Abstract
BackgroundStudies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China.MethodsWe collected daily asthma hospitalizations, meteorological factors and air quality data in Beijing from 2012 to 2015. We applied a time-stratified case-crossover design and fitted a distributed lag non-linear model with a conditional quasi-Poisson regression to explore the association between ambient temperature and adult asthma hospitalizations. The effect modifications of these associations by gender and age were assessed by stratified analyses. We also computed the attributable fractions and numbers with 95% empirical confidence intervals (eCI) of asthma hospitalizations due to extreme and moderate temperatures.ResultsFrom 2012 to 2015, we identified a total of 18,500 hospitalizations for asthma among adult residents in Beijing, China. Compared with the optimal temperature (22 °C), the cumulative relative risk (CRR) over lag 0–30 days was 2.32 with a 95% confidence interval (CI) of 1.57–3.42 for extreme cold corresponding to the 2.5th percentile (− 6.5 °C) of temperature distribution and 2.04 (95% CI 1.52–2.74) for extreme heat corresponding to the 97.5th percentile (29 °C) of temperature distribution. 29.1% (95% eCI 17.5–38.0%) of adult asthma hospitalizations was attributable to non-optimum temperatures. Moderate cold temperatures yielded most of the burdens, with an attributable fraction of 20.3% (95% eCI 9.1–28.7%). The temperature-related risks of asthma hospitalizations were more prominent in females and younger people (19–64 years old).ConclusionsThere was a U-shaped association between ambient temperature and the risk of adult asthma hospitalizations in Beijing, China. Females and younger patients were more vulnerable to the effects of non-optimum temperatures. Most of the burden was attributable to moderate cold. Our findings may uncover the potential impact of climate changes on asthma exacerbations.
Highlights
Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial
We found that both extreme cold (2.5th percentile vs. minimum admission temperature (MAT)) and heat (97.5th percentile vs. MAT) exposures were significantly associated with higher risks of asthma hospitalizations through lag 14 to 30 days, with the maximum cumulative relative risk (CRR) over lag 0–30 days (Extreme cold: CRR = 2.32, 95% confidence interval (CI) 1.57, 3.42; Extreme heat: CRR = 2.04, 95% CI 1.52, 2.74)
We only focused on the association between ambient temperature and more severe asthma exacerbations requiring admission to a hospital ward, which may underestimate the effect of abnormal temperatures
Summary
Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China. Asthma is among the most prevalent chronic airway diseases with significant public health consequences. According to the Global Burden of Disease, asthma affected about 358 million people in 2015, leading to. Considering the high prevalence of asthma and the difficulty in control and intervention, a comprehensive understanding of the risk factors of asthma exacerbations is imperative. Many environmental risk factors, such as air pollution, pollen, tobacco smoke and meteorological factors have been reported to contribute to asthma exacerbations, leading to hospitalization [4,5,6]
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