Abstract
BackgroundThe correlation of unintentional injury mortality to rising temperatures found in several studies could result from changes in behavior that increases exposure to hazards or risk when exposed. Temperature, precipitation and air pollutants may contribute to symptoms and distractions that increase risk or avoidance behavior that reduces risk. This study examines data that allows estimates of the relation of daily maximum temperature, precipitation and ozone pollution to injury mortality risk, each corrected statistically for the correlation with the others.MethodsDaily data on unintentional injury deaths and exposures to temperature, precipitation and ozone in 9 cities in Jiangsu Province, China during 2015–2017 were analyzed using Poisson regression. The regression estimates were adjusted for weekends, holidays, an anomalous difference in death rates in Nanjing, and population size.ResultsNon transport injury death risk increased substantially in relation to higher temperatures when temperatures were in the moderate range and even more so at temperatures 35 degrees (C) and higher. Transport deaths were related to increasing deaths when temperatures were low but the correlation reversed at higher temperatures. Deaths were lower on rainy days when temperatures were cool and moderate with the exception of non-transport injuries when temperatures were moderate. Higher ozone concentrations were associated with more deaths except when temperatures were low.ConclusionsThe variations in deaths in relation to temperature, precipitation and ozone suggest that people are behaving differently or are in different environments when specific combinations of the predictor variables are prevalent, putting them at greater or less risk. More study of the behaviors and circumstances that result in injury under those conditions is needed.
Highlights
The correlation of unintentional injury mortality to rising temperatures found in several studies could result from changes in behavior that increases exposure to hazards or risk when exposed
The purpose of this paper is to report analysis of the extent to which daily fluctuations in temperature, precipitation and ozone concentrations were related to the daily counts of fatal injury during 2015 through 2017 in nine cities located in Jiangsu Province, China
The three year upward trend in total injury death rates in several cities is mainly due to unintentional injuries other than those experienced in transport
Summary
The correlation of unintentional injury mortality to rising temperatures found in several studies could result from changes in behavior that increases exposure to hazards or risk when exposed. This study examines data that allows estimates of the relation of daily maximum temperature, precipitation and ozone pollution to injury mortality risk, each corrected statistically for the correlation with the others. Temperature, precipitation and air pollution may affect risk of injury in two ways: behavior changes that increase or decrease exposure to potentially injurious energy or increased risk if exposed. While peoples’ attention to tasks at hand may be distracted by extreme temperatures, the more likely explanation for much of the correlation is changes in human activity based on temperature and precipitation that expose them to greater or less environmental hazards. The correlation of temperature to drug overdoses could partly be the result of addicts being more often under the watch of families or other persons who care for them on cold or wet days that inhibit freedom of movement
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