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Mortality burden attributable to temperature variability in China

Journal of Exposure Science & Environmental Epidemiology volume 33, pages 118–124 (2023)Cite this article

Abstract

Background

Several studies have investigated the associations between temperature variability (TV) and death counts. However, evidence of TV-attributable years of life lost (YLL) is scarce.

Objectives

To investigate the associations between TV and YLL rates (/100,000 population), and quantify average life loss per death (LLD) caused by TV in China.

Methods

We calculated daily YLL rates (/100,000 population) of non-accidental causes and cardiorespiratory diseases by using death data from 364 counties of China during 2006–2017, and collected meteorological data during the same period. A distributed lag non-linear model (DLNM) and multivariate meta-analysis were used to estimate the effects of TV at national or regional levels. Then, we calculated the LLD to quantify the mortality burden of TV.

Results

U-shaped curves were observed in the associations of YLL rates with TV in China. The minimum YLL TV (MYTV) was 2.5 °C nationwide. An average of 0.89 LLD was attributable to TV in total, most of which was from high TV (0.86, 95% CI: 0.56, 1.16). However, TV caused more LLD in the young (<65 years old) (1.87, 95% CI: 1.03, 2.71) than 65–74 years old (0.85, 95% CI: 0.40–1.31) and ≥75 years old (0.40, 95% CI: 0.21–0.59), cerebrovascular disease (0.74, 95% CI: 0.36, 1.11) than respiratory disease (0.54, 95% CI: 0.21, 0.87), South (1.23, 95% CI: 0.77, 1.68) than North (0.41, 95% CI: −0.7, 1.52) and Central China (0.40, 95% CI: −0.02, 0.81). TV-attributed LLD was modified by annual mean temperature, annual mean relative humidity, altitude, latitude, longitude, and education attainment.

Significance

Our findings indicate that high and low TVs are both associated with increases in premature death, however the majority of LLD was attributable to high TV. TV-related LLD was modified by county level characteristics. TV should be considered in planning adaptation to climate change or variability.

Impact

  1. (1)

    We estimated the associations of TV with YLL rates, and quantified the life loss per death (LLD) caused by TV.

  2. (2)

    An average of 0.89 years of LLD were attributable to TV, most of which were from high TVs.

  3. (3)

    TV caused more LLD in the young, cerebrovascular disease, and southern China.

  4. (4)

    The mortality burdens were modified by county level characteristics.

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Fig. 1: The pooled cumulative exposure-response relationship between TV and YLL rate in all 364 counties and subgroups throughout China (over 0–21 days lag).
Fig. 2: Comparison of average life lost per death caused by TV in all 364 counties and subgroups across China.

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Data availability

The mortality data are available upon reasonable request from the corresponding author (gztt_2002@163.com). It is not publicly available because the information that could compromise the personal privacy. Meteorological data could be downloaded from the China Meteorological Data Sharing Service System (http://data.cma.cn/). All related codes could be accessed in https://github.com/gztt2002/YLL-of-Tm-and-Tv.

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Acknowledgements

We thank Professor Antonio Gasparrini for providing assistance during statistical analysis.

Funding

This work was supported by the National Key Research and Development Program of China (2018YFA0606200), National Natural Science Foundation of China (42075173, 42175181), Medical Scientific Research Foundation of Guangdong Province (A2020051), the Guangdong Health Innovation Platform, the Foshan Key Technology Project for COVID-19 (2020001000376), and Foshan Science and Technology Innovation Project (2020001005585).

Author information

Author notes

  1. These authors contributed equally: Weiwei Gong, Xing Li.

Authors and Affiliations

  1. Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China

    Weiwei Gong

  2. Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China

    Xing Li, Jianxiong Hu, Jianpeng Xiao, Weilin Zeng & Guanhao He

  3. The National Center for Chronic and Noncommunicable Disease Control and Prevention, 100050, Beijing, China

    Maigeng Zhou

  4. Department of Environment and Health, Hunan Provincial Center for Disease Control and Prevention, Changsha, 450001, China

    Chunliang Zhou

  5. Yunnan Center for Disease Control and Prevention, Kunming, 650022, China

    Yize Xiao

  6. Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China

    Biao Huang

  7. Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China

    Lifeng Lin

  8. School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China

    Cunrui Huang

  9. Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, China

    Tao Liu & Wenjun Ma

  10. Disease Control and Prevention Institute of Jinan University, Guangzhou, 510632, China

    Tao Liu & Wenjun Ma

  11. General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, 528200, China

    Qingfeng Du

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Contributions

Conceptualization: TL and QD. Formal analysis: WG and XL. Investigation: WG, XL, MZ, CZ, YX, BH, and LL. Methodology: TL, XL, and QD. Writing-original draft: WG and XL. Writing-review and editing: WM, TL, JH, JX, WZ, GH, and CH.

Corresponding authors

Correspondence to Tao Liu or Qingfeng Du.

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The authors declare no competing interests.

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The study was approved by the Ethics Committee of Guangdong Provincial Center for Disease Control and Prevention (2019025).

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Gong, W., Li, X., Zhou, M. et al. Mortality burden attributable to temperature variability in China. J Expo Sci Environ Epidemiol 33, 118–124 (2023). https://doi.org/10.1038/s41370-022-00424-x

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