Effects of heat waves and cold spells on the incidence of hemorrhagic stroke / 预防医学

Objective@#To examine the impact of heat waves and cold spells on the incidence of hemorrhagic stroke, so as to provide insights into prevention of hemorrhagic stroke.@*Methods@#Data pertaining to the incidence of hemorrhagic stroke in Zibo City from 2015 to 2019 were collected from Shandong Provincial Management Information System for Chronic Diseases and Cause of Death Surveillance, and the meteorological data during the period from 2015 to 2019 were captured from National Meteorological Information Center of China. The air quality index (AQI) was collected from the National Daily Report of Urban Air Quality in China. Heat wave was defined as the highest daily temperature that was no less than the 90th percentile (P90), P92.5, P95 and P97.5 of the highest daily temperature in the warm season for at least 2, 3 or 4 days, and cold spell was defined as the lowest daily temperature that was no more than the P10, P7.5, P5 and P2.5 of the lowest daily temperature in the cold season for at least 2, 3 or 4 days. The effect of heat waves and cold spells on the incidence of hemorrhagic stroke was evaluated using a generalized additive model and described with relative risk (RR) and its 95%CI.@*Results@#A total of 8 844 case with first-onset hemorrhagic stroke were recorded in Zibo City from 2015 to 2019. The lowest daily temperature that was no more than P10, P7.5 or P5 of the lowest daily temperature in the cold season for at least two days, or that was no more than P10 or P7.5 of the lowest daily temperature for at least 3 days resulted a remarkably increased risk of hemorrhagic stroke (lowest RR=1.187, 95%CI: 1.031-1.366; highest RR=1.242, 95%CI: 1.042-1.480), and after adjusting the effect of daily mean temperature, the lowest daily temperature that was no more than P10 or P7.5 of the lowest daily temperature in the cold season for at least two days, or that was no more than P10 of the lowest daily temperature for at least 3 days resulted a remarkably increased risk of hemorrhagic stroke (lowest RR=1.236, 95%CI: 1.009-1.513; highest RR=1.274, 95%CI: 1.023-1.585). However, there was no significant association between heat waves and the risk of hemorrhagic stroke.@*Conclusion@#Cold spells may increase the risk of hemorrhagic stroke, while no significant association is examined between heat waves and the risk of hemorrhagic stroke.

Evaluation of excess mortality risk related to heat wave in Ningbofrom 2013 to 2018 / 预防医学

Objective @#To evaluate the excess mortality risk related to heat wave in Ningbo, Zhejiang from 2013 to 2018, so as to provide a basis for formulating coping strategies for heat wave.@*Methods @#The data of daily mortality, meteorological and air quality from May to October in Ningbo from 2013 to 2018 were obtained from Ningbo Center for Disease Control and Prevention, Ningbo Meteorological Bureau and Environmental Monitoring Center of Ningbo, respectively. The generalized linear model ( GLM ) and distributed lag non-linear model ( DLNM ) were used to estimate the associations between heat wave and cause-specific mortality. @*Results @#Among 1 104 days of the study period, 18 heat waves occured and lasted for 132 days, accounting for 11.96%. A total of 102 954 deaths were reported in the same period. The risks of mortality in circulatory system diseases ( RR=1.09, 95%CI: 1.03-1.16 ), respiratory system diseases ( RR=1.14, 95%CI: 1.04-1.25 ), digestive system diseases ( RR=1.38, 95%CI: 1.15-1.65 ), nervous system diseases ( RR=1.32, 95%CI: 1.08-1.61 ), mental disorders ( RR=1.51, 95%CI: 1.12-2.03 ) and accidental injury ( RR=1.18, 95%CI: 1.06-1.32 ) and all causes ( RR=1.10, 95%CI: 1.06-1.14 ) increased at lag 0-1 day of heat wave. The total excess death related to heat wave was 1 218 ( 95%CI: 731-1 705 ) . The excess deaths of circulatory system diseases, respiratory system diseases, accidental injury, digestive system diseases, nervous system diseases, mental disorders, urinary system diseases and endocrine system diseases were 313 ( 95%CI: 104-556 ), 206 ( 95%CI: 59-368 ), 164 ( 95%CI: 55-292 ), 122 ( 95%CI: 48-208 ), 69 ( 95%CI: 17-131 ), 56 ( 95%CI: 13-113 ), 18 ( 95%CI: -15-64 ) and 3 ( 95%CI: -51-72 ). The excess deaths of urinary system and endocrine system diseases was not statistically significant ( P>0.05 ). @*Conclusion @#Heat wave can increase the mortality risk on the day and after a day in Ningbo from 2013 to 2018. Circulatory system diseases, respiratory system diseases and accidental injury rank top three in excess deaths.

