Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam; Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Environ Res. 2019 Aug;175:167-177. doi: 10.1016/j.envres.2019.04.023. Epub 2019 Apr 25.
Vietnam is one of the countries most affected by climate change, but few studies have focused on the population health effects of climate variation. Extreme heatwaves and cold spells might exacerbate underlying chronic conditions and precipitate hospitalization or early death. This study examined the short-term effects of ambient temperature extremes on hospital admissions (HAs) due to acute myocardial infarction (AMI) between different climate zones in the Central Coast region of Vietnam.
Information from medical records of all 3328 cases of AMI HAs (with hospital records cross-checked by clinicians) was collected from three hospitals in the South-Central Coast region (tropical savanna climate) and North-Central Coast region (tropical monsoon climate) for the period 2008-2015. Meteorological data were obtained from the National Hydro-Meteorological and Environment Network Centre. We used distributed lag non-linear models to assess the association between daily average temperature and AMI HAs, accounting for long-term trend and other meteorological variables.
We found a negative and significant association between AMI HAs and temperature in the North-Central Coast region while conversely there was a positive and significant association in the South-Central Coast region. In the North-Central Coast region, the risk of AMI HAs increased by 11% (Relative risk (RR): 1.11, 95% CI: 0.91-1.35, p > 0.05) at moderately low temperatures (10th percentile of temperature range - 18.5 °C) and increased by 25% (RR: 1.25, 95% CI: 1.02-1.55, p < 0.05) at extremely low temperatures (5th percentile of temperature range - 16.8 °C). In the South-Central Coast region, the risk of AMI HAs increased by 18% (RR: 1.18, 95% CI: 0.95-1.47, p > 0.05) and 36% (RR: 1.36, 95% CI: 1.06-1.73, p < 0.05) at moderately high temperatures (90 percentile of temperature range -29.5 °C) and extreme high temperatures (95th percentile of temperature range - 29.9 °C), respectively.
Risk of AMI is associated with extremely high and extremely low temperature in Vietnam and the risk varies in relation to the local regional climate. Public health preparedness and multi-level interventions should attempt to reduce people's exposure in periods of disadvantageous temperatures.
越南是受气候变化影响最严重的国家之一，但很少有研究关注气候变化对人口健康的影响。极端热浪和寒冷天气可能会使潜在的慢性疾病恶化，并导致住院或早逝。本研究考察了越南中海岸地区不同气候带的环境温度极值对急性心肌梗死（AMI）住院（HA）的短期影响。
收集了 2008-2015 年间来自中南部海岸地区（热带稀树草原气候）和中北部海岸地区（热带季风气候）的三家医院的所有 3328 例 AMI HA 患者（临床医生核对了医院记录）的病历信息。气象数据来自国家水文气象和环境网络中心。我们使用分布式滞后非线性模型评估了日平均温度与 AMI HA 之间的关联，考虑了长期趋势和其他气象变量。
我们发现中北部海岸地区的 AMI HA 与温度之间存在负相关且具有统计学意义，而中南部海岸地区则存在正相关且具有统计学意义。在中北部海岸地区，当温度处于中低水平（温度范围的第 10 百分位数-18.5°C）时，AMI HA 的风险增加 11%（相对风险（RR）：1.11，95%置信区间：0.91-1.35，p>0.05），当温度处于极低水平（温度范围的第 5 百分位数-16.8°C）时，AMI HA 的风险增加 25%（RR：1.25，95%置信区间：1.02-1.55，p<0.05）。在中南部海岸地区，当温度处于中高温水平（温度范围的第 90 百分位数-29.5°C）和极高温水平（温度范围的第 95 百分位数-29.9°C）时，AMI HA 的风险分别增加了 18%（RR：1.18，95%置信区间：0.95-1.47，p>0.05）和 36%（RR：1.36，95%置信区间：1.06-1.73，p<0.05）。
在越南，AMI 的风险与极高和极低温度有关，风险因当地区域气候而异。公共卫生准备和多层次干预措施应试图减少人们在不利温度期间的暴露。
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