Indexed on: 29 Mar '20Published on: 29 Mar '20Published in: Science of the Total Environment
This study evaluated vulnerable subpopulation on mortality, emergency room visits (ERVs) and outpatient visits associated with ambient daily temperature from 2000 to 2014 using vital statistics and insurance claims of Taiwan. We used the distributed lag non-linear model to assess circulatory disease-specific deaths, ERVs, and outpatient visits by mean temperature after controlling particulate matter (PM) and other covariates. Lag effect of temperature changes on health risks accumulated for 0-10 days associated with low temperature and for 0-5 days for high temperature were evaluated. Cause-specific pooled relative risk (RR) and 95% confidence intervals (CI) were estimated for the whole population of Taiwan using random-effects meta-analysis. We used reference temperatures of 60th percentiles for mortality from circulatory diseases, 99th percentile for ERVs of circulatory diseases, 2nd percentile for ERVs of heart diseases and ischemic heart disease, 53th percentile for ERVs of cerebrovascular disease, and 12-16th percentiles for outpatient visits of circulatory diseases. The lag effects peaked at lag 4-5 day for low temperature exposure and at lag 0 for high temperature exposure. Pooled cold related health risk was the highest for mortality from and ERV of circulatory diseases with RR of 1.41 (95% CI: 1.34, 1.49) and 1.41 (95% CI: 1.35, 1.48), respectively, as daily mean temperatures was at 1st percentile (12.8 °C). Heat related health risk was significant for mortality from heart diseases [RR = 1.12 (95% CI: 1.07, 1.18)] and ischemic heart diseases [RR = 1.13 (95% CI: 1.06, 1.20)] as daily mean temperatures was at 99th percentile (29.9 °C). Health authority should evaluate the effectiveness of adaptive policy, strategy, and actions responding to extreme temperatures to prevent mortality from circulatory diseases. Copyright © 2020. Published by Elsevier B.V.