Ambient Temperature and Years of Life Lost: A National Study in China

Tao Liu, Chunliang Zhou, Haoming Zhang, Biao Huang, Yanjun Xu, Lifeng Lin, Lijun Wang, Ruying Hu, Zhulin Hou, Yize Xiao, Junhua Li, Xiaojun Xu, Donghui Jin, Mingfang Qin, Qinglong Zhao, Weiwei Gong, Peng Yin, Yiqing Xu, Jianxiong Hu, Jianpeng XiaoWeilin Zeng, Xing Li, Siqi Chen, Lingchuan Guo, Zuhua Rong, Yonghui Zhang, Cunrui Huang, Yaodong Du, Yuming Guo, Shannon Rutherford, Min Yu, Maigeng Zhou, Wenjun Ma

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2 Citations (Scopus)


Although numerous studies have investigated premature deaths attributable to temperature, effects of temperature on years of life lost (YLL) remain unclear. We estimated the relationship between temperatures and YLL, and quantified the YLL per death caused by temperature in China. We collected daily meteorological and mortality data, and calculated the daily YLL values for 364 locations (2013–2017 in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces, and 2006–2011 in other locations) in China. A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates (YLL/100,000 population), and a multivariate meta-analysis model was used to pool location-specific associations. Then, YLL per death caused by temperatures was calculated. The temperature and YLL rates consistently showed U-shaped associations. A mean of 1.02 (95% confidence interval: 0.67, 1.37) YLL per death was attributable to temperature. Cold temperature caused 0.98 YLL per death with most from moderate cold (0.84). The mean YLL per death was higher in those with cardiovascular diseases (1.14), males (1.15), younger age categories (1.31 in people aged 65–74 years), and in central China (1.34) than in those with respiratory diseases (0.47), females (0.87), older people (0.85 in people ≥75 years old), and northern China (0.64) or southern China (1.19). The mortality burden was modified by annual temperature and temperature variability, relative humidity, latitude, longitude, altitude, education attainment, and central heating use. Temperatures caused substantial YLL per death in China, which was modified by demographic and regional characteristics.

Original languageEnglish
Article number100072
Number of pages7
JournalThe Innovation
Issue number1
Publication statusPublished - 28 Feb 2021


  • China
  • distributed lag nonlinear model
  • mortality burden
  • multivariate meta-analysis
  • temperature
  • years of life lost

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