Suicide and Ambient Temperature: A Multi-Country Multi-City Study

Kim, Yoonhee; Kim, Ho; Gasparrini, Antonio; Armstrong, Ben; Honda, Yasushi; Chung, Yeonseung; Ng, Chris Fook Sheng; Tobías, Aurelio; Íñiguez, Carmen; Lavigne, Éric; Sera, Francesco; Vicedo‐Cabrera, Ana M.; Ragettli, Martina S.; Scovronick, Noah; Acquaotta, Fiorella; Chen, Bing‐Yu; Guo, Yang; Seposo, Xerxes; Đăng, Trần Ngọc; Coêlho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilário Nascimento; Kosheleva, Anna; Zanobetti, Antonella; Schwartz, Joel; Bell, Michelle L.; Hashizume, Masahiro

doi:10.1289/ehp4898

Cited by 110 publications

(81 citation statements)

References 34 publications

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“…Changes in ambient temperature (increases or decreases) were related to short-term health impacts. Particularly in adults, increases in the ambient temperature above the 93rd percentile were found to be a risk factor of suicide [ 81 ], those expose to temperatures above 90th percentile or below 10th percentile to diabetes mortality [ 82 ], and those under orthopedic procedure during warmer weather periods of the year had an increased risk of postoperative infection [ 83 ]. Comparing high versus low temperatures, high temperature increases the risk of low birth weight and stillbirth among pregnant women [ 84 ].…”

Section: Resultsmentioning

confidence: 99%

Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses

Rojas-Rueda

Morales-Zamora

Alsufyani

et al. 2021

IJERPH

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Background: Environmental health is a growing area of knowledge, continually increasing and updating the body of evidence linking the environment to human health. Aim: This study summarizes the epidemiological evidence on environmental risk factors from meta-analyses through an umbrella review. Methods: An umbrella review was conducted on meta-analyses of cohort, case-control, case-crossover, and time-series studies that evaluated the associations between environmental risk factors and health outcomes defined as incidence, prevalence, and mortality. The specific search strategy was designed in PubMed using free text and Medical Subject Headings (MeSH) terms related to risk factors, environment, health outcomes, observational studies, and meta-analysis. The search was limited to English, Spanish, and French published articles and studies on humans. The search was conducted on September 20, 2020. Risk factors were defined as any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or death. The environment was defined as the external elements and conditions that surround, influence, and affect a human organism or population’s life and development. The environment definition included the physical environment such as nature, built environment, or pollution, but not the social environment. We excluded occupational exposures, microorganisms, water, sanitation and hygiene (WASH), behavioral risk factors, and no-natural disasters. Results: This umbrella review found 197 associations among 69 environmental exposures and 83 diseases and death causes reported in 103 publications. The environmental factors found in this review were air pollution, environmental tobacco smoke, heavy metals, chemicals, ambient temperature, noise, radiation, and urban residential surroundings. Among these, we identified 65 environmental exposures defined as risk factors and 4 environmental protective factors. In terms of study design, 57 included cohort and/or case-control studies, and 46 included time-series and/or case-crossover studies. In terms of the study population, 21 included children, and the rest included adult population and both sexes. In this review, the largest body of evidence was found in air pollution (91 associations among 14 air pollution definitions and 34 diseases and mortality diagnoses), followed by environmental tobacco smoke with 24 associations. Chemicals (including pesticides) were the third larger group of environmental exposures found among the meta-analyses included, with 19 associations. Conclusion: Environmental exposures are an important health determinant. This review provides an overview of an evolving research area and should be used as a complementary tool to understand the connections between the environment and human health. The evidence presented by this review should help to design public health interventions and the implementation of health in all policies approach aiming to improve populational health.