Epidemiological characteristics of heat stroke and its relationship with high temperature and heat wave in Minhang District of Shanghai in 2013-2018 / 上海预防医学

Objective:To investigate the epidemiological characteristics of heat stroke cases in Minhang District of Shanghai in 2013-2018 and to explore potential risk factors， so as to provide the evidence for making the preventive and control measures. Methods:Meteorological parameters and heat stroke cases during May-September were included for statistical analysis. Results:A total of 101 heat stroke cases were studied， in which the majority occurred during June-August. Male cases were more than female cases and 51.5% （52/101） of the cases were severe cases. The incidence of severe heat stroke in people aged 40-59， and 60 and over was significantly higher than that in people under 40 years old. The number of people with severe heat stroke was positively correlated with daily maximum temperature and daily minimum temperature， whereas the number of mild heat stroke was only positively correlated with daily maximum temperature. More than half of total cases （86 cases） were documented in 15 heat wave periods， two of which had significantly increased risk. Conclusion:High temperature in summer is dangerous in Minhang District of Shanghai. Men and older people are susceptible to heat stroke， which occurs mainly in the period of high temperature in July and August. The period of daily highest temperature ≥35 ℃， especially during continual high temperature， is the key stage for heat stroke prevention. In addition to focusing on the effect of daily maximum temperature on heat stroke， the effect of daily minimum temperature on severe heat stroke should be considered.

Importance of Contextualized Communication for Better Disaster Preparedness and Disaster Risk Reduction: A Case Study from Bihar

India, the disaster preparedness has primarily been restricted to being response oriented that is mainlyconcentrated on the rescue operations. Insufficient community preparedness and lack of propercommunication leads to large scale causalities. The lack of proper communication is due to the fact thatthe relevant information among the community participants is not spread properly. One of the majorreasons for this is: the difference in the language of communication among the people and the language inwhich the information is officially shared. Due to this language gap it becomes very difficult for thenative people to understand the guidelines related to the disaster risks and disaster preparedness, therebymaking them more vulnerable to disaster risks. Five districts from Bihar have been identified for datacollection. The districts feature prominently from North to South on the map showing Multi HazardZones in Bihar issued by Bihar State Disaster Management Authority. Quantitative data analysis clearlyreflects that firstly, the official languages (English and Hindi) used by the government agencies forknowledge transfer are totally inadequate and secondly, translating the information in regional languageslike Magahi, Bhojpuri and Maithili considerably enhance the quality and the quantity of responses thatare generated during data collection. Community involvement can be promoted and made efficient onlywhen the regional languages are used as the desired media of communication.

Estresse por calor na Atenção Primária à Saúde: uma revisão clínica / Heat stress in Primary Health Care: A clinical review / Estrés por calor en la Atención Primaria a la Salud: una revisión clínica

Introdução: A exposição nociva ao calor ganha mais relevância com a progressão do aquecimento global antropogênico e a Atenção Primária à Saúde (APS) tem um papel crescente nesse cenário. No Brasil, as ondas de calor entre 2014 e 2015 duraram mais tempo que nos anos prévios, além disso, entre 2000-2015 a associação entre temperatura e hospitalizações variou de acordo com a duração da exposição ao calor. Nesse contexto, o objetivo desta revisão é realizar uma atualização sobre manejo clínico de patologias relacionadas ao calor na APS. Metodologia: Realizou-se a busca na base de dados ACCESSS, que utiliza a pirâmide 5.0 da assistência à saúde baseada em evidências. Foram identificados 103 sumários sintetizados para referência clínica com as palavras "Heat stress", "Heat Stroke", "Heat Wave" e "Heat Exhaustion", mas apenas três entravam no escopo deste estudo. Resultados e Discussão: O estresse pelo calor é uma condição comum, negligenciada e evitável que afeta diversos pacientes, iniciando-se com uma má adaptação ao calor que se não for corrigida pode gerar uma cascata de eventos inflamatórios. O estresse pelo calor é caracterizado por sintomas inespecíficos, como mal-estar, cefaleia e náusea. O tratamento envolve o resfriamento do paciente e monitoramento, garantindo hidratação adequada. A exaustão pelo calor, se não tratada, pode evoluir para insolação, uma doença grave que pode levar ao coma e morte, envolvendo disfunção do sistema nervoso central - necessitando de um tratamento mais agressivo além do resfriamento

