Abstract
ObjectiveThis study evaluated risks of the emergency room visits (ERV) for cerebrovascular diseases, heart diseases, ischemic heart disease, hypertensive diseases, chronic renal failure (CRF), diabetes mellitus (DM), asthma, chronic airway obstruction not elsewhere classified (CAO), and accidents associated with the ambient temperature from 2000 to 2009 in metropolitan Taipei.MethodsThe distributed lag non-linear model was used to estimate the cumulative relative risk (RR) and confidence interval (CI) of cause-specific ERV associated with daily temperature from lag 0 to lag 3 after controlling for potential confounders.ResultsThis study identified that temperatures related to the lowest risk of ERV was 26 °C for cerebrovascular diseases, 18 °C for CRF, DM, and accidents, and 30 °C for hypertensive diseases, asthma, and CAO. These temperatures were used as the reference temperatures to measure RR for the corresponding diseases. A low temperature (14°C) increased the ERV risk for cerebrovascular diseases, hypertensive diseases, and asthma, with respective cumulative 4-day RRs of 1.56 (95% CI: 1.23, 1.97), 1.78 (95% CI: 1.37, 2.34), and 2.93 (95% CI: 1.26, 6.79). The effects were greater on, or after, lag one. At 32°C, the cumulative 4-day RR for ERV was significant for CRF (RR = 2.36; 95% CI: 1.33, 4.19) and accidents (RR = 1.23; 95% CI: 1.14, 1.33) and the highest RR was seen on lag 0 for CRF (RR = 1.69; 95% CI: 1.01, 3.58), DM (RR = 1.69; 95% CI: 1.09, 2.61), and accidents (RR = 1.19; 95% CI: 1.11, 1.27).ConclusionsHigher temperatures are associated with the increased ERV risks for CRF, DM, and accidents and lower temperatures with the increased ERV risks for cerebrovascular diseases, hypertensive diseases, and asthma in the subtropical metropolitan.
Highlights
Extreme temperature on a given day and prolonged extreme heat and cold events are associated worldwide with increased mortality from, and morbidity of, all causes or cardiovascular diseases, respiratory diseases, and renal diseases [1,2,3,4,5,6,7,8,9,10,11,12,13]
Among 192089 insured persons, we identified 6962 emergency room visits (ERV) for cerebrovascular diseases, 5198 for heart diseases, 5743 for ischemic heart disease (IHD), 7366 for hypertensive diseases, 2610 for chronic renal failure (CRF), 3573 for diabetes mellitus (DM), 835 for asthma, 2371 for CAO, and 141792 for accidents
The lowest ERV were associated with an average temperature of 26 uC in the case of cerebrovascular diseases, 18 uC for CRF, DM, and accidents, and 30 uC for hypertensive diseases, asthma, and CAO; these temperatures were used as the centered temperatures for the corresponding diseases
Summary
Extreme temperature on a given day and prolonged extreme heat and cold events (referred to in this paper as ‘‘events’’) are associated worldwide with increased mortality from, and morbidity of, all causes or cardiovascular diseases, respiratory diseases, and renal diseases [1,2,3,4,5,6,7,8,9,10,11,12,13]. A few studies have addressed the effect of extreme temperatures on specific diseases [1,9,12,13,14]. These findings result in better general public health preparedness for extreme heat and cold events. How extreme temperatures may exacerbate disease for a population living in this subtropical climate is of interest. An extreme temperature event was defined as a daily average temperature in the 97th or 5th percentile lasting for 3 days or longer or temperatures in the 99th or 1st percentile lasting for 2 days or longer
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