Associations of heat with diseases and specific symptoms in Flanders, Belgium: An 8-year retrospective study of general practitioner registration data

IF 10.3 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2024-10-24 DOI:10.1016/j.envint.2024.109097

Endale Alemayehu Ali, Bianca Cox, Karen Van de Vel, Els Verachtert, Bert Vaes, Simon Gabriel Beerten, Elisa Duarte, Charlotte Scheerens, Raf Aerts, Gijs Van Pottelbergh

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引用次数: 0

Abstract

Introduction

Global temperature rise has become a major health concern. Most previous studies on the impact of heat on morbidity have used hospital data.

Objective

This study aimed to quantify the association between ambient temperature and a variety of potentially heat-related medical conditions and symptoms using general practitioner (GP) data, in Flanders, Belgium.

Methods

We used eight years (2012–2019) of aggregated data of daily GP visits during the Belgian summer period (May-September). A distributed lag nonlinear model (DLNM) with time-stratified conditional quasi-Poisson regression was used to account for the non-linear and delayed effect of temperature indicators (minimum, mean and maximum). We controlled for potential confounders such as particulate matter, humidity, and ozone.

Results

The overall (lag0-14) association between heat and most of the outcomes was J-shaped, with an increased risk of disease observed at higher temperatures. The associations were more pronounced using the minimum temperatures indicator. Comparing the 99th (20 °C) to the minimum morbidity temperature (MMT) of the minimum temperature distribution during summer, the relative risk (RR) was significantly higher for heat-related general symptoms (RR = 1.30 [95 % CI: 1.07, 1.57]), otitis externa (RR = 4.87 [95 % CI:2.98, 7.98]), general heart problems (RR = 2.43 [95 % CI: 1.33, 4.42]), venous problems (RR = 2.48 [95 % CI:1.55, 3.96]), respiratory complaints (RR = 1.97 [95 % CI: 1.25, 3.09]), skin problems (RR = 3.26 [95 % CI: 2.51, 4.25]), and urinary infections (RR = 1.37 [95 % CI: 1.11, 1.69]). However, we did not find evidence for heat-related increases in gastrointestinal problems, cerebrovascular events, cardiovascular events, arrhythmia, mental health problems, upper respiratory problems and lower respiratory problems. An increased risk of allergy was observed when the minimum temperature reached 17.8 °C (RR = 1.50 [95 % CI: 1.23, 1.83]). Acute effects of heat were observed (largest effects at the first few lags).

Summary

Our findings indicated that the occurrence of certain symptoms and illnesses during summer season is associated to high temperature or environmental exposures that are augmented by elevated temperatures. Overall, unlike hospitalization data, GP visits data provide broader population coverage, revealing a more accurate representation of heat-health association.

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比利时佛兰德斯地区高温与疾病和特殊症状的关系：一项为期 8 年的全科医生登记数据回顾性研究

导言全球气温升高已成为一个主要的健康问题。本研究旨在利用比利时佛兰德斯地区全科医生（GP）的数据，量化环境温度与各种可能与高温有关的病症和症状之间的关联。方法我们使用了比利时夏季（5 月至 9 月）八年（2012 年至 2019 年）全科医生每日就诊的汇总数据。我们采用了分布式滞后非线性模型（DLNM）和时间分层条件准泊松回归，以考虑温度指标（最低气温、平均气温和最高气温）的非线性和延迟效应。我们对颗粒物、湿度和臭氧等潜在混杂因素进行了控制。结果高温与大多数结果之间的总体关联（滞后 0-14 年）呈 "J "形，温度越高，患病风险越高。最低气温指标的相关性更为明显。将夏季最低气温分布的第 99 位（20 °C）与最低发病温度（MMT）进行比较，与高温有关的一般症状（RR = 1.30 [95 % CI: 1.07, 1.57]）、外耳道炎（RR = 4.87 [95 % CI:2.98, 7.98]）、一般心脏问题（RR = 2.43 [95 % CI：1.33，4.42]）、静脉问题（RR = 2.48 [95 % CI：1.55，3.96]）、呼吸道不适（RR = 1.97 [95 % CI：1.25，3.09]）、皮肤问题（RR = 3.26 [95 % CI：2.51，4.25]）和泌尿系统感染（RR = 1.37 [95 % CI：1.11，1.69]）。但是，我们没有发现与高温有关的胃肠道问题、脑血管事件、心血管事件、心律失常、精神健康问题、上呼吸道问题和下呼吸道问题增加的证据。当最低气温达到 17.8 °C时，过敏风险增加（RR = 1.50 [95 % CI: 1.23, 1.83]）。小结我们的研究结果表明，夏季某些症状和疾病的发生与高温或环境暴露有关，而气温升高会加剧这些症状和疾病。总体而言，与住院数据不同，全科医生就诊数据可提供更广泛的人口覆盖，从而更准确地反映高温与健康的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.