Influenza is associated with deaths due to ischemic heart disease as well from respiratory diseases. Overall influenza-associated mortality in a region with a warm climate, such as Hong Kong, is comparable with that documented in temperate regions. The need for influenza vaccination in tropical regions needs to be reassessed.

BackgroundPoverty is a major determinant of population health, but little is known about its role in modifying air pollution effects.ObjectivesWe set out to examine whether people residing in socially deprived communities are at higher mortality risk from ambient air pollution.MethodsThis study included 209 tertiary planning units (TPUs), the smallest units for town planning in the Special Administrative Region of Hong Kong, China. The socioeconomic status of each TPU was measured by a social deprivation index (SDI) derived from the proportions of the population with a) unemployment, b) monthly household income < US$250, c) no schooling at all, d) one-person household, e) never-married status, and f ) subtenancy, from the 2001 Population Census. TPUs were classified into three levels of SDI: low, middle, and high. We performed time-series analysis with Poisson regression to examine the association between changes in daily concentrations of ambient air pollution and daily number of deaths in each SDI group for the period from January 1996 to December 2002. We evaluated the differences in pollution effects between different SDI groups using a case-only approach with logistic regression.ResultsWe found significant associations of nitrogen dioxide, sulfur dioxide, particulate matter with aerodynamic diameter < 10 μm, and ozone with all nonaccidental and cardiovascular mortality in areas of middle or high SDI (p < 0.05). Health outcomes, measured as all nonaccidental, cardiovascular, and respiratory mortality, in people residing in high SDI areas were more strongly associated with SO2 and NO2 compared with those in middle or low SDI areas.ConclusionsNeighborhood socioeconomic deprivation increases mortality risks associated with air pollution.

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The growth of pathogens potentially relevant to respiratory tract infection may be triggered by changes in ambient temperature. Few studies have examined the association between ambient temperature and pneumonia incidence, and no studies have focused on the susceptible elderly population. We aimed to examine the short-term association between ambient temperature and geriatric pneumonia and to assess the disease burden attributable to cold and hot temperatures in Hong Kong, China. Daily time-series data on emergency hospital admissions for geriatric pneumonia, mean temperature, relative humidity, and air pollution concentrations between January 2005 and December 2012 were collected. Distributed-lag nonlinear modeling integrated in quasi-Poisson regression was used to examine the exposure-lag-response relationship between temperature and pneumonia hospitalization. Measures of the risk attributable to nonoptimal temperature were calculated to summarize the disease burden. Subgroup analyses were conducted to examine the sex difference. We observed significant nonlinear and delayed associations of both cold and hot temperatures with pneumonia in the elderly, with cold temperatures having stronger effect estimates. Among the 10.7% of temperature-related pneumonia hospitalizations, 8.7% and 2.0% were attributed to cold and hot temperatures, respectively. Most of the temperature-related burden for pneumonia hospitalizations in Hong Kong was attributable to cold temperatures, and elderly men had greater susceptibility.

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