Introduction: The nocive exposure to heat gets more attention with anthropogenic global warming, and Primary Health Care (PHC) has a growing role in this scenario. In Brazil heat waves between 2014 and 2015 lasted longer than in previous years. Further, in addition between 2000-2015 the association between temperature and hospitalizations varied according to the duration of heat exposure. Therefore, the aim of this review is to perform an update on clinical management of heat related pathologies in PHC. Methodology: The ACCESSS database was searched using the evidence-based health care pyramid 5.0, where we identified 103 synthesized summaries for clinical reference with words "Heat stress", "Heat Stroke", "Heat Wave" and "Heat Exhaustion", but only three fell within the scope of this study. Results and Discussion: Heat stress is a common, neglected and preventable condition that affects several patients, it starts with a poor adaptation to heat that if it is not adjusted it can generate a cascade of inflammatory events. Heat stress is characterized by nonspecific symptoms such as malaise, headache and nausea. The treatment involves patient monitoring and cooling, ensuring adequate hydration. Heat exhaustion, if untreated, can progress to heatstroke, a serious illness that can lead to coma and death, involving central nervous system dysfunction - requiring more aggressive treatment than cooling.

Introducción: La exposición nociva al calor gana más destaque con la progresión del calentamiento global antropogénico, y la Atención Primaria a la Salud tienen un papiel cresciente en este escenario. En Brasil las olas de calor entre 2014 y 2015 duraron más tiempo que en los años previos, además entre 2000-2015 la asociación entre temperatura y hospitalizaciones ha variado de acuerdo con la duración de la exposición al calor. En este contexto, el objetivo de esta revisión es realizar una actualización sobre manejo clínico de patologías relacionadas al calor en la APS. Metodología: Se realizó la búsqueda en la base de datos ACCESSS, que utiliza la pirámide 5.0 de la asistencia a la salud basada en evidencias. Se han identificado 103 sumarios sintetizados para referencia clínica con las palabras "Heat stress", "Heat Stroke", "Heat Wave" y "Heat Exhaustion", pero sólo tres son considerados en el ámbito de este estudio. Resultados y Discusión: El estrés por el calor es una condición común, descuidada y evitable que afecta a varios pacientes, iniciándose con una mala adaptación al calor que si no se corrige puede generar una cascada de eventos inflamatorios. El estrés por el calor se caracteriza por síntomas inespecíficos, como malestar, cefalea y náuseas. El tratamiento implica el enfriamiento del paciente y el monitoreo, garantizando la hidratación adecuada. El agotamiento por el calor, si no se trata, puede evolucionar hacia la insolación, una enfermedad grave que puede llevar al coma y a la muerte, involucrando disfunción del sistema nervioso central - necesitando un tratamiento más agresivo además del enfriamiento.

The impact of meteorological and environmental conditions on the spread of COVID-19 / 公共卫生与预防医学

Objective To understand the impact of meteorological and environmental conditions on the spread of COVID-19, and to provide a scientific basis for prediction, prevention and control of COVID-19. Methods The number of confirmed cases, population density and meteorological data of all cities in Hubei Province during COVID-19 outbreak period were collected. The relationship between COVID-19 infection rate and climatic factors were analyzed using Excel and SPSS software. Results The infection rate of COVID-19 had the greatest correlation with population density. The infection rate of COVID-19 showed a very significant power-law relationship with the number of the hot days before COVID-19 outbreak, and it also had a good correlation with the high temperature accumulation, the rank of hot days and the drought intensity. Conclusion The adverse effect of high temperature and heat wave on the human body had an impact on the spread of COVID-19. The ability of people in different areas to resist high temperature was different because of different climates. Drought may affect the spread of COVID-19 by destroying the ecological environment.

The definition of heat-wave based on mortality risk assessment in different regions of China / 中华预防医学杂志

Objective@#To identify the definition of heat wave based on mortality risk assessment in different regions of China.@*Methods@#Daily mortality (from China Information System for Disease Control and Prevention) and meteorological data (from National Meteorological Information Center in China) from 66 counties with a population of over 200 000 were collected from 2006-2011. With the consideration of climate type and administrative division, China was classified as seven regions. Firstly, distributed lag non-linear model (DLNM) was used to estimate community-specific effects of temperature on non-accidental mortality. Secondly, a multivariate meta-analysis was applied to pool the estimates of community-specific effects to explore the region-specific temperature threshold and the duration for definition of heat wave.@*Results@#We defined regional heat wave of Northeast, North, Northwest, East, Central and Southwest China as being two or more consecutive days with daily mean temperature higher than or equal to the P64, P71, P85, P67, P75 and P77 of warm season (May to October) temperature, respectively, while the thresholds of temperature were 21.6, 23.7, 24.3, 25.7, 28.0 and 25.3 ℃. The heat wave in South China was defined as five or more consecutive days with daily mean temperature higher than or equal to the P93 (30.4 ℃) of warm season (May to October) temperature.@*Conclusion@#The region-specific definition of heat wave developed in our study may provide local government with the guidance of establishment and implementation of early heat-health response systems to address the negative health outcomes due to heat wave.

Effects of Simulated Heat Wave and Ozone on High Fat Diet ApoE Deficient Mice / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To discuss the cardiac toxicities of a heat waves and ozone exposure on cardiovascular diseases (CVDs) and explore a possible mechanism.</p><p><b>METHODS</b>The incidence of ozone exposure combined with heat wave was simulated in the Shanghai Meteorological and Environmental Animal Exposure System (Shanghai-METAS). A total of 64 ApoE-/- mice, matched by weight, were randomly divided into 8 groups and exposed to heat wave conditions or ozone. The levels of creatine kinase (CK), D-lactate dehydrogenase (D-LDH), intercellular adhesion molecule 1 (sICAM-1), tumor necrosis factor alpha (TNF-α), nitric oxide (NO), endothelin-1 (ET-1), D-dimer (D2D), plasminogen activator inhibitor-1 (PAI-1) and blood lipid in plasma and heat shock protein-60 (HSP60), hypoxia inducible factor 1 alpha (HIF-1α), interleukin-6 (IL-6), C-reactive protein (CRP), superoxide dismutase (SOD), and malondialdehyde (MDA) in hearts were measured after exposure.</p><p><b>RESULTS</b>The levels of all indicators, except for SOD, increased with the ozone-only exposure. However, cardiac damage was most significant when the heat wave conditions were combined with severe ozone exposure. Moreover, the levels of CK, D-LDH, NO, PAI-1, sICAM-1, and TNF-α in plasma increased significantly (P < 0.05), and the contents of HSP60, HIF-1α, CRP, and MDA in hearts increased considerably (P < 0.05), but the activity of SOD decreased significantly. In addition, the levels of four blood lipid items remarkably increased (except the level of HDL-C which decreased significantly) with ozone exposure.</p><p><b>CONCLUSION</b>A short-term exposure to a heat wave and ozone causes severe toxic effects on the heart. Cardiac damage was most significant under combined heat wave and severe ozone exposure simulations.</p>

Factors affecting heat-related diseases in outdoor workers exposed to extreme heat

BACKGROUND: The objectives of the present study are to: (i) evaluate the effect of environmental and metabolic heat on heat-related illnesses in outdoor workers; and (ii) evaluate the effect of personal factors, including heat acclimation, on the risk of heat-related illnesses in outdoor workers. METHODS: We identified 47 cases of illnesses from exposure to environmental heat in outdoor workers in Korea from 2010 to 2014, based on review of workers' compensation data. We also obtained the information on location, time, and work environment of each heat-related illness. RESULTS: Our major results are that 29 cases (61.7%) occurred during a heat wave. Forty five cases (95.7%) occurred when the maximum estimated WBGT (WBGTmax) was equal to or greater than the case specific threshold value which was determined by acclimatization and metabolic rate. Twenty two cases (46.8%) were not acclimated to the heat. Thirty-seven cases (78.7%) occurred after tropical night (temperature above 25 °C), during which many people may find it hard to sleep. CONCLUSION: Personal risk factors such as heat acclimation as well as environmental factors and high metabolic rate during work are the major determinants of heat-related illnesses.

Heat stroke during long-term clozapine treatment: should we be concerned about hot weather? / Heat stroke durante tratamento de longo prazo com clozapina: devemos nos preocupar com o tempo quente?

Objective To describe the case of a patient with schizophrenia on clozapine treatment who had an episode of heat stroke. Case description During a heat wave in January and February 2014, a patient with schizophrenia who was on treatment with clozapine was initially referred for differential diagnose between systemic infection and neuroleptic malignant syndrome, but was finally diagnosed with heat stroke and treated with control of body temperature and hydration. Comments This report aims to alert clinicians take this condition into consideration among other differential diagnoses, especially nowadays with the rise in global temperatures, and to highlight the need for accurate diagnosis of clinical events during pharmacological intervention, in order to improve treatment decisions and outcomes.

Objetivo Descrever o caso de um paciente com esquizofrenia em tratamento com clozapina acometido por um episódio de heat stroke. Descrição do caso Durante uma onda de calor em janeiro e fevereiro de 2014, um paciente com esquizofrenia em tratamento com clozapina foi inicialmente encaminhado para diagnóstico diferencial de infecção sistêmica e síndrome neuroléptica maligna, tendo obtido o diagnóstico final de heat stroke, tratado com controle de temperatura corporal e hidratação. Comentários Este relato de caso tem como objetivo alertar os clínicos para este diagnóstico diferencial, que pode surgir com mais frequência à medida que as temperaturas globais continuarem a aumentar, e também destacar a importância da realização de um diagnóstico mais acurado, que possa melhorar as decisões de tratamento e os desfechos clínicos para os pacientes.

Willingness to Pay for Measures of Managing the Health Effects of Heat Wave in Beijing, China: a Cross-sectional Survey / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>There are evidences that heat wave events cause deaths and emergency cases. This article used the contingent valuation method to find the willingness to pay for the protective measures and investigated the factors that influence the willingness to pay.</p><p><b>METHODS</b>A cross-sectional face-to-face household survey was completed by 637 urban long-term residents and 591 rural long-term residents aged 15-79 in Beijing, China. Binary logistic regression was used to identify factors that influenced the payment rate or payment amount for the protective measures, including independent variables for district, gender, age, education, income, air conditioner ownership, heat wave experience, and chronic non-communicable disease.</p><p><b>RESULTS</b>The payment rate was 41.1% for protective measures provided by the government and 39.5% by measures provided by the market. Most of the respondents were willing to pay 40 CNY per capita annually for measures provided by the government or the market. The factors influencing willingness to pay were district, gender, income, air conditioner ownership, heat wave experience, and chronic non-communicable disease..</p><p><b>CONCLUSION</b>Protective measures for heat waves need to be provided immediately. More attention should be paid to the situation of vulnerable groups, such as people who live in urban areas, those without air conditioning, and those who have experienced a heat wave in the past.</p>

Modifying Effect of Heat Waves on the Relationship between Temperature and Mortality

Studies conducted to evaluate temporal trends of heat-related mortality have not considered the effects of heat waves; although it is known they can affect mortality and act as a modifying factor. After adjusting for long-term trends and seasonality, the effects of temperature on non-accidental deaths in Seoul and Busan (inland and coastal cities, respectively) were analyzed using a generalized additive model of Poisson distribution. We evaluated temporal trends of heat-related mortalities in four periods (1991-1995, 1996-2000, 2001-2005, and 2006-2012). The effects of temperature on mortality were evaluated according to the occurrence of a heat wave and results were compared in the two cities. The effect of temperature on mortality was the greatest in 1991-1995 in Seoul; no significant change was observed in Busan. When we stratified the study period by heat wave status, the risk increase in mortality was 15.9% per 1℃ during years with a heat wave in Seoul, which was much higher than 0.31% increase observed during years without a heat wave. On the other hand, Busan showed a linear relationship between temperature and mortality and no significant difference between years with or without a heat wave. Variations in the relationship between temperature and mortality could be misunderstood if heat waves are not considered. Furthermore, heterogeneity was found in the modifying effect of heat waves on heat-related mortality in inland and coastal cities. The findings of this study help understand relations between temperature and mortality.

Impact of heat wave in 2005 on mortality in Guangzhou, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To assess the impact of the heat wave in 2005 on mortality among the residents in Guangzhou and to identify susceptible subpopulations in Guangzhou, China.</p><p><b>METHODS</b>The data of daily number of deaths and meteorological measures from 2003 to 2006 in Guangzhou were used in this study. Heat wave was defined as ⋝7 consecutive days with daily maximum temperature above 35.0 °C and daily mean temperature above the 97th percentile during the study period. The excess deaths and rate ratio (RR) of mortality in the case period compared with the reference period in the same summer were calculated.</p><p><b>RESULTS</b>During the study period, only one heat wave in 2005 was identified and the total number of excess deaths was 145 with an average of 12 deaths per day. The effect of the heat wave on non-accidental mortality (RR=1.23, 95% CI: 1.11-1.37) was found with statistically significant difference. Also, greater effects were observed for cardiovascular mortality (RR=1.34, 95% CI: 1.13-1.59) and respiratory mortality (RR=1.31, 95% CI: 1.02-1.69). Females, the elderly and people with lower socioeconomic status were at significantly higher risk of heat wave-associated mortality.</p><p><b>CONCLUSION</b>The 2005 heat wave had a substantial impact on mortality among the residents in Guangzhou, particularly among some susceptible subpopulations. The findings from the present study may provide scientific evidences to develop relevant public health policies and prevention measures aimed at reduction of preventable mortality from heat waves.</p>

Characteristics of Summer Heatwave Victims of Emergency Department Visits in Korea During 2011: Results from the Surveillance System of Heat-related Illness Based on Emergency Department

PURPOSE: The aim of this study was to examine characteristics of health-related victims identified through the Surveillance System of Heat-related Illness (SSHI) based on emergency department (ED) visits. METHODS: Between July 1 and September 3 of 2011, 443 heat-related patients were reported by 396 of the 461 EDs participating in the SSHI. Heat-related illness included heat (sun) stroke, heat cramp, heat syncope, and heat exhaustion. A hot day was defined as a day above 30degrees C of daily maximum temperature in locations of provincial and metropolitan government offices. We used chi square test for identification of risk factors associated with Heat-related illness in the workplace and heat-related illness heat (sun) stroke. RESULTS: Heatwave, defined as lasting three or more hot days, occurred three times during this period. The daily average number of heat-related patients reported during the heatwave period was 15.7 per day, more than four times the usual rate. The daily maximum temperature showed positive correlation with occurrence of heat-related illness. Heat exhaustion was the most frequent cause (46.0%), with approximately 70% of all cases occurring between noon and 6 p.m. The number of people suffering from heat-related illness while outdoors was three times greater than that of those who experienced it indoors. Work-related occurrence comprised 56.7% of all cases. All six deaths occurred during the heatwave period and were work-related. CONCLUSION: Working conditions, outdoor activities, and old age may be associated with health-related illnesses. A surveillance system that monitors emergency room visits may be useful in assessment of adverse health effects of summer heatwaves.

A case-crossover study on the association between heat waves and daily deaths caused by acute myocardial infarction / 中华流行病学杂志

Objective To explore the effects of heat wave on daily deaths caused by acute myocardial infarction (AMI) in Beijing.Methods A case-crossover design was used to study the impact of 5 heat waves on the daily number of AMI deaths from Jan.1,1999 to Jun.30,2000.The effect of heat wave on death in different gender or age groups was also compared.The 7th day before and after death occurred was chosen as its own bi-directional self-control.The OR value and its corresponding risk period was used to reflect the impact of heat wave on daily number of AMI deaths,lag days and duration.Results There were five heat waves during the study period.The first heat wave sustained 9 days and the maximum temperature was 38.8 ℃ with average humidity as 46.7％.The OR value for the AMI death was 1.437 (95％CI:1.066-1.937).The second heat wave lasted 3 days,with the maximum temperature of 36.8 ℃ and average humidity of 61.0％.The OR value for the AM1 death was 1.846 (95％ CI:0.671-5.076).The third heat wave continued 7 days,with the maximum temperature of 41.5 ℃ with average humidity of 58.5％.The OR value for the daily death counts caused by AMI was 2.427 (95％ CI:1.825-3.229).The fourth lasted for 3 days,with the maximum temperature of 39.6 ℃ and average humidity as 3 1.9％.The OR value for the AMI deaths was 2.857 (95％ CI:1.088-7.506).The fifth heat wave lasted for 4 days,with the maximum temperature as 37.4 ℃,and average humidity as 42.0％ during this period.The OR value for daily death counts caused by AMI was 1.500(95％CI:0.632-3.560).The OR value of the first heat wave for daily death counts of men and women caused by AMI were 1.153 (95％CI:0.756-1.758 ) and 1.818 (95％CI:1.185-2.790) respectively.The OR value for daily death counts of under 65 age was 1.200 (95％ CI:0.669-2.153),with the OR value for the older than 64 age group was 1.534 (95％ CI:1.083-2.173).The OR value for daily death counts of older than 64 age women was 1.818 (95％CI:1.109-2.981 ).The OR values of the third heat wave for daily death counts of men and women caused by AMI were 2.392 (95％CI:1.649-3.470) and 2.514 (95％CI:1.613-3.919) respectively.The OR value for daily death counts of under 65 age group was 2.000 (95％CI:1.149-3.482 ) and the OR value for the older than 64 age group was 2.623 (95％CI:1.880-3.660).The OR value for daily death counts of older than 64 age group women was 2.800 (95％CI:1.676-4.678).Conclusion (1) Significant increase for daily death counts of AMI in Beijing was noticed during the heat wave and usually causing hysteretic effect.The lag phase was 0-2 days in general.(2)The increase of maximum temperature was greater at the beginning day when the heat wave occurred in the previous day,with shorter lag time and greater risk of AMI death.(3)The risk of AMI death in women was greater than in men during the heat wave period.(4)The risk of AMI death among those older than 64 age group was greater than the under 65 year olds.(5)The impact of heat wave to the elderly female was greater.

Effects of Heat Wave on Body Temperature and Blood Pressure in the Poor and Elderly

OBJECTIVES: We aimed to investigate the acute effects of heat stress on body temperature and blood pressure of elderly individuals living in poor housing conditions. METHODS: Repeated measurements of the indoor temperature, relative humidity, body temperature, and blood pressure were conducted for 20 elderly individuals living in low-cost dosshouses in Seoul during hot summer days in 2010. Changes in the body temperature, systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to variations in the indoor and outdoor temperature and humidity were analyzed using a repeated-measures ANOVA controlling for age, sex, alcohol, and smoking. RESULTS: Average indoor and outdoor temperatures were 31.47degrees C (standard deviation [SD], 0.97degrees C) and 28.15degrees C (SD, 2.03degrees C), respectively. Body temperature increased by 0.21degrees C (95% confidence interval [CI], 0.16 to 0.26degrees C) and 0.07degrees C (95% CI, 0.04 to 0.10degrees C) with an increase in the indoor and outdoor temperature of 1degrees C. DBP decreased by 2.05 mmHg (95% CI, 0.05 to 4.05 mmHg), showing a statistical significance, as the indoor temperature increased by 1degrees C, while it increased by 0.20 mmHg (95% CI, -0.83 to 1.22 mmHg) as outdoor temperature increased by 1degrees C. SBP decreased by 1.75 mmHg (95% CI, -1.11 to 4.61 mmHg) and 0.35 mmHg (95% CI, -1.04 to 1.73 mmHg), as the indoor and outdoor temperature increased by 1degrees C, respectively. The effects of relative humidity on SBP and DBP were not statistically significant for both indoor and outdoor. CONCLUSIONS: The poor and elderly are directly exposed to heat waves, while their vital signs respond sensitively to increase in temperature. Careful adaptation strategies to climate change considering socioeconomic status are therefore necessary.

A case-crossover study between heat waves and daily death from cardiovascular and cerebrovascular disease / 中华流行病学杂志

Objective To explore the impct of heat wave on the daily deaths caused by cardiovascular disease and cerebrovascular diseases in Beijing.Methods A case-crossover design was used to study the impact of 5 heat waves on the daily number of deaths from cardiovascular diseases and cerebrovascular disease,from Jan.1,1999 to Jun.30,2000.We also investigated the relationship between the heat wave and acute myocardial infarction deaths.The 7th day before death was chose as the indicator of self-control.The OR value of different lengths of risk period was calculated.The highest OR value and its corresponding risk period was used to reflect the impact of heat wave on daily number of cardiovascular and cerebrovascular disease deaths,lag days and their durations.Results There were five heat waves during the study period.The first heat wave lasted for 9 days,with the maximum temperature as 38.8 ℃ and average humidity as 46.7%.The Off value for the cardiovascular disease death,cerebrovascular disease death and acute myocardial infarction death were 1.384(95%CI:1.128-1.697),1.776(95%CI:1.456-2.167)and 1.276(95%CI:0.905-1.799)respectively.The second heat wave lasted 3 days,with the maximum temperature of 36.8 ℃ and average humidity of 61.0%.The OR value for the three causes of death were 1.385(95%CI:0.678-2.826),1.300(95% CI:0.726-2.329)and 2.000(95% CI:0.684-5.851)respectively.The third heat wave continued for 7 days,with the maximum temperature of 41.5 ℃,and average humidity of 58.5%.The OR value for the daily death counts caused by cardiovascular disease,cerebrovascular diseases and acute myocardial infarction were 2.613(95%CI:2.116-3.228),2.317(95%CI:1.875-2.863)and 3.088(95%CI:2.098-4.546)respectively.The fourth wave lasted for 3 days,with the maximum temperature as 39.6 ℃ and average humidity as 31.9%.The OR value for the deaths caused by cardiovascular disease,cerebrovascular diseases and acute myocardial infarction were 1.333(95%CI:0.724-2.457),2.429(95%CI:1.007-5.856)and 3.333(95%67:0.917-12.112)respectively.The fifth heat wave lasted for 4 days.The maximum temperature was 37.4 ℃,and the average humidity was 42.0% during the period.The OR value for daily death counts caused by cardiovascular disease,cerebrovascular disease and acute myocardial infarction were 2.333(95%CI:1.187-4.588),1.727(95%CI:0.822-3.630)and 1.800(95%CI:0.603-5.371)respectively.Conclusions(1)There were significant increases for daily death counts of both cardiovascular and cerebrovascular disease in Beijing during the heat wave and there appeared hysteresis effect as well.The lag phase of cardiovascular disease and cerebrovascular disease death was generally 2-4 days and acute myocardial infarction death usually was 0-2 days.(2)The rising of maximum temperature was greater at the beginning day of heat wave than the previous day,but the lag time was shorter,and the risk of death was greater,especially for the risk of deaths from cerebrovascular disease.(3)Fluctuations of daily maximum air temperature during the heat wave could increase the risk of death from cardiovascular disease.

Heat Wave and Daily Mortality of Residents in a Coastal City in China / 环境与健康杂志

Objective To understand the effects of heat wave on daily mortality of residents in a coastal city in China.Methods In this paper,semi-parametric generalized additive model was used to study the relationship between average daily temperature and the daily mortality of local residents,and every day lag on the impact of daily mortality was observed by the distributed lag model,2005 -2007.Results The relation between the coastal city daily mortality and the daily average temperature was fitted,2005-2007.The relation between them was approximately "V".In summer,the daily average temperature increased 1℃,the relative risk factor increased 0.036.In the establishment of the semi-parametric generalized additive regression model,the daily average temperature and daily mortality showed a significant linear relationship(P

Advance of Research for Effects of Heat Wave on Health of Urban Residents and Warning / 环境与健康杂志

In recent years,high-temperature heat wave caused an increase in the number of deaths than other climate disasters,the study of the effects of heat waves on the health of urban residents health becomes a subject of concern.Sustained high-temperature heat waves will inevitably cause harm to human health,to understand the characteristics of heat waves is conducive to the prediction of high temperature heat waves and to the establishment of reasonable response measures.This paper mainly introduces the present status of heat wave occur,the impact of heat wave on human health,the influencing factors for excess mortality during heat waves as well as the research methods for heat wave which are commonly used to predict.

Epidemiological Research Progress in Health Impact of Heat Wave on Urban Residents / 环境与健康杂志

With the development of global warming,urbanization,ageing of the population,it is paid more attention to the human health impacts on the frequent occurrence of heat wave and urban heat island effect.The study methods and advances in impacts of heat wave on human health were reviewed in the present paper.