The association of heatwave with drowning mortality in five provinces of China

Zhongguo Huang; Zhixing Li; Jianxiong Hu; Sui Zhu; Weiwei Gong; Chunliang Zhou; Ruilin Meng; Xiaomei Dong; Min Yu; Xiaojun Xu; Lifeng Lin; Jianpeng Xiao; Jieming Zhong; Donghui Jin; Yiqing Xu; Tao Liu; Ziqiang Lin; Guanhao He; Wenjun Ma

doi:10.1016/j.scitotenv.2023.166321

The association of heatwave with drowning mortality in five provinces of China

Sci Total Environ. 2023 Dec 10:903:166321. doi: 10.1016/j.scitotenv.2023.166321. Epub 2023 Aug 15.

Authors

Zhongguo Huang¹, Zhixing Li², Jianxiong Hu³, Sui Zhu¹, Weiwei Gong⁴, Chunliang Zhou⁵, Ruilin Meng⁶, Xiaomei Dong¹, Min Yu⁴, Xiaojun Xu⁶, Lifeng Lin⁶, Jianpeng Xiao⁷, Jieming Zhong⁴, Donghui Jin⁵, Yiqing Xu⁵, Tao Liu¹, Ziqiang Lin¹, Guanhao He⁸, Wenjun Ma³

Affiliations

¹ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China.
² Department of Nosocomial Infection Management, Nanfang Hospital, Southern Medical University, China.
³ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
⁴ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China.
⁵ Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China.
⁶ Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
⁷ Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
⁸ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510630, China; Disease Control and Prevention Institute, Jinan University, Guangzhou 511443, China. Electronic address: heguanh1991@163.com.

PMID: 37586513
DOI: 10.1016/j.scitotenv.2023.166321

Abstract

Drowning is a serious public health problem in the world. Several studies have found that ambient temperature is associated with drowning, but few have investigated the effect of heatwave on drowning. This study aimed to explore the associations between heatwave and drowning mortality, and further estimate the mortality burden of drowning attributed to heatwave in China. Drowning mortality data were collected in 71 prefectures in China during 2013-2018 from provincial vital register system. Meteorological data at the same period were collected from European Centre for Medium-Range Weather Forecasts (ECMWF). A distributed lag non-linear model (DLNM) was first to explore the association between heatwave and drowning mortality in each prefecture. Secondly, the prefecture-specific associations were pooled using meta-analysis. Finally, attributable fractions (AFs) of drowning deaths caused by heatwave were estimated. Compared to normal day, the mortality risk of drowning significantly increased during heatwave (RR = 1.20, 95%CI: 1.18-1.23). Higher risks were observed in males (RR = 1.23, 95%CI: 1.20-1.27) than females (RR = 1.18, 95%CI: 1.13-1.23), in children aged 5-14 years old (RR = 1.24, 95%CI: 1.15-1.33) than other age groups, in urban city (RR = 1.32, 95%CI: 1.28-1.36) than rural area (RR = 1.09, 95%CI: 1.07-1.12) and in Jilin province (RR = 2.85, 95%CI: 1.61-5.06) than other provinces. The AF of drowning deaths due to heatwave was 11.4 % (95%CI: 10.0 %-12.9 %) during heatwave and 1.0 % (95%CI: 0.9 %-1.1 %) during study period, respectively. Moreover, the AFs during study period were higher for male (1.2 %, 95%CI: 1.0 %-1.3 %), children 5-14 years (1.1 %, 95%CI: 0.7 %-1.6 %), urban city (1.6 %, 95%CI: 1.4 %-1.8 %) than their correspondents. These differences were also observed in AFs during heatwave. We found that heatwave may significantly increase the mortality risk of drowning mortality, and its mortality burden attributable to heatwave was noteworthy. Targeted intervention should be carried out to decrease drowning mortality during heatwave.

Keywords: Distributed lag non-linear model; Drowning; Heatwave; Mortality burden.