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Short-term effects of the 2008 cold spell on mortality in three subtropical cities in Guangdong Province, China.

Xie H, Yao Z, Zhang Y, Xu Y, Xu X, Liu T, Lin H, Lao X, Rutherford S, Chu C, Huang C, Baum S, Ma W - Environ. Health Perspect. (2012)

Bottom Line: Estimated effects at lag0-27 were more pronounced for males than for females, for respiratory mortality than for cardiovascular mortality, and for the elderly (≥ 75 years of age) than for those 0-64 years of age.Most of the cumulative RRs increased with longer lag times in Guangzhou and Taishan.However, in Nanxiong, the trend with cumulative RRs was less consistent, and we observed no statistically significant associations at lag0-27.

View Article: PubMed Central - PubMed

Affiliation: Guangdong Provincial Institute of Public Health, Guangzhou, Guangdong, China.

ABSTRACT

Background: Few studies have been conducted to investigate the impact of extreme cold events on mortality in subtropical regions.

Objective: In the present study we aimed to investigate the effects of the 2008 cold spell on mortality and the possibility of mortality displacement in three subtropical cities in China.

Methods: Daily mortality, air pollution, and weather data were collected from 2006 to 2009 in Guangzhou, Nanxiong (no air pollutants), and Taishan. We used a polynomial distributed lag model (DLM) to analyze the relationship between the 2008 cold spell and mortality. To observe the mortality displacement of the cold spell, we estimated the cumulative effects at lag0, lag0-6, lag0-13, lag0-20, and lag0-27 separately.

Results: During the 2008 cold spell, the cumulative risk of nonaccidental mortality increased significantly in Guangzhou [relative risk (RR) = 1.60; 95% CI: 1.19, 2.14] and Taishan (RR = 1.60; 95% CI: 1.06, 2.40) when lagged up to 4 weeks after the cold spell ended. Estimated effects at lag0-27 were more pronounced for males than for females, for respiratory mortality than for cardiovascular mortality, and for the elderly (≥ 75 years of age) than for those 0-64 years of age. Most of the cumulative RRs increased with longer lag times in Guangzhou and Taishan. However, in Nanxiong, the trend with cumulative RRs was less consistent, and we observed no statistically significant associations at lag0-27.

Conclusion: We found associations between the 2008 cold spell and increased mortality in the three subtropical cities of China. The lag effect structure of the cold spell varied with location and the type of mortality, and evidence of short-term mortality displacement was inconsistent. These findings suggest that extreme cold is an important public health problem in subtropical regions.

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Relationship between Tmin and daily mortality in Guangzhou (A), Nanxiong (B), and Taishan (C) during the 2008 cold spell relative to corresponding days in 2006, 2007, and 2009.
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f2: Relationship between Tmin and daily mortality in Guangzhou (A), Nanxiong (B), and Taishan (C) during the 2008 cold spell relative to corresponding days in 2006, 2007, and 2009.

Mentions: Figure 2 shows the increase of daily death counts observed in the three cities during the 2008 cold spell relative to the means for corresponding days in 2006, 2007, and 2009. The largest increase in mortality was observed in Nanxiong, with 52% more deaths than the average for the corresponding days in 2006, 2007 and 2009, and the smallest increase in deaths was observed in Taishan, with 35% more deaths than in 2006, 2007, and 2009 (Table 3). The excess mortality rate increased dramatically with age in all three cities, and was highest for residents > 75 years of age in Nanxiong (427.2 excess deaths per 100,000; 95% CI: 336.6, 543.7).


Short-term effects of the 2008 cold spell on mortality in three subtropical cities in Guangdong Province, China.

Xie H, Yao Z, Zhang Y, Xu Y, Xu X, Liu T, Lin H, Lao X, Rutherford S, Chu C, Huang C, Baum S, Ma W - Environ. Health Perspect. (2012)

Relationship between Tmin and daily mortality in Guangzhou (A), Nanxiong (B), and Taishan (C) during the 2008 cold spell relative to corresponding days in 2006, 2007, and 2009.
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569675&req=5

f2: Relationship between Tmin and daily mortality in Guangzhou (A), Nanxiong (B), and Taishan (C) during the 2008 cold spell relative to corresponding days in 2006, 2007, and 2009.
Mentions: Figure 2 shows the increase of daily death counts observed in the three cities during the 2008 cold spell relative to the means for corresponding days in 2006, 2007, and 2009. The largest increase in mortality was observed in Nanxiong, with 52% more deaths than the average for the corresponding days in 2006, 2007 and 2009, and the smallest increase in deaths was observed in Taishan, with 35% more deaths than in 2006, 2007, and 2009 (Table 3). The excess mortality rate increased dramatically with age in all three cities, and was highest for residents > 75 years of age in Nanxiong (427.2 excess deaths per 100,000; 95% CI: 336.6, 543.7).

Bottom Line: Estimated effects at lag0-27 were more pronounced for males than for females, for respiratory mortality than for cardiovascular mortality, and for the elderly (≥ 75 years of age) than for those 0-64 years of age.Most of the cumulative RRs increased with longer lag times in Guangzhou and Taishan.However, in Nanxiong, the trend with cumulative RRs was less consistent, and we observed no statistically significant associations at lag0-27.

View Article: PubMed Central - PubMed

Affiliation: Guangdong Provincial Institute of Public Health, Guangzhou, Guangdong, China.

ABSTRACT

Background: Few studies have been conducted to investigate the impact of extreme cold events on mortality in subtropical regions.

Objective: In the present study we aimed to investigate the effects of the 2008 cold spell on mortality and the possibility of mortality displacement in three subtropical cities in China.

Methods: Daily mortality, air pollution, and weather data were collected from 2006 to 2009 in Guangzhou, Nanxiong (no air pollutants), and Taishan. We used a polynomial distributed lag model (DLM) to analyze the relationship between the 2008 cold spell and mortality. To observe the mortality displacement of the cold spell, we estimated the cumulative effects at lag0, lag0-6, lag0-13, lag0-20, and lag0-27 separately.

Results: During the 2008 cold spell, the cumulative risk of nonaccidental mortality increased significantly in Guangzhou [relative risk (RR) = 1.60; 95% CI: 1.19, 2.14] and Taishan (RR = 1.60; 95% CI: 1.06, 2.40) when lagged up to 4 weeks after the cold spell ended. Estimated effects at lag0-27 were more pronounced for males than for females, for respiratory mortality than for cardiovascular mortality, and for the elderly (≥ 75 years of age) than for those 0-64 years of age. Most of the cumulative RRs increased with longer lag times in Guangzhou and Taishan. However, in Nanxiong, the trend with cumulative RRs was less consistent, and we observed no statistically significant associations at lag0-27.

Conclusion: We found associations between the 2008 cold spell and increased mortality in the three subtropical cities of China. The lag effect structure of the cold spell varied with location and the type of mortality, and evidence of short-term mortality displacement was inconsistent. These findings suggest that extreme cold is an important public health problem in subtropical regions.

Show MeSH
Related in: MedlinePlus