Jie Zeng|Xuehai Zhang|Jun Yang|Junzhe Bao|Hao Xiang|Keith Dear|Qiyong Liu|Shao Lin|Wayne R. Lawrence|Ang Lin|Cunrui Huang
Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China
background evidence increased mortality attributable extreme temperatures widely characterized climatehealth studies however studies examined role humidity temperaturemortality association investigated joint effect temperature humidity cardiovascular disease cvd mortality zhejiang province china methods collected data daily meteorological cvd mortality 11 cities zhejiang province 20102013 first applied timeseries poisson regression analysis within framework distributed lag nonlinear models estimate cityspecific effect temperature humidity cvd mortality controlling temporal trends potential confounding variables applied multivariate metaanalytical model pool effect estimates 11 cities generate overall provincial estimate joint effects calculated attributable fraction af analyses stratified gender age group education level location cities results total 120544 cvd deaths recorded study mean values temperature humidity 176 c 723 joint effect low temperature high humidity greatest impact cvd death burden lag 021 days significant af 3136 95 eci 14793841 condition low temperature low humidity significant af 1674 95 eci 089 2444 afs higher low temperature high humidity different subgroups considering levels humidity afs significant low temperature high humidity males youth low level education coastal area people conclusions combination low temperature high humidity greatest impact cvd death burden zhejiang province evidence important implications developing cvd interventions