The impact of cold spells on mortality and effect modification by cold spell characteristics

Wang, Lijun; Liu, Tao; Hu, Mengjue; Zeng, Weilin; Zhang, Yonghui; Rutherford, Shannon; Lin, Hualiang; Xiao, Jianpeng; Yin, Peng; Liu, Jiangmei; Chu, Cordia; Tong, Shilu; Zhou, Maigeng

doi:10.1038/srep38380

Cited by 70 publications

(30 citation statements)

References 50 publications

(87 reference statements)

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“…Our results showed larger effect estimates for all mortality types during longer cold spells and for most mortality types during cold spells that were more intense, which is consistent with previous studies ( Chen et al. 2020 ; Wang et al. 2016 ).…”

Section: Discussionsupporting

confidence: 93%

Cold Spells and Cause-Specific Mortality in 47 Japanese Prefectures: A Systematic Evaluation

Yang

Nakayama

et al. 2021

Environ Health Perspect

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Background: Many studies have investigated the devastating health effects of heat waves, but less is known about health risks related to cold spells, despite evidence that extreme cold may contribute to a larger proportion of deaths. Objectives: We aimed to systematically investigate the association between cold spells and mortality in Japan. Methods: Daily data for weather conditions and 12 common causes of death during the 1972–2015 cold seasons (November–March) were obtained from 47 Japanese prefectures. Cold spells were defined as consecutive days with daily mean temperatures percentile for the cold season in each prefecture. Quasi-Poisson regression was combined with a distributed lag model to estimate prefecture-specific associations, and pooled associations at the national level were obtained through random-effects meta-analysis. The potential influence of cold spell characteristics (intensity, duration, and timing in season) on associations between cold spells and mortality was examined using a similar two-stage approach. Temporal trends were investigated using a meta-regression model. Results: A total of 18,139,498 deaths were recorded during study period. Mortality was significantly higher during cold spell days vs. other days for all selected causes of death. Mortality due to age-related physical debilitation was more strongly associated with cold spells than with other causes of death. Associations between cold spells and mortality from all causes and several more specific outcomes were stronger for longer and more intense cold spells and for cold spells earlier in the cold season. However, although all outcomes were positively associated with cold spell duration, findings for cold spell intensity and seasonal timing were heterogeneous across the outcomes. Associations between cold spells and mortality due to cerebrovascular disease, cerebral infarction, and age-related physical debility decreased in magnitude over time, whereas temporal trends were relatively flat for all-cause mortality and other outcomes. Discussion: Our findings may have implications for establishing tailored public health strategies to prevent avoidable cold spell–related health consequences. https://doi.org/10.1289/EHP7109

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Section: Discussionsupporting

confidence: 93%

Cold Spells and Cause-Specific Mortality in 47 Japanese Prefectures: A Systematic Evaluation

Yang

Nakayama

et al. 2021

Environ Health Perspect

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“…In addition, in the present study the duration of cold events did not show a relevant impact on respiratory mortality, in line with two previous Swedish studies (Rocklöv et al 2011;Rocklöv et al 2014). Different results, however, were found by Wang et al (2016), who reported that the duration of cold events significantly increases respiratory mortality.…”

Section: Wintersupporting

confidence: 87%

“…In Skåne we also found a cumulative effect of a 28-day cold DIS duration on cardiovascular mortality. The duration of cold events is a risk factor for an increase in cardiovascular mortality, as reported by other authors (Wang et al 2016 ). Also, a recent study found that a long duration of extreme cold events generally results in a much larger and significantly increased rate of mortality (Smith and Sheridan 2018 ).…”

Section: Discussionsupporting

confidence: 69%

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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“…6 Moreover, some researchers suggested that daily mean temperature is superior to the minimum or maximum temperature as an indicator to define cold spells because it reflects the exposure throughout the day rather than a short Open access period. 20 29 Therefore, we defined cold spell episodes as days when the daily mean temperature was at or below the 10th, 5th or 3rd percentile for at least 2, 3 or 4 consecutive days of the study period. 21 To avoid possible biases caused by a few extreme summer events, we restricted the study period to the five coldest adjacent months (from November of the previous year to March of the following year) for each year.…”

Section: Materials and Methods Data Collectionmentioning

confidence: 99%

Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China

et al. 2021

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ObjectivesOur work aimed at exploring the relationship between cold spells and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalisations in Beijing, China, and assessing the moderating effects of the intensities and the durations of cold spells, as well as identifying the vulnerable.DesignA time-series study.SettingWe obtained time-series data of AECOPD hospitalisations, meteorological variables and air quality index in Beijing, China during 2012–2016.ParticipantsAll AECOPD hospitalisations among permanent residents in Beijing, China during the cold seasons (November–March) of 2012–2016 were included (n=84 571).Primary and secondary outcome measuresA quasi-Poisson regression with a distributed lag model was fitted to investigate the short-term effects of cold spells on AECOPD hospitalisations by comparing the counts of AECOPD admissions during cold spell days with those during non-cold spell days.ResultsCold spells under different definitions were associated with increased risk of AECOPD hospitalisations, with the maximum cumulative relative risk (CRR) over 3 weeks (lag0–21). The cumulative effects at lag0–21 increased with the intensities and the durations of cold spells. Under the optimal definition, the most significant single-day relative risk (RR) was found on the days of cold spells (lag0) with an RR of 1.042 (95% CI 1.013 to 1.072), and the CRR at lag0–21 was 1.394 (95% CI 1.193 to 1.630). The elderly (aged ≥65) were more vulnerable to the effects of cold spells on AECOPD hospitalisations.ConclusionCold spells are associated with increased AECOPD hospitalisations in Beijing, with the cumulative effects increased with intensities and durations. The elderly are at particular risk of AECOPD hospitalisations triggered by cold spells.

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The impact of cold spells on mortality and effect modification by cold spell characteristics

Cited by 70 publications

References 50 publications

Cold Spells and Cause-Specific Mortality in 47 Japanese Prefectures: A Systematic Evaluation

Cold Spells and Cause-Specific Mortality in 47 Japanese Prefectures: A Systematic Evaluation

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

Short-term effects of cold spells on hospitalisations for acute exacerbation of chronic obstructive pulmonary disease: a time-series study in Beijing, China

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