Joint effects of heat-humidity compound events on drowning mortality in Southern China.

ABSTRACT

BACKGROUND: Several previous studies have examined the association of ambient temperature with drowning. However, no study has investigated the effects of heat-humidity compound events on drowning mortality. METHODS: The drowning mortality data and meteorological data during the five hottest months (May to September) were collected from 46 cities in Southern China (2013-2018 in Guangdong, Hunan and Zhejiang provinces). Distributed lag non-linear model was first conducted to examine the association between heat-humidity compound events and drowning mortality at city level. Then, meta-analysis was employed to pool the city-specific exposure-response associations. Finally, we analysed the additive interaction of heat and humidity on drowning mortality. RESULTS: Compared with wet-non-hot days, dry-hot days had greater effects (excess rate (ER)=32.34%, 95% CI 24.64 to 40.50) on drowning mortality than wet-hot days (ER=14.38%, 95%CI 6.80 to 22.50). During dry-hot days, males (ER=42.40%, 95% CI 31.92 to 53.72), adolescents aged 0-14 years (ER=45.00%, 95% CI 21.98 to 72.35) and urban city (ER=36.91%, 95% CI 23.87 to 51.32) showed higher drowning mortality risk than their counterparts. For wet-hot days, males, adolescents and urban city had higher ERs than their counterparts. Attributable fraction (AF) of drowning attributed to dry-hot days was 23.83% (95% CI 21.67 to 26.99) which was significantly higher than that for wet-hot days (11.32%, 95% CI 9.64 to 13.48%). We also observed that high temperature and low humidity had an additive interaction on drowning mortality. CONCLUSION: We found that dry-hot days had greater drowning mortality risk and burden than wet-hot days, and high temperature and low humidity might have synergy on drowning mortality.