Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015

Abstract Little evidence is available about how temperature variability (TV) may modify the association between ambient heat and health conditions, especially in less developed countries, for example, Brazil. This study explored the change in heat‐hospitalization association from days with low to hi...

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Main Authors: Mengwei Zhuang, Yanwen Cao, Shanshan Li, Micheline S. Z. S. Coelho, Paulo H. N. Saldiva, Yuming Guo, Qi Zhao
Format: Article
Language:English
Published: American Geophysical Union (AGU) 2025-04-01
Series:GeoHealth
Online Access:https://doi.org/10.1029/2024GH001284
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author Mengwei Zhuang
Yanwen Cao
Shanshan Li
Micheline S. Z. S. Coelho
Paulo H. N. Saldiva
Yuming Guo
Qi Zhao
author_facet Mengwei Zhuang
Yanwen Cao
Shanshan Li
Micheline S. Z. S. Coelho
Paulo H. N. Saldiva
Yuming Guo
Qi Zhao
author_sort Mengwei Zhuang
collection DOAJ
description Abstract Little evidence is available about how temperature variability (TV) may modify the association between ambient heat and health conditions, especially in less developed countries, for example, Brazil. This study explored the change in heat‐hospitalization association from days with low to high temperature variabilities (TVs) in Brazil. We collected data on daily hospitalization and weather from 1,814 Brazilian cities during the 2000–2015 hot seasons. For each city, the heat‐hospitalization association was estimated using the quasi‐Poisson regression with constrained lag model on days with low and high TVs, respectively. City‐specific effect estimates were then pooled using random‐effect meta‐analysis. Stratified analyses were performed by region, sex, age‐group and cause category. Our results showed that at the national level the risk of hospitalization increased by 4.4% [95% confidence interval (CI): 4.0%–4.7%] and 2.7% (95%CI: 2.4%–3.0%) per 5°C increase in daily mean temperature on days with low and high TVs, respectively. The effect modification of TV on heat‐hospitalization association was significant in the northeast, southeast and south, and for most population groups except for the children aged 0–4 years and the elderly aged ≥80 years. Significant effect modification of TV was observed in injury and poisoning, respiratory and cardiovascular diseases. Our findings suggest that in Brazil, the heat‐health association is substantially modified by exposure to TV. The high heat susceptibility on the day with low TV warrants particular concern in order reducing the risk of disease burden.
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spelling doaj-art-e0284f3691ce4f69808fe3e0d76010032025-08-20T02:29:03ZengAmerican Geophysical Union (AGU)GeoHealth2471-14032025-04-0194n/an/a10.1029/2024GH001284Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015Mengwei Zhuang0Yanwen Cao1Shanshan Li2Micheline S. Z. S. Coelho3Paulo H. N. Saldiva4Yuming Guo5Qi Zhao6Advanced Medical Research Institute Cheeloo College of Medicine Shandong University Jinan ChinaDepartment of Epidemiology School of Public Health Cheeloo College of Medicine Shandong University Jinan ChinaClimate Air Quality Research Unit School of Public Health and Preventive Medicine Monash University Melbourne VIC AustraliaDepartment of Pathology Faculty of Medicine University of São Paulo São Paulo BrazilDepartment of Pathology Faculty of Medicine University of São Paulo São Paulo BrazilClimate Air Quality Research Unit School of Public Health and Preventive Medicine Monash University Melbourne VIC AustraliaDepartment of Epidemiology School of Public Health Cheeloo College of Medicine Shandong University Jinan ChinaAbstract Little evidence is available about how temperature variability (TV) may modify the association between ambient heat and health conditions, especially in less developed countries, for example, Brazil. This study explored the change in heat‐hospitalization association from days with low to high temperature variabilities (TVs) in Brazil. We collected data on daily hospitalization and weather from 1,814 Brazilian cities during the 2000–2015 hot seasons. For each city, the heat‐hospitalization association was estimated using the quasi‐Poisson regression with constrained lag model on days with low and high TVs, respectively. City‐specific effect estimates were then pooled using random‐effect meta‐analysis. Stratified analyses were performed by region, sex, age‐group and cause category. Our results showed that at the national level the risk of hospitalization increased by 4.4% [95% confidence interval (CI): 4.0%–4.7%] and 2.7% (95%CI: 2.4%–3.0%) per 5°C increase in daily mean temperature on days with low and high TVs, respectively. The effect modification of TV on heat‐hospitalization association was significant in the northeast, southeast and south, and for most population groups except for the children aged 0–4 years and the elderly aged ≥80 years. Significant effect modification of TV was observed in injury and poisoning, respiratory and cardiovascular diseases. Our findings suggest that in Brazil, the heat‐health association is substantially modified by exposure to TV. The high heat susceptibility on the day with low TV warrants particular concern in order reducing the risk of disease burden.https://doi.org/10.1029/2024GH001284
spellingShingle Mengwei Zhuang
Yanwen Cao
Shanshan Li
Micheline S. Z. S. Coelho
Paulo H. N. Saldiva
Yuming Guo
Qi Zhao
Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015
GeoHealth
title Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015
title_full Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015
title_fullStr Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015
title_full_unstemmed Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015
title_short Effect Modification of Temperature Variability on the Association Between Ambient Heat and Hospitalization: A Nationwide Study in Brazil Between 2000 and 2015
title_sort effect modification of temperature variability on the association between ambient heat and hospitalization a nationwide study in brazil between 2000 and 2015
url https://doi.org/10.1029/2024GH001284
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