Non-optimal apparent temperature and cardiovascular mortality: the association in Puducherry, India between 2011 and 2020

BMC Public Health

Research

Antonio Gasparrini¹  Hugo Pedder²  Mohammad Aqiel Dalvie³  Ravivarman Lakshmanasamy⁴  Jürg Utzinger⁵  Martin Röösli⁵  Guéladio Cissé⁵  Shreya S. Shrikhande⁵ 

[1] Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK;Centre On Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK;Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK;Population Health Sciences, University of Bristol, Bristol, UK;School of Public Health and Family Medicine, Centre for Environmental and Occupational Health Research, University of Cape Town, Cape Town, South Africa;State Surveillance Officer, Department of Health and Family Welfare Services, Govt. of Puducherry, Puducherry, India;Swiss Tropical and Public Health Institute, Kreuzstrasse 2, CH-4123, Allschwil, Switzerland;University of Basel, Basel, Switzerland;

关键词: Climate change;    Temperature;    Cardiovascular disease;    LMIC;    Adaptation;    Modelling;    India;    Puducherry;   

DOI  :  10.1186/s12889-023-15128-6

 received in 2022-05-26, accepted in 2023-01-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time.MethodsUsing in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (Tapp) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between Tapp and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach.ResultsWe found that the optimal temperature range for Puducherry is between 30°C and 36°C with respect to CVDs. Both cold and hot non-optimal Tapp were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that maleswere more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature.ConclusionBoth heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans.

【 授权许可】

CC BY   
© The Author(s) 2023

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