RESUMEN
Along with climate change, unstable weather patterns are becoming more frequent. However, the temporal trend associated with the effect of temperature variation on schizophrenia (SCZ) is not clear. Daily time-series data on SCZ and meteorological factors for 15-year between January 1, 2005 and December 31, 2019 were collected. And we used the Poisson regression model combined with the time-varying distribution lag nonlinear model (DLNM) to explore the temporal trend of the association between three temperature variation indicators (diurnal temperature range, DTR; temperature variability, TV; temperature change between neighboring days, TCN) and SCZ hospitalizations, respectively. Meanwhile, we also explore the temporal trend of the interaction between temperature and temperature variation. Stratified analyses were performed in different gender, age, and season. Across the whole population, we found a decreasing trend in the risk of SCZ hospitalizations associated with high DTR (from 1.721 to 1.029), TCN (from 1.642 to 1.066), and TV (TV0-1, from 1.034 to 0.994; TV0-2, from 1.041 to 0.994, TV0-3, from 1.044 to 0.992, TV0-4, from 1.049 to 0.992, TV0-5, from 1.055 to 0.993, TV0-6, from 1.059 to 0.991, TV0-7, from 1.059 to 0.990), but an increasing trend in low DTR (from 0.589 to 0.752). Subgroup analysis results further revealed different susceptible groups. Besides, the interactive effect suggests that temperature variation may cause greater harm under low-temperature conditions. There was a synergy between TCN and temperature on the addition and multiplication scales, which were 1.068 (1.007, 1.133) and 0.067 (0.009, 0.122), respectively. Our findings highlight public health interventions to mitigate temperature variation effects needed to focus not only on high temperature variations but also moderately low temperature variations. Future hospitalizations for SCZ associated with temperature variation may be more severely affected by temperature variability from low temperature environments. The temporal trend is associated with the effect of temperature variation on schizophrenia (SCZ).
Asunto(s)
Dinámicas no Lineales , Esquizofrenia , China , Hospitalización , Humanos , Esquizofrenia/epidemiología , TemperaturaRESUMEN
BACKGROUND: Daily air quality index (AQI) forecast can provide early warning information, and it is not clear whether it is appropriate for childhood asthma hospitalizations (CAHs). Furthermore, little is known about the effects of AQI on CAHs, as well as the interactions between temperature, humidity and AQI. METHODS: We collected 32,238 cases in Hefei from 2013 to 2016 and estimated the association between daily CAHs and AQI by combining the Poisson Generalized Linear Models (PGLMs) with the Distributed Lag Nonlinear Models (DLNMs). The interaction between AQI and temperature was tested by stratifying AQI and temperature, as well as humidity. RESULTS: AQI was associated with an increased risk of hospitalizations for childhood asthma. The adverse effect first appeared on the 3rd day, with the RR of 1.011 (95%CI: 1.000-1.023) and continued until the 19th day of lag (RR = 1.010, 95%CI: 1.001-1.020). In the subgroup analysis, the male and pre-school children were more sensitive to AQI, and there are seasonal differences in the effects of AQI on CAHs. Besides, in a stratified analysis with an AQI of 150, we found synergies between temperature, humidity and AQI. The interaction relative risk (IRR) and relative excess risk due to interaction (RERI) for the interaction between temperature and AQI were 1.157 (95%CI: 1.029-1.306) and 0.122 (95%CI: 0.022-0.223) respectively. For the humidity, the IRR and RERI were 1.090 (95%CI: 1.056-1.206) and 0.083 (95%CI: 0.083-0.143) respectively. Exploring different subgroups in the interaction analyses, it was worth noting that female and pre-school children were more sensitive to the interaction between AQI and temperature, while school-age children were more sensitive to the interaction between AQI and humidity. CONCLUSIONS: The study found that not only AQI can significantly increase the risk of CAHs, but also that under the context of climate change, temperature and humidity have a synergistic effect on AQI, suggesting that considering only the warning information of air pollution is not enough to strengthen the prevention of childhood asthma hospitalization.