Time Trends in the Burden of Environmental Heat and Cold Exposure Among Children and Adolescents.

IF 24.7 1区医学 Q1 PEDIATRICS

JAMA Pediatrics Pub Date : 2024-11-04 DOI:10.1001/jamapediatrics.2024.4392

Yi-Sheng He, Fan Cao, Xiao Hu, Yu-Chen Liu, Sha-Sha Tao, Peng Wang, Shengping Hou, Hai-Feng Pan

{"title":"Time Trends in the Burden of Environmental Heat and Cold Exposure Among Children and Adolescents.","authors":"Yi-Sheng He, Fan Cao, Xiao Hu, Yu-Chen Liu, Sha-Sha Tao, Peng Wang, Shengping Hou, Hai-Feng Pan","doi":"10.1001/jamapediatrics.2024.4392","DOIUrl":null,"url":null,"abstract":"Importance: Environmental heat and cold exposure (EHCE) remains the principal preventable cause of morbidity and mortality in children and adolescents globally.Objective: To report EHCE-related burden and analyze its temporal trends among children and adolescents from 1990 to 2019.Design, setting, and participants: This repeated cross-sectional study used data from the Global Burden of Disease Study 2019, which encompassed 204 countries and territories from 1990 to 2019. Children and adolescents aged 0 to 19 years were included in the study. Data analysis occurred from December 2023 to March 2024.Exposure: EHCE in children and adolescents from January 1990 to December 2019.Main outcomes and measures: The primary outcomes were cases and rates of EHCE incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Global trends in these metrics were also analyzed by sex, age, and sociodemographic index (SDI), which is a comprehensive indicator of the socioeconomic status of a country or region. A linear regression model was used to calculate AAPCs and a joinpoint regression model was used to identify the years in which trends changed significantly.Results: From 1990 to 2019, EHCE-related incidence, prevalence, mortality, and DALYs showed a downward trend globally. However, an upward trend in EHCE incidence and prevalence was detected between 2010 and 2019 (incidence AAPC, 1.46; 95% CI, 1.05-1.87; prevalence AAPC, 1.25; 95% CI, 1.01-1.50). Regionally, although EHCE-related incidence showed a decreasing trend in most regions from 1990 to 2019, there were still some regions with an increasing trend (Southern sub-Saharan Africa AAPC, 0.23; 95% CI, 0.01-0.44). In 2019, the mortality and DALYs of EHCE were higher among children and adolescents in countries with low SDI levels. Additionally, the burden of EHCE among children and adolescents varied according to sex and age.Conclusions and relevance: In this cross-sectional study, a global increase was observed in EHCE incidence and prevalence since 2010. Furthermore, children and adolescents in low-SDI regions, which bear the brunt of the climate crisis, were disproportionately impacted. This suggests that future responses to climate change crises should emphasize health equity, which implies that vulnerable populations, such as children and adolescents, should be given priority in the allocation of resources to address climate change.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":null,"pages":null},"PeriodicalIF":24.7000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536307/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamapediatrics.2024.4392","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Importance: Environmental heat and cold exposure (EHCE) remains the principal preventable cause of morbidity and mortality in children and adolescents globally.

Objective: To report EHCE-related burden and analyze its temporal trends among children and adolescents from 1990 to 2019.

Design, setting, and participants: This repeated cross-sectional study used data from the Global Burden of Disease Study 2019, which encompassed 204 countries and territories from 1990 to 2019. Children and adolescents aged 0 to 19 years were included in the study. Data analysis occurred from December 2023 to March 2024.

Exposure: EHCE in children and adolescents from January 1990 to December 2019.

Main outcomes and measures: The primary outcomes were cases and rates of EHCE incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Global trends in these metrics were also analyzed by sex, age, and sociodemographic index (SDI), which is a comprehensive indicator of the socioeconomic status of a country or region. A linear regression model was used to calculate AAPCs and a joinpoint regression model was used to identify the years in which trends changed significantly.

Results: From 1990 to 2019, EHCE-related incidence, prevalence, mortality, and DALYs showed a downward trend globally. However, an upward trend in EHCE incidence and prevalence was detected between 2010 and 2019 (incidence AAPC, 1.46; 95% CI, 1.05-1.87; prevalence AAPC, 1.25; 95% CI, 1.01-1.50). Regionally, although EHCE-related incidence showed a decreasing trend in most regions from 1990 to 2019, there were still some regions with an increasing trend (Southern sub-Saharan Africa AAPC, 0.23; 95% CI, 0.01-0.44). In 2019, the mortality and DALYs of EHCE were higher among children and adolescents in countries with low SDI levels. Additionally, the burden of EHCE among children and adolescents varied according to sex and age.

Conclusions and relevance: In this cross-sectional study, a global increase was observed in EHCE incidence and prevalence since 2010. Furthermore, children and adolescents in low-SDI regions, which bear the brunt of the climate crisis, were disproportionately impacted. This suggests that future responses to climate change crises should emphasize health equity, which implies that vulnerable populations, such as children and adolescents, should be given priority in the allocation of resources to address climate change.

查看原文本刊更多论文

儿童和青少年暴露于环境冷热负担的时间趋势。

重要性：环境冷热暴露（EHCE）仍然是全球儿童和青少年发病和死亡的主要可预防原因：报告环境冷热暴露相关负担，并分析 1990 年至 2019 年期间儿童和青少年的时间趋势：这项重复性横断面研究使用了《2019 年全球疾病负担研究》中的数据，该研究涵盖了 1990 年至 2019 年期间的 204 个国家和地区。研究对象包括 0 至 19 岁的儿童和青少年。数据分析时间为 2023 年 12 月至 2024 年 3 月。暴露情况：1990 年 1 月至 2019 年 12 月期间儿童和青少年的 EHCE：主要结果是EHCE发病率、流行率、死亡率、残疾调整生命年（DALYs）和年均百分比变化（AAPCs）的病例和比率。这些指标的全球趋势也按性别、年龄和社会人口指数（SDI）进行了分析，社会人口指数是衡量一个国家或地区社会经济状况的综合指标。采用线性回归模型计算AAPCs，采用连接点回归模型确定趋势发生显著变化的年份：结果：从 1990 年到 2019 年，全球与 EHCE 相关的发病率、流行率、死亡率和残疾调整寿命年数呈下降趋势。然而，在 2010 年至 2019 年期间，发现 EHCE 发病率和流行率呈上升趋势（发病率 AAPC，1.46；95% CI，1.05-1.87；流行率 AAPC，1.25；95% CI，1.01-1.50）。从地区来看，虽然从 1990 年到 2019 年，大多数地区与 EHCE 相关的发病率呈下降趋势，但仍有一些地区呈上升趋势（南部撒哈拉以南非洲 AAPC，0.23；95% CI，0.01-0.44）。2019 年，在 SDI 水平较低的国家，儿童和青少年的 EHCE 死亡率和残疾调整寿命年数都较高。此外，不同性别和年龄的儿童和青少年的长者健康和教育负担也有所不同：在这项横断面研究中，我们观察到自 2010 年以来，EHCE 的发病率和流行率在全球范围内均有所上升。此外，气候危机首当其冲的低SDI地区的儿童和青少年受到的影响尤为严重。这表明，未来应对气候变化危机的措施应强调健康公平，这意味着在分配应对气候变化的资源时，应优先考虑儿童和青少年等弱势群体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

JAMA Pediatrics PEDIATRICS-

CiteScore

31.60

自引率

1.90%

发文量

357

期刊介绍： JAMA Pediatrics, the oldest continuously published pediatric journal in the US since 1911, is an international peer-reviewed publication and a part of the JAMA Network. Published weekly online and in 12 issues annually, it garners over 8.4 million article views and downloads yearly. All research articles become freely accessible online after 12 months without any author fees, and through the WHO's HINARI program, the online version is accessible to institutions in developing countries. With a focus on advancing the health of infants, children, and adolescents, JAMA Pediatrics serves as a platform for discussing crucial issues and policies in child and adolescent health care. Leveraging the latest technology, it ensures timely access to information for its readers worldwide.