國家衛生研究院 NHRI:Item 3990099045/16107

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Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/16107

Title:	Climate change projections for stroke incidence in Taiwan: Impact of 2 °C and 4 °C global warming level
Authors:	Wu, WT;Kono, M;Lee, CP;Chang, YY;Yang, YH;Lin, CC;Liu, TM;Li, HC;Chen, YM;Chen, PC
Contributors:	National Institute of Environmental Health Sciences
Abstract:	ObjectivesThis study aimed to establish the exposure-lag-response effect between daily maximum temperature and stroke-related emergency department visits and to project heat-induced stroke impacts under global warming levels (GWL) of 2 degrees C and 4 degrees C.MethodsStroke-related emergency department visits in Taiwan from 2001 to 2020 were identified using the National Health Insurance Research Database (NHIRD). The study population consisted of 1,100,074 initial stroke cases matched with 2,200,148 non-stroke controls. We employed Distributed Lag Nonlinear Models (DLNM) in a case-crossover study to investigate the association between temperature and stroke. Generalized Estimating Equations (GEE) models with a Poisson function were used to correlate high-temperature exposure with annual stroke incidence rates. Projections were made under two global warming scenarios, GWL 2.0 degrees C and 4.0 degrees C, using Coupled General Circulation Model (GCMs). Baseline data from 1995 to 2014 were transformed for spatial distribution at the township level. Geographic Information System (GIS) spatial analysis was performed using Quantum GIS 3.2.0 software.ResultsDLNM exposure-lag-response effect revealed that daily maximum temperature exceeding 34 degrees C significantly increased the risk of stroke-related emergency department visits, particularly for ischemic stroke. Under the 2 degrees C GWL scenario, the frequency of days with temperatures surpassing 34 degrees C is projected to rise substantially by the median year of 2042, with a further increase to 92.6 +/- 18.0 days/year by 2065 under the 4 degrees C GWL scenario. Ischemic stroke showed the highest increase in temperature-related incidence rates, notably rising from 7.80% under the GWL 2 degrees C to 36.06% under the GWL 4 degrees C. Specifically, the annual temperature-related incidence rate for ischemic stroke is expected to increase significantly by 2065. Regions such as Taichung, Hsinchu, Yilan, and Taitung demonstrated pronounced changes in heat-related ischemic stroke incidence under the GWL 4 degrees C.ConclusionsThe findings emphasize the importance of addressing temperature-related stroke risks, particularly in regions projected to experience significant temperature increases. Effective mitigation strategies are crucial to reduce the impact of rising temperatures on stroke incidence and safeguard public health.
Date:	2024-09-02
Relation:	Journal of Epidemiology and Global Health. 2024 Sep 02;14:1319-1331.
Link to:	http://dx.doi.org/10.1007/s44197-024-00289-3
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=2210-6006&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:001303890700001
Cited Times(Scopus):	https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85202847520
Appears in Collections:	[Pau-Chung Chen] Periodical Articles [Wei-Te Wu] Periodical Articles

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