Low temperature, cold spells, and cardiorespiratory hospital admissions in Helsinki, Finland

Abstract

There is only limited scientific evidence with varying results on the association between hospital admissions and low ambient temperatures. Furthermore, there has been no research in Northern Europe on cold-associated morbidity. Therefore, this study investigated the associations of daily wintertime temperature and cold spells with cardiorespiratory hospital admissions in the Helsinki metropolitan area, Finland. Daily number of non-elective hospital admissions for 2001–2017 was obtained from the national hospital discharge register and meteorological data from the Finnish Meteorological Institute. Quasi-Poisson regression models were fitted, controlling for potential confounders such as time trend, weekday, holidays, air pollution, barometric pressure, and influenza. The associations of cold season daily mean ambient temperature and cold spells with hospital admissions were estimated using a penalized distributed lag linear models with 21 lag days. Decreased wintertime ambient temperature was associated with an increased risk of hospitalization for myocardial infarction in the whole population (relative risk [RR] per 1 °C decrease in temperature: 1.017, 95% confidence interval [CI]: 1.002–1.032). An increased risk of hospital admission for respiratory diseases (RR: 1.012, 95% CI: 1.002, 1.022) and chronic obstructive pulmonary disease (RR: 1.031, 95% CI: 1.006, 1.056) was observed only in the ≥ 75 years age group. There was an independent effect of cold spell days only for asthma admissions (RR: 2.348, 95% CI: 1.026, 5.372) in the all-ages group. Cold temperature increases the need for acute hospital care due to myocardial infarction and respiratory causes during winter in a northern climate.