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. 2013 Feb;121(2):210-6.
doi: 10.1289/ehp.1104541. Epub 2012 Oct 31.

Short-term effects of the 2008 cold spell on mortality in three subtropical cities in Guangdong Province, China

Huiyan Xie  1 , Zhibin Yao, Yonghui Zhang, Yanjun Xu, Xiaojun Xu, Tao Liu, Hualiang Lin, Xiangqian Lao, Shannon Rutherford, Cordia Chu, Cunrui Huang, Scott Baum, Wenjun Ma
Affiliations

Short-term effects of the 2008 cold spell on mortality in three subtropical cities in Guangdong Province, China

Huiyan Xie et al. Environ Health Perspect. 2013 Feb.

Abstract

Background: Few studies have been conducted to investigate the impact of extreme cold events on mortality in subtropical regions.

Objective: In the present study we aimed to investigate the effects of the 2008 cold spell on mortality and the possibility of mortality displacement in three subtropical cities in China.

Methods: Daily mortality, air pollution, and weather data were collected from 2006 to 2009 in Guangzhou, Nanxiong (no air pollutants), and Taishan. We used a polynomial distributed lag model (DLM) to analyze the relationship between the 2008 cold spell and mortality. To observe the mortality displacement of the cold spell, we estimated the cumulative effects at lag0, lag0-6, lag0-13, lag0-20, and lag0-27 separately.

Results: During the 2008 cold spell, the cumulative risk of nonaccidental mortality increased significantly in Guangzhou [relative risk (RR) = 1.60; 95% CI: 1.19, 2.14] and Taishan (RR = 1.60; 95% CI: 1.06, 2.40) when lagged up to 4 weeks after the cold spell ended. Estimated effects at lag0-27 were more pronounced for males than for females, for respiratory mortality than for cardiovascular mortality, and for the elderly (≥ 75 years of age) than for those 0-64 years of age. Most of the cumulative RRs increased with longer lag times in Guangzhou and Taishan. However, in Nanxiong, the trend with cumulative RRs was less consistent, and we observed no statistically significant associations at lag0-27.

Conclusion: We found associations between the 2008 cold spell and increased mortality in the three subtropical cities of China. The lag effect structure of the cold spell varied with location and the type of mortality, and evidence of short-term mortality displacement was inconsistent. These findings suggest that extreme cold is an important public health problem in subtropical regions.

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Conflict of interest statement

The authors declare they have no actual or potential competing financial interests.

Figures

Figure 1
Figure 1
Map of Guangdong Province, China, highlighting the cities of Nanxiong, Guangzhou, and Taishan.
Figure 2
Figure 2
Relationship between Tmin and daily mortality in Guangzhou (A), Nanxiong (B), and Taishan (C) during the 2008 cold spell relative to corresponding days in 2006, 2007, and 2009.
Figure 3
Figure 3
City-specific cumulative RRs (95% CIs) of mortality in three cities in Guangdong, China, during the 2008 cold spell, by cause of death, sex, and age group using dlnm for different lag days, with adjustment for RH, seasonality and long-term trends, day of the week, and influenza deaths.
See this image and copyright information in PMC

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