Science of the Total Environment
Volume 654, 2019, Pages 1372-1378

Effects of heat on first-ever strokes and the effect modification of atmospheric pressure: A time-series study in Shenzhen, China (Article)

Bao J. , Guo Y. , Wang Q. , He Y. , Ma R. , Hua J. , Jiang C. , Morabito M. , Lei L. , Peng J.* , Huang C.
  • a Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Shenzhen Center for Chronic Disease Control, Shenzhen, 518020, China
  • b Bao'an District Hospital for Chronic Diseases Prevention and Cure, Shenzhen, 518100, China
  • c Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
  • d Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
  • e Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
  • f Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
  • g Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, United States
  • h Institute of Biometeorology, National Research Council, Florence, 50145, Italy, Centre of Bioclimatology, University of Florence, Florence, 50144, Italy
  • i Shenzhen Center for Chronic Disease Control, Shenzhen, 518020, China
  • j Shenzhen Center for Chronic Disease Control, Shenzhen, 518020, China
  • k Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China

Abstract

Background: Stroke is a leading cause of death globally. Extreme temperatures may induce stroke, but evidence on the effects of heat on first-ever strokes is not clear. Low air pressure can lead to depression and an increase in blood pressure, and it may exacerbate the health impact of heat. In this study, we aimed to evaluate the effects of heat on first-ever strokes, the possible sensitive populations, and the effect of modification of atmospheric pressure. Methods: We collected data on 142,569 first-ever strokes during 2005–2016 in Shenzhen, a coastal city in southern China, with subtropical oceanic monsoon climate. We fitted a time-series Poisson model in our study, estimating the association between daily mean temperature and first-ever strokes in hot months, with a distributed lag non-linear model with 7 days of lag. We calculated strokes attributable to heat in various gender, age groups, household register types, stroke subtypes, and atmospheric pressure levels. Results: Heat had a significant cumulative association with first-ever strokes, and the risk of strokes increased with the rise in temperature after it was higher than 30 °C (the 85th percentile). In total, 1.95% (95% empirical CI 0.63–3.20%) of first-ever strokes were attributable to high temperature. The attributable fraction and attributable number of heat were statistically significant in male, female, middle-aged and old patients, immigrant patients, and CBI patients. The fraction attributable to heat was 3.33% in the low atmospheric pressure group, and the number of estimated daily attributable strokes at low atmospheric pressure levels was higher than that of medium and high atmospheric pressure levels (p < 0.01). Conclusions: High temperatures in hot months may trigger first-ever strokes, and low atmospheric pressure may exacerbate the effect. We mainly found associations between heat and first-ever strokes for intracerebral hemorrhage, middle-aged and old patients, as well as immigrant patients. © 2018 Elsevier B.V.

Author Keywords

Effect modification Atmospheric pressure Heat Time-series study First-ever strokes

Index Keywords

China immigrant household heat Atmospheric Pressure Intracerebral hemorrhages First-ever strokes Attributable fraction Time series Pressure effects Low air pressure Stroke Heating blood pressure cerebrovascular accident health risk brain hemorrhage attributable risk heat shock Atmospheric temperature Extreme temperatures human Low atmospheric pressures Hot Temperature risk assessment statistics and numerical data priority journal Aged sensitivity analysis greenhouse effect Humans air pollution health impact male female risk factor environmental exposure environmental impact heat stroke Shenzhen Guangdong time series analysis Effect modifications Article high temperature major clinical study adult gender age weather
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056881105&doi=10.1016%2fj.scitotenv.2018.11.101&partnerID=40&md5=0560583f98d502aa160d4096bdb606e9
DOI: 10.1016/j.scitotenv.2018.11.101
ISSN: 00489697
Original Language: English