Comparative Study

. 2024 May:187:108712.

doi: 10.1016/j.envint.2024.108712. Epub 2024 May 3.

Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study

Bo Wen¹, Yao Wu¹, Yuming Guo², Antonio Gasparrini³, Shilu Tong⁴, Ala Overcenco⁵, Aleš Urban⁶, Alexandra Schneider⁷, Alireza Entezari⁸, Ana Maria Vicedo-Cabrera⁹, Antonella Zanobetti¹⁰, Antonis Analitis¹¹, Ariana Zeka¹², Aurelio Tobias¹³, Baltazar Nunes¹⁴, Barrak Alahmad¹⁰, Ben Armstrong¹⁵, Bertil Forsberg¹⁶, Shih-Chun Pan¹⁷, Carmen Íñiguez¹⁸, Caroline Ameling¹⁹, César De la Cruz Valencia²⁰, Christofer Åström¹⁶, Danny Houthuijs¹⁹, Do Van Dung²¹, Dominic Royé²², Ene Indermitte²³, Eric Lavigne²⁴, Fatemeh Mayvaneh⁸, Fiorella Acquaotta²⁵, Francesca de'Donato²⁶, Shilpa Rao²⁷, Francesco Sera²⁸, Gabriel Carrasco-Escobar²⁹, Haidong Kan³⁰, Hans Orru²³, Ho Kim³¹, Iulian-Horia Holobaca³², Jan Kyselý⁶, Joana Madureira³³, Joel Schwartz¹⁰, Jouni J K Jaakkola³⁴, Klea Katsouyanni³⁵, Magali Hurtado Diaz²⁰, Martina S Ragettli³⁶, Masahiro Hashizume³⁷, Mathilde Pascal³⁸, Micheline de Sousa Zanotti Stagliorio Coélho³⁹, Nicolás Valdés Ortega⁴⁰, Niilo Ryti³⁴, Noah Scovronick⁴¹, Paola Michelozzi²⁶, Patricia Matus Correa⁴⁰, Patrick Goodman⁴², Paulo Hilario Nascimento Saldiva⁴³, Raanan Raz⁴⁴, Rosana Abrutzky⁴⁵, Samuel Osorio⁴⁶, Tran Ngoc Dang²¹, Valentina Colistro⁴⁷, Veronika Huber⁴⁸, Whanhee Lee⁴⁹, Xerxes Seposo⁵⁰, Yasushi Honda⁵¹, Yoonhee Kim⁵², Yue Leon Guo⁵³, Michelle L Bell⁵⁴, Shanshan Li⁵⁵

Affiliations

¹ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
² Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: yuming.guo@monash.edu.
³ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
⁴ Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
⁵ National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Republic of Moldova.
⁶ Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.
⁷ Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
⁸ Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran.
⁹ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
¹⁰ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
¹¹ Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
¹² Institute for Environment, Health and Societies, Brunel University London, London, UK.
¹³ Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
¹⁴ Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
¹⁵ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
¹⁶ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
¹⁷ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.
¹⁸ Department of Statistics and Computational Research, Universitat de València, València, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain.
¹⁹ National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands.
²⁰ Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico.
²¹ Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
²² CIBER of Epidemiology and Public Health, Madrid, Spain; Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain.
²³ Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
²⁴ School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada.
²⁵ Department of Earth Sciences, University of Torino, Turin, Italy.
²⁶ Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
²⁷ Norwegian Institute of Public Health, Oslo, Norway.
²⁸ Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy.
²⁹ Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA.
³⁰ Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.
³¹ Graduate School of Public Health, Seoul National University, Seoul, South Korea.
³² Faculty of Geography, Babeş-Bolyai University, Cluj-Napoca, Romania.
³³ Environmental Health Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
³⁴ Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
³⁵ Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, London, UK.
³⁶ Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
³⁷ Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³⁸ Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France.
³⁹ Department of Pathology, Faculty of Medicine, University of São Paulo, Brazil.
⁴⁰ Department of Public Health, Universidad de los Andes, Santiago, Chile.
⁴¹ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁴² School of Physics, Technological University Dublin, Dublin, Ireland.
⁴³ INSPER, São Paulo, Brazil.
⁴⁴ Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel.
⁴⁵ Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina.
⁴⁶ Department of Environmental Health, University of São Paulo, São Paulo, Brazil.
⁴⁷ Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay.
⁴⁸ IBE-Chair of Epidemiology, LMU Munich, Munich, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain.
⁴⁹ School of the Environment, Yale University, New Haven, CT, USA; Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea.
⁵⁰ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁵¹ Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan.
⁵² Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
⁵³ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, National Taiwan University, Taipei, Taiwan.
⁵⁴ School of the Environment, Yale University, New Haven, CT, USA.
⁵⁵ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: shanshan.li@monash.edu.

PMID: 38714028
PMCID: PMC12317778
DOI: 10.1016/j.envint.2024.108712

Comparative Study

Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study

Bo Wen et al. Environ Int. 2024 May.

. 2024 May:187:108712.

doi: 10.1016/j.envint.2024.108712. Epub 2024 May 3.

Authors

Affiliations

¹ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
² Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: yuming.guo@monash.edu.
³ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
⁴ Shanghai Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
⁵ National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Republic of Moldova.
⁶ Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.
⁷ Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
⁸ Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran.
⁹ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
¹⁰ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
¹¹ Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
¹² Institute for Environment, Health and Societies, Brunel University London, London, UK.
¹³ Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
¹⁴ Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
¹⁵ Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
¹⁶ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
¹⁷ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.
¹⁸ Department of Statistics and Computational Research, Universitat de València, València, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain.
¹⁹ National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands.
²⁰ Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico.
²¹ Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
²² CIBER of Epidemiology and Public Health, Madrid, Spain; Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain.
²³ Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
²⁴ School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada.
²⁵ Department of Earth Sciences, University of Torino, Turin, Italy.
²⁶ Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
²⁷ Norwegian Institute of Public Health, Oslo, Norway.
²⁸ Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy.
²⁹ Health Innovation Lab, Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA, USA.
³⁰ Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.
³¹ Graduate School of Public Health, Seoul National University, Seoul, South Korea.
³² Faculty of Geography, Babeş-Bolyai University, Cluj-Napoca, Romania.
³³ Environmental Health Department, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.
³⁴ Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland; Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
³⁵ Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, London, UK.
³⁶ Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
³⁷ Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³⁸ Santé Publique France, Department of Environmental and Occupational Health, French National Public Health Agency, Saint Maurice, France.
³⁹ Department of Pathology, Faculty of Medicine, University of São Paulo, Brazil.
⁴⁰ Department of Public Health, Universidad de los Andes, Santiago, Chile.
⁴¹ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
⁴² School of Physics, Technological University Dublin, Dublin, Ireland.
⁴³ INSPER, São Paulo, Brazil.
⁴⁴ Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel.
⁴⁵ Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina.
⁴⁶ Department of Environmental Health, University of São Paulo, São Paulo, Brazil.
⁴⁷ Department of Quantitative Methods, School of Medicine, University of the Republic, Montevideo, Uruguay.
⁴⁸ IBE-Chair of Epidemiology, LMU Munich, Munich, Germany; Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain.
⁴⁹ School of the Environment, Yale University, New Haven, CT, USA; Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea.
⁵⁰ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁵¹ Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan.
⁵² Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
⁵³ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan; Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, National Taiwan University, Taipei, Taiwan.
⁵⁴ School of the Environment, Yale University, New Haven, CT, USA.
⁵⁵ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: shanshan.li@monash.edu.

PMID: 38714028
PMCID: PMC12317778
DOI: 10.1016/j.envint.2024.108712

Abstract

Background: Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects.

Objectives: We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality.

Methods: We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates.

Results: Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV_0-7 (0.9 °C). An IQR increase in inter-day TV_0-7 (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV_0-7 and inter-day TV_0-7 was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type.

Conclusions: Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.

Keywords: Inter-day; Intra-day; Mortality; Temperature variability.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1.**
Location of study areas and mean values of inter-day and intra-day temperature variability (°C, TV_0–7).

**Fig. 2.**
Overall percentage change (%) of mortality risk over one interquartile range of inter-day and intra-day TV (TV_0–1 to TV_0–7).

**Fig. 3.**
Overall percentage change (%) of mortality risk for inter-day and intra-day TV (TV_0–1 to TV_0–7) in different climate areas (A), seasons (B), and Köppen–Geiger climate groups (C). Definition of abbreviations: (A) C = cold, MC = moderate cold, MW = moderate warm, W = warm; (B) C = cold, M = moderate, W = warm; (C) A = tropical, B = dry, C = temperate, D = continental, and E = polar.

**Fig. 4.**
Overall percentage change (%) of mortality risk for inter-day and intra-day TV_0–7 in all countries/regions (A) and locations (B and C).

See this image and copyright information in PMC

References

1. Bell ML, Dominici F, Samet JM, 2005. A meta-analysis of time-series studies of ozone and mortality with comparison to the national morbidity, mortality, and air pollution study. Epidimiology 16, 436–445. - PMC - PubMed
1. Casanueva A, Burgstall A, Kotlarski S, Messeri A, Morabito M, Flouris AD, Nybo L, Spirig C, Schwierz C, 2019. Overview of existing heat-health warning systems in Europe. Int. J. Environ. Res. Public Health - PMC - PubMed
1. Chen K, Breitner S, Wolf K, Stafoggia M, Sera F, Vicedo-Cabrera AM, Guo Y, Tong S, Lavigne E, Matus P, Valdes N, Kan H, Jaakkola JJK, Ryti NRI, Huber V, Scortichini M, Hashizume M, Honda Y, Nunes B, Madureira J, Holobaca IH, Fratianni S, Kim H, Lee W, Tobias A, Iniguez C, Forsberg B, Astrom C, Ragettli MS, Guo YL, Chen BY, Li S, Milojevic A, Zanobetti A, Schwartz J, Bell ML, Gasparrini A, Schneider A, 2021. Ambient carbon monoxide and daily mortality: a global time-series study in 337 cities. Lancet Planet Health 5, e191–e199. - PubMed
1. Cheng J, Xu Z, Zhu R, Wang X, Jin L, Song J, Su H, 2014. Impact of diurnal temperature range on human health: a systematic review. Int. J. Biometeorol 58, 2011–2024. - PubMed
1. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, Friel S, Groce N, Johnson A, Kett M, Lee M, Levy C, Maslin M, McCoy D, McGuire B, Montgomery H, Napier D, Pagel C, Patel J, De Oliveira JAP, Redclift N, Rees H, Rogger D, Scott J, Stephenson J, Twigg J, Wolff J, Patterson C, 2009. Managing the health effects of climate change. Lancet 373, 1693–1733. - PubMed

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Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study

Affiliations

Comparison for the effects of different components of temperature variability on mortality: A multi-country time-series study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources