Abstract

Background:

Both chronic and acute heat result in a substantial health burden globally, causing particular concern for at-risk populations, such as older adults. Outdoor temperatures are often assessed as the exposure and are used for heat warning systems despite individuals spending most of their time indoors. Many studies use ecological designs, with death or hospitalizations rates. Individual-level outcomes that are directly related to heat-symptoms should also be considered to refine prevention efforts.

Objectives:

In this longitudinal study, we assessed the association between indoor temperature and proximal symptoms in individuals $\ge 60\text{\hspace{0.17em}years}$ of age living in non–air-conditioned households in Montérégie, Quebec, during the 2017–2018 summer months.

Methods:

We gathered continuously measured indoor temperature and humidity from HOBO sensors and repeated health-related questionnaires about health-related symptoms administered across three periods of increasing outdoor temperatures, where the reference measurement (T1) occurred during a cool period with a target temperature of 18–22°C and two measurements (T2 and T3) occurred during warmer periods with target temperatures of 28–30°C and 30–33°C, respectively. We used generalized estimating equations with Poisson regression models and estimated risk ratios (RRs) between temperature, humidity, and each heat-related symptom.

Results:

Participants ($n=277$) had an average age $(\text{mean}\pm \text{standard\hspace{0.17em}deviation})$ of $72.8\pm 7.02\mathrm{y}$. Higher indoor temperatures were associated with increased risk of dry mouth (T3 $\text{RR}=2.5$; 95% CI: 1.8, 3.5), fatigue ($\text{RR}=2.3$; 95% CI: 1.8, 3.0), thirst ($\text{RR}=3.4$; 95% CI: 2.5, 4.5), less frequent urination ($\text{RR}=3.7$; 95% CI: 1.8, 7.3), and trouble sleeping ($\text{RR}=2.2$; 95% CI: 1.6, 3.2) compared with T1. We identified a nonlinear relationship with indoor temperatures across most symptoms of interest.

Discussion:

This study identified that increasing indoor temperatures were associated with various health symptoms. By considering the prevalence of these early stage outcomes and indoor temperature exposures, adaptation strategies may be improved to minimize the burden of heat among vulnerable communities. https://doi.org/10.1289/EHP10291

中文翻译：

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一项关于室内温度对居住在无空调家庭的老年人热相关症状影响的纵向研究

摘要

背景：

慢性和急性高温都会在全球范围内造成巨大的健康负担，引起高危人群（例如老年人）的特别关注。尽管人们大部分时间都在室内度过，但室外温度通常被评估为暴露并用于热警告系统。许多研究使用生态设计，包括死亡率或住院率。还应考虑与热症状直接相关的个体水平结果，以改进预防工作。

目标：

在这项纵向研究中，我们评估了室内温度与个体近端症状之间的关联$\ge 60\text{\hspace{0.17em}年}$2017 年至 2018 年夏季月份，在魁北克省蒙特雷吉居住在没有空调的家庭中的适龄儿童。

方法：

我们从 HOBO 传感器收集了连续测量的室内温度和湿度，并在室外温度升高的三个时期内重复进行了有关健康相关症状的健康相关问卷，其中参考测量 (T1) 发生在目标温度为 18-18 的凉爽时期。 22°C 和两次测量（T2 和 T3）发生在温暖时期，目标温度分别为 28–30°C 和 30–33°C。我们使用具有泊松回归模型的广义估计方程和温度、湿度和每种热相关症状之间的估计风险比 (RR)。

结果：

参加者（$n=277$) 平均年龄$(\text{意思是}\pm \text{标准差})$的$72.8\pm 7.02\mathrm{是的}$. 较高的室内温度与口干风险增加有关（T3$\text{RR}=2.5$; 95% CI: 1.8, 3.5), 疲劳 ($\text{RR}=2.3$; 95% CI: 1.8, 3.0), 口渴 ($\text{RR}=3.4$; 95% CI: 2.5, 4.5)，尿频减少 ($\text{RR}=3.7$; 95% CI：1.8, 7.3）和睡眠困难（$\text{RR}=2.2$; 95% CI: 1.6, 3.2) 与 T1 相比。我们在大多数感兴趣的症状中确定了与室内温度的非线性关系。

讨论：

这项研究发现，室内温度升高与各种健康症状有关。通过考虑这些早期结果的普遍性和室内温度暴露，可以改进适应策略，以尽量减少脆弱社区的热量负担。https://doi.org/10.1289/EHP10291