Spatiotemporal and demographic variation in the association between temperature variability and hospitalizations in Brazil during 2000–2015: A nationwide time-series study

Background: Limited evidence is available regarding the association between heat exposure and morbidity in Brazil and how the effect of heat exposure on health outcomes may change over time. Objectives: This study sought to quantify the geographic, demographic and temporal variations in the heat–hospitalization association in Brazil from 2000–2015. Methods: Data on hospitalization and meteorological conditions were collected from 1,814 cities during the 2000–2015 hot seasons. Quasi-Poisson regression with constrained lag model was applied to examine city-specific estimates, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, 10 age groups, and 11 cause categories. Meta-regression was used to examine the temporal change in estimates of heat effect from 2000 to 2015. Results: For every 5°C increase in daily mean temperature during the 2000–2015 hot seasons, the estimated risk of hospitalization over lag 0–7 d rose by 4.0% [95% confidence interval (CI): 3.7%, 4.3%] nationwide. Estimated 6.2% [95% empirical CI (eCI): 3.3%, 9.1%] of hospitalizations were attributable to heat exposure, equating to 132 cases (95% eCI: 69%, 192%) per 100,000 residents. The attributable rate was greatest in children and was highest for hospitalizations due to infectious and parasitic diseases. Women of reproductive age and those had higher heat burden than men. The attributable burden was greatest for cities in the central west and the inland of the northeast; lowest in the north and eastern coast. Over the 16-y period, the estimated heat effects declined insignificantly at the national level. Conclusions: In Brazil’s hot seasons, 6% of hospitalizations were estimated to be attributed to heat exposure. As there was no evidence indicating that thermal adaptation had occurred at the national level, the burden of hospitalization associated with heat exposure in Brazil is likely to increase in the context of global warming. https://doi.org/10.1289/EHP3889

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“…2016). City-specific data were collected from the grid overlaying the centroid of each city (Zhao et al. 2018).…”

Section: Methodsmentioning

confidence: 99%

Geographic, Demographic, and Temporal Variations in the Association between Heat Exposure and Hospitalization in Brazil: A Nationwide Study between 2000 and 2015

Zhao

Coelho

et al. 2019

Environ Health Perspect

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“…Studies have considered the health impacts of past heatwaves by comparing health outcomes from heatwave events with local or global heatwave indexes. In general, this has been performed for a selection of cities or regions (Anderson and Bell 2009;Campbell et al 2018;Li et al 2015;Russo et al 2015;Scalley et al 2015;Zhao et al 2019Zhao et al , 2018 or by collecting many individual studies (Mora et al 2017). Guo et al (2018Guo et al ( , 2017 combined mortality and climate data to estimate heatwave impacts for 412 communities in 20 regions.…”

Section: Health Impacts Of Heatwavesmentioning

confidence: 99%

“…For example, in reviews of case studies, by Campbell et al (2018) and Mora et al (2017), four studies were found for Africa and seven for South America. More recent works include studies for South Africa (Wright et al 2019) Senegal (Sarr et al 2019), and Brazil (Zhao et al 2018). The dataset developed by Guo et al (2018) included no data for Africa and limited data for Brazil, Chile, and Columbia.…”

Section: Health Impacts Of Heatwavesmentioning

confidence: 99%

Global and cross-country analysis of exposure of vulnerable populations to heatwaves from 1980 to 2018

Chambers

2020

Climatic Change

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Heatwaves have become more frequent and intense due to anthropogenic global warming and have serious and potentially life-threatening impacts on human health, particularly for people over 65 years old. While a range of studies examine heatwave exposures, few cover the whole globe and very few cover key areas in Africa, South America, and East Asia. By using global gridded climate reanalysis, population, and demographic data, this work analyses trends in change in exposure of vulnerable populations to heatwaves, providing global and per-country aggregate statistics. The difference between the global mean of heatwave indexes and the mean weighted by vulnerable population found that these populations are experiencing up to five times the number of heatwave days relative to the global average. The total exposures, measured in person-days of heatwave, highlight the combined effect of increased heatwaves and aging populations. In China and India, heatwave exposure increased by an average of 508 million person-days per year in the last decade. Mapping of changes per country highlighted significant exposure increases, particularly in the Middle East and in South East Asia. Major disparities were found between the heatwave exposures, country income group, and country health system capacity, thus highlighting the significant inequalities in global warming impacts and response capacities with respect to health across countries. It is therefore of prime importance that health development and response are coordinated with climate change mitigation and adaptation work.

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“…9 , 10 We have previously shown that temperature anomalies are independent predictors for a variety of health-related conditions. 11 , 12 In this study, we explore how the association between heat exposure and health outcomes changes according to timing of exposure. Specifically, using a nationwide hospitalization data set, we examine whether there is intraseasonal variation in the association between heat exposure and hospitalization in the Brazilian population.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Intraseasonal Variation in Hospitalization Associated With Heat Exposure in Brazil

Zhao

Coelho

et al. 2019

JAMA Netw Open

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Key Points Question During the hot season, is timing of heat exposure associated with varied risk of hospitalization in the Brazilian population? Findings In this time-stratified case-crossover study, the association between heat exposure and hospitalization was greatest in the early hot season, particularly for residents living in the northeast and central west regions of Brazil. Exposure to early heat was associated with the highest risk of hospitalization for children and elderly individuals, and for admissions for endocrine, nutritional, and metabolic diseases. Meaning Preventive strategies to mitigate the association of high temperature with population health should focus on extreme high temperatures occurring early in the hot season.

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Spatiotemporal and demographic variation in the association between temperature variability and hospitalizations in Brazil during 2000–2015: A nationwide time-series study

Cited by 50 publications

References 39 publications

Geographic, Demographic, and Temporal Variations in the Association between Heat Exposure and Hospitalization in Brazil: A Nationwide Study between 2000 and 2015

Geographic, Demographic, and Temporal Variations in the Association between Heat Exposure and Hospitalization in Brazil: A Nationwide Study between 2000 and 2015

Global and cross-country analysis of exposure of vulnerable populations to heatwaves from 1980 to 2018

Assessment of Intraseasonal Variation in Hospitalization Associated With Heat Exposure in Brazil

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