Effect of temperature on the risk of varicella in Lu'an City / 预防医学

Objective@#To examine the effect of temperature on the risk of varicella in Lu'an City, Anhui Province, so as to provide insights into varicella prevention and control. @*Methods@#Data on incidence of varicella in Lu'an City from 2010 to 2021 were collected from Chinese Disease Prevention and Control System, and meteorological data in Lu'an City were also collected from National Meteorological Science Data Center and China National Urban Air Quality Real-Time Publishing Platform during the same period. The effect of temperature on the risk of varicella was examined using a distributed lag non-linear model (DLNM) and subgroup analyses for gender and age were conducted. The effects of extremely low and high temperatures on the cumulative risk of varicella and trends in the cumulative risk of varicella over time were analyzed using a time-varying DLNM. @*Results@# Totally 25 318 varicella cases were reported in Lu'an City from 2010 to 2021, including 15 013 men (59.30%) and 10 305 women (40.70%). The median number of varicella cases was 4 (interquartile range, 6) cases, and the daily median air temperature was 17.50 (interquartile range, 15.80) ℃, with the lowest temperature recorded as -5.80 ℃ and the highest temperatures as 34.90 ℃. The results from the DLNM showed that the extremely low temperatures reduced the risk of varicella (RR=0.522, 95%CI: 0.375-0.728) in relative to median temperature, while extremely high temperature increased the risk of varicella (RR=1.604, 95%CI: 1.112-2.316). Subgroup analysis revealed the effect curve for men was similar to total populations (extremely low temperature: RR=0.497, 95%CI: 0.331-0.746; extremely high temperature: RR=1.978, 95%CI: 1.260-3.106), and the effect of temperature on varicella risk was mainly concentrated among children at ages of 6 to 12 years (extremely low temperature: RR=0.426, 95%CI: 0.247-0.736; extremely high temperature: RR=2.431, 95%CI: 1.378-4.288). The results from the time-varying DLNM revealed that the cumulative risk of varicella due to both extremely low and high temperatures appeared a tendency towards a rise over years (P<0.05). @*Conclusions@#Low temperature may reduce the risk of varicella, while high temperature increases the risk of varicella in Lu'an City, which is more remarkable among men and children at ages of 6 to 12 years. The cumulative risk of varicella at both extremely low and high temperatures shows a tendency towards a rise over years.

Effects of daily mean temperature on the incidence of other infectious diarrhea in Hebei Province / 中华传染病杂志

Objective:To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods:The data of meteorological factors (including temperature and average daily temperature) and the daily incidence of other infectious diarrhea in Zhangjiakou City, Chengde City, Tangshan City, Qinhuangdao City, Baoding City, Langfang City, Cangzhou City, Shijiazhuang City, Hengshui City, Xingtai City, and Handan City in Hebei Province from 2017 to 2020 were collected. Eleven prefecture-level cities were divided into four regions, including east, north, middle and south regions. Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea. Meanwhile, the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results:A total of 231 008 cases of other infectious diarrhea were reported in Hebei Province. The seasonal distribution was obvious, showing a bimodal distribution of large peaks in summer and small peaks in winter. An inverse S-shaped association between average daily temperature and cumulative risk ratio ( RR) of other infectious diarrhea was observed in Hebei Province. Both high temperature (higher than 27.50 ℃) and low temperature (less than 13.67 ℃) could increase the risk of other infectious diarrhea. When the temperature was lower than 13.00 ℃, the lag time and RR had a U-shaped association (lag four to seven days, 23 to 30 days). Meanwhile, when it was higher than 13.00 ℃, it had an inverted U-shaped association (lag 5 to 21 days). A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24 ℃. When the temperature getting hot ( P95=28.25 ℃), the risk occurred at lag 0 days, and the lag time gradually got short from north to south. Thus, the high temperature effect reached maximum quickly with a relative short duration. Conclusions:The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed. Both low temperature and high temperature are associated with increased risk of other infectious diarrhea. But the impact of low temperature is more notable, which has a relative long duration.

Effects of daily mean temperature and other meteorological variables on bacillary dysentery in Beijing-Tianjin-Hebei region, China

BACKGROUND@#Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution.@*METHODS@#Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM.@*RESULTS@#A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates.@*CONCLUSIONS@#This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.

