Association between ambient temperature and childhood respiratory hospital visits in Beijing, China: a time-series study (2013–2017)
- 8 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Environmental Science and Pollution Research
- Vol. 28 (23), 29445-29454
- https://doi.org/10.1007/s11356-021-12817-w
Abstract
Little is known on the potential impact of temperature on respiratory morbidity, especially for children whose respiratory system can be more vulnerable to climate changes. In this time-series study, Poisson generalized additive models combined with distributed lag nonlinear models were used to assess the associations between ambient temperature and childhood respiratory morbidity. The impacts of extreme cold and hot temperatures were calculated as cumulative relative risks (cum.RRs) at the 1st and 99th temperature percentiles relative to the minimum morbidity temperature percentile. Attributable fractions of respiratory morbidity due to cold or heat were calculated for temperatures below or above the minimum morbidity temperature. Effect modifications by air pollution, age, and sex were assessed in stratified analyses. A total of 877,793 respiratory hospital visits of children under 14 years old between 2013 and 2017 were collected from Beijing Children's Hospital. Overall, we observed J-shaped associations with greater respiratory morbidity risks for exposure to lower temperatures, and higher fraction of all-cause respiratory hospital visits was caused by cold (33.1%) than by heat (0.9%). Relative to the minimum morbidity temperature (25 degrees C, except for rhinitis, which is 31 degrees C), the cum.RRs for extreme cold temperature (-6 degrees C) were 2.64 (95%CI: 1.51-4.61) for all-cause respiratory hospital visits, 2.73 (95%CI: 1.44-5.18) for upper respiratory infection, 2.76 (95%CI: 1.56-4.89) for bronchitis, 2.12 (95%CI: 1.30-3.47) for pneumonia, 2.06 (95%CI: 1.27-3.34) for rhinitis, and 4.02 (95%CI: 2.14-7.55) for asthma, whereas the associations between extreme hot temperature (29 degrees C) and respiratory hospital visits were not significant. The impacts of extreme cold temperature on asthma hospital visits were greater at higher levels of ozone (O-3) exposure (> 50th percentile). Our findings suggest significantly increased childhood respiratory morbidity risks at extreme cold temperature, and the impact of extreme cold temperature on asthma hospital visits can be enhanced under higher level exposure to O-3.Keywords
Funding Information
- National Science Foundation of China (81773381)
- National Key Research and Development Project (2016YFC0901103)
This publication has 44 references indexed in Scilit:
- High and low temperatures aggravate airway inflammation of asthma: Evidence in a mouse modelEnvironmental Pollution, 2019
- Lag effect of air temperature on the incidence of respiratory diseases in Lanzhou, ChinaInternational Journal of Biometeorology, 2019
- Association between ambient temperature and mortality risk and burden: time series study in 272 main Chinese citiesBMJ, 2018
- Two-way effect modifications of air pollution and air temperature on total natural and cardiovascular mortality in eight European urban areasEnvironment International, 2018
- Mortality risk attributable to high and low ambient temperature: a multicountry observational studyThe Lancet, 2015
- Short-term effects of air temperature on mortality and effect modification by air pollution in three cities of Bavaria, Germany: A time-series analysisScience of The Total Environment, 2014
- Attributable risk from distributed lag modelsBMC Medical Research Methodology, 2014
- Interactive short-term effects of equivalent temperature and air pollution on human mortality in Berlin and LisbonEnvironmental Pollution, 2013
- Effect of the Interaction Between Outdoor Air Pollution and Extreme Temperature on Daily Mortality in Shanghai, ChinaJournal of Epidemiology, 2012
- Pulmonary responses of asthmatic and normal subjects to different temperature and humidity conditions in an environmental chamberLung, 1992