Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A.

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Abstract

Background

Several studies have investigated the association between asthma exacerbations and exposures to ambient temperature and precipitation. However, limited data exists regarding how extreme events, projected to grow in frequency, intensity, and duration in the future in response to our changing climate, will impact the risk of hospitalization for asthma. The objective of our study was to quantify the association between frequency of extreme heat and precipitation events and increased risk of hospitalization for asthma in Maryland between 2000 and 2012.

Methods

We used a time-stratified case-crossover design to examine the association between exposure to extreme heat and precipitation events and risk of hospitalization for asthma ( ICD-9 code 493, n = 115,923).

Results

Occurrence of extreme heat events in Maryland increased the risk of same day hospitalization for asthma (lag 0) by 3 % (Odds Ratio (OR): 1.03, 95 % Confidence Interval (CI): 1.00, 1.07), with a considerably higher risk observed for extreme heat events that occur during summer months (OR: 1.23, 95 % CI: 1.15, 1.33). Likewise, summertime extreme precipitation events increased the risk of hospitalization for asthma by 11 % in Maryland (OR: 1.11, 95 % CI: 1.06, 1.17). Across age groups, increase in risk for asthma hospitalization from exposure to extreme heat event during the summer months was most pronounced among youth and adults, while those related to extreme precipitation event was highest among ≤4 year olds.

Conclusion

Exposure to extreme heat and extreme precipitation events, particularly during summertime, is associated with increased risk of hospitalization for asthma in Maryland. Our results suggest that projected increases in frequency of extreme heat and precipitation event will have significant impact on public health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12940-016-0142-z) contains supplementary material, which is available to authorized users.

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Most cited references 36

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Extreme high temperatures and hospital admissions for respiratory and cardiovascular diseases.

Shao-Lin Peng, Xiu Liu, Robert Chinery … (2009)

Although the association of high temperatures with mortality is well-documented, the association with morbidity has seldom been examined. We assessed the potential impact of hot weather on hospital admissions due to cardiovascular and respiratory diseases in New York City. We also explored whether the weather-disease relationship varies with socio-demographic variables. We investigated effects of temperature and humidity on health by linking the daily cardiovascular and respiratory hospitalization counts with meteorologic conditions during summer, 1991-2004. We used daily mean temperature, mean apparent temperature, and 3-day moving average of apparent temperature as the exposure indicators. Threshold effects for health risks of meteorologic conditions were assessed by log-linear threshold models, after controlling for ozone, day of week, holidays, and long-term trend. Stratified analyses were used to evaluate temperature-demographic interactions. For all 3 exposure indicators, each degree C above the threshold of the temperature-health effect curve (29 degrees C-36 degrees C) was associated with a 2.7%-3.1% increase in same-day hospitalizations due to respiratory diseases, and an increase of 1.4%-3.6% in lagged hospitalizations due to cardiovascular diseases. These increases for respiratory admissions were greater for Hispanic persons (6.1%/ degrees C) and the elderly (4.7%/ degrees C). At high temperatures, admission rates increased for chronic airway obstruction, asthma, ischemic heart disease, and cardiac dysrhythmias, but decreased for hypertension and heart failure. Extreme high temperature appears to increase hospital admissions for cardiovascular and respiratory disorders in New York City. Elderly and Hispanic residents may be particularly vulnerable to the temperature effects on respiratory illnesses.

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Recent warming by latitude associated with increased length of ragweed pollen season in central North America.

L. Ziska, K. Knowlton, C. Rogers … (2011)

A fundamental aspect of climate change is the potential shifts in flowering phenology and pollen initiation associated with milder winters and warmer seasonal air temperature. Earlier floral anthesis has been suggested, in turn, to have a role in human disease by increasing time of exposure to pollen that causes allergic rhinitis and related asthma. However, earlier floral initiation does not necessarily alter the temporal duration of the pollen season, and, to date, no consistent continental trend in pollen season length has been demonstrated. Here we report that duration of the ragweed (Ambrosia spp.) pollen season has been increasing in recent decades as a function of latitude in North America. Latitudinal effects on increasing season length were associated primarily with a delay in first frost of the fall season and lengthening of the frost free period. Overall, these data indicate a significant increase in the length of the ragweed pollen season by as much as 13-27 d at latitudes above ~44°N since 1995. This is consistent with recent Intergovernmental Panel on Climate Change projections regarding enhanced warming as a function of latitude. If similar warming trends accompany long-term climate change, greater exposure times to seasonal allergens may occur with subsequent effects on public health.

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Heat-related emergency hospitalizations for respiratory diseases in the Medicare population.

Daniel Anderson, Francesca Dominici, Yun Wang … (2013)

The heat-related risk of hospitalization for respiratory diseases among the elderly has not been quantified in the United States on a national scale. With climate change predictions of more frequent and more intense heat waves, it is of paramount importance to quantify the health risks related to heat, especially for the most vulnerable. To estimate the risk of hospitalization for respiratory diseases associated with outdoor heat in the U.S. elderly. An observational study of approximately 12.5 million Medicare beneficiaries in 213 United States counties, January 1, 1999 to December 31, 2008. We estimate a national average relative risk of hospitalization for each 10°F (5.6°C) increase in daily outdoor temperature using Bayesian hierarchical models. We obtained daily county-level rates of Medicare emergency respiratory hospitalizations (International Classification of Diseases, Ninth Revision, 464-466, 480-487, 490-492) in 213 U.S. counties from 1999 through 2008. Overall, each 10°F increase in daily temperature was associated with a 4.3% increase in same-day emergency hospitalizations for respiratory diseases (95% posterior interval, 3.8, 4.8%). Counties' relative risks were significantly higher in counties with cooler average summer temperatures. We found strong evidence of an association between outdoor heat and respiratory hospitalizations in the largest population of elderly studied to date. Given projections of increasing temperatures from climate change and the increasing global prevalence of chronic pulmonary disease, the relationship between heat and respiratory morbidity is a growing concern.

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Author and article information

Contributors

Amir Sapkota: 301-405-8716 , amirsap@umd.edu

Journal

Journal ID (nlm-ta): Environ Health

Journal ID (iso-abbrev): Environ Health

Title: Environmental Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1476-069X

Publication date (Electronic): 27 April 2016

Publication date PMC-release: 27 April 2016

Publication date Collection: 2016

Volume: 15

Electronic Location Identifier: 57

Affiliations

[ ]Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, 2234F SPH Building #255, College Park, 20742 MD USA

[ ]Department of Epidemiology, University of Maryland School of Public Health, College Park, 20742 MD USA

[ ]Maryland Department of Health and Mental Hygiene, Prevention and Health Promotion Administration, Baltimore, MD USA

Article

Publisher ID: 142

DOI: 10.1186/s12940-016-0142-z

PMC ID: 4847234

PubMed ID: 27117324

SO-VID: 902b12b3-e08f-4fd2-92d5-726a1db792d6

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 7 January 2016

Date accepted : 22 April 2016

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000030, Centers for Disease Control and Prevention;

Award ID: 1UE1EH001049-01

Custom metadata

ScienceOpen disciplines: Public health

Keywords: asthma,climate change,extreme weather,heat,hospitalization,precipitation,respiratory illness

Data availability:

ScienceOpen disciplines: Public health

Keywords: asthma, climate change, extreme weather, heat, hospitalization, precipitation, respiratory illness

Exposure to extreme heat and precipitation events associated with increased risk of hospitalization for asthma in Maryland, U.S.A.

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Abstract

Background

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Climate Change: Open Access

Most cited references 36

Extreme high temperatures and hospital admissions for respiratory and cardiovascular diseases.

Recent warming by latitude associated with increased length of ragweed pollen season in central North America.

Heat-related emergency hospitalizations for respiratory diseases in the Medicare population.

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