COVID-19 pandemic modifies temperature and heat-related illness ambulance transport association in Japan: a nationwide observational study

Environmental Health

Yasushi Honda¹  Xerxes Seposo²  Chris Fook Sheng Ng³  Lina Madaniyazi⁴  Masahiro Hashizume⁵ 

[1] Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan;National Institute for Environmental Studies, Tsukuba, Japan;Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan;Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan;Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan;Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan;Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan;Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan;Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;

关键词: COVID-19;    Heat-related illness;    Ambulance transport;    Effect modification;   

DOI  :  10.1186/s12940-021-00808-w

来源: Springer

【 摘 要 】

BackgroundDuring the COVID-19 pandemic, several illnesses were reduced. In Japan, heat-related illnesses were reduced by 22% compared to pre-pandemic period. However, it is uncertain as to what has led to this reduction. Here, we model the association of maximum temperature and heat-related illnesses in the 47 Japanese prefectures. We specifically examined how the exposure and lag associations varied before and during the pandemic.MethodsWe obtained the summer-specific, daily heat-related illness ambulance transport (HIAT), exposure variable (maximum temperature) and covariate data from relevant data sources. We utilized a stratified (pre-pandemic and pandemic), two-stage approach. In each stratified group, we estimated the 1) prefecture-level association using a quasi-Poisson regression coupled with a distributed lag non-linear model, which was 2) pooled using a random-effects meta-analysis. The difference between pooled pre-pandemic and pandemic associations was examined across the exposure and the lag dimensions.ResultsA total of 321,655 HIAT cases was recorded in Japan from 2016 to 2020. We found an overall reduction of heat-related risks for HIAT during the pandemic, with a wide range of reduction (10.85 to 57.47%) in the HIAT risk, across exposure levels ranging from 21.69 °C to 36.31 °C. On the contrary, we found an increment in the delayed heat-related risks during the pandemic at Lag 2 (16.33%; 95% CI: 1.00, 33.98%).ConclusionThis study provides evidence of the impact of COVID-19, particularly on the possible roles of physical interventions and behavioral changes, in modifying the temperature-health association. These findings would have implications on subsequent policies or heat-related warning strategies in light of ongoing or future pandemics.

【 授权许可】

CC BY