Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study

doi:10.1007/s11783-023-1705-1

Front. Environ. Sci. Eng.

2023, Vol. 17

Issue (9) : 105 https://doi.org/10.1007/s11783-023-1705-1

RESEARCH ARTICLE

Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study

Hao Zheng¹, Jian Cheng^2,³, Hung Chak Ho⁴, Baoli Zhu¹, Zhen Ding¹, Wencong Du⁵, Xin Wang⁶, Yang Yu¹, Juan Fei¹, Zhiwei Xu⁷, Jinyi Zhou⁵(

), Jie Yang⁶(

)

¹. Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
². Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
³. Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei 230032, China
⁴. Department of Anaesthesiology, School of Clinical Medicine, The University of Hong Kong, Hong Kong 999077, China
⁵. Department of Noncommunicable Diseases, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
⁶. Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
⁷. School of Public Health, University of Queensland, Queensland 4006, Australia

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Abstract

● A study assessing the temperature-injury relationship was conducted among students.

● The maximum risks of injury appeared at moderate temperatures.

● The temperature effect on outdoor falls was greater in older students.

Although studies have suggested that non-optimal temperatures may increase the risk of injury, epidemiological studies focusing on the association between temperature and non-fatal injury among children and adolescents are limited. Therefore, we investigated the short-term effect of ambient temperature on non-fatal falls and road traffic injuries (RTIs) among students across Jiangsu Province, China. Meteorological data and records of non-fatal outdoor injuries due to falls and RTIs among students aged 6–17 were collected during 2018–2020. We performed a time-stratified case-crossover analysis with a distributed lag nonlinear model to examine the effect of ambient temperature on the risk of injury. Individual meteorological exposure was estimated based on the address of the selected school. We also performed stratified analyses by sex, age, and area. A total of 57322 and 5455 cases of falls and RTIs were collected, respectively. We observed inverted U-shaped curves for temperature-injury associations, with maximum risk temperatures at 18 °C (48th of daily mean temperature distribution) for falls and 22 °C (67th of daily mean temperature distribution) for RTIs. The corresponding odds ratios (95% confidence intervals) were 2.193 (2.011, 2.391) and 3.038 (1.988, 4.644) for falls and RTIs, respectively. Notably, there was a significant age-dependent trend in which the temperature effect on falls was greater in older students (P-trend < 0.05). This study suggests a significant association between ambient temperature and students’ outdoor falls and RTIs. Our findings may help advance tailored strategies to reduce the incidence of outdoor falls and RTIs in children and adolescents.

Keywords Ambient temperature Fall Road traffic injury Student China

Corresponding Author(s): Jinyi Zhou,Jie Yang

Issue Date: 31 March 2023

Cite this article:

Hao Zheng,Jian Cheng,Hung Chak Ho, et al. Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study[J]. Front. Environ. Sci. Eng., 2023, 17(9): 105.

URL:

https://academic.hep.com.cn/fese/EN/10.1007/s11783-023-1705-1
https://academic.hep.com.cn/fese/EN/Y2023/V17/I9/105

Tab.1 Descriptive statistics for the cases of falls and RTIs in students in Jiangsu Province, China, 2018–2020

Tab.2 Summary statistics of daily meteorological variables and AQI on case days and control days for falls and RTIs in Jiangsu Province, China, 2018–2020

Fig.1 Overall lag-cumulative (0–7 days) exposure-response associations for falls (a) and RTIs (b). The dashed vertical line represents the minimum risk temperature, and the dotted vertical line represents the maximum risk temperature. Shaded areas represent 95% confidence intervals.

Tab.3 ORs and 95% CIs for falls and RITs and the corresponding subgroups in students in Jiangsu Province, China, 2018–2020

Fig.2 Overall lag-cumulative ORs with 95% CIs for falls (a) and RTIs (b) in subgroup analyses by sex, age group, and area.

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