Abstract
Previous studies have demonstrated that outdoor temperature exposure was an important risk factor for respiratory diseases. However, no study investigates the effect of indoor temperature exposure on respiratory diseases and further assesses cumulative effect. The objective of this study is to study the cumulative effect of indoor temperature exposure on emergency department visits due to infectious (IRD) and non-infectious (NIRD) respiratory diseases among older adults. Subjects were collected from the Longitudinal Health Insurance Database in Taiwan. The cumulative degree hours (CDHs) was used to assess the cumulative effect of indoor temperature exposure. A distributed lag nonlinear model with quasi-Poisson function was used to analyze the association between CDHs and emergency department visits due to IRD and NIRD. For IRD, there was a significant risk at 27, 28, 29, 30, and 31 °C when the CDHs exceeded 69, 40, 14, 5, and 1 during the cooling season (May to October), respectively, and at 19, 20, 21, 22, and 23 °C when the CDHs exceeded 8, 1, 1, 35, and 62 during the heating season (November to April), respectively. For NIRD, there was a significant risk at 19, 20, 21, 22, and 23 °C when the CDHs exceeded 1, 1, 16, 36, and 52 during the heating season, respectively; the CDHs at 1 was only associated with the NIRD at 31 °C during the cooling season. Our data also indicated that the CDHs was lower among men than women. We conclude that the cumulative effects of indoor temperature exposure should be considered to reduce IRD risk in both cooling and heating seasons and NIRD risk in heating season and the cumulative effect on different gender.
Highlights
The extreme temperature has critical effects on human health
Temperature change could affect the concentrations of inflammatory markers [6,7], such as C-reactive protein, fibrinogen, and interleukin-6 (IL-6), which induces non-infectious respiratory diseases (NIRD) [8,9,10], such as asthma and chronic obstructive pulmonary disease (COPD)
Our findings demonstrated that a significant risk of emergency department visits due to IRD occurred when the indoor temperature exceeded 27 ◦ C during the cooling season and the cumulative degree hours (CDHs) decreased with increases in indoor temperature; the risk was significant when the indoor temperature was lower than 23 ◦ C during the heating season, and the CDHs decreased with decreasing in indoor temperature
Summary
Numerous studies have investigated the risk of respiratory diseases associated with extreme outdoor temperature exposure [1,2,3] and have demonstrated that extreme temperature change is an important risk factor. Some studies have further revealed that temperature change is associated with mortality from infectious respiratory diseases (IRD) [4,5]. Temperature change could affect the concentrations of inflammatory markers [6,7], such as C-reactive protein, fibrinogen, and interleukin-6 (IL-6), which induces non-infectious respiratory diseases (NIRD) [8,9,10], such as asthma and chronic obstructive pulmonary disease (COPD). The outdoor temperature change could be a risk factor for NIRD. The frequency of people-to-people contact significantly increases or changes human
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