Association of compound hot extreme with blood pressure in Guangdong province / 环境与职业医学

Background It is projected that the frequency, density, and duration of compound hot extreme may increase in the 21st century in the context of global warming. Objective To explore the association between compound hot extreme and blood pressure, and identify sensitive populations. Methods This was a cross-sectional study. The study subjects were from six Guangdong Province Chronic Disease and Nutrition Surveys during 2002 through 2015. A questionnaire was administered to the participants with questions about demographic information, drinking and smoking status, and measurements on their height, weight, and blood pressure were also collected. We chose the data of May, September, and October to explore the association between compound hot extreme and blood pressure. Compound hot extreme means a hot day with a proceeding hot night. Daily meteorological data were obtained from China Meteorological Data Service Centre. We employed inverse distance weighting to interpolate the temperature and relative humidity values for each participant. A distributed lag non-linear model was used to estimate the association between compound hot extreme and blood pressure. Stratified analyses by sex, age, area, body mass index (BMI), smoking status, and drinking status were also performed to identify sensitive populations. A sensitivity analysis was conducted by adjusting the degrees of freedom for lag spline and removing relative humidity. Result A total of 10967 participants without history of hypertension were included in this study. The average systolic blood pressure (SBP) was 120.8 mmHg and the average diastolic blood pressure (DBP) was 74.5 mmHg. The proportion of participants who experienced hot day, hot night, or compound hot extreme were 9.34%, 17.95% and 2.90%, respectively. Compared to hot day, hot night and compound hot extreme were related with decreased blood pressure, and the effect of compound hot extreme was stronger: the changes and 95%CI for SBP was −6.2 (−10.3-−2.1) mmHg, and for DBP was −2.7 (−5.2-−0.2) mmHg. Compound hot extreme induced decreased SBP among male, population ≥ 65 years, and those whose BMI < 24 kg·m-2, and their ORs (95%CIs) were −6.2 (−10.7-−1.6). −19.1 (−33.0-−5.1), and −6.7 (−11.8~−1.6) mmHg, respectively, and also decreased DBP among population ≥ 65 years, and its OR (95%CI) was −8.4 (−15.6-−1.1) mmHg. During compound hot extremes, participants living in rural areas showed decreased SBP and DBP, and the ORs (95%CIs) were −10.5 (−16.6-−4.5) and −4.4 (−7.7-−1.1) mmHg respectively, while those living in urban areas showed increased SBP, and the OR (95%CI) was 9.7 (2.9-16.5) mmHg. A significant decrease in blood pressure [OR (95%CI)] was also found in non-smokers [DBP, −3.7 (−6.6-−0.8) mmHg] and non-drinkers [SBP, −4.8 (−9.4-−0.2) mmHg; DBP, −3.4 (−6.0-−0.9) mmHg]. Conclusion Compound hot extreme is negatively associated with SBP, and being male, aged 65 years and over, and having BMI < 24 kg·m−2 may be more sensitive to compound hot extreme.

Air Temperature Affects the Hospital Admission for Cardiovascular Diseases among Rural Residents in Dingxi City / 中国医学科学院学报

