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BMJ Open. 2014 Jul 1;4(7):e004961. doi: 10.1136/bmjopen-2014-004961.

Temporal relationship between hospital admissions for pneumonia and weather conditions in Shanghai, China: a time-series analysis.

Author information

1
School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.
2
School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China Fudan Tyndall Centre, Shanghai, China.
3
Shanghai Center for Urban Environmental Meteorology, Shanghai, China Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
4
Health and Climate Foundation, Washington DC, USA.

Abstract

OBJECTIVES:

To explore the association between weather conditions and hospital admissions for pneumonia in Shanghai.

DESIGN:

A time-series analysis was performed for a period of 4 years (January 2008-December 2011). A generalised additive model was used to calculate the relative risks.

SETTING:

Shanghai, China.

PARTICIPANTS:

All daily hospital admissions for pneumonia were obtained from the Shanghai health insurance system between 1 January 2008 and 31 December 2011 (n=99 403).

RESULTS:

The relationship between the mean temperature and pneumonia hospital admissions followed a V-shaped curve, with an optimum temperature (OT) at 13°C. When the mean temperature was below the OT, a 1°C decrease corresponded to a 4.88% (95% CI 2.71% to 7.09%) and 5.34% (95% CI 2.04% to 8.74%) increase in pneumonia hospital admissions in lag 4 using a single-day lag structure and lag 0-7 using a multiday lag structure. When the mean temperature ≥OT, no adverse effects from the temperature on pneumonia hospital admissions were found. The magnitude of the effects of temperature varied across gender and age groups. Hospitalisations for pneumonia increased by 15.99% (95% CI 0.06% to 34.46%) in the cold period.

CONCLUSIONS:

Cold temperature may be one of the important risk factors for pneumonia hospitalisations. Prevention programmes are needed to reduce the impact of cold temperature on pneumonia hospitalisations such as developing a weather warning system within a wide public health context.

KEYWORDS:

generalized additive model; pneumonia; temperature; time-series

PMID:
24989619
PMCID:
PMC4091538
DOI:
10.1136/bmjopen-2014-004961
[Indexed for MEDLINE]
Free PMC Article

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