Effects of air temperature on the number of ambulance calls for asthma during cold season in Nur-Sultan- the second coldest capital in the world.

Deleterious effect of cold on overall mortality is well-established. We studied associations between the air temperature and the number f ambulance calls for asthma in Nur-Sultan, Kazakhstan - the second coldest capital in the world. Daily counts of ambulance calls for asthma in Nur-Sultan for the cold seasons (October-March) 2006-2010 were obtained from the Municipal Ambulance Station. Associations between the number of calls and mean and minimum apparent temperatures (average for lags 0-15) were studied using first-order Poisson auto-regression models controlling for wind speed and effects of month, year, weekends and holidays. Altogether, there were 7373 ambulance calls for asthma during the study period. An inverse association between minimum apparent temperature and the number of calls was observed for the age-group 60 years and older. A decrease of the minimum apparent temperature by 1°C was associated with an increase in the number of calls by 1.7% (95% CI: 0.1%-3.3%) across the whole temperature spectrum. No associations in other age groups were found. Our results suggest an inverse association between the average 15-day lag minimum apparent temperature and the number of ambulance calls during the cold season in Nur-Sultan, but this is limited to the oldest age-group.

Associations between air temperature and daily suicide counts in Astana, Kazakhstan.

BACKGROUND AND OBJECTIVE. Seasonal variations in suicide mortality and its association with ambient air temperature have been observed in many countries. However, the evidence from Central Asia is scarce. The aim of the study was to assess the relationship between 4 indicators of air temperature and daily suicide counts in Astana, Kazakhstan. MATERIAL AND METHODS. The daily counts of suicides (ICD-10 codes, X60-X84) for the population of Astana in 2005-2010 were collected using death certificates and medical records at the Municipal Bureau of Forensic Medicine. Associations between the number of cases and mean, maximum, mean apparent, and maximum apparent temperatures were studied using negative binomial regression models controlling for the effects of month, year, weekends, holidays, wind velocity, barometric pressure, and relative humidity. RESULTS. Altogether, there were 685 suicides in Astana in 2005-2010. A clear seasonal pattern with the peak in summer was observed. In crude analyses, significant associations between suicide counts and all 4 temperatures were found. After adjustment for other variables, only apparent temperatures remained significantly associated with the outcome. An increase in the mean apparent temperature by 1°C was associated with an increase in suicide counts by 2.1% (95% CI, 0.4-3.8). Similar results were obtained for the maximum apparent temperature (1.2%, 95% CI, 0.1-2.3). CONCLUSIONS. The results suggest a linear relationship between apparent temperatures and daily suicide counts across the whole spectrum of temperatures. Factors behind this association need further research with a further going aim to develop mitigation strategies in the period of climate change.

No association between temperature and deaths from cardiovascular and cerebrovascular diseases during the cold season in Astana, Kazakhstan--the second coldest capital in the world.

BACKGROUND: Several European and North American studies have reported associations between cold temperatures and mortality from diseases of the circulatory system. However, the effects of cold vary between the settings warranting further research in other parts of the world. OBJECTIVES: To study associations between temperature and mortality from selected diseases of circulatory system in Astana, Kazakhstan--the second coldest capital in the world. METHODS: Daily counts of deaths from hypertensive diseases (ICD-10 codes: I10-I15), ischemic heart disease (I20-I25) and cerebrovascular diseases (I60-I69) among adults 18 years and older in Astana, Kazakhstan, during cold periods (October-March) in 2000-2001 and 2006-2010 were collected from the City Registry Office. Associations between mortality and mean apparent temperature and minimum apparent temperature (average for lags 0-15) were studied using Poisson regression controlling for barometric pressure (average for lags 0-3), wind speed and effects of month, year, weekends and holidays. Analyses were repeated using mean and minimum temperatures. RESULTS: Overall, there were 320, 4468 and 2364 deaths from hypertensive disorders, ischemic heart disease and cerebrovascular diseases, respectively. No significant associations between either mean, mean apparent, minimum or minimum apparent temperatures were found for any of the studied outcomes. CONCLUSIONS: Contrary to the European findings, we did not find inverse associations between apparent temperatures and mortality from cardiovascular or cerebrovascular causes. Factors behind the lack of association may be similar to those in urban settings in Siberia, that is, centrally heated houses and a culture of wearing large volumes of winter clothes outdoors. Further research on the sensitivity of the population in Kazakhstan to climatic factors and its adaptive capacity is warranted.

Effect of high temperatures on daily counts of mortality from diseases of circulatory system in Astana, Kazakhstan.

BACKGROUND AND OBJECTIVE: Associations between hot temperatures and both overall and cardio- and cerebrovascular mortality have been observed in many European, North American, and Southeastern Asian cities. However, the effects varied among the settings with limited evidence from the countries with arid and semiarid climates. The aim of this study was to assess the effect of air temperature on deaths from the selected diseases of the circulatory system in the city of Astana, Kazakhstan. MATERIAL AND METHODS: The daily counts of deaths from hypertensive diseases (ICD-10 codes, I10-I15), cerebrovascular diseases (ICD-10 codes, I60-I69), and ischemic heart disease (ICD-10 codes, I20-I25) during the warm seasons (April-September) of 2000-2001 and 2006-2010 were obtained from the City Registry Office. The associations between the maximum apparent temperature (average of lags 0-3) and mortality were assessed by a first-order autoregressive Poisson regression with the adjustment for barometric pressure (average of lags 0-3), wind speed, and effects of month, year, holidays, and weekends. RESULTS: Altogether, there were 282, 1177, and 2994 deaths from hypertensive diseases, cerebrovascular diseases, and ischemic heart disease, respectively. The maximum effective temperature varied between -2.2°C and 44.5°C. An increase in temperature by 1°C was associated with a 1.9% (95% CI, 0.3-3.5) increase in the daily number of deaths from cerebrovascular diseases and with a 3.1% (95% CI, 0.2-6.1) decrease in the number of deaths from hypertensive diseases among women. CONCLUSIONS: The results suggest a positive association between the maximum apparent temperature and the daily counts of deaths from cerebrovascular diseases and an inverse association between temperature and mortality from hypertensive diseases, but only among women.