Objective To explore the effect of air temperature on the hospitalization of rural residents with cardiovascular diseases and its lag effect in Dingxi city. Methods The meteorological data and air pollution data of Dingxi city from 2018 to 2019,as well as the daily hospitalization data of rural residents due to cardiovascular diseases,were collected.The distributed lag non-linear models were employed to analyze the relationship between daily mean air temperature and the number of inpatients with cardiovascular diseases.Meanwhile,stratified analysis was carried out according to gender,age,and disease. Results There was a non-linear relationship between air temperature and the number of hospitalized rural residents with cardiovascular diseases in Dingxi city.The exposure-response curve approximated a bell shape.The curves for different cardiovascular diseases appeared similar shapes,with different temperature thresholds.Low temperature(-7 ℃) and moderately low temperature(0 ℃) exhibited a cumulative lag effect on the number of patients hospitalized with cardiovascular diseases.With a cumulative lag of 7 days at -7 ℃ and 14 days at 0 ℃,the RR values peaked,which were 1.121(95% CI=1.002-1.255) and 1.198(95% CI=1.123-1.278),respectively.With a cumulative lag of 14 days at 0 ℃,the RR values were 1.034(95% CI=1.003-1.077) and 1.039(95% CI=1.004-1.066) for the number of hospitalized patients with ischemic heart disease and heart rhythm disorders,respectively.The cumulative lag effects of moderately high temperature(17 ℃) and high temperature(21 ℃) on ischemic heart disease,heart rhythm disorders,and cerebrovascular disease all peaked on that day.Specifically,the RR values at 17 ℃ and 21 ℃ were 1.148(95% CI=1.092-1.206) and 1.176(95% CI=1.096-1.261) for ischemic heart disease,1.071(95% CI=1.001-1.147) and 1.112(95% CI=1.011-1.223) for heart rhythm disorders,and 1.084(95% CI=1.025-1.145) and 1.094(95% CI=1.013-1.182) for cerebrovascular disease,respectively.There was no cumulative lag effect of air temperature on the number of hospitalized patients with heart failure.In addition,stratified analysis showed that low temperature(-7 ℃) and moderately low temperature(0 ℃) affected the number of hospitalized female patients with cardiovascular diseases,and only moderately low temperature(0 ℃) affected males.The cumulative lag effect of high temperature on females was higher than that on males.Air temperature exhibited a stronger impact on female patients than on male patients. Additionally,the population aged<65 years old was more sensitive to low temperature and high temperature than that aged ≥65 years old. Conclusions Air temperature changes increase the hospitalization risk of rural residents with cardiovascular diseases in Dingxi city,which presents a lag effect.The effects of air temperature on patients hospitalized due to cardiovascular diseases varied among different etiologies,genders,and ages.It is necessary to emphasize on the impact of temperature changes on health in residents,especially for key populations such as females,people aged<65 years old,and those with ischemic heart disease.

Influenza-associated excess mortality in Zhejiang Province from 2016 to 2019 / 预防医学

Objective@#To estimate the influenza-associated excess mortality (IEM) in Zhejiang Province from 2016 to 2019, so as to provide insights into estimates of mortality burden due to influenza. @* Methods@#The data pertaining to all-cause death and influenza surveillance in Zhejiang Province from 2016 to 2019 were retrieved from Zhejiang Provincial Cause of Death Registration System and Influenza Surveillance System to create distributed lag non-linear models (DLNMs). The year-, influenza subtype- and age-specific IEM rates were estimated.@*Results@#The overall IEM was 18.67/105 (95%CI: 15.32/105-21.97/105) in Zhejiang Province from 2016 to 2019, with the lowest in 2016 (14.19/105, 95%CI: 12.00/105-16.37/105) and the highest in 2018 (22.92/105, 95%CI: 19.23/105-26.56/105). The IEM rates of influenza A (H1N1), influenza A (H3N2) and influenza B were 9.32/105 (95%CI: 7.65/105-10.98/105), 5.68/105 (95%CI: 4.24/105-7.11/105), and 3.66/105 (95%CI: 2.13/105-5.18/105). The greatest IEM was seen among residents at ages of 65 years and older (142.91/105, 95%CI: (115.99/105-169.55/105, followed by among individuals at ages of 15 to 64 years (2.74/105, 95%CI: 1.87/105-3.61/105), and the lowest was seen among individuals under 15 years of age (0.41/105, 95%CI: -0.33/105-1.14/105). @*Conclusions@#From 2016 to 2019, the highest IEM was seen in Zhejiang Province in 2018, and the elderly residents at ages of 65 years and above presented the greatest IEM, with influenza A (H1N1) as the predominant influenza subtype. Influenza surveillance and vaccination is recommended to be reinforced.

Effects of Temperature on Outpatient Visits for Urticaria among Lanzhou Residents Based on Distributed Lag Non-linear Model / 中国医学科学院学报

Objective To evaluate the influence of temperature on the outpatient visits for urticaria in Lanzhou City and its hysteresis and to find out the sensitive populations by sex and age stratification.Methods We collected the urticaria outpatient data in three grade A class three hospitals as well as the meteorological data and air pollutant data in Lanzhou from January 2011 to December 2017.The distributed lag non-linear model(DLNM)was employed to analyze the influence of daily mean temperature on the outpatient visits for urticaria.Stratification analysis was performed for different age groups(0-14,15-59,≥60 years)and different sex populations.Results Temperature had a non-linear relationship with the outpatient visits for urticaria,and there existed hysteresis.During the research period,the average daily outpatient visits for urticaria at the three hospitals in Lanzhou was 25,ranging from 1 to 76.With the rise in the daily mean temperature within 0-10 ℃,the risk of outpatient visits for urticaria first increased and then decreased.When the daily mean temperature was 2 ℃,hysteresis occurred on the 18th day,and the relative risk(

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.

