Increased susceptibility to heat for respiratory hospitalizations in Hong Kong

• Published in: The Science of the total environment Vol. 666; pp. 197 - 204
• Main Authors: Sun, Shengzhi, Cao, Wangnan, Mason, Tonya G., Ran, Jinjun, Qiu, Hong, Li, Jinhui, Yang, Yang, Lin, Hualiang, Tian, Linwei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 20.05.2019
• Subjects: Aged; Emergency department; Extreme temperatures; Female; Hong Kong - epidemiology; Hospitalization - statistics & numerical data; Hot Temperature - adverse effects; Humans; Male; Middle Aged; Pneumonia - epidemiology; Pneumonia - etiology; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - etiology; Respiration Disorders - epidemiology; Respiration Disorders - etiology; Respiratory disease; Risk Factors; Seasons; Temporal change; Hong Kong; Extreme temperatures; Emergency department; Temporal change; Respiratory disease
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2019.02.229

Emerging studies have shown temperature-mortality association is changing over time, but little is known about the temporal changes of the temperature-morbidity association. We aimed to evaluate the temporal variations in both temperature-respiratory hospitalizations associations and temperature-related attributable risks in Hong Kong. We collected 17-year time-series data on daily ambient temperature and emergency hospital admissions for respiratory diseases between 2000 and 2016 in Hong Kong. Quasi-Poisson regression with a time-varying distributed lag nonlinear model was used to estimate the year-specific association between temperature and respiratory hospitalizations [total respiratory, pneumonia, and chronic obstructive pulmonary disease (COPD)] and the year-specific attributable fraction (AF) for heat and cold (defined as above/below the optimum temperature, respectively). Heat-related risks and AFs increased continuously for total respiratory, pneumonia and COPD hospitalizations during the past 17 years, respectively. Cold-hospitalization associations and cold-related AFs showed heterogeneous patterns, showing a decreasing trend for pneumonia but a general increasing trend for COPD for both the associations and AFs. The total temperature-related AFs remained stable for total respiratory (p for trend = 0.136) and pneumonia (p for trend = 0.406), but showed an increasing trend for COPD (p for trend < 0.001) from 10% (95% empirical CI: 2%, 17%) in 2000 to 17% (95% empirical CI: 11%, 22%) in 2016. Our findings indicate an increased susceptibility to heat but a decreased susceptibility to cold for respiratory hospitalizations during the past 17 years. The overall temperature-related hospitalization burden for respiratory diseases was generally stable in Hong Kong. [Display omitted] •Trends in temperature-respiratory hospitalization risks and AFs were assessed.•Hong Kong people are more susceptible to heat but less susceptible to cold for RD.•The overall temperature-related AFs for RD hospitalizations were generally constant.