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Section: Resultsmentioning

confidence: 99%

Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses

Rojas-Rueda

Morales-Zamora

Alsufyani

et al. 2021

IJERPH

View full text Add to dashboard Cite

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“…A stratum variable was composed for year, month and day of the week, allowing us to control for long-term trends and seasonal and weekday effects, assuming that unmeasured time-dependent confounders are constant within a stratum (Lu et al 2008). Thus, the case and control days were compared within the same stratum; hence, each case day was matched to its control days on the same day of the week in the same month and the same year (Kim et al 2019).…”

Section: Resultsmentioning

confidence: 99%

Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden: a time-stratified case-crossover study

et al. 2020

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The spatial synoptic classification (SSC) is a holistic categorical assessment of the daily weather conditions at specific locations; it is a useful tool for assessing weather effects on health. In this study, we assessed (a) the effect of hot weather types and the duration of heat events on cardiovascular and respiratory mortality in summer and (b) the effect of cold weather types and the duration of cold events on cardiovascular and respiratory mortality in winter. A time-stratified case-crossover design combined with a distributed lag nonlinear model was carried out to investigate the association of weather types with cause-specific mortality in two southern (Skåne and Stockholm) and two northern (Jämtland and Västerbotten) locations in Sweden. During summer, in the southern locations, the Moist Tropical (MT) and Dry Tropical (DT) weather types increased cardiovascular and respiratory mortality at shorter lags; both hot weather types substantially increased respiratory mortality mainly in Skåne. The impact of heat events on mortality by cardiovascular and respiratory diseases was more important in the southern than in the northern locations at lag 0. The cumulative effect of MT, DT and heat events lagged over 14 days was particularly high for respiratory mortality in all locations except in Jämtland, though these did not show a clear effect on cardiovascular mortality. During winter, the dry polar and moist polar weather types and cold events showed a negligible effect on cardiovascular and respiratory mortality. This study provides valuable information about the relationship between hot oppressive weather types with cause-specific mortality; however, the cold weather types may not capture sufficiently effects on cause-specific mortality in this sub-Arctic region.

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“…Also, the amplitude of seasonality was larger for the elderly population than for younger people in many countries. Although age group differences have been inconclusive in previous studies (Woo et al ., 2012 ), our observation could relate to the temperature–suicide association reported as larger in elderly populations in some countries (Kim et al ., 2019 ; Sim et al ., 2020 ). The elderly may be more sensitive to seasonal temperature changes in terms of the risk of dying by suicide.…”

Section: Discussionmentioning

confidence: 99%

“…spring in the Northern Hemisphere) and more sensitive to seasonal temperature changes that may increase suicide risks. Such acclimatisation has been observed in the studies that investigated the association between temperature and all-cause mortality (Chung et al ., 2018 ; Sera et al ., 2019 ) and the temperature–suicide association also (Kim et al ., 2019 ; Sim et al ., 2020 ). In addition, larger seasonality in communities with higher proportions of elderly people is consistent with larger amplitudes observed for older age groups in most countries.…”

Section: Discussionmentioning

confidence: 99%

Seasonality of suicide: a multi-country multi-community observational study

Yang

Kim

et al. 2020

Epidemiol Psychiatr Sci

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Aims We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations. Methods Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986–2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression. Results We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The amplitude of seasonal patterns (i.e. the peak/trough relative risk) also varied from 1.47 (95% confidence interval [CI]: 1.33–1.62) to 1.05 (95% CI: 1.01–1.1) among 12 countries. The subgroup difference in the seasonal pattern also varied over countries. In some countries, larger amplitude was shown for females and for the elderly population (≥65 years of age) than for males and for younger people, respectively. The subperiod difference also varied; some countries showed increasing seasonality while others showed a decrease or little change. Finally, the amplitude was larger for communities with colder climates, higher proportions of elderly people and lower unemployment rates (p-values < 0.05). Conclusions Despite the common features of a spring peak and a winter trough, seasonal suicide patterns were largely heterogeneous in shape, amplitude, subgroup differences and temporal changes among different populations, as influenced by climate, demographic and socioeconomic conditions. Our findings may help elucidate the underlying mechanisms of seasonal suicide patterns and aid in improving the design of population-specific suicide prevention programmes based on these patterns.

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Suicide and Ambient Temperature: A Multi-Country Multi-City Study

Cited by 110 publications

References 34 publications

Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses

Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses

Hot and cold weather based on the spatial synoptic classification and cause-specific mortality in Sweden: a time-stratified case-crossover study

Seasonality of suicide: a multi-country multi-community observational study

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