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- Title
Association between Heat Exposure and Hospitalization for Diabetes in Brazil during 2000-2015: A Nationwide Case-Crossover Study.
- Authors
Rongbin Xu; Qi Zhao; Coelho, Micheline S. Z. S.; Saldiva, Paulo H. N.; Zoungas, Sophia; Huxley, Rachel R.; Abramson, Michael J.; Yuming Guo; Shanshan Li
- Abstract
BACKGROUND: Exposure to excessive heat, which will continue to increase with climate change, is associated with increased morbidity due to a range of noncommunicable diseases (NCDs). Whether this is true for diabetes is unknown. OBJECTIVES: We aimed to quantify the relationship between heat exposure and risk of hospitalization due to diabetes in Brazil. METHODS: Data on hospitalizations and weather conditions were collected from 1,814 cities during the hot seasons from 2000 to 2015. A time-stratified case-crossover design was used to quantify the association between hospitalization for diabetes and heat exposure. Region-specific odds ratios (ORs) were used to calculate the attributable fractions (AFs). RESULTS: A total of 553,351 hospitalizations associated with diabetes were recorded during 2000-2015. Every 5°C increase in daily mean temperature was associated with 6% [OR= 1.06; 95% confidence interval (CI): 1.04, 1.07] increase in hospitalization due to diabetes with lag 0-3 d. The association was greatest (OR = 1.18; 95% CI: 1.13, 1.23) in those ≥80 y of age, but did not vary by sex, and was generally consistent by region and type of diabetes. Assuming a causal association, we estimated that 7.3% (95% CI: 3.5, 10.9) of all hospitalizations due to diabetes in the hot season could be attributed to heat exposure during the study period. DISCUSSION: Short-term heat exposure may increase the burden of diabetes-related hospitalization, especially among the very elderly. As global temperatures continue to rise, this burden is likely to increase.
- Subjects
BRAZIL; BAROCLINICITY; CONFIDENCE intervals; CROSSOVER trials; DIABETES; PHYSIOLOGICAL effects of heat; HOSPITAL care; NOSOLOGY; RESEARCH funding; SEASONS; WEATHER; LOGISTIC regression analysis; DESCRIPTIVE statistics; ODDS ratio
- Publication
Environmental Health Perspectives, 2019, Vol 127, Issue 11, p117005-1
- ISSN
0091-6765
- Publication type
Article
- DOI
10.1289/EHP5688