Short-Term Effects of the 2008 Cold Spell on Mortality in Three Subtropical Cities in Guangdong Province, China

Abstract

Background: Few studies have been conducted to investigate the impact of extreme cold events on mortality in subtropical regions. Objective: The present study aimed to investigate the effects of the 2008 cold spell on mortality and the possibility of mortality displacement in three subtropical cities in China. Methods: Daily mortality, air pollution, and weather data were collected from 2006 to 2009 in Guangzhou, Nanxiong (no air pollutants) and Taishan. A polynomial distributed lag model (DLM) was used to analyze the relationship between the 2008 cold spell and mortality. To observe the mortality displacement of the cold spell, we estimated the cumulative effects at lag0, lag0-6, lag0-13, lag0-20, and lag0-27 separately. Results: During the 2008 cold spell, the cumulative risk of non-accidental mortality increased significantly in Guangzhou (RR=1.60; 95%CI: 1.19, 2.14) and Taishan (RR=1.60; 95%CI: 1.06, 2.40) when lagged up to 4 weeks after the cold spell ended. Estimated effects at lag0-27 were more pronounced for males than females, for respiratory mortality than cardiovascular mortality, and for the elderly (=75 years) than for those 0-64 years. Most of the cumulative RRs increased with longer lag times in Guangzhou and Taishan. However, in Nanxiong, the trend with cumulative RRs was less consistent, and no statistically significant associations were observed at lag0-27. Conclusion: The 2008 cold spell was associated with increased mortality in three subtropical cities of China. The lag effect structure of the cold spell varied with location and the type of mortality, and evidence of short-term mortality displacement was inconsistent. These findings suggest that extreme cold is an important public health problem in subtropical regions.