title: Acute effects of diurnal temperature range on mortality in 8 Chinese cities.
abstract: Diurnal temperature range (DTR) is a meteorological indicator closely associated with global climate change. There have been no multicity studies in China addressing the DTR-related health impact. We hypothesized that an increase of DTR is associated with higher daily mortality with a potential lag of effect, and investigated the acute effects of DTR on total, cardiovascular, and respiratory mortality in 8 large Chinese cities from 2001 to 2010. We first calculated city-specific effect of DTR in the full year, the cool season (November to the next April) and the warm season (May to October) separately using a semi-parametric generalized additive model; then we pooled the city-specific estimates with meta analysis. After adjusting for long-term and seasonal trends, temperature, relative humidity and air pollution levels, we found statistically significant associations between DTR and daily mortality, especially in cool seasons. A 1 °C increment of DTR on lag-day 1 corresponded to a 0.42% (95% CI, 0.14 to 0.70) increase in total non-accidental mortality, 0.45% (95% CI, 0.26 to 0.65) increase in cardiovascular mortality, and a 0.76% (95% CI, 0.24 to 1.29) increase in respiratory mortality in cool seasons. Deaths among females and elderly (≥ 65 years) were more strongly associated with DTR than among males and younger people (<65 years). Our analysis suggests that DTR is a potential trigger for death in China. Our findings may have important implications for the climate policies in the country.
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Zhou
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Zhao
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Meng
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Occupational Medicine, Shanghai Yangpu District Central Hospital, Shanghai, China.
authors.forename: Xingya
authors.initials: X
authors.lastname: Kuang
authors.affiliation: Department of Environmental Pollution and Health, Chinese Research Academy of Environmental Sciences (CRAES), State Key Lab of Environmental Criteria and Risk Assessment, Beijing, China. Electronic address: duan_jasmine@126.com.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Duan
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China. Electronic address: haidongkan@gmail.com.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002681:China / Q000453:epidemiology; D057231:Climate Change; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D013696:Temperature
keywords: Climate change; Diurnal temperature range; Mortality; Time-series