Nishimura Hisaaki, Nawa Nobutoshi, Ogawa Takahisa, Fushimi Kiyohide, Schwartz Brian S, Fujiwara Takeo
Department of Public Health, Institute of Science Tokyo, Tokyo, Japan.
Department of Public Health, Institute of Science Tokyo, Tokyo, Japan.
Environ Res. 2025 Feb 1;266:120498. doi: 10.1016/j.envres.2024.120498. Epub 2024 Nov 30.
There is growing concern about climate impacts on human health. However, empirical evidence is lacking regarding future projections of heat-related asthma hospitalizations. This study aimed to project excess emergency hospitalizations for heat-related asthma exacerbation in Japan.
Using Japanese nationwide administrative data from 2011 to 2019, we conducted an ecological time-series quasi-Poisson regression analysis to estimate the heat-related relative risk of emergency hospitalization for asthma over a lag of 0-3 days during the warm season (June to September). Heat exposure was defined as the region-specific daily mean temperature exceeding the locally defined minimum morbidity temperature percentile (MMP). Heat-related excess hospitalizations for asthma were projected under future climate and demographic change scenarios based on Shared Socioeconomic Pathways (SSPs).
We identified 75,829 emergency hospitalizations for asthma. The heat-related relative risk of hospitalization was 1.22 (95% confidence interval (CI): 1.12-1.33) at the 99th percentile temperature relative to the MMP, with the highest estimates for cases aged 0-14 years. Heat-related excess hospitalizations were projected to increase by 6.78 (95%CI: 5.84-7.67) times in 2091-2099 versus 2011-2019 along SSP5-8.5 when constant population structure was assumed. The increasing trend persisted even when the future population decline was considered (4.19 (95%CI: 3.53-4.85) times in 2091-2099 versus 2011-2019 under SSP5-8.5).
Future heat-related impacts on asthma exacerbation are expected to increase in Japan toward the end of this century, even when the future demographic change is considered. Our projections will contribute to resilient health systems adapting to ongoing climate change.
气候对人类健康的影响日益受到关注。然而，关于与高温相关的哮喘住院未来预测的实证证据却很缺乏。本研究旨在预测日本因高温导致的哮喘加重而额外增加的急诊住院人数。
利用2011年至2019年日本全国行政数据，我们进行了一项生态时间序列准泊松回归分析，以估计温暖季节（6月至9月）0至3天滞后期间哮喘急诊住院与高温相关的相对风险。高温暴露定义为特定地区的日平均温度超过当地定义的最低发病温度百分位数（MMP）。基于共享社会经济路径（SSP），在未来气候和人口变化情景下预测了与高温相关的哮喘额外住院人数。
我们确定了75829例哮喘急诊住院病例。相对于MMP，在第99百分位温度时，与高温相关的住院相对风险为1.22（95%置信区间（CI）：1.12 - 1.33），0至14岁病例的估计值最高。假设人口结构不变，沿SSP5 - 8.5路径，2091 - 2099年与高温相关的额外住院人数预计将比2011 - 2019年增加6.78（95%CI：5.84 - 7.67）倍。即使考虑到未来人口下降，增长趋势仍然存在（在SSP5 - 8.5路径下，2091 - 2099年与2011 - 2019年相比为4.19（95%CI：3.53 - 4.85）倍）。
即使考虑到未来人口变化，预计到本世纪末，日本未来与高温相关的哮喘加重影响仍将增加。我们的预测将有助于卫生系统适应持续的气候变化并具备恢复力。
