TY - JOUR
T1 - High-temperature indices associated with mortality and outpatient visits
T2 - Characterizing the association with elevated temperature
AU - Lin, Yu Kai
AU - Chang, Chin Kuo
AU - Li, Ming Hsu
AU - Wu, Yu Chung
AU - Wang, Yu Chun
N1 - Funding Information:
We appreciate the authorities of Department of Health, Taiwan National Health Research Institute, Taiwan Environmental Protection Administration, and Taiwan Central Weather Bureau for providing research data. Interpretations and conclusions herein do not represent those of these agencies. Dr. Fung-Chang Sung and Ted Knoy are appreciated for their editorial assistance. This study was supported in part by Taiwan National Science Council ( NSC 96-3111-B-033-001 , NSC 99-2621-M-039-001 and NSC 99-2221-E-033-052 ), the China Medical University Hospital ( 1MS1 ) , and the Taiwan Department of Health ( DOH100-TD-B-111-004 , DOH100-TD-C-111-005 ).
PY - 2012/7/15
Y1 - 2012/7/15
N2 - This study aimed to identify optimal high-temperature indices to predict risks of all-cause mortality and outpatient visits for subtropical islanders in warm seasons (May to October). Eight high-temperature indices, including three single measurements (average, maximum and minimum temperature) and five composite indices (heat index, humidex, temperature humidity index, apparent temperature and wet-bulb globe temperature), and their standardized Z scores, were used in distributed lag non-linear models. Cumulative 8-day (lag zero to seven days) relative risks (RRs) and 95% confidence intervals were estimated, 1 and 2 standardized deviations above the medium (i.e., at 84.1th and 97.7th percentile, respectively), by comparing with Z scores for the lowest risks of mortality and outpatient visits as references. Analyses were performed for Taipei in north, Central Taiwan and Southern Taiwan. Results showed that standardized Z-values of high-temperature indices associated with the lowest health risk were approximately 0 in Taipei and Central Taiwan, and ?. 1 in Southern Taiwan. As the apparent temperature was at Z = 2, the cumulative 8-day mortality risk increased significantly, by 23% in Taipei and 28% in Southern Taiwan, but not in Central Taiwan. The maximum temperature displayed consistently a high correlation with all-cause outpatient visits at Z = 1; with the cumulative 8-day RRs for outpatient visits increased by 7%, 3%, and 4% in the three corresponding areas. In conclusion, this study has demonstrated methods to compare multiple high-temperature indices associated with all-cause mortality and outpatient visits for population residing in a subtropical island. Apparent temperature is an optimal indicator for predicting all-cause mortality risk, and maximum temperature is recommended to associate with outpatient visits. The impact of heat varied with study areas, evaluated health outcomes, and high-temperature indices. The increased extreme heat is associated with stronger risk for all-cause mortality than for outpatient visits.
AB - This study aimed to identify optimal high-temperature indices to predict risks of all-cause mortality and outpatient visits for subtropical islanders in warm seasons (May to October). Eight high-temperature indices, including three single measurements (average, maximum and minimum temperature) and five composite indices (heat index, humidex, temperature humidity index, apparent temperature and wet-bulb globe temperature), and their standardized Z scores, were used in distributed lag non-linear models. Cumulative 8-day (lag zero to seven days) relative risks (RRs) and 95% confidence intervals were estimated, 1 and 2 standardized deviations above the medium (i.e., at 84.1th and 97.7th percentile, respectively), by comparing with Z scores for the lowest risks of mortality and outpatient visits as references. Analyses were performed for Taipei in north, Central Taiwan and Southern Taiwan. Results showed that standardized Z-values of high-temperature indices associated with the lowest health risk were approximately 0 in Taipei and Central Taiwan, and ?. 1 in Southern Taiwan. As the apparent temperature was at Z = 2, the cumulative 8-day mortality risk increased significantly, by 23% in Taipei and 28% in Southern Taiwan, but not in Central Taiwan. The maximum temperature displayed consistently a high correlation with all-cause outpatient visits at Z = 1; with the cumulative 8-day RRs for outpatient visits increased by 7%, 3%, and 4% in the three corresponding areas. In conclusion, this study has demonstrated methods to compare multiple high-temperature indices associated with all-cause mortality and outpatient visits for population residing in a subtropical island. Apparent temperature is an optimal indicator for predicting all-cause mortality risk, and maximum temperature is recommended to associate with outpatient visits. The impact of heat varied with study areas, evaluated health outcomes, and high-temperature indices. The increased extreme heat is associated with stronger risk for all-cause mortality than for outpatient visits.
KW - High-temperature indices
KW - Mortality
KW - Outpatient visits
KW - Standardization
KW - Taiwan
UR - http://www.scopus.com/inward/record.url?scp=84861194339&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2012.04.039
DO - 10.1016/j.scitotenv.2012.04.039
M3 - 期刊論文
C2 - 22575378
AN - SCOPUS:84861194339
SN - 0048-9697
VL - 427-428
SP - 41
EP - 49
JO - Science of the Total Environment
JF - Science of the Total Environment
ER -