Life loss per death of respiratory disease attributable to non-optimal temperature: results from a national study in 364 Chinese locations

• Published in: Environmental research letters 2021-03, Vol.16 (3), p.35001
• Main Authors: Li, Xing, Zhou, Maigeng, Yu, Min, Xu, Yanjun, Li, Junhua, Xiao, Yize, Huang, Biao, Hu, Jianxiong, Liu, Tao, Guan, Weijie, Chen, Siqi, Xu, Xiaojun, Lin, Lifeng, Hu, Ruying, Gong, Weiwei, Hou, Zhulin, Jin, Donghui, Qin, Mingfang, Yin, Peng, Wang, Lijun, Xu, Yiqing, Xiao, Jianpeng, Zeng, Weilin, Guo, Lingchuan, Wang, Qiong, He, Guanhao, Huang, Cunrui, Zhou, Chunliang, Ma, Wenjun
• Format: Article
• Language: English
• Subjects: Chronic obstructive pulmonary disease; Death; Disease; distributed lag non-linear model; Epidemiology; Exposure; Lung diseases; Meteorological data; Mortality; multivariate meta-analysis; Obstructive lung disease; Pneumonia; Respiration; Respiratory diseases; Subgroups; Temperature; years of life lost
• ISSN: 1748-9326; 1748-9326
• DOI: 10.1088/1748-9326/abe06c

Many studies have linked temperature with respiratory deaths, but epidemiological evidence of temperature-attributable years of life lost (YLL) from respiratory diseases is limited. Daily respiratory YLL rates were calculated using mortality data from 364 locations of China during 2006-2017, and meteorological data were collected for the same period. First, the distributed lag non-linear model (DLNM) was applied to estimate specific temperature-respiratory YLL rate associations in each location. Then multivariable meta-analysis was conducted to pool the location-specific estimates. Finally, we calculated the average life loss per death (LLD) to quantify the respiratory mortality burden of non-optimal temperature. Subgroup analyses were conducted by gender, age, region and cause of death. Inversely J-shaped association was observed between non-optimal temperature and respiratory YLL rate in China. The minimum YLL-rate temperature was 26.9 °C nationwide. An average of 1.37 years (95% CI: 1.06-1.65) LLD was attributable to non-optimal temperatures with 2.06 years (95% CI: 1.57-2.60) for pneumonia, 2.03 years (95% CI: 1.76-2.31) for chronic lower respiratory infections (LRTI), 0.88 years (95% CI: 0.65-1.09) for chronic obstructive pulmonary disease (COPD), most of which was attributed to moderate cold (0.73 years, 95% CI: 0.65-0.80). LLD caused by non-optimal temperature was higher in males, the young, and north China. Exposure to non-optimal temperature increases respiratory YLL rate in China, most of which were attributed to moderate cold. People with respiratory diseases including pneumonia, chronic LRTI and COPD are vulnerable to non-optimal temperature exposure. The result of this study provides useful information to reduce temperature-related respiratory disease burden.