbidity, especially for children whose respiratory system can be more vulnerable to climate changes. In this time-series study, Poisson generalized additive models combined with distributed lag nonlinear models were used to assess the associations between ambient temperature and childhood respiratory morbidity. The impacts of extreme cold and hot temperatures were calculated as cumulative relative risks (cum.RRs) at the 1st and 99th temperature percentiles relative to the minimum morbidity temperature percentile. Attributable fractions of respiratory morbidity due to cold or heat were calculated for temperatures below or above the minimum morbidity temperature. Effect modifications by air pollution, age, and sex were assessed in stratified analyses. A total of 877,793 respiratory hospital visits of children under 14 years old between 2013 and 2017 were collected from Beijing Children’s Hospital. Overall, we observed J-shaped associations with greater respiratory morbidity risks for exposure to lower temperatures, and higher fraction of all-cause respiratory hospital visits was caused by cold (33.1%) than by heat (0.9%). Relative to the minimum morbidity temperature (25 °C, except for rhinitis, which is 31 °C), the cum.RRs for extreme cold temperature (-6 °C) were 2.64 (95%CI: 1.51–4.61) for all-cause respiratory hospital visits, 2.73 (95%CI: 1.44–5.18) for upper respiratory infection, 2.76 (95%CI: 1.56–4.89) for bronchitis, 2.12 (95%CI: 1.30–3.47) for pneumonia, 2.06 (95%CI: 1.27–3.34) for rhinitis, and 4.02 (95%CI: 2.14–7.55) for asthma, whereas the associations between extreme hot temperature (29 °C) and respiratory hospital visits were not significant. The impacts of extreme cold temperature on asthma hospital visits were greater at higher levels of ozone (O₃) exposure (> 50th percentile). Our findings suggest significantly increased childhood respiratory morbidity risks at extreme cold temperature, and the impact of extreme cold temperature on asthma hospital visits can be enhanced under higher level exposure to O₃.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

We thank all those who have helped us.

Funding

This study was supported by grants from National Key Research and Development Project (2017YFC0211701, 2016YFC0901103).

Author information

Jiakun Fang and Jing Song contributed equally to this work.

Affiliations

Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
Jiakun Fang, Rongshan Wu, Yunfei Xie, Yutong Zhu, Tong Wang, Ningman Yuan, Hongbing Xu, Xiaoming Song & Wei Huang
Beijing Children’s Hospital, Capital Medical University, Beijing, China
Jing Song, Xin Xu, Yueping Zeng & Baoping Xu
State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing, China
Rongshan Wu
Department of Atmospheric and Oceanic Sciences, School of Physics, Peking University, Beijing, China
Qinghong Zhang
Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China
Wei Huang

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Jiakun Fang
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Jing Song
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Rongshan Wu
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Yunfei Xie
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Xin Xu
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Yueping Zeng
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Yutong Zhu
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Tong Wang
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Ningman Yuan
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Hongbing Xu
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Xiaoming Song
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Qinghong Zhang
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Baoping Xu
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Wei Huang
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Contributions

Concept and design: W Huang, BP Xu, QH Zhang. Acquisition, analysis, or interpretation of data: J Song, RS Wu, HB Xu, YT Zhu, X Xu. Drafting of the manuscript: JK Fang, J Song. Critical revision of the manuscript for important intellectual content: W Huang, BP Xu. Statistical analysis: JK Fang, HB Xu, RS Wu, T Wang, NM Yuan. Obtained funding: W Huang, BP Xu. Administrative, technical, or material support: XM Song, YP Zeng, YF Xie. Supervision: W Huang, BP Xu, QH Zhang. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Baoping Xu or Wei Huang.

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This study did not contain confidential patient data. The Institutional Review Board of Beijing Children’s Hospital, Capital Medical University approved this study (IEC-C-028-A10-V.05). The patient’s consent to participate is not applicable in this study.

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Fang, J., Song, J., Wu, R. et al. Association between ambient temperature and childhood respiratory hospital visits in Beijing, China: a time-series study (2013–2017). Environ Sci Pollut Res 28, 29445–29454 (2021). https://doi.org/10.1007/s11356-021-12817-w

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Received: 23 October 2020
Accepted: 01 February 2021
Published: 08 February 2021
Issue Date: June 2021
DOI: https://doi.org/10.1007/s11356-021-12817-w

Keywords

Ambient temperature
Respiratory disease
Air pollution
Outpatient visits
Emergency room visits
Children