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Short-term effects of air quality and thermal stress on non-accidental morbidity—a multivariate meta-analysis comparing indices to single measures

  • Students and New Professionals 2015
  • Published:
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Abstract

Air quality and thermal stress lead to increased morbidity and mortality. Studies on morbidity and the combined impact of air pollution and thermal stress are still rare. To analyse the correlations between air quality, thermal stress and morbidity, we used a two-stage meta-analysis approach, consisting of a Poisson regression model combined with distributed lag non-linear models (DLNMs) and a meta-analysis investigating whether latitude or the number of inhabitants significantly influence the correlations. We used air pollution, meteorological and hospital admission data from 28 administrative districts along a north-south gradient in western Germany from 2001 to 2011. We compared the performance of the single measure particulate matter (PM10) and air temperature to air quality indices (MPI and CAQI) and the biometeorological index UTCI. Based on the Akaike information criterion (AIC), it can be shown that using air quality indices instead of single measures increases the model strength. However, using the UTCI in the model does not give additional information compared to mean air temperature. Interaction between the 3-day average of air quality (max PM10, max CAQI and max MPI) and meteorology (mean air temperature and mean UTCI) did not improve the models. Using the mean air temperature, we found immediate effects of heat stress (RR 1.0013, 95% CI: 0.9983–1.0043) and by 3 days delayed effects of cold stress (RR: 1.0184, 95% CI: 1.0117–1.0252). The results for air quality differ between both air quality indices and PM10. CAQI and MPI show a delayed impact on morbidity with a maximum RR after 2 days (MPI 1.0058, 95% CI: 1.0013–1.0102; CAQI 1.0068, 95% CI: 1.0030–1.0107). Latitude was identified as a significant meta-variable, whereas the number of inhabitants was not significant in the model.

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Acknowledgements

We gratefully acknowledge the financial support of the National Research Fund in Luxembourg (4965163-FRESHAIR) and the health data provision by the “Research Data Centres of the Federal Statistical Office and the statistical offices of the Länder”. A. Gutleb is thanked for the help provided to identify the relevant diseases for our research.

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Authors and Affiliations

  1. Institute of Landscape Ecology, Climatology Group, University of Münster, Heisenbergstraße 2, 48149, Münster, Germany

    Hanna Leona Lokys

  2. ERIN—Environmental Research and Innovation Department, Luxembourg Institute of Science and Technology (LIST), 5, avenue des Hauts-Fourneaux, Esch/Alzette, 4362, Luxembourg

    Jürgen Junk & Andreas Krein

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  1. Hanna Leona Lokys
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Correspondence to Hanna Leona Lokys.

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Ethical approval

Ethical approval to the use of hospital admission data was given by the “RDC of the Federal Statistical Office and the Statistical Offices of the federal states” together with the signature to statistical confidentiality in accordance with section 16 (7) of the Federal Statistics Act (BStatG). It is ensured by the contract not to be able to identify individual data from the published results.

Funding

The research reported was funded by the National Research Fund in Luxembourg (FNR) (4965163-FRESHAIR). The FNR was neither involved in the design of the study and collection, analysis and interpretation of data nor in writing the manuscript.

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Lokys, H.L., Junk, J. & Krein, A. Short-term effects of air quality and thermal stress on non-accidental morbidity—a multivariate meta-analysis comparing indices to single measures. Int J Biometeorol 62, 17–27 (2018). https://doi.org/10.1007/s00484-017-1326-0

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  • DOI: https://doi.org/10.1007/s00484-017-1326-0

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