Geographic, Demographic, and Temporal Variations in the Association between Heat Exposure and Hospitalization in Brazil: A Nationwide Study between 2000 and 2015.

Autor: Zhao Q; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Li S; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Coelho MSZS; Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil., Saldiva PHN; Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil., Hu K; Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan, China., Arblaster JM; School of Earth, Atmosphere and Environment, Monash University, Melbourne, Australia.; Centre of Excellence for Climate Extremes, Australian Research Council, Sydney, Australia., Nicholls N; School of Earth, Atmosphere and Environment, Monash University, Melbourne, Australia., Huxley RR; College of Science, Health and Engineering, La Trobe University, Melbourne, Australia., Abramson MJ; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Guo Y; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Environmental health perspectives [Environ Health Perspect] 2019 Jan; Vol. 127 (1), pp. 17001.
DOI: 10.1289/EHP3889
Abstrakt: Background: Limited evidence is available regarding the association between heat exposure and morbidity in Brazil and how the effect of heat exposure on health outcomes may change over time.
Objectives: This study sought to quantify the geographic, demographic and temporal variations in the heat–hospitalization association in Brazil from 2000–2015.
Methods: Data on hospitalization and meteorological conditions were collected from 1,814 cities during the 2000–2015 hot seasons. Quasi-Poisson regression with constrained lag model was applied to examine city-specific estimates, which were then pooled at the regional and national levels using random-effect meta-analyses. Stratified analyses were performed by sex, 10 age groups, and 11 cause categories. Meta-regression was used to examine the temporal change in estimates of heat effect from 2000 to 2015.
Results: For every 5°C increase in daily mean temperature during the 2000–2015 hot seasons, the estimated risk of hospitalization over lag 0-7 d rose by 4.0% [95% confidence interval (CI): 3.7%, 4.3%] nationwide. Estimated 6.2% [95% empirical CI (eCI): 3.3%, 9.1%] of hospitalizations were attributable to heat exposure, equating to 132 cases (95% eCI: 69%, 192%) per 100,000 residents. The attributable rate was greatest in children [Formula: see text] and was highest for hospitalizations due to infectious and parasitic diseases. Women of reproductive age and those [Formula: see text] had higher heat burden than men. The attributable burden was greatest for cities in the central west and the inland of the northeast; lowest in the north and eastern coast. Over the 16-y period, the estimated heat effects declined insignificantly at the national level.
Conclusions: In Brazil's hot seasons, 6% of hospitalizations were estimated to be attributed to heat exposure. As there was no evidence indicating that thermal adaptation had occurred at the national level, the burden of hospitalization associated with heat exposure in Brazil is likely to increase in the context of global warming. https://doi.org/10.1289/EHP3889.
Databáze: MEDLINE
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