Temperature Change between Neighboring Days Contributes to Years of Life Lost per Death from Respiratory Disease: A Multicounty Analysis in Central China.

BACKGROUND: Many epidemiological studies have recently assessed respiratory mortality attributable to ambient temperatures. However, the associations between temperature change between neighboring days and years of life lost are insufficiently studied. Therefore, we assessed the attributable risk of temperature change between neighboring days on life loss due to respiratory disease. METHODS: We obtained daily mortality and weather data and calculated crude rates of years of life lost for 70 counties in Hunan Province, Central China, from 2013 to 2017. A time-series design with distributed lag nonlinear model and multivariate meta-regression was used to pool the relationships between temperature change between neighboring days and rates of years of life lost. Then, we calculated the temperature change between neighboring days related to average life loss per death from respiratory disease. RESULTS: The total respiratory disease death was 173,252 during the study period. The association between temperature change and years of life lost rates showed a w-shape. The life loss per death attributable to temperature change between neighboring days was 2.29 (95% CI: 0.46-4.11) years, out of which 1.16 (95% CI: 0.31-2.01) years were attributable to moderately high-temperature change between neighboring days, and 0.99 (95% CI: 0.19-1.79) years were attributable to moderately low-temperature change between neighboring days. The temperature change between neighboring days related to life loss per respiratory disease death for females (2.58 years, 95% CI: 0.22-4.93) and the younger group (2.97 years, 95% CI: -1.51-7.44) was higher than that for males (2.21 years, 95% CI: 0.26-4.16) and the elderly group (1.96 years, 95% CI: 0.85-3.08). An average of 1.79 (95% CI: 0.18-3.41) life loss per respiratory disease death was related to non-optimal ambient temperature. CONCLUSIONS: The results indicated that more attention should be given to temperature change, and more public health policies should be implemented to protect public health.

Impact of ambient temperature on life loss per death from cardiovascular diseases: a multicenter study in central China.

BACKGROUND: In the context of global climate change, studies have focused on the ambient temperature and mortality of cardiovascular diseases (CVDs). However, little is known about the effect of ambient temperature on year of life lost (YLL), especially the life loss per death caused by ambient temperature. In this study, we aimed to assess the relationship between ambient temperature and life loss and estimate the impact of ambient temperature on life loss per death. METHODS: We collected daily time series of mortality and meteorological data from 70 locations in Hunan province, central China, in periods ranging from Jan. 1, 2013, to Dec. 31, 2017. Crude rates of YLL were calculated per 100,000 people per year (YLL/100,000 population) for each location. A distributed lag nonlinear model and multivariate meta-regression were used to estimate the associations between ambient temperature and YLL rates. Then, the average life loss per death attributable to ambient temperature was calculated. RESULTS: There were 711,484 CVD deaths recorded within the study period. The exposure-response curve between ambient temperature and YLL rates was inverted J or U-shaped. Relative to the minimum YLL rate temperature, the life loss risk of extreme cold temperature lasted for 10 to 12 days, whereas the risk of extreme hot temperature appeared immediately and lasted for 3 days. On average, the life loss per death attributable to non-optimum ambient temperatures was 1.89 (95% CI, 1.21-2.56) years. Life loss was mainly caused by cold temperature (1.13, 95% CI, 0.89­1.37), particularly moderate cold (1.00, 95% CI, 0.78­1.23). For demographic characteristics, the mean life loss per death was relatively higher for males (2.07, 95% CI, 1.44­2.68) and younger populations (3.72, 95% CI, 2.06­5.46) than for females (1.88, 95% CI, 1.21-2.57) and elderly people (1.69, 95% CI, 1.28-2.10), respectively. CONCLUSIONS: We found that both cold and hot temperatures significantly aggravated premature death from CVDs. Our results indicated that the whole range of effects of ambient temperature on CVDs should be given attention.

Association of neural tube defects with congenital abnormalities of the urogenital system in a Chinese cohort.

BACKGROUND: This study aimed to retrospectively analyze the correlation between congenital abnormality of the urogenital system and various factors in children with neural tube defects (NTDs). METHODS: A total of 190 children with congenital NTDs, who were admitted to a hospital from May 2013 to May 2018, were included into the present study. All admitted children with congenital NTDs were carried out routine abdominal B-ultrasound examinations to determine the malformations of the abdominal organs, including the urinary system. Children with a B-ultrasound result of suspected and unsure malformation underwent intravenous pyelography (IVP) and voiding cysto-urethrography (VCU), and this was further confirmed by the CT results. RESULTS: The incidence of urogenital malformation was 12.1% (23/190) in children with congenital NTDs. For the 23 children with urogenital malformations, most of these children had no definite urinary system symptoms, while some of these children had multiple incidences of urinary system infections. CONCLUSIONS: Congenital NTDs are often combined with urogenital malformations, if not specifically searched these may be overlooked. The early detection of these malformations is beneficial to reduce the risk of operation and improve the prognosis.

The Impact of Non-optimum Ambient Temperature on Years of Life Lost: A Multi-county Observational Study in Hunan, China.

The ambient temperature-health relationship is of growing interest as the climate changes. Previous studies have examined the association between ambient temperature and mortality or morbidity, however, there is little literature available on the ambient temperature effects on year of life lost (YLL). Thus, we aimed to quantify the YLL attributable to non-optimum ambient temperature. We obtained data from 1 January 2013 to 31 December 2017 of 70 counties in Hunan, China. In order to combine the effects of each county, we used YLL rate as a health outcome indicator. The YLL rate was equal to the total YLL divided by the population of each county, and multiplied by 100,000. We estimated the associations between ambient temperature and YLL with a distributed lag non-linear model (DNLM) in a single county, and then pooled them in a multivariate meta-regression. The daily mean YLL rates were 22.62 y/(p·100,000), 10.14 y/(p·100,000) and 2.33 y/(p·100,000) within the study period for non-accidental, cardiovascular, and respiratory disease death. Ambient temperature was responsible for advancing a substantial fraction of YLL, with attributable fractions of 10.73% (4.36-17.09%) and 16.44% (9.09-23.79%) for non-accidental and cardiovascular disease death, respectively. However, the ambient temperature effect was not significantly for respiratory disease death, corresponding to 5.47% (-2.65-13.60%). Most of the YLL burden was caused by a cold temperature than the optimum temperature, with an overall estimate of 10.27% (4.52-16.03%) and 15.94% (8.82-23.05%) for non-accidental and cardiovascular disease death, respectively. Cold and heat temperature-related YLLs were higher in the elderly and females than the young and males. Extreme cold temperature had an effect on all age groups in different kinds of disease-caused death. This study highlights that general preventative measures could be important for moderate temperatures, whereas quick and effective measures should be provided for extreme temperatures.

[Analysis on the changing trend of mortality rate and spectrum regarding causes of death in the last recent 30 years in Hunan province].

OBJECTIVE: To investigate the changing trend of mortality and the spectrum regarding causes of death in the population of Hunan, and to analyze the health-related major diseases. METHODS: With retrospective study method, a sample survey on causes of death and the related information was carried out from 2004 to 2005 among the residents in Hunan province. Results were compared with the data from a retrospective survey on causes of death in Hunan during 1973-1975 and 1990-1992, respectively. RESULTS: The crude mortality rates and the standardized mortality ratios (SMR) of the residents in Hunan were 901.59/100 000 and 865.14/100 000 during the period of 1973-1975 while 588.64/100 000 and 537.42/100 000 during the period of 1990-1992, and 608.27/100 000 and 413.67/100 000 during the period of 2004-2005, respectively. During the past 30 years, the SMR of the residents in Hunan decreased by 52.18% and the descending range from the rural areas was more than that of the urban areas, and higher in females than in males. The death proportion of infectious diseases, maternal and perinatal diseases, nutritional deficiencies decreased significantly (P<0.01), but the death proportion of chronic non-communicable diseases increased significantly (P<0.01). The changing ranges of the former two proportions were both larger in the rural areas than those in the urban areas. The highest proportions of deaths due to injury and poisoning during the past 30 years were both seen in the 5 year olds, followed by the age groups of 25 year olds (P<0.01). During the period of 2004-2005, the death proportion of all the infectious diseases, maternal/perinatal diseases and nutritional deficiencies was 8.01% altogether, and those of chronic non-communicable diseases, injury and poisoning were 80.66% and 11.33%, respectively. During the past 30 years, the SMR of the three kinds of diseases all significantly decreased, more significantly seen in infectious diseases, maternal and perinatal diseases, and nutritional deficiencies but less in chronic non-communicable diseases. Among the death cases of chronic non-communicable diseases, the SMR of cerebrovascular disease, malignant tumor, and heart disease showed an increasing tendency and the sequences of them had been advanced to the first, the second, and the fourth in the death ranking during the period of 2004-2005, respectively. CONCLUSION: The SMRs of the residents in the urban and rural areas from Hunan province showed a declining tendency. Cardiovascular, cerebrovascular diseases and malignant tumors had become the important diseases affecting the health of the people, while injury and poisoning had otherwise topped the causes of death among children and adolescents in Hunan province.

[Study on the score criteria of severe hand, foot and mouth disease cases].

OBJECTIVE: To explore the score criteria of severe hand, foot and mouth disease (HFMD) cases and to provide evidence for unified criteria and treatment on severe HFMD cases. METHODS: All severe cases and partial mild cases reported by two designated hospitals of HFMD in Fuyang during March to June, 2008 were scored by the methods of criteria constructed in advance. ROC curve was adopted to evaluate the score criteria and the gold standard was defined according to ICU, intubation and clinical outcomes, etc. Sensitivity, specificity and Youden's index were used to determine the division scores on critical, severe and mild cases. RESULTS: 97% of the cases (34 cases) were scored less than 6 points. 88% of cases (24 cases) who were intubated or mechanical ventilated had the scores of 6 points or higher. 79% of deaths (11 cases) were scored 10 points or higher. The area of receiver operation characteristic (ROC) curve was 0.90 (95%CI: 0.83 - 0.98) between severe and mild cases and the area of ROC curve was 0.95 (95%CI: 0.92 - 0.98) between critical and severe, mild cases. When comprehensively considering the sensitivity and specificity, severe cases were best judged when score was 4 points (sensitivity, specificity and Youden's index were 0.94, 0.68 and 0.62 respectively). When score was 6 points, critical cases were judged very well (sensitivity, specificity and Youden's index were 0.92, 0.84 and 0.76 respectively). CONCLUSION: Score criteria could be quantified to determine the degree of seriousness and with high-value for diagnosis on HFMD.