Temperature variability associations with cardiovascular and respiratory emergency department visits in Dhaka, Bangladesh

Md Mostafijur Rahman; Erika Garcia; Chris C Lim; Marya Ghazipura; Nur Alam; Lawrence A Palinkas; Rob McConnell; George Thurston

doi:10.1016/j.envint.2022.107267

Temperature variability associations with cardiovascular and respiratory emergency department visits in Dhaka, Bangladesh

Environ Int. 2022 Jun:164:107267. doi: 10.1016/j.envint.2022.107267. Epub 2022 May 2.

Authors

Md Mostafijur Rahman¹, Erika Garcia², Chris C Lim³, Marya Ghazipura⁴, Nur Alam⁵, Lawrence A Palinkas⁶, Rob McConnell², George Thurston⁷

Affiliations

¹ Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: mmr572@nyu.edu.
² Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Department of Community, Environment, and Policy at the Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
⁴ New York University Langone Health, Department of Population Health, New York, NY; ZS Associates, Global Health Economics and Outcomes Research, New York, NY.
⁵ Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh.
⁶ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
⁷ Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Population Health, New York University School of Medicine, New York, NY, USA.

PMID: 35533532
DOI: 10.1016/j.envint.2022.107267

Abstract

Background: Greenhouse gas emissions are changing the Earth's climate, most directly by modifying temperatures and temperature variability (TV). Residents of low- and middle-income countries (LMICs) are likely more adversely affected, due to lack of air conditioning to compensate. To date, there is no local epidemiological evidence documenting the cardio-respiratory health effects of TV in Dhaka, Bangladesh, one of the most climate change vulnerable cities in the world.

Objectives: We assessed short-term TV associations with daily cardiovascular disease (CVD) and respiratory emergency department (ED) visits, as well as effect modification by age and season.

Methods: TV was calculated from the standard deviations of the daily minimum and maximum temperatures over exposure days. Time-series regression modeling was applied to daily ED visits for respiratory and CVD from January 2014 through December 2017. TV effect sizes were estimated after controlling for long-term trends and seasonality, day-of-week, holidays, and daily mean relative humidity and ambient temperature.

Results: A 1 °C increase in TV was associated with a 1.00% (95 %CI: 0.05%, 1.96%) increase in CVD ED visits at lag 0-1 days (TV_0-1) and a 2.77% (95 %CI: 0.24%, 5.20%) increase in respiratory ED visits at lag 0-7 days (TV_0-7). TV-CVD associations were larger in the monsoon and cold seasons. Respiratory ED visit associations varied by age, with older adults more affected by the TV across all seasons. A 1 °C increase in TV at lag 0-7 days (TV_0-7) was associated with a 7.45% (95 %CI: 2.33%, 12.57%) increase in respiratory ED visits among patients above 50 years of age.

Conclusion: This study provided novel and important evidence that cardio-pulmonary health in Dhaka is adversely affected year-round by day-to-day increases in TV, especially among older adults. TV is a key factor that should be considered in evaluating the potential human health impacts of climate change induced temperature changes.

Keywords: Cardiovascular; Dhaka; Emergency Department Visits; Respiratory; Temperature Variability.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Air Pollutants* / analysis
Bangladesh / epidemiology
Cardiovascular Diseases* / epidemiology
Cities
Emergency Service, Hospital
Female
Humans
Pregnancy
Seasons
Temperature

Substances

Air Pollutants

Abstract

Publication types

MeSH terms

Substances

Grants and funding