Projections of future heat-related emergency hospitalizations for asthma under climate and demographic change scenarios: A Japanese nationwide time-series analysis

IF 7.7 2区 环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES Environmental Research Pub Date : 2025-02-01 DOI:10.1016/j.envres.2024.120498
Hisaaki Nishimura , Nobutoshi Nawa , Takahisa Ogawa , Kiyohide Fushimi , Brian S. Schwartz , Takeo Fujiwara
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Abstract

Background

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.

Methods

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).

Results

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).

Conclusion

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.
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气候和人口变化情景下未来与热相关的哮喘急诊住院预测:日本全国时间序列分析。
背景:人们越来越关注气候对人类健康的影响。然而,缺乏经验证据关于未来预测与热相关的哮喘住院治疗。本研究旨在预测日本因热相关哮喘加重而导致的急诊住院人数。方法:利用日本2011年至2019年的全国行政数据,进行生态时间序列准泊松回归分析,估计暖季(6月至9月)0-3天滞后的哮喘急诊住院的热相关相对风险。热暴露被定义为特定区域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),预测了未来气候和人口变化情景下与高温相关的哮喘住院率。结果:我们确定了75,829例哮喘急诊住院病例。在相对于MMP的第99个百分位温度下,与热相关的住院相对风险为1.22(95%置信区间(CI): 1.12-1.33), 0-14岁的病例估计最高。假设人口结构不变,预计2091-2099年与2011-2019年相比,沿SSP5-8.5,热相关的超额住院率将增加6.78倍(95%CI: 5.84-7.67)。即使考虑到未来的人口减少,这种增加趋势仍然存在(在SSP5-8.5下,2091-2099年是2011-2019年的4.19倍(95%CI: 3.53-4.85))。结论:到本世纪末,即使考虑到未来的人口变化,日本未来与热有关的哮喘恶化影响预计将增加。我们的预测将有助于建立有韧性的卫生系统,以适应持续的气候变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Environmental Research
Environmental Research 环境科学-公共卫生、环境卫生与职业卫生
CiteScore
12.60
自引率
8.40%
发文量
2480
审稿时长
4.7 months
期刊介绍: The Environmental Research journal presents a broad range of interdisciplinary research, focused on addressing worldwide environmental concerns and featuring innovative findings. Our publication strives to explore relevant anthropogenic issues across various environmental sectors, showcasing practical applications in real-life settings.
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