Abstract
We aimed to estimate the non-accidental and cause-specific mortality burden attributed to diurnal temperature range (DTR) and the relative contributions of low, high, and extremely low and extremely high DTR in Yunnan, southwest China. Furthermore, we explored the possible effect modification of the DTR–mortality association by season, sex, age, ethnicity, marital status, and occupation. A standard time-series quasi-Poisson regression model combined with a distributed lag nonlinear model was used to derive estimates of city-specific DTR–mortality associations, then random effects meta-analysis was used to pool the estimated city-specific overall cumulative DTR–mortality association, estimating empirical confidence intervals (eCIs). The overall fraction of non-accidental mortality caused by DTR was 11.00% (95% eCI 3.40–17.28): high DTR accounted for most of burden (total estimate 10.03%, 95% eCI 2.59–16.32). The estimated mortality risk attributable to DTR was significantly associated with cardiovascular and respiratory mortality, with attributable fractions of 13.61% (95% eCI 3.91–21.13) and 14.32% (95% eCI 0.47–21.44), respectively. The estimated risk attributable to DTR was slightly greater for males, people ≥75 years old, married people, and non-farmers than their corresponding categories. Most of the DTR-related mortality burden was attributable to high DTR, and the mortality risk attributable to DTR might be modified by specific causes, sex, age, marital status, and occupation.
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The data that support the findings of this study are available from Yunnan Center for Disease Control and Prevention but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Yunnan Center for Disease Control and Prevention.
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This study was supported by the National key R&D program of China (2016YFC1304000) and the National Natural Science Foundation of China (No. 81703323).
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Q.Y.Z. and Y.J.W. conceived and designed the experiments. Y.C. and S.Z. provide primary data. P.G., Y.J.W., RW, and J.Q.C. collected and cleaned the data. Y.J.W. analyzed the data. Y.J.W. drafted the manuscript. Y.J.W. and Q.Y.Z. revised the manuscript and interpreted the results. All authors read and approved the final manuscript.
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Wang, Y., Chen, Y., Chen, J. et al. Mortality risk attributable to diurnal temperature range: a multicity study in Yunnan of southwest China. Environ Sci Pollut Res 28, 60597–60608 (2021). https://doi.org/10.1007/s11356-021-14981-5
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DOI: https://doi.org/10.1007/s11356-021-14981-5