Short-term exposure to extreme temperature and outpatient visits for respiratory diseases among children in the northern city of China: A time-series study

Abstract

Abstract Background Although studies have indicated that extreme temperature is strongly associated with respiratory diseases, there is a dearth of studies focused on children, especially in China. We aimed to explore the association between extreme temperature and children’s outpatient visits for respiratory diseases and seasonal modification effects in Harbin, China. Methods A distributed lag nonlinear model (DLNM) was used to explore the effect of extreme temperature on the daily outpatient visits for respiratory diseases among children and lag effects as well as seasonal modification effects. Results Extremely low temperatures were defined as the 1st percentile and 2.5th percentile of temperature. Extremely high temperatures were defined as the 97.5th percentile and 99th percentile of temperature. At extremely high temperatures, both 26°C (97.5th ) and 27°C (99th ) showed adverse effects at lag 0–6 days, with relative risks (RRs) of 1.34 [95% confidence interval (CI): 1.21–1.48] and 1.38 (95% CI: 1.24–1.53), respectively. However, at extremely low temperatures, both − 26°C (1st ) and − 23°C (2.5th ) showed protective effects on children’s outpatient visits for respiratory diseases at lag 0–10 days, with RRs of 0.86 (95% CI: 0.76–0.97) and 0.85 (95% CI: 0.75–0.95), respectively. We also found seasonal modification effects, with the association being stronger in the warm season than in the cold season at extremely high temperatures. Conclusions Our study indicated that extremely hot temperatures increase the risk of children’s outpatient visits for respiratory diseases. Efforts to reduce the exposure of children to extremely high temperatures may have the potential to mitigate the burden of pediatric respiratory diseases, especially in the warm season.