Acute and Prolonged Adverse Effects of Temperature on Mortality from Cardiovascular Diseases

Abstract

BackgroundCardiovascular diseases are the leading causes of death worldwide, especially for developed countries. Elevated mortality from cardiovascular diseases has been shown related to extreme temperature. We thus assessed the risk of mortality from cerebrovascular diseases, heart diseases, and ischemic heart disease (IHD) in relation to temperature profiles in four subtropical metropolitans (Taipei, Taichung, Tainan, and Kaohsiung) from 1994 to 2007 in Taiwan.MethodsDistributed lag non-linear models were applied to estimate the cumulative relative risks (RRs) with confidence intervals of cause-specific mortality associated with daily temperature from lag 0 to 20 days, and specific effect of extreme temperature episodes with PM10, NOx, and O3, and other potential confounders controlled. Estimates for cause-specific mortalities were then pooled by random-effect meta-analysis.ResultsComparing to centered temperature at 27°C, the cumulative 4-day (lag 0 to 3) risk of mortality was significantly elevated at 31°C for cerebrovascular diseases (RR = 1.14; 95% CI: 1.00, 1.31) and heart diseases (RR = 1.22; 95% CI: 1.02, 1.46) , but not for IHD (RR = 1.09; 95% CI: 0.99, 1.21). To the other extreme, at 15°C, the cumulative 21-day (lag 0 to 20) risk of mortality were also remarkably increased for cerebrovascular diseases, heart diseases, and IHD (RRs = 1.48 with 95% CI: 1.04, 2.12, 2.04 with 95% CI: 1.61, 2.58, and 1.62 with 95% CI: 1.30, 2.01, respectively). Mortality risks for cardiovascular diseases were generally highest on the present day (lag 0) of extreme heat. No particular finding was detected on prolonged extreme temperature event by pooling estimations for cause-specific mortality.ConclusionsLow temperature was associated with greater risk of mortality from cardiovascular diseases in comparison with that of high temperature. Adverse effects of extreme temperatures are acute at the beginning of exposure.

The impact of temperature on mortality in a subtropical city: effects of cold, heat, and heat waves in São Paulo, Brazil

“…This finding is similar with previous studies reporting risk from acute exposure, such as same day and a few days earlier, for heat-related mortality, and that the association between cold and mortality persisted for up to a few weeks (Braga et al, 2002; Lin et al, 2013). …”

“…Mortality was not associated with high temperatures in Kerman, Iran, which could be explained by acclimatization to high temperatures in the desert climate (Khanjani and Bahrampour, 2013). Cold was associated with higher risk of cardiovascular mortality than heat in Taiwanese subtropical areas (Lin et al, 2013). In the U.S., heat effects appeared to be larger in the colder northern cities than warmer southern cities (Anderson and Bell, 2009; Zanobetti and Schwartz, 2008).…”

Air temperature exposure and agricultural occupational injuries in the Autonomous Province of Trento (2000–2013, North-Eastern Italy)

“…Available data included daily maximum temperature of the air (T max ), and daily average air temperature (T day ). As exposure to severe heat has been associated with OIs through a non-linear association, with a presumptive role for cumulative, short-term exposure [1,3,7,29,35], T day was assessed in 3 time lags, i.e., for the day of the event (T day lag 0), for the day of the event and during the previous 24 h (T day lag 1), for the day of the event and during the previous 48 h (T day lag 2). In order to assess whether days with higher environmental temperature were actually associated with increased daily rates of OIs, the whole observation period was initially dichotomized as HW time period vs. non-HW time period.…”

“…Available estimates suggest that the increased magnitude and frequency of extreme events would ultimately lead to a significant excess in morbidity and mortality for cardiovascular and respiratory illnesses, and that the climate changes will presumptively increase both the incidence and the severity of these effects [4][5][6][7][8][9][10][11][12], in particular in Mediterranean-like climates [13]. migrant background [33,34], part-time or seasonal workers, and "hobby farmers" (i.e., subjects running a farm as a hobby rather than as means of making a living), the number of which usually surges during hot moths and the harvest season, including subjects who otherwise spend little time outdoor [25,29,35].…”

Association between air temperatures and occupational injuries: a case-crossover analysis using workers’ compensation claims data in the construction industries in Northern Italy

“…During the last decades, climate changes have significantly affected both living and working environments (1-3). The Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change (IPCC) has estimated in 0.78°C the increase of the average global temperature between 2003 and 2012 (4), with an even higher risk for population exposed to Mediterranean-like climates (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Because of a combination of external thermal environment, heat sources in the workplace, and internal heat generation by physical activity associated with strenuous muscular work, climate changes and eventual heat exposure represent an even greater challenge to workers' health and safety, especially in persons with pre-existing illnesses (2,7,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”