Interactive Effect of Diurnal Temperature Range and Temperature on Mortality, Northeast Asia

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Background: The diurnal temperature range (DTR) represents temperature variability within a day and has been reported as a potential risk factor for mortality. Previous studies attempted to identify the role of temperature in the DTR-mortality association, but results are inconclusive. The aim of this study was to investigate the interactive effect of temperature and DIR on mortality using a multicountry time series analysis. Methods: We collected time series data for mortality and weather variables for 57 communities of three countries (Taiwan, Korea, and Japan) in Northeast Asia (1972-2012). Two-stage time series regression with a distributed lag nonlinear model and meta-analysis was used to estimate the DTR-mortality association changing over temperature strata (six strata were defined based on community-specific temperature percentiles). We first investigated the whole population and then, the subpopulations defined by temperature distribution (cold and warm regions), sex, and age group (people <65 and >= 65 years of age), separately. Results: The DTR-mortality association changed over temperature strata. The relative risk (RR) of mortality for 10 degrees C increase in DTR was larger for high-temperature strata compared with cold-temperature strata (e.g., = 1.050; 95% confidence interval [CI] = 1.040, 1.060 at extreme-hot stratum and RR = 1.040; 95% CI = 1.031, 1.050 at extreme-cold stratum); extreme-hot and -cold strata were defined as the days with daily mean temperature above 90th and below 10th percentiles each community's temperature distribution. Such increasing pattern was more pronounced in cold region and in people who were 65 years or older. Conclusions: We found evidence that the DTR-related mortality may increase as temperature increases.
Publisher
LIPPINCOTT WILLIAMS &amp; WILKINS
Issue Date
2019-07
Language
English
Article Type
Article
Citation

EPIDEMIOLOGY, v.30, pp.S99 - S106

ISSN
1044-3983
DOI
10.1097/EDE.0000000000000997
URI
http://hdl.handle.net/10203/266090
Appears in Collection
MA-Journal Papers(저널논문)
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