Ambient heat and hospitalisation for COPD in Brazil

A nationwide case-crossover study

Qi Zhao, Shanshan Li, Micheline De Sousa Zanotti Stagliorio Coelho, Paulo Hilário Nascimento Saldiva, Rongbin Xu, Rachel R. Huxley, Michael J. Abramson, Yuming Guo

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Heat exposure has been related to increased morbidity and mortality for several health outcomes. There is little evidence whether this is also true for COPD. This study quantified the relationship between ambient heat and hospitalisation for COPD in the Brazilian population. Methods: Data on hospitalisations for COPD and weather conditions were collected from 1642 cities during the 2000-2015 hot seasons. A time-stratified, case-crossover design was used for city-specific analyses, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, age group and early/late hot season. Annual change in the association was examined using a random-effect meta-regression model. Results: The OR of hospitalisation was 1.05 (95% CI 1.04 to 1.06) for every 5 increase in daily mean temperature at the national level, with the effect estimate stronger in the late hot season compared with the early hot season. The effect was similar in women and in men but was greatest for those aged ≥75 years. The association was stronger in the central west and southeast regions and minimal in the northeast. Assuming a causal relationship, 7.2% of admissions were attributable to heat exposure. There was no significant temporal decline in the impact of ambient heat over the 16-year study period. Conclusion: In Brazil, exposure to ambient heat was positively associated with hospitalisation for COPD, particularly during the late hot season. These data add to the growing evidence base implicating global warming as being an important contributor to the future healthcare burden.

Original languageEnglish
Number of pages6
JournalThorax
DOIs
Publication statusAccepted/In press - 13 Sep 2019

Keywords

  • COPD epidemiology

Cite this

Zhao, Qi ; Li, Shanshan ; Coelho, Micheline De Sousa Zanotti Stagliorio ; Saldiva, Paulo Hilário Nascimento ; Xu, Rongbin ; Huxley, Rachel R. ; Abramson, Michael J. ; Guo, Yuming. / Ambient heat and hospitalisation for COPD in Brazil : A nationwide case-crossover study. In: Thorax. 2019.
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title = "Ambient heat and hospitalisation for COPD in Brazil: A nationwide case-crossover study",
abstract = "Background: Heat exposure has been related to increased morbidity and mortality for several health outcomes. There is little evidence whether this is also true for COPD. This study quantified the relationship between ambient heat and hospitalisation for COPD in the Brazilian population. Methods: Data on hospitalisations for COPD and weather conditions were collected from 1642 cities during the 2000-2015 hot seasons. A time-stratified, case-crossover design was used for city-specific analyses, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, age group and early/late hot season. Annual change in the association was examined using a random-effect meta-regression model. Results: The OR of hospitalisation was 1.05 (95{\%} CI 1.04 to 1.06) for every 5 increase in daily mean temperature at the national level, with the effect estimate stronger in the late hot season compared with the early hot season. The effect was similar in women and in men but was greatest for those aged ≥75 years. The association was stronger in the central west and southeast regions and minimal in the northeast. Assuming a causal relationship, 7.2{\%} of admissions were attributable to heat exposure. There was no significant temporal decline in the impact of ambient heat over the 16-year study period. Conclusion: In Brazil, exposure to ambient heat was positively associated with hospitalisation for COPD, particularly during the late hot season. These data add to the growing evidence base implicating global warming as being an important contributor to the future healthcare burden.",
keywords = "COPD epidemiology",
author = "Qi Zhao and Shanshan Li and Coelho, {Micheline De Sousa Zanotti Stagliorio} and Saldiva, {Paulo Hil{\'a}rio Nascimento} and Rongbin Xu and Huxley, {Rachel R.} and Abramson, {Michael J.} and Yuming Guo",
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Ambient heat and hospitalisation for COPD in Brazil : A nationwide case-crossover study. / Zhao, Qi; Li, Shanshan; Coelho, Micheline De Sousa Zanotti Stagliorio; Saldiva, Paulo Hilário Nascimento; Xu, Rongbin; Huxley, Rachel R.; Abramson, Michael J.; Guo, Yuming.

In: Thorax, 13.09.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Ambient heat and hospitalisation for COPD in Brazil

T2 - A nationwide case-crossover study

AU - Zhao, Qi

AU - Li, Shanshan

AU - Coelho, Micheline De Sousa Zanotti Stagliorio

AU - Saldiva, Paulo Hilário Nascimento

AU - Xu, Rongbin

AU - Huxley, Rachel R.

AU - Abramson, Michael J.

AU - Guo, Yuming

PY - 2019/9/13

Y1 - 2019/9/13

N2 - Background: Heat exposure has been related to increased morbidity and mortality for several health outcomes. There is little evidence whether this is also true for COPD. This study quantified the relationship between ambient heat and hospitalisation for COPD in the Brazilian population. Methods: Data on hospitalisations for COPD and weather conditions were collected from 1642 cities during the 2000-2015 hot seasons. A time-stratified, case-crossover design was used for city-specific analyses, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, age group and early/late hot season. Annual change in the association was examined using a random-effect meta-regression model. Results: The OR of hospitalisation was 1.05 (95% CI 1.04 to 1.06) for every 5 increase in daily mean temperature at the national level, with the effect estimate stronger in the late hot season compared with the early hot season. The effect was similar in women and in men but was greatest for those aged ≥75 years. The association was stronger in the central west and southeast regions and minimal in the northeast. Assuming a causal relationship, 7.2% of admissions were attributable to heat exposure. There was no significant temporal decline in the impact of ambient heat over the 16-year study period. Conclusion: In Brazil, exposure to ambient heat was positively associated with hospitalisation for COPD, particularly during the late hot season. These data add to the growing evidence base implicating global warming as being an important contributor to the future healthcare burden.

AB - Background: Heat exposure has been related to increased morbidity and mortality for several health outcomes. There is little evidence whether this is also true for COPD. This study quantified the relationship between ambient heat and hospitalisation for COPD in the Brazilian population. Methods: Data on hospitalisations for COPD and weather conditions were collected from 1642 cities during the 2000-2015 hot seasons. A time-stratified, case-crossover design was used for city-specific analyses, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, age group and early/late hot season. Annual change in the association was examined using a random-effect meta-regression model. Results: The OR of hospitalisation was 1.05 (95% CI 1.04 to 1.06) for every 5 increase in daily mean temperature at the national level, with the effect estimate stronger in the late hot season compared with the early hot season. The effect was similar in women and in men but was greatest for those aged ≥75 years. The association was stronger in the central west and southeast regions and minimal in the northeast. Assuming a causal relationship, 7.2% of admissions were attributable to heat exposure. There was no significant temporal decline in the impact of ambient heat over the 16-year study period. Conclusion: In Brazil, exposure to ambient heat was positively associated with hospitalisation for COPD, particularly during the late hot season. These data add to the growing evidence base implicating global warming as being an important contributor to the future healthcare burden.

KW - COPD epidemiology

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U2 - 10.1136/thoraxjnl-2019-213486

DO - 10.1136/thoraxjnl-2019-213486

M3 - Article

JO - Thorax

JF - Thorax

SN - 0040-6376

ER -