The association between heat exposure and hospitalization for undernutrition in Brazil during 2000-2015: A nationwide case-crossover study
| العنوان: | The association between heat exposure and hospitalization for undernutrition in Brazil during 2000-2015: A nationwide case-crossover study |
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| المؤلفون: | Yuming Guo, Micheline de Sousa Zanotti Stagliorio Coelho, Paulo Hilário Nascimento Saldiva, Shanshan Li, Rongbin Xu, Qi Zhao, Michael J. Abramson |
| المصدر: | PLoS Medicine, Vol 16, Iss 10, p e1002950 (2019) PLoS Medicine |
| بيانات النشر: | Public Library of Science (PLoS), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Atmospheric Science, Hot Temperature, Climate, 030204 cardiovascular system & hematology, Global Warming, Geographical locations, 0302 clinical medicine, Syndemic, Risk Factors, Odds Ratio, Medicine and Health Sciences, 030212 general & internal medicine, Young adult, Child, Aged, 80 and over, Climatology, 2. Zero hunger, Geriatrics, Cross-Over Studies, Temperature, 1. No poverty, General Medicine, Middle Aged, 3. Good health, Hospitalization, Child, Preschool, Medicine, Female, Seasons, Brazil, Research Article, Adult, medicine.medical_specialty, Adolescent, Climate Change, Young Adult, 03 medical and health sciences, Meteorology, Air Pollution, Environmental health, medicine, Humans, Cities, Aged, Nutrition, business.industry, Malnutrition, Global warming, Infant, Newborn, Infant, Biology and Life Sciences, Humidity, Environmental Exposure, Odds ratio, South America, medicine.disease, Crossover study, Health Care, 13. Climate action, Weather data, Earth Sciences, People and places, Health Statistics, Morbidity, business |
| الوصف: | Background Global warming is predicted to indirectly result in more undernutrition by threatening crop production. Whether temperature rise could affect undernutrition directly is unknown. We aim to quantify the relationship between short-term heat exposure and risk of hospitalization due to undernutrition in Brazil. Methods and findings We collected hospitalization and weather data for the hot season (the 4 adjacent hottest months for each city) from 1,814 Brazilian cities during 1 January 2000−31 December 2015. We used a time-stratified case-crossover design to quantify the association between heat exposure and hospitalization due to undernutrition. Region-specific odds ratios (ORs) were used to calculate the attributable fractions (AFs). A total of 238,320 hospitalizations for undernutrition were recorded during the 2000−2015 hot seasons. Every 1°C increase in daily mean temperature was associated with a 2.5% (OR 1.025, 95% CI 1.020−1.030, p < 0.001) increase in hospitalizations for undernutrition across lag 0–7 days. The association was greatest for individuals aged ≥80 years (OR 1.046, 95% CI 1.034−1.059, p < 0.001), 0–4 years (OR 1.039, 95% CI 1.024–1.055, p < 0.001), and 5–19 years (OR 1.042, 95% CI 1.015–1.069, p = 0.002). Assuming a causal relationship, we estimate that 15.6% of undernutrition hospitalizations could be attributed to heat exposure during the study period. The AF grew from 14.1% to 17.5% with a 1.1°C increase in mean temperature from 2000 to 2015. The main limitations of this study are misclassification of different types of undernutrition, lack of individual temperature exposure data, and being unable to adjust for relative humidity. Conclusions Our study suggests that global warming might directly increase undernutrition morbidity, by a route other than by threatening food security. This short-term effect is increasingly important with global warming. Global strategies addressing the syndemic of climate change and undernutrition should focus not only on food systems, but also on the prevention of heat exposure. Rongbin Xu and colleagues reveal the association between heat exposure and hospital admissions for undernutrition in Brazil. Author summary Why was this study done? It has been well documented that global warming will indirectly result in more undernourished people by threatening crop production in the long term. However, no study has yet evaluated the short-term and direct effect of heat exposure on morbidity related to undernutrition. What did the researchers do and find? With daily hospitalization data covering nearly 80% of the Brazilian population during 2000−2015, we used a time-stratified case-crossover design to quantify the association between heat exposure and hospitalization for undernutrition. We also estimated the heat-related hospitalization burden. There was a 2.5% increase in undernutrition hospitalizations following every 1°C increase in daily mean temperature during the hot season. The young (0–19 years) and elderly people (≥80 years) with undernutrition were more vulnerable to heat exposure than other age groups. Heat exposure was responsible for 15.6% of the undernutrition hospitalizations during the study period, corresponding to 37,129 cases. The attributable fraction increased from 14.1% in 2000 to 17.5% in 2015, paralleling a 1.1°C increase in average temperature. What do these findings mean? Rising temperature might impact undernutrition morbidity directly and more rapidly than through threatening food security alone. The possible pathways of this direct impact of heat might include reducing undernourished people’s food intake, impairing their digestion and absorption function, and causing fluid and electrolyte disturbances. This direct, short-term effect will be increasingly important with global warming, as illustrated by what happened in Brazil over 2000−2015. Global strategies addressing the syndemic of climate change and undernutrition should focus not only on food systems, but also on the prevention of heat exposure, especially among the young and elderly. |
| اللغة: | English |
| تدمد: | 1549-1676 1549-1277 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e2b04f6869da10d77fd1f6d07a71a1e3Test https://doaj.org/article/e8868c2b61f44f4b91452d74d36735ccTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e2b04f6869da10d77fd1f6d07a71a1e3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15491676 15491277 |
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