Effect of extreme hot and cold weather on cause-specific hospitalizations in Sweden: A time series analysis

Osvaldo Fonseca-Rodríguez,Scott C Sheridan,Erling Häggström Lundevaller,Barbara Schumann

doi:10.1016/j.envres.2020.110535

Osvaldo Fonseca-Rodríguez, Scott C Sheridan + Show 2 more

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https://doi.org/10.1016/j.envres.2020.110535

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Journal: Environmental Research	Publication Date: Nov 30, 2020
Citations: 16	License type: cc-by

Affiliation: Umeå University, Kent State University

Abstract

Considering that several meteorological variables can contribute to weather vulnerability, the estimation of their synergetic effects on health is particularly useful. The spatial synoptic classification (SSC) has been used in biometeorological applications to estimate the effect of the entire suite of weather conditions on human morbidity and mortality. In this study, we assessed the relationships between extremely hot and dry (dry tropical plus, DT+) and hot and moist (moist tropical plus, MT+) weather types in summer and extremely cold and dry (dry polar plus, DP+) and cold and moist (moist polar, MP+) weather types in winter and cardiovascular and respiratory hospitalizations by age and sex. Time-series quasi-Poisson regression with distributed lags was used to assess the relationship between oppressive weather types and daily hospitalizations over 14 subsequent days in the extended summer (May to August) and 28 subsequent days during the extended winter (November to March) over 24 years in 4 Swedish locations from 1991 to 2014. In summer, exposure to hot weather types appeared to reduce cardiovascular hospitalizations while increased the risk of hospitalizations for respiratory diseases, mainly related to MT+. In winter, the effect of cold weather on both cause-specific hospitalizations was small; however, MP+ was related to a delayed increase in cardiovascular hospitalizations, whilst MP+ and DP + increased the risk of hospitalizations due to respiratory diseases. This study provides useful information for the staff of hospitals and elderly care centers who can help to implement protective measures for patients and residents. Also, our results could be helpful for vulnerable people who can adopt protective measures to reduce health risks.

Highlights

The effect of heat and cold on cardiovascular and respiratory mor tality has been studied extensively in a wide range of different geographic regions (Chen et al, 2017; Scovronick et al, 2018; Urban and Kysely 2018; Yang et al, 2018), including Sweden (Fonseca-Ro dríguez et al, 2020; Rocklov et al 2011, 2014)
This study aimed to assess the relationships between the extreme subsets of the hot and cold weather types and cardiovascular and respiratory hospitaliza tions according to age and sex in summer and winter, respectively, in four Swedish locations
Our data show a strong seasonality of hospitalizations, with a sub stantial dip in July, which differs from the mortality patterns that showed a smoothed reduction of deaths in summer

Summary

Introduction

The effect of heat and cold on cardiovascular and respiratory mor tality has been studied extensively in a wide range of different geographic regions (Chen et al, 2017; Scovronick et al, 2018; Urban and Kysely 2018; Yang et al, 2018), including Sweden (Fonseca-Ro dríguez et al, 2020; Rocklov et al 2011, 2014). Other studies have addressed the role of weather variability on total and cause-specific mortality before and during industrialization in Sweden (Astrom et al, 2016; Rocklov et al, 2014; Schumann et al, 2013). Most studies on morbidity have focused on the effect of temperature without considering other weather variables, showing partly opposing results (Kovats and Hajat 2008; Ma et al, 2011; Michelozzi et al, 2009; Phung et al, 2016; Sheridan and Lin 2014; Turner et al, 2013; Urban et al, 2014; Urban and Kysely 2018; Wang et al, 2009; Wichmann et al, 2013).

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