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The Joint Effects of Thunderstorms and Power Outages on Respiratory-Related Emergency Visits and Modifying and Mediating Factors of This Relationship.

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Title: The Joint Effects of Thunderstorms and Power Outages on Respiratory-Related Emergency Visits and Modifying and Mediating Factors of This Relationship.
Authors: Shao Lin1,2 slin@albany.edu, Quan Qi3, Han Liu4, Xinlei Deng5, Trees, Ian6, Xiaojun Yuan7, Gallant, Mary P.8
Source: Environmental Health Perspectives. Jun2024, Vol. 132 Issue 6, p067002-1-067002-12. 12p.
Subject Terms: *Air pollution, *Electricity, *Weather, *Particulate matter, Respiratory disease risk factors, Seasons, Research funding, Descriptive statistics, Age distribution, Medical emergencies, Obstructive lung diseases, Medical appointments, Sociodemographic factors, Health equity, Confidence intervals, Comorbidity
Abstract: BACKGROUND: While limited studies have evaluated the health impacts of thunderstorms and power outages (POs) separately, few have assessed their joint effects. We aimed to investigate the individual and joint effects of both thunderstorms and POs on respiratory diseases, to identify disparities by demographics, and to examine the modifications and mediations by meteorological factors and air pollution. METHODS: Distributed lag nonlinear models were used to examine exposures during three periods (i.e., days with both thunderstorms and POs, thunderstorms only, and POs only) in relation to emergency department visits for respiratory diseases (2005-2018) compared to controls (no thunderstorm/no PO) in New York State (NYS) while controlling for confounders. Interactions between thunderstorms and weather factors or air pollutants on health were assessed. The disparities by demographics and seasons and the mediative effects by particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) and relative humidity (RH) were also evaluated. RESULTS: Thunderstorms and POs were independently associated with total and six subtypes of respiratory diseases in NYS [highest risk ratio (RR) = 1.12; 95% confidence interval (CI): 1.08, 1.17], but the impact was stronger when they co-occurred (highest RR = 1.44; 95% CI: 1.22, 1.70), especially during grass weed, ragweed, and tree pollen seasons. The stronger thunderstorm/PO joint effects were observed on chronic obstructive pulmonary diseases, bronchitis, and asthma (lasted 0–10 d) and were higher among residents who lived in rural areas, were uninsured, were of Hispanic ethnicity, were 6–17 or over 65 years old, and during spring and summer. The number of comorbidities was significantly higher by 0.299–0.782/case. Extreme cold/heat, high RH, PM2.5, and ozone concentrations significantly modified the thunderstorm–health effect on both multiplicative and additive scales. Over 35% of the thunderstorm effects were mediated by PM2.5 and RH. CONCLUSION: Thunderstorms accompanied by POs showed the strongest respiratory effects. There were large disparities in thunderstorm-health associations by demographics. Meteorological factors and air pollution levels modified and mediated the thunderstorm-health effects. [ABSTRACT FROM AUTHOR]
Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: The Joint Effects of Thunderstorms and Power Outages on Respiratory-Related Emergency Visits and Modifying and Mediating Factors of This Relationship.
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  Data: <searchLink fieldCode="AR" term="%22Shao+Lin%22">Shao Lin</searchLink><relatesTo>1,2</relatesTo><i> slin@albany.edu</i><br /><searchLink fieldCode="AR" term="%22Quan+Qi%22">Quan Qi</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Han+Liu%22">Han Liu</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Xinlei+Deng%22">Xinlei Deng</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Trees%2C+Ian%22">Trees, Ian</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Xiaojun+Yuan%22">Xiaojun Yuan</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Gallant%2C+Mary+P%2E%22">Gallant, Mary P.</searchLink><relatesTo>8</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Environmental+Health+Perspectives%22">Environmental Health Perspectives</searchLink>. Jun2024, Vol. 132 Issue 6, p067002-1-067002-12. 12p.
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  Data: *<searchLink fieldCode="DE" term="%22Air+pollution%22">Air pollution</searchLink><br />*<searchLink fieldCode="DE" term="%22Electricity%22">Electricity</searchLink><br />*<searchLink fieldCode="DE" term="%22Weather%22">Weather</searchLink><br />*<searchLink fieldCode="DE" term="%22Particulate+matter%22">Particulate matter</searchLink><br /><searchLink fieldCode="DE" term="%22Respiratory+disease+risk+factors%22">Respiratory disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Seasons%22">Seasons</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Age+distribution%22">Age distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+emergencies%22">Medical emergencies</searchLink><br /><searchLink fieldCode="DE" term="%22Obstructive+lung+diseases%22">Obstructive lung diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+appointments%22">Medical appointments</searchLink><br /><searchLink fieldCode="DE" term="%22Sociodemographic+factors%22">Sociodemographic factors</searchLink><br /><searchLink fieldCode="DE" term="%22Health+equity%22">Health equity</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Comorbidity%22">Comorbidity</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND: While limited studies have evaluated the health impacts of thunderstorms and power outages (POs) separately, few have assessed their joint effects. We aimed to investigate the individual and joint effects of both thunