The effects of temperature and humidity on mortality in acute medical admissions

Philippa White; Richard Conway; Declan Byrne; Deirdre O’Riordan; Bernard Silke

doi:10.29333/ejeph/12446

Full Text (PDF)

Philippa White ¹ ^* , Richard Conway ¹ , Declan Byrne ¹ , Deirdre O’Riordan ¹ , Bernard Silke ¹

More Detail

¹ Department of Internal Medicine, St James’s Hospital, Dublin, IRELAND^* Corresponding Author

Abstract

The full effects of meteorological variables on mortality have not yet been elucidated. This study’s aim was to investigate whether 30-day in-hospital mortality in emergency hospital admissions for non-respiratory diseases were sensitive to the effects of humidity and ambient temperature on the day of admission. We studied all emergency medical admissions to St. James’s Hospital, Dublin, during 2002-2018 (n=113,807) and investigated temperature and humidity on day of admission. We employed multivariable logistic regression to identify temperature and humidity mortality predictors, adjusting for underlying comorbidities. Lower temperatures on day of admission predicted higher 30-day in-hospital mortality (adjusted OR: 1.12, 95% CI: 1.06-1.17), but lower humidity levels did not (adjusted OR: 0.97, 95% CI: 0.91-1.03). There was no interaction between meteorological variables and comorbidities on mortality. In conclusion, temperature may be a more significant predictor of in-hospital mortality than humidity for non-respiratory patients.

Keywords

temperature
humidity
comorbidity
mortality outcomes

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Research Article

EUR J ENV PUBLIC HLT, 2023, Volume 7, Issue 1, Article No: em0123

https://doi.org/10.29333/ejeph/12446

Publication date: 01 Jan 2023

Online publication date: 09 Sep 2022

Article Views: 776

Article Downloads: 1044

Open Access References How to cite this article

References

Abelsohn, A. and Stieb, D. M. (2011). Health effects of outdoor air pollution: Approach to counseling patients using the air quality health index. Canadian Family Physician Medecin de Famille Canadien, 57(8), 881-887, e280-7. PMID: 21841106; PMCID: PMC3155438.
Akasheh, N., Cournane, S., Byrne, D., Conway, R., O’Riordan, D. and Silke, B. (2018). The cumulative effects of ambient particulate matter and humidity on acute clinical outcomes. Archives of Environmental Sciences and Environmental Toxicology, 13(4), 556.
Armstrong, B. G., Chalabi, Z., Fenn, B., Hajat, S., Kovats, S., Milojevic, A. and Wilkinson, P. (2011). Association of mortality with high temperatures in a temperate climate: England and Wales. Journal of Epidemiology and Community Health, 65(4), 340-345. https://doi.org/10.1136/jech.2009.093161
Armstrong, B., Sera, F., Vicedo-Cabrera, A. M., Abrutzky, R., et al. (2019). The role of humidity in associations of high temperature with mortality: A multicountry, multicity study. Environmental Health Perspectives, 127(9), 097007. https://doi.org/10.1289/EHP5430
Atsumi, A., Ueda, K., Irie, F., Sairenchi, T., et al. (2013). Relationship between cold temperature and cardiovascular mortality, with assessment of effect modification by individual characteristics: Ibaraki prefectural health study. Circulation Journal, 77(7), 1854-1861. https://doi.org/10.1253/circj.CJ-12-0916
Baccini, M., Biggeri, A., Accetta, G., Kosatsky, T., et al. (2008). Heat effects on mortality in 15 European cities. Epidemiology, 19(5), 711-719. https://doi.org/10.1097/EDE.0b013e318176bfcd
Barnett, A. G., Tong, S. and Clements, A. C. (2010). What measure of temperature is the best predictor of mortality? Environmental Research, 110(6), 604-611. https://doi.org/10.1016/j.envres.2010.05.006
Basu, R. 2009. High ambient temperature and mortality: A review of epidemiologic studies from 2001 to 2008. Environmental Health, 8, 40. https://doi.org/10.1186/1476-069X-8-40
Beeknoo, N. and Jones, R. (2016). Factors influencing A & E attendance, admissions and waiting times at two London hospitals. British Journal of Medicine & Medical Research, 17(10), 1-29. https://doi.org/10.9734/BJMMR/2016/28783
Braga, A. L. F., Zanobetti, A. and Schwartz, J. (2002). The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities. Environmental Health Perspectives, 110(9), 859-863. https://doi.org/10.1289/ehp.02110859
Bunker, A., Wildenhain, J., Vandenbergh, A., Henschke, N., Rocklöv, J., Hajat, S. and Sauerborn, R. (2016). Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence. EBioMedicine, 6, 258-268. https://doi.org/10.1016/j.ebiom.2016.02.034
Charlson, M. E., Pompei, P., Ales, K. L. and Mackenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373-383. https://doi.org/10.1016/0021-9681(87)90171-8
Chen, J. and Hoek, G. (2020). Long-term exposure to PM and all-cause and cause-specific mortality: A systematic review and meta-analysis. Environment International, 143, 105974. https://doi.org/10.1016/j.envint.2020.105974
Chin, J. L., O’Dowd, S., Adnan, W. A., Bennett, K., O’Riordan, D., Mellotte, G. J. and Silke, B. (2011). Using the MDRD value as an outcome predictor in emergency medical admissions. Nephrology Dialysis Transplantation, 26(10), 3155-3159. https://doi.org/10.1093/ndt/gfr031
Conway, R., Byrne, D., Cournane, S., O’Riordan, D. and Silke, B. (2018). Fifteen-year outcomes of an acute medical admission unit. Irish Journal of Medical Science, 187, 1097-1105. https://doi.org/10.1007/s11845-018-1789-y
Conway, R., Byrne, D., O’Riordan, D. and Silke, B. (2015). Emergency readmissions are substantially determined by acute illness severity and chronic debilitating illness: A sngle centre cohort study. European Journal of Internal Medicine, 26(1), 12-17. https://doi.org/10.1016/j.ejim.2014.12.013
Conway, R., Byrne, D., O’Riordan, D. and Silke, B. (2020a). Comparative influence of acute illness severity and cmorbidity on mortality. European Journal of Internal Medicine, 72, 42-46. https://doi.org/10.1016/j.ejim.2019.11.014
Conway, R., O’Connell, B., Byrne, D., O’Riordan, D. and Silke, B. (2020b). Prognostic value of blood cultures as an illness severity marker in emergency medical admissions. Acute Medicine, 19(2), 83-89. https://doi.org/10.52964/AMJA.0806
Conway, R., O’Riordan, D. and Silke, B. (2014). Long-term outcome of an AMAU—A decade’s experience. Quarterly Journal of Medicine, 107(1), 43-49. https://doi.org/10.1093/qjmed/hct199
Courtney, D., Conway, R., Kavanagh, J., O’Riordan, D. and Silke, B. (2014a). High-sensitivity troponin as an outcome predictor in acute medical admissions. Postgraduate Medical Journal, 90(1064), 311-316. https://doi.org/10.1136/postgradmedj-2013-132325
D’ippoliti, D., Michelozzi, P., Marino, C., De’donato, F., et al. (2010). The impact of heat waves on mortality in 9 European cities: Results from the Euroheat Project. Environmental Health, 9, 37. https://doi.org/10.1186/1476-069X-9-37
Davis, R. E., Mcgregor, G. R. and Enfield, K. B. (2016). Humidity: A review and primer on atmospheric moisture and human health. Environmental Research, 144(Pt A), 106-116. https://doi.org/10.1016/j.envres.2015.10.014
de Barros, F. S., Gonçalves, F. L. T., Gobo, J. P. A. and Chiquetto, J. B. (2021). Analysis of the association between meteorological variables and mortality in the elderly applied to different climatic characteristics of the State of São Paulo, Brazil. Theoretical and Applied Climatology, 144, 327-338. https://doi.org/10.1007/s00704-021-03555-7
Dilaveris, P., Synetos, A., Giannopoulos, G., Gialafos, E., Pantazis, A. and Stefanadis, C. (2006). Climate impacts on myocardial infarction deaths in the Athens territory: The climate study. Heart (British Cardiac Society), 92(12), 1747-1751. https://doi.org/10.1136/hrt.2006.091884
Donaldson, G. C., Keatinge, W. R. and Saunders, R. D. (2003). Cardiovascular responses to heat stress and their adverse consequences in healthy and vulnerable human populations. International Journal of Hyperthermia, 19(3), 225-235. https://doi.org/10.1080/0265673021000058357
Froom, P. and Shimoni, Z. (2006). Prediction of hospital mortality rates by admission laboratory tests. Clinical Chemistry, 52(2), 325-328. https://doi.org/10.1373/clinchem.2005.059030
Gasparrini, A., Guo, Y., Hashizume, M., Lavigne, E., et al. (2015). Mortality risk attributable to high and low ambient temperature: A multicountry observational study. The Lancet, 386(9991), 369-375. https://doi.org/10.1016/S0140-6736(14)62114-0
Hajat, S. and Kosatky, T. (2010). Heat-related mortality: A review and eploration of heterogeneity. Journal of Epidemiology and Community Health, 64(9), 753-760. https://doi.org/10.1136/jech.2009.087999
Kopelman, P. G. and Sanderson, A. J. (1996). Application of database systems in diabetes care. Medical Informatics (London), 21(4), 259-271. https://doi.org/10.3109/14639239608999288
Manisalidis, I., Stavropoulou, E., Stavropoulos, A. and Bezirtzoglou, E. (2020). Environmental and health impacts of air pollution: A review. Frontiers in Public Health, 8, 14. https://doi.org/10.3389/fpubh.2020.00014
Medina-Ramón, M., Zanobetti, A., Cavanagh, D. P. and Schwartz, J. (2006). Extreme temperatures and mortality: Assessing effect modification by personal characteristics and specific cause of death in a multi-city case-only analysis. Environmental Health Perspectives, 114(9), 1331-1336. https://doi.org/10.1289/ehp.9074
O’Callaghan, A., Colgan, M. P., Mcguigan, C., Smyth, F., Haider, N., O’Neill, S., Moore, D. and Madhavan, P. (2012). A critical evaluation of HIPE data. Irish Medical Journal, 105(1), 21-23. PMID:22397209.
O’Loughlin, R., Allwright, S., Barry, J., Kelly, A. and Teljeur, C. (2005). Using HIPE data as a research and planning tool: Limitations and opportunities. Irish Medical Journal, 174(2), 40-45; discussion 52-57. https://doi.org/10.1007/BF03169128
O’Sullivan, E., Callely, E., O’Riordan, D., Bennett, K. and Silke, B. (2012). Predicting outcomes in emergency medical admissions–role of laboratory data and co-morbidity. Acute Medicine, 11(2), 59-65. https://doi.org/10.52964/AMJA.0547
Ou, C. Q., Yang, J., Ou, Q. Q., Liu, H. Z., et al. (2014). The impact of relative humidity and atmospheric pressure on mortality in Guangzhou, China. Biomedical and Environmental Sciences, 27(12), 917-25. https://doi.org/10.3967/bes2014.132
Ozminkowski, R. J., Smith, M. W., Coffey, R. M., Mark, T. L., Neslusan, C. A. and Drabek, J. (2000). Private payers serving individuals with disabilities and chronic conditions. https://aspe.hhs.gov/sites/default/files/migrated_legacy_files//138496/privpay.pdf
Prytherch, D. R., Sirl, J. S., Schmidt, P., Featherstone, P. I., Weaver, P. C. and Smith, G. B. (2005). The use of routine laboratory data to predict in-hospital death in medical admissions. Resuscitation, 66(2), 203-207. https://doi.org/10.1016/j.resuscitation.2005.02.011
Qi, L., Gao, Y., Yang, J., Ding, X.-B., Xiong, Y., Su, K., Liu, T., Li, Q., Tang, W.-G. and Liu, Q.-Y. (2020). The burden of influenza and pneumonia mortality attributable to absolute humidity among elderly people in Chongqing, China, 2012-2018. Science of The Total Environment, 716, 136682. https://doi.org/10.1016/j.scitotenv.2020.136682
Quan, H., Sundararajan, V., Halfon, P., Fong, A., et al. (2005). Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Medical Care, 43(11), 1130-1139. https://doi.org/10.1097/01.mlr.0000182534.19832.83
Ragettli, M. S., Vicedo-Cabrera, A. M., Schindler, C. and Röösli, M. (2017). Exploring the association between heat and mortality in Switzerland between 1995 and 2013. Environmental Research, 158, 703-709. https://doi.org/10.1016/j.envres.2017.07.021
Rodrigues, M., Santana, P. and Rocha, A. (2019). Effects of extreme temperatures on cerebrovascular mortality in Lisbon: A distributed lag non-linear model. International Journal of Biometeorology, 63(4), 549-559. https://doi.org/10.1007/s00484-019-01685-2
Ryti, N. R. I., Guo, Y. and Jaakkola, J. J. K. (2016). Global association of cold spells and adverse health effects: A systematic review and meta-analysis. Environmental Health Perspectives, 124(1), 12-22. https://doi.org/10.1289/ehp.1408104
Schwartz, J., Samet, J. M. and Patz, J. A. (2004). Hospital admissions for heart disease: The effects of temperature and humidity. Epidemiology, 15(6), 755-761. https://doi.org/10.1097/01.ede.0000134875.15919.0f
Silke, B., Kellett, J., Rooney, T., Bennett, K. and O’Riordan, D. (2010). An improved medical admissions risk system using multivariable fractional polynomial logistic regression modelling. Quarterly Journal of Medicine, 103(1), 23-32. https://doi.org/10.1093/qjmed/hcp149
Son, J.-Y., Liu, J. C. and Bell, M. L. (2019). Temperature-related mortality: A systematic review and investigation of effect modifiers. Environmental Research Letters, 14(7), 073004. https://doi.org/10.1088/1748-9326/ab1cdb
Song, X., Wang, S., Hu, Y., Yue, M., Zhang, T., Liu, Y., Tian, J. and Shang, K. (2017). Impact of ambient temperature on morbidity and mortality: An overview of reviews. Science of the Total Environment, 586, 241-254. https://doi.org/10.1016/j.scitotenv.2017.01.212
Tonelli, M., Wiebe, N., Fortin, M., Guthrie, B., et al. (2015). Methods for identifying 30 chronic conditions: Application to administrative data. BMC Medical Informatics and Decision Making, 15, 31. https://doi.org/10.1186/s12911-015-0155-5
Turner, L. R., Barnett, A. G., Connell, D. and Tong, S. (2012). Ambient temperature and cardiorespiratory morbidity: A systematic review and meta-analysis. Epidemiology, 23(4), 594-606. https://doi.org/10.1097/EDE.0b013e3182572795
Watso, J. C. and Farquhar, W. B. (2019). Hydration status and cardiovascular function. Nutrients, 11(8), 1866. https://doi.org/10.3390/nu11081866
Zeka, A., Browne, S., Mcavoy, H. and Goodman, P. (2014). The association of cold weather and all-cause and cause-specific mortality in the Island of Ireland between 1984 and 2007. Environmental Health, 13, 104. https://doi.org/10.1186/1476-069X-13-104

How to cite this article

Vancouver

White P, Conway R, Byrne D, O’Riordan D, Silke B. The effects of temperature and humidity on mortality in acute medical admissions. EUR J ENV PUBLIC HLT. 2023;7(1):em0123. https://doi.org/10.29333/ejeph/12446

APA

White, P., Conway, R., Byrne, D., O’Riordan, D., & Silke, B. (2023). The effects of temperature and humidity on mortality in acute medical admissions. European Journal of Environment and Public Health, 7(1), em0123. https://doi.org/10.29333/ejeph/12446

AMA

White P, Conway R, Byrne D, O’Riordan D, Silke B. The effects of temperature and humidity on mortality in acute medical admissions. EUR J ENV PUBLIC HLT. 2023;7(1), em0123. https://doi.org/10.29333/ejeph/12446

Chicago

White, Philippa, Richard Conway, Declan Byrne, Deirdre O’Riordan, and Bernard Silke. "The effects of temperature and humidity on mortality in acute medical admissions". European Journal of Environment and Public Health 2023 7 no. 1 (2023): em0123. https://doi.org/10.29333/ejeph/12446

Harvard

White, P., Conway, R., Byrne, D., O’Riordan, D., and Silke, B. (2023). The effects of temperature and humidity on mortality in acute medical admissions. European Journal of Environment and Public Health, 7(1), em0123. https://doi.org/10.29333/ejeph/12446

MLA

White, Philippa et al. "The effects of temperature and humidity on mortality in acute medical admissions". European Journal of Environment and Public Health, vol. 7, no. 1, 2023, em0123. https://doi.org/10.29333/ejeph/12446