Attributable risks of hospitalizations for urologic diseases due to heat exposure in Queensland, Australia, 1995-2016.

BACKGROUND: Heat exposure is a risk factor for urologic diseases. However, there are limited existing studies that have examined the relationship between high temperatures and urologic disease. The aim of this study was to examine the associations between heat exposure and hospitalizations for urologic diseases in Queensland, Australia, during the hot seasons of 1995-2016 and to quantify the attributable risks. METHODS: We obtained 238 427 hospitalized cases with urologic diseases from Queensland Health between 1 December 1995 and 31 December 2016. Meteorological data were collected from the Scientific Information for Land Owners-a publicly accessible database of Australian climate data that provides daily data sets for a range of climate variables. A time-stratified, case-crossover design fitted with the conditional quasi-Poisson regression model was used to estimate the associations between temperature and hospitalizations for urologic diseases at the postcode level during each hot season (December-March). Attributable rates of hospitalizations for urologic disease due to heat exposure were calculated. Stratified analyses were performed by age, sex, climate zone, socio-economic factors and cause-specific urologic diseases. RESULTS: We found that a 1°C increase in temperature was associated with a 3.3% [95% confidence interval (CI): 2.9%, 3.7%] increase in hospitalization for the selected urologic diseases during the hot season. Hospitalizations for renal failure showed the strongest increase 5.88% (95% CI: 5.25%, 6.51%) among the specific causes of hospital admissions considered. Males and the elderly (≥60 years old) showed stronger associations with heat exposure than females and younger groups. The sex- and age-specific associations with heat exposure were similar across specific causes of urologic diseases. Overall, nearly one-fifth of hospitalizations for urologic diseases were attributable to heat exposure in Queensland. CONCLUSIONS: Heat exposure is associated with increased hospitalizations for urologic disease in Queensland during the hot season. This finding reinforces the pressing need for dedicated public health-promotion campaigns that target susceptible populations, especially for those more predisposed to renal failure. Given that short-term climate projections identify an increase in the frequency, duration and intensity of heatwaves, this public health advisory will be of increasing urgency in coming years.

Mental health of new undergraduate students before and after COVID-19 in China.

The purpose of this study was to examine the changes in severity of anxiety and depression symptoms, stress and sleeping quality after three months of mass quarantine for COVID-19 among undergraduate fresh students compared to their pre-COVID-19 measures. We used participants from the Chinese Undergraduate Cohort (CUC), a national prospective longitudinal study to examine the changes in anxiety and depression symptoms severity, stress and sleep quality after being under mass quarantine for three months. Wilcoxon matched pair signed-rank test was used to compare the lifestyle indicators. Severity of anxiety, depression symptoms, stress and sleep quality were compared with Wilcoxon signed-rank test. We used generalized estimating equation (GEE) to further quantify the change in mental health indicators and sleep quality after the COVID-19 mass quarantine compared to baseline. This study found that there was no deterioration in mental health status among Chinese new undergraduate students in 2020 after COVID-19 mass quarantine compared with the baseline measures in 2019. There was an improvement in sleep quality and anxiety symptoms. After adjusting for age, sex, exercise habit, time spent on mobile gadgets, and time spent outdoors, year 2020 was significantly associated with severity of depression symptoms in males (OR:1.52. 95%CI:1.05-2.20, p-value = 0.027). Year 2020 was significantly associated with the improvement of sleeping quality in total (OR:0.45, 95%CI:0.38-0.52, p < 0.001) and in all the subgroups. This longitudinal study found no deterioration in mental health status among Chinese new undergraduate students after three months of mass quarantine for COVID-19.

Temporal trends of the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016: A time-stratified case-crossover study.

BACKGROUND: In the context of global warming, studies have turned to assess the temporal trend of the association between temperature and health outcomes, which can be used to reflect whether human beings have adapted to the local temperature. However, most studies have only focused on hot temperature and mortality. We aim to investigate the temporal variations in the association between ambient temperature and hospitalisations for cardiovascular diseases in Queensland, Australia from 1995 to 2016. METHODS AND FINDINGS: We obtained data on 1,855,717 cardiovascular hospitalisations (mean age: 65.9 years, 42.7% female) from all 443 postal areas in Queensland, Australia between January 1, 1995 and December 31, 2016. Grid-level meteorological data were downloaded from scientific information for landowners. We used a time-stratified case-crossover design fitted with a conditional quasi-Poisson regression model and time-varying distributed lag nonlinear model (DLNM) to evaluate the association between temperature and cardiovascular hospitalisations and the temporal trends of the associations. Stratified analyses were performed in different age, sex, and climate zones. In all groups, relative risks (RRs) of cardiovascular hospitalisations associated with high temperatures (heat effects) increased, but cold effects showed a decreasing trend from 1995 to 2016. The increasing magnitude of heat effects was larger (p = 0.002) in men than in women and larger (p < 0.001) in people aged ≤69 years than in those aged ≥70 years. There was no apparent difference amongst different climate zones. The study was limited by the switch from ICD-9 to ICD-10 coding systems, by being unable to separate first-time hospitalisation from repeated hospitalisations, and possibly by confounding by air pollution or by influenza infections. CONCLUSION: The impacts of cold temperatures on cardiovascular hospitalisations have decreased, but the impacts of high temperatures have increased in Queensland, Australia. The findings highlight that Queensland people have adapted to the impacts of cold temperatures, but not high temperatures. The burden of cardiovascular hospitalisations due to high temperatures is likely to increase in the context of global warming.

Attributable risks associated with hospital outpatient visits for mental disorders due to air pollution: A multi-city study in China.

AIM: To determine the associations between outdoor air pollution and hospital outpatient visits for mental disorders in China. METHODS: We obtained data of 111,842 hospital outpatient visits for mental disorders from the largest hospitals of 13 cities, China, between January 01, 2013 and December 31, 2015. We collected air pollutant data including particulate matter ≤2.5 µm in diameter (PM2.5), particulate matter ≤10 µm in diameter (PM10), nitrogen dioxide (NO2), ozone (O3) and sulphur dioxide (SO2) from China National Environmental Monitoring Centre during the same period. We conducted a time-stratified case-crossover design with conditional logistic regression models to determine the associations. RESULTS: A 10 µg/m3 increase in PM2.5, PM10, NO2 and SO2 was associated with a significant increase in hospital outpatient visits for mental disorders on the current day. When stratified by age, sex and season, the effects of PM2.5 and NO2 were robust among different subgroups at lag05 days. PM10 showed positive associations in males, in cold season, and in depression patients. SO2 showed positive associations in males, in cold season, and in anxiety patients. O3 showed positive associations in females, in warm season, and in depression patients. Nearly one sixth hospital outpatient visits for mental disorders can be attributable to NO2. CONCLUSIONS: Short-term increase in PM2.5, PM10, NO2, SO2 and O3 concentrations was significantly associated with exacerbation of mental disorders in China as indicated by increases in hospital outpatient visits. NO2 had more serious health threat than other pollutants in terms of mental disorders. Our findings strongly suggest a need for more strict emission control regulations to protect mental health from air pollution.

Multi-city study on air pollution and hospital outpatient visits for asthma in China.

BACKGROUND: The proportion of asthma patients with mild to moderate exacerbations is far greater than the number who experience episodes that are severe enough to require emergency room visits or hospital admission. However the routinely collected data from hospitals is absent in the past. OBJECTIVE: To evaluate associations between short-term exposures to air pollutants and hospital outpatient visits for asthma in China. METHODS: We obtained data for 143,057 asthma outpatient visits from the largest hospitals in 17 Chinese cities, between Jan 01 2013 and Dec 31 2015. We used daily concentrations of air pollutants measured by the China National Environmental Monitoring Centre. We used a time-stratified case-crossover design, and fitted conditional logistic regression models to determine the associations. RESULTS: Particulate matter ≤10µm in diameter (PM10) and nitrogen dioxide (NO2) were associated with increased risks of hospital outpatient visits for asthma on the same day, while the effects were delayed for particulate matter ≤2.5µm in diameter (PM2.5) and sulphur dioxide (SO2). For the cumulative effect model at lag05 days, 10 µg/m3 increase in air pollutants concentrations were correlated with hospital outpatient visits for asthma with odds ratios (ORs) and 95% confidence intervals 1.004 (1.000-1.008) for PM2.5, 1.005 (1.002-1.008) for PM10, 1.030 (1.021-1.040) for NO2, and 1.015 (1.008-1.021) for SO2. Almost one in nine (10.9%; 7.7, 13.9%) hospital outpatient visits for asthma were attributable to NO2. CONCLUSION: Short-term exposures to PM2.5, PM10, NO2 and SO2 were associated with hospital outpatient visits for asthma in China.

Short-term exposure to air pollution and conjunctivitis outpatient visits: A multi-city study in China.

BACKGROUND: Conjunctivitis has hazardous effects on patients' quality of life through influencing school performance, work productivity, and daily activities such as driving. However, limited evidence is available on the contributory role of air pollution on conjunctivitis, particularly in China. METHODS: We obtained data of 81,351 conjunctivitis outpatients from the largest comprehensive hospitals of four cities, China, between Jan 1, 2013 and Dec 31, 2014. Data on air pollutants, including particulate matter ≤2.5 µm in diameter (PM2.5), particulate matter ≤10 µm in diameter (PM10), nitrogen dioxide (NO2), ozone (O3) and sulphur dioxide (SO2) were collected from China National Environmental Monitoring Centre. Conjunctivitis outpatient visits were linked with air pollution concentrations by the visiting dates. A time-stratified case-crossover design with conditional logistic regression model was used to examine the effect of short-term exposure to air pollution on conjunctivitis outpatient visits. RESULTS: We found that the associations between air pollutants (per 10 µg/m3 increase) and hospital outpatient visits for asthma were [odds ratios (ORs) and 95% confidence intervals]: 1.004(1.002-1.007) for PM2.5, 1.004 (1.002-1.005) for PM10, 1.012(1.005-1.020) for NO2, 1.006 (1.001-1.011) for SO2, and 1.007 (1.003-1.010) for O3, respectively at lag0 day. Outpatients aged 35-64 years showed significant associations with exposure to PM2.5 (1.005, 1.001-1.010), PM10 (1.005, 1.002-1.008), NO2 (1.014, 1.003-1.026), and O3 (1.005, 1.000-1.011), while those aged 15-34 years showed significant associations with exposure to O3 (1.010, 1.004-1.017). CONCLUSIONS: Short-term exposure to air pollution has impacts on outpatient visits for conjunctivitis in China. This study suggests that improving air quality could protect eye health.