. 2020 Dec 16;2(1):100072.

doi: 10.1016/j.xinn.2020.100072. eCollection 2021 Feb 28.

Ambient Temperature and Years of Life Lost: A National Study in China

Tao Liu¹, Chunliang Zhou², Haoming Zhang³, Biao Huang⁴, Yanjun Xu⁵, Lifeng Lin⁵, Lijun Wang⁶, Ruying Hu⁷, Zhulin Hou⁴, Yize Xiao³, Junhua Li², Xiaojun Xu⁵, Donghui Jin², Mingfang Qin³, Qinglong Zhao⁴, Weiwei Gong⁷, Peng Yin⁶, Yiqing Xu², Jianxiong Hu¹, Jianpeng Xiao¹, Weilin Zeng¹, Xing Li¹, Siqi Chen¹, Lingchuan Guo¹, Zuhua Rong¹, Yonghui Zhang⁵, Cunrui Huang⁸, Yaodong Du⁹, Yuming Guo¹⁰, Shannon Rutherford¹¹, Min Yu⁷, Maigeng Zhou⁶, Wenjun Ma¹

Affiliations

¹ Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
² Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China.
³ Yunnan Center for Disease Control and Prevention, Kunming, 650022, China.
⁴ Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China.
⁵ Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
⁶ The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China.
⁷ Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China.
⁸ School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
⁹ Guangdong Provincial Climate Center, Guangzhou, 510080, China.
¹⁰ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia.
¹¹ School of Medicine, Griffith University, Gold Coast, 4214, Australia.

PMID: 34557729
PMCID: PMC8454660
DOI: 10.1016/j.xinn.2020.100072

Ambient Temperature and Years of Life Lost: A National Study in China

Tao Liu et al. Innovation (Camb). 2020.

. 2020 Dec 16;2(1):100072.

doi: 10.1016/j.xinn.2020.100072. eCollection 2021 Feb 28.

Authors

Affiliations

¹ Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
² Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, China.
³ Yunnan Center for Disease Control and Prevention, Kunming, 650022, China.
⁴ Health Hazard Factors Control Department, Jilin Provincial Center for Disease Control and Prevention, Changchun, 130062, China.
⁵ Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
⁶ The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China.
⁷ Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China.
⁸ School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
⁹ Guangdong Provincial Climate Center, Guangzhou, 510080, China.
¹⁰ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3800, Australia.
¹¹ School of Medicine, Griffith University, Gold Coast, 4214, Australia.

PMID: 34557729
PMCID: PMC8454660
DOI: 10.1016/j.xinn.2020.100072

Abstract

Although numerous studies have investigated premature deaths attributable to temperature, effects of temperature on years of life lost (YLL) remain unclear. We estimated the relationship between temperatures and YLL, and quantified the YLL per death caused by temperature in China. We collected daily meteorological and mortality data, and calculated the daily YLL values for 364 locations (2013-2017 in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces, and 2006-2011 in other locations) in China. A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates (YLL/100,000 population), and a multivariate meta-analysis model was used to pool location-specific associations. Then, YLL per death caused by temperatures was calculated. The temperature and YLL rates consistently showed U-shaped associations. A mean of 1.02 (95% confidence interval: 0.67, 1.37) YLL per death was attributable to temperature. Cold temperature caused 0.98 YLL per death with most from moderate cold (0.84). The mean YLL per death was higher in those with cardiovascular diseases (1.14), males (1.15), younger age categories (1.31 in people aged 65-74 years), and in central China (1.34) than in those with respiratory diseases (0.47), females (0.87), older people (0.85 in people ≥75 years old), and northern China (0.64) or southern China (1.19). The mortality burden was modified by annual temperature and temperature variability, relative humidity, latitude, longitude, altitude, education attainment, and central heating use. Temperatures caused substantial YLL per death in China, which was modified by demographic and regional characteristics.

Keywords: China; distributed lag nonlinear model; mortality burden; multivariate meta-analysis; temperature; years of life lost.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Figure 1**
Pooled Cumulative Exposure-Response Relationships between Daily Mean Temperature and YLL Rate Over 0–21 Days lag in All 364 Locations and in Different Subgroups across China

**Figure 2**
Spatial Distribution of Annual Mean YLL Attributable to Temperatures in China (A) At the provincial level. (B) At the city level.

See this image and copyright information in PMC

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Ambient Temperature and Years of Life Lost: A National Study in China

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Ambient Temperature and Years of Life Lost: A National Study in China

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