Associations between floods and bacillary dysentery cases in main urban areas of Chongqing, China, 2005-2016: a retrospective study

BACKGROUND@#Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods.@*METHODS@#The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation.@*RESULTS@#After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216-1.596). Male had higher risk than female. People under 5 years old and people aged 15-64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons.@*CONCLUSIONS@#This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public.

Burden of Outpatient Visits Attributable to Ambient Temperature in Qingdao, China / 生物医学与环境科学（英文）

Climate change has been referred to as one of the greatest threats to human health, with reports citing likely increases in extreme meteorological events. In this study, we estimated the relationships between temperature and outpatients at a major hospital in Qingdao, China, during 2015-2017, and assessed the morbidity burden. The results showed that both low and high temperatures were associated with an increased risk of outpatient visits. High temperatures were responsible for more morbidity than low temperatures, with an attributed fraction (AF) of 16.86%. Most temperature-related burdens were attributed to moderate cold and hot temperatures, with AFs of 5.99% and 14.44%, respectively, with the young (0-17) and male showing greater susceptibility. The results suggest that governments should implement intervention measures to reduce the adverse effects of non-optimal temperatures on public health-especially in vulnerable groups.

The role of absolute humidity in respiratory mortality in Guangzhou, a hot and wet city of South China

BACKGROUND@#For the reason that many studies have been inconclusive on the effect of humidity on respiratory disease, we examined the association between absolute humidity and respiratory disease mortality and quantified the mortality burden due to non-optimal absolute humidity in Guangzhou, China.@*METHODS@#Daily respiratory disease mortality including total 42,440 deaths from 1 February 2013 to 31 December 2018 and meteorological data of the same period in Guangzhou City were collected. The distributed lag non-linear model was used to determine the optimal absolute humidity of death and discuss their non-linear lagged effects. Attributable fraction and population attributable mortality were calculated based on the optimal absolute humidity, defined as the minimum mortality absolute humidity.@*RESULTS@#The association between absolute humidity and total respiratory disease mortality showed an M-shaped non-linear curve. In total, 21.57% (95% CI 14.20 ~ 27.75%) of respiratory disease mortality (9154 deaths) was attributable to non-optimum absolute humidity. The attributable fractions due to high absolute humidity were 13.49% (95% CI 9.56 ~ 16.98%), while mortality burden of low absolute humidity were 8.08% (95% CI 0.89 ~ 13.93%), respectively. Extreme dry and moist absolute humidity accounted for total respiratory disease mortality fraction of 0.87% (95% CI - 0.09 ~ 1.58%) and 0.91% (95% CI 0.25 ~ 1.39%), respectively. There was no significant gender and age difference in the burden of attributable risk due to absolute humidity.@*CONCLUSIONS@#Our study showed that both high and low absolute humidity are responsible for considerable respiratory disease mortality burden, the component attributed to the high absolute humidity effect is greater. Our results may have important implications for the development of public health measures to reduce respiratory disease mortality.

Association between high air temperature and mortality in summer: A multi-city analysis in China / 中华流行病学杂志

Objective To understand the associations between changes of high air temperature and mortality in summer in 31 cities in China.Methods Daily mortality and meteorological data in 31 cities in China from January 1,2008 to December 31,2013 were collected.Distributed lag nonlinear model was used to evaluate the association between high air temperature change and mortality in early summer and late summer after controlling for the long-term trend and the effect of "day of week".Results The relative risk of high air temperature on mortality was higher in early summer,with relative risk in the range of 1.08-2.14 in early summer and 1.03-1.67 in late summer.In early summer,the influence of high temperature on mortality was mainly below 5th of percentile and above 50th of percentile,while in late summer it was mainly above 95th of percentile.The lag effect of high air temperature on mortality in early summer was 6 days,while the lag effect in late summer was only about 2 days.Conclusions Association existed between high air temperature and mortality.The influence of high air temperature on mortality in early summer was stronger than that in late summer.It is necessary to take targeted protection measures.

Association between high air temperature and mortality in summer: A multi-city analysis in China / 中华流行病学杂志

Objective To understand the associations between changes of high air temperature and mortality in summer in 31 cities in China.Methods Daily mortality and meteorological data in 31 cities in China from January 1,2008 to December 31,2013 were collected.Distributed lag nonlinear model was used to evaluate the association between high air temperature change and mortality in early summer and late summer after controlling for the long-term trend and the effect of "day of week".Results The relative risk of high air temperature on mortality was higher in early summer,with relative risk in the range of 1.08-2.14 in early summer and 1.03-1.67 in late summer.In early summer,the influence of high temperature on mortality was mainly below 5th of percentile and above 50th of percentile,while in late summer it was mainly above 95th of percentile.The lag effect of high air temperature on mortality in early summer was 6 days,while the lag effect in late summer was only about 2 days.Conclusions Association existed between high air temperature and mortality.The influence of high air temperature on mortality in early summer was stronger than that in late summer.It is necessary to take targeted protection measures.

Influence of diurnal temperature range on influenza incidence in the elderly / 中华流行病学杂志

Objective To understand the influence of diurnal temperature range (DTR) on influenza incidence in the elderly in Beijing and to conduct a subgroup analysis.Methods The incidence data of daily influenza cases in the elderly and daily meteorological data from 2014 to 2016 in Beijing were collected for this study.A generalized additive model (GAM) was used to explore whether the relationship between daily influenza cases and DTR is a linear one.A distributed lag non-linear model (DLNM) was established to quantify the lagged effect of DTR on daily influenza incidence in the elderly.The model was also used to estimate the effects of DTR on daily influenza incidence among various subgroups.Results A total of 4 097 influenza cases in the elderly were notified during study period.The mean DTR was 10.153 ℃.A linear relationship between daily influenza incidence and DTR was detected by using GAM.DTR was significantly associated with daily influenza incidence between lag0 and lag5 with a maximal effect at lag0.An 1 ℃ increase of DTR was associated with a 2.0％ increase in daily influenza incidence in the elderly (95％CI:0.9％-3.0％).The RR values of males,females,people aged 60-69 years,people aged ≥70 years were 1.018 (95％CI:1.005-1.032),1.021(95％CI:1.007-1.035),1.012 (95％CI:1.002-1.022),1.025 (95％CI:1.012-1.039),respectively.The influencing time of DTR on females (lag6) was longer than males (lag2).Conclusions DTR was associated with increased risk of influenza in the elderly in Beijing.It is necessary to take targeted measures in the elderly to control the incidence of influenza when DTR becomes greater.

Influence of diurnal temperature range on influenza incidence in the elderly / 中华流行病学杂志

Objective To understand the influence of diurnal temperature range (DTR) on influenza incidence in the elderly in Beijing and to conduct a subgroup analysis.Methods The incidence data of daily influenza cases in the elderly and daily meteorological data from 2014 to 2016 in Beijing were collected for this study.A generalized additive model (GAM) was used to explore whether the relationship between daily influenza cases and DTR is a linear one.A distributed lag non-linear model (DLNM) was established to quantify the lagged effect of DTR on daily influenza incidence in the elderly.The model was also used to estimate the effects of DTR on daily influenza incidence among various subgroups.Results A total of 4 097 influenza cases in the elderly were notified during study period.The mean DTR was 10.153 ℃.A linear relationship between daily influenza incidence and DTR was detected by using GAM.DTR was significantly associated with daily influenza incidence between lag0 and lag5 with a maximal effect at lag0.An 1 ℃ increase of DTR was associated with a 2.0％ increase in daily influenza incidence in the elderly (95％CI:0.9％-3.0％).The RR values of males,females,people aged 60-69 years,people aged ≥70 years were 1.018 (95％CI:1.005-1.032),1.021(95％CI:1.007-1.035),1.012 (95％CI:1.002-1.022),1.025 (95％CI:1.012-1.039),respectively.The influencing time of DTR on females (lag6) was longer than males (lag2).Conclusions DTR was associated with increased risk of influenza in the elderly in Beijing.It is necessary to take targeted measures in the elderly to control the incidence of influenza when DTR becomes greater.

Impact of temperature on non-accidental deaths and cause-specific mortality in four districts of Jinan / 中华流行病学杂志

Objective To study the relationship between daily temperature and non-accidental deaths in four districts of Jinan,and to investigate the impact of temperature on cause-specific mortality. Methods Data on daily mortality of the four districts(Shizhong,Huaiyin,Tianqiao,Lixia) as well as data related to meteorology and air pollution index were collected from January 1,2008 to December 31,2012. Distributed lag non-linear model(DLNM)was then used to assess the effects of temperature on all non-accidental deaths and deaths caused by cardiovascular diseases (CVD), respiratory diseases(RD),digestive diseases,urinary diseases,and also subcategories to hypertension, ischemic heart diseases(IHD),acute myocardial infarction(AMI),cerebro-vascular diseases(CBD) and chronic lower respiratory diseases. Results A W-shaped relationship was noticed between daily average temperature and non-accidental deaths. The effect of low temperature last for more than 30 days,much longer than that of high temperature,in which presented a harvesting effect less than 5 days. As to the cause-specific mortality,short-term heat effects were seen in CVD and RD as well as related subgroups as IHD,CBD and AMI,with RRs at lag 0 as 1.12(95%CI:1.07-1.17),1.06 (95%CI:1.02-1.31),1.08(95%CI:1.003-1.16),1.10(95%CI:1.02-1.20) and 1.13 (95%CI:1.003-1.26). Relatively higher RRs were seen in urinary diseases and hypertension under extremely high temperature,reaching as high as 2.30(95%CI:1.18-4.51)and 1.65(95%CI:1.02-2.69). Cold weather presented a delayed effect for 30 days,with cumulative RRs as 1.51(95%CI:1.42-1.60),1.90 (95%CI:1.64-2.20),2.12(95%CI:1.67-2.69),1.48(95%CI:1.08-2.03),1.60(95%CI:1.46-1.75), 1.40(95%CI:1.26-1.55),1.68(95%CI:1.45-1.95)for CVD,RD,chronic lower respiratory diseases, hypertension,IHD,CBD and AMI,on sequence. Conclusion A relationship was seen between daily temperature and non-accidental deaths as well as cause-specific mortality. Either high or low temperature seemed to be detrimental. Related measures on disease prevention should be taken during the cold and hot seasons.

Impact of temperature on non-accidental deaths and cause-specific mortality in four districts of Jinan / 中华流行病学杂志

Objective To study the relationship between daily temperature and non-accidental deaths in four districts of Jinan,and to investigate the impact of temperature on cause-specific mortality. Methods Data on daily mortality of the four districts(Shizhong,Huaiyin,Tianqiao,Lixia) as well as data related to meteorology and air pollution index were collected from January 1,2008 to December 31,2012. Distributed lag non-linear model(DLNM)was then used to assess the effects of temperature on all non-accidental deaths and deaths caused by cardiovascular diseases (CVD), respiratory diseases(RD),digestive diseases,urinary diseases,and also subcategories to hypertension, ischemic heart diseases(IHD),acute myocardial infarction(AMI),cerebro-vascular diseases(CBD) and chronic lower respiratory diseases. Results A W-shaped relationship was noticed between daily average temperature and non-accidental deaths. The effect of low temperature last for more than 30 days,much longer than that of high temperature,in which presented a harvesting effect less than 5 days. As to the cause-specific mortality,short-term heat effects were seen in CVD and RD as well as related subgroups as IHD,CBD and AMI,with RRs at lag 0 as 1.12(95%CI:1.07-1.17),1.06 (95%CI:1.02-1.31),1.08(95%CI:1.003-1.16),1.10(95%CI:1.02-1.20) and 1.13 (95%CI:1.003-1.26). Relatively higher RRs were seen in urinary diseases and hypertension under extremely high temperature,reaching as high as 2.30(95%CI:1.18-4.51)and 1.65(95%CI:1.02-2.69). Cold weather presented a delayed effect for 30 days,with cumulative RRs as 1.51(95%CI:1.42-1.60),1.90 (95%CI:1.64-2.20),2.12(95%CI:1.67-2.69),1.48(95%CI:1.08-2.03),1.60(95%CI:1.46-1.75), 1.40(95%CI:1.26-1.55),1.68(95%CI:1.45-1.95)for CVD,RD,chronic lower respiratory diseases, hypertension,IHD,CBD and AMI,on sequence. Conclusion A relationship was seen between daily temperature and non-accidental deaths as well as cause-specific mortality. Either high or low temperature seemed to be detrimental. Related measures on disease prevention should be taken during the cold and hot seasons.