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      Vulnerabilities to Temperature Effects on Acute Myocardial Infarction Hospital Admissions in South Korea

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          Abstract

          Most previous studies have focused on the association between acute myocardial function (AMI) and temperature by gender and age. Recently, however, concern has also arisen about those most susceptible to the effects of temperature according to socioeconomic status (SES). The objective of this study was to determine the effect of heat and cold on hospital admissions for AMI by subpopulations (gender, age, living area, and individual SES) in South Korea. The Korea National Health Insurance (KNHI) database was used to examine the effect of heat and cold on hospital admissions for AMI during 2004–2012. We analyzed the increase in AMI hospital admissions both above and below a threshold temperature using Poisson generalized additive models (GAMs) for hot, cold, and warm weather. The Medicaid group, the lowest SES group, had a significantly higher RR of 1.37 (95% CI: 1.07–1.76) for heat and 1.11 (95% CI: 1.04–1.20) for cold among subgroups, while also showing distinctly higher risk curves than NHI for both hot and cold weather. In additions, females, older age group, and those living in urban areas had higher risks from hot and cold temperatures than males, younger age group, and those living in rural areas.

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          Most cited references60

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          Universal definition of myocardial infarction.

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            Heat-related and cold-related deaths in England and Wales: who is at risk?

            Despite the high burden from exposure to both hot and cold weather each year in England and Wales, there has been relatively little investigation on who is most at risk, resulting in uncertainties in informing government interventions. To determine the subgroups of the population that are most vulnerable to heat-related and cold-related mortality. Ecological time-series study of daily mortality in all regions of England and Wales between 1993 and 2003, with postcode linkage of individual deaths to a UK database of all care and nursing homes, and 2001 UK census small-area indicators. A risk of mortality was observed for both heat and cold exposure in all regions, with the strongest heat effects in London and strongest cold effects in the Eastern region. For all regions, a mean relative risk of 1.03 (95% confidence interval (CI) 1.02 to 1.03) was estimated per degree increase above the heat threshold, defined as the 95th centile of the temperature distribution in each region, and 1.06 (95% CI 1.05 to 1.06) per degree decrease below the cold threshold (set at the 5th centile). Elderly people, particularly those in nursing and care homes, were most vulnerable. The greatest risk of heat mortality was observed for respiratory and external causes, and in women, which remained after control for age. Vulnerability to either heat or cold was not modified by deprivation, except in rural populations where cold effects were slightly stronger in more deprived areas. Interventions to reduce vulnerability to both hot and cold weather should target all elderly people. Specific interventions should also be developed for people in nursing and care homes as heat illness is easily preventable.
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              The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States.

              Heat and heat waves are projected to increase in severity and frequency with increasing global mean temperatures. Studies in urban areas show an association between increases in mortality and increases in heat, measured by maximum or minimum temperature, heat index, and sometimes, other weather conditions. Health effects associated with exposure to extreme and prolonged heat appear to be related to environmental temperatures above those to which the population is accustomed. Models of weather-mortality relationships indicate that populations in northeastern and midwestern U.S. cities are likely to experience the greatest number of illnesses and deaths in response to changes in summer temperature. Physiologic and behavioral adaptations may reduce morbidity and mortality. Within heat-sensitive regions, urban populations are the most vulnerable to adverse heat-related health outcomes. The elderly, young children, the poor, and people who are bedridden or are on certain medications are at particular risk. Heat-related illnesses and deaths are largely preventable through behavioral adaptations, including the use of air conditioning and increased fluid intake. Overall death rates are higher in winter than in summer, and it is possible that milder winters could reduce deaths in winter months. However, the relationship between winter weather and mortality is difficult to interpret. Other adaptation measures include heat emergency plans, warning systems, and illness management plans. Research is needed to identify critical weather parameters, the associations between heat and nonfatal illnesses, the evaluation of implemented heat response plans, and the effectiveness of urban design in reducing heat retention.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                13 November 2015
                November 2015
                : 12
                : 11
                : 14571-14588
                Affiliations
                [1 ]Department of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea; E-Mails: boyeon02@ 123456gmail.com (B.Y.K.); seulkeeheo@ 123456naver.com (S.H.)
                [2 ]Department of Preventive Medicine, College of Medicine, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
                [3 ]Graduate School of Public Health, Graduate School, Korea University, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea; E-Mails: jkh861114@ 123456nate.com (K.J.); lilykim1011@ 123456gmail.com (J.K.)
                [4 ]Department of Statistics, College of Natural Science, Sungshin Women’s University, 249-1, Dongseon-dong 3-ga, Seongbuk-gu, Seoul 02844, Korea; E-Mail: mansikpark@ 123456sungshin.ac.kr
                Author notes
                [* ]Authors to whom correspondence should be addressed; E-Mails: eunil@ 123456korea.ac.kr (E.L.); sjstars7@ 123456korea.ac.kr (S.L.); Tel.: +82-2-2286-1170 (E.L.); +82-2-2286-1414 (S.L.); Fax: +82-2-2286-1416 (E.L. & S.L.).
                Article
                ijerph-12-14571
                10.3390/ijerph121114571
                4661668
                26580643
                f58e4406-4681-473e-b749-7412b041ecf6
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 10 October 2015
                : 10 November 2015
                Categories
                Article

                Public health
                myocardial infarction,hospital admissions,temperature,socioeconomic status,medicaid,gender,age

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