Extreme ambient temperatures and cardiorespiratory emergency room visits: assessing risk by comorbid health conditions in a time series study.
Identifieur interne : 000290 ( Main/Corpus ); précédent : 000289; suivant : 000291Extreme ambient temperatures and cardiorespiratory emergency room visits: assessing risk by comorbid health conditions in a time series study.
Auteurs : Eric Lavigne ; Antonio Gasparrini ; Xiang Wang ; Hong Chen ; Abderrahmane Yagouti ; Manon D. Fleury ; Sabit CakmakSource :
- Environmental health : a global access science source [ 1476-069X ] ; 2014.
English descriptors
- KwdEn :
- Air Pollutants (analysis), Carbon Monoxide (analysis), Cardiovascular Diseases (epidemiology), Comorbidity, Emergency Service, Hospital (statistics & numerical data), Extreme Cold Weather (adverse effects), Extreme Heat (adverse effects), Humans, Nitrogen Dioxide (analysis), Ontario (epidemiology), Ozone (analysis), Particulate Matter (analysis), Respiratory Tract Diseases (epidemiology), Risk, Sulfur Dioxide (analysis).
- MESH :
- chemical , analysis : Air Pollutants, Carbon Monoxide, Nitrogen Dioxide, Ozone, Particulate Matter, Sulfur Dioxide.
- geographic , epidemiology : Ontario.
- adverse effects : Extreme Cold Weather, Extreme Heat.
- epidemiology : Cardiovascular Diseases, Respiratory Tract Diseases.
- statistics & numerical data : Emergency Service, Hospital.
- Comorbidity, Humans, Risk.
Abstract
BACKGROUND
Extreme ambient temperatures are an increasing public health concern. The aim of this study was to assess if persons with comorbid health conditions were at increased risk of adverse cardiorespiratory morbidity during temperature extremes.
METHODS
A time series study design was applied to 292,666 and 562,738 emergency room (ER) visits for cardiovascular and respiratory diseases, respectively, that occurred in Toronto area hospitals between April 1st 2002 and March 31st 2010. Subgroups of persons with comorbid health conditions were identified. Relative risks (RRs) and their corresponding 95% confidence intervals (CIs) were estimated using a Poisson regression model with distributed lag non-linear model, and were adjusted for the confounding influence of seasonality, relative humidity, day-of-the-week, outdoor air pollutants and daily influenza ER visits. Effect modification by comorbid health conditions was tested using the relative effect modification (REM) index.
RESULTS
Stronger associations of cardiovascular disease ER visits were observed for persons with diabetes compared to persons without diabetes (REM = 1.12; 95% CI: 1.01 - 1.27) with exposure to the cumulative short term effect of extreme hot temperatures (i.e. 99th percentile of temperature distribution vs. 75th percentile). Effect modification was also found for comorbid respiratory disease (REM = 1.17; 95% CI: 1.02 - 1.44) and cancer (REM = 1.20; 95% CI: 1.02 - 1.49) on respiratory disease ER visits during short term hot temperature episodes. The effect of extreme cold temperatures (i.e. 1st percentile of temperature distribution vs. 25th percentile) on cardiovascular disease ER visits were stronger for individuals with comorbid cardiac diseases (REM = 1.47; 95% CI: 1.06 - 2.23) and kidney diseases (REM = 2.43; 95% CI: 1.59 - 8.83) compared to those without these conditions when cumulated over a two-week period.
CONCLUSIONS
The identification of those most susceptible to temperature extremes is important for public health officials to implement adaptation measures to manage the impact of extreme temperatures on population health.
DOI: 10.1186/1476-069X-13-5
PubMed: 24484632
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Fleury</name></author><author><name sortKey="Cakmak, Sabit" sort="Cakmak, Sabit" uniqKey="Cakmak S" first="Sabit" last="Cakmak">Sabit Cakmak</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:24484632</idno><idno type="pmid">24484632</idno><idno type="doi">10.1186/1476-069X-13-5</idno><idno type="wicri:Area/Main/Corpus">000290</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000290</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Extreme ambient temperatures and cardiorespiratory emergency room visits: assessing risk by comorbid health conditions in a time series study.</title><author><name sortKey="Lavigne, Eric" sort="Lavigne, Eric" uniqKey="Lavigne E" first="Eric" last="Lavigne">Eric Lavigne</name><affiliation><nlm:affiliation>Environmental Issues Division, Public Health Agency of Canada, Ottawa, Canada. eric.lavigne@phac-aspc.gc.ca.</nlm:affiliation></affiliation></author><author><name sortKey="Gasparrini, Antonio" sort="Gasparrini, Antonio" uniqKey="Gasparrini A" first="Antonio" last="Gasparrini">Antonio Gasparrini</name></author><author><name sortKey="Wang, Xiang" sort="Wang, Xiang" uniqKey="Wang X" first="Xiang" last="Wang">Xiang Wang</name></author><author><name sortKey="Chen, Hong" sort="Chen, Hong" uniqKey="Chen H" first="Hong" last="Chen">Hong Chen</name></author><author><name sortKey="Yagouti, Abderrahmane" sort="Yagouti, Abderrahmane" uniqKey="Yagouti A" first="Abderrahmane" last="Yagouti">Abderrahmane Yagouti</name></author><author><name sortKey="Fleury, Manon D" sort="Fleury, Manon D" uniqKey="Fleury M" first="Manon D" last="Fleury">Manon D. Fleury</name></author><author><name sortKey="Cakmak, Sabit" sort="Cakmak, Sabit" uniqKey="Cakmak S" first="Sabit" last="Cakmak">Sabit Cakmak</name></author></analytic><series><title level="j">Environmental health : a global access science source</title><idno type="eISSN">1476-069X</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Air Pollutants (analysis)</term><term>Carbon Monoxide (analysis)</term><term>Cardiovascular Diseases (epidemiology)</term><term>Comorbidity</term><term>Emergency Service, Hospital (statistics & numerical data)</term><term>Extreme Cold Weather (adverse effects)</term><term>Extreme Heat (adverse effects)</term><term>Humans</term><term>Nitrogen Dioxide (analysis)</term><term>Ontario (epidemiology)</term><term>Ozone (analysis)</term><term>Particulate Matter (analysis)</term><term>Respiratory Tract Diseases (epidemiology)</term><term>Risk</term><term>Sulfur Dioxide (analysis)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analysis" xml:lang="en"><term>Air Pollutants</term><term>Carbon Monoxide</term><term>Nitrogen Dioxide</term><term>Ozone</term><term>Particulate Matter</term><term>Sulfur Dioxide</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ontario</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Extreme Cold Weather</term><term>Extreme Heat</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cardiovascular Diseases</term><term>Respiratory Tract Diseases</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Emergency Service, Hospital</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Comorbidity</term><term>Humans</term><term>Risk</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Extreme ambient temperatures are an increasing public health concern. The aim of this study was to assess if persons with comorbid health conditions were at increased risk of adverse cardiorespiratory morbidity during temperature extremes.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A time series study design was applied to 292,666 and 562,738 emergency room (ER) visits for cardiovascular and respiratory diseases, respectively, that occurred in Toronto area hospitals between April 1st 2002 and March 31st 2010. Subgroups of persons with comorbid health conditions were identified. Relative risks (RRs) and their corresponding 95% confidence intervals (CIs) were estimated using a Poisson regression model with distributed lag non-linear model, and were adjusted for the confounding influence of seasonality, relative humidity, day-of-the-week, outdoor air pollutants and daily influenza ER visits. Effect modification by comorbid health conditions was tested using the relative effect modification (REM) index.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Stronger associations of cardiovascular disease ER visits were observed for persons with diabetes compared to persons without diabetes (REM = 1.12; 95% CI: 1.01 - 1.27) with exposure to the cumulative short term effect of extreme hot temperatures (i.e. 99th percentile of temperature distribution vs. 75th percentile). Effect modification was also found for comorbid respiratory disease (REM = 1.17; 95% CI: 1.02 - 1.44) and cancer (REM = 1.20; 95% CI: 1.02 - 1.49) on respiratory disease ER visits during short term hot temperature episodes. The effect of extreme cold temperatures (i.e. 1st percentile of temperature distribution vs. 25th percentile) on cardiovascular disease ER visits were stronger for individuals with comorbid cardiac diseases (REM = 1.47; 95% CI: 1.06 - 2.23) and kidney diseases (REM = 2.43; 95% CI: 1.59 - 8.83) compared to those without these conditions when cumulated over a two-week period.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The identification of those most susceptible to temperature extremes is important for public health officials to implement adaptation measures to manage the impact of extreme temperatures on population health.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24484632</PMID><DateCompleted><Year>2014</Year><Month>10</Month><Day>09</Day></DateCompleted><DateRevised><Year>2019</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1476-069X</ISSN><JournalIssue CitedMedium="Internet"><Volume>13</Volume><Issue>1</Issue><PubDate><Year>2014</Year><Month>Feb</Month><Day>03</Day></PubDate></JournalIssue><Title>Environmental health : a global access science source</Title><ISOAbbreviation>Environ Health</ISOAbbreviation></Journal><ArticleTitle>Extreme ambient temperatures and cardiorespiratory emergency room visits: assessing risk by comorbid health conditions in a time series study.</ArticleTitle><Pagination><MedlinePgn>5</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1476-069X-13-5</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Extreme ambient temperatures are an increasing public health concern. The aim of this study was to assess if persons with comorbid health conditions were at increased risk of adverse cardiorespiratory morbidity during temperature extremes.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A time series study design was applied to 292,666 and 562,738 emergency room (ER) visits for cardiovascular and respiratory diseases, respectively, that occurred in Toronto area hospitals between April 1st 2002 and March 31st 2010. Subgroups of persons with comorbid health conditions were identified. Relative risks (RRs) and their corresponding 95% confidence intervals (CIs) were estimated using a Poisson regression model with distributed lag non-linear model, and were adjusted for the confounding influence of seasonality, relative humidity, day-of-the-week, outdoor air pollutants and daily influenza ER visits. Effect modification by comorbid health conditions was tested using the relative effect modification (REM) index.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Stronger associations of cardiovascular disease ER visits were observed for persons with diabetes compared to persons without diabetes (REM = 1.12; 95% CI: 1.01 - 1.27) with exposure to the cumulative short term effect of extreme hot temperatures (i.e. 99th percentile of temperature distribution vs. 75th percentile). Effect modification was also found for comorbid respiratory disease (REM = 1.17; 95% CI: 1.02 - 1.44) and cancer (REM = 1.20; 95% CI: 1.02 - 1.49) on respiratory disease ER visits during short term hot temperature episodes. The effect of extreme cold temperatures (i.e. 1st percentile of temperature distribution vs. 25th percentile) on cardiovascular disease ER visits were stronger for individuals with comorbid cardiac diseases (REM = 1.47; 95% CI: 1.06 - 2.23) and kidney diseases (REM = 2.43; 95% CI: 1.59 - 8.83) compared to those without these conditions when cumulated over a two-week period.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The identification of those most susceptible to temperature extremes is important for public health officials to implement adaptation measures to manage the impact of extreme temperatures on population health.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lavigne</LastName><ForeName>Eric</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Environmental Issues Division, Public Health Agency of Canada, Ottawa, Canada. eric.lavigne@phac-aspc.gc.ca.</Affiliation></AffiliationInfo></Author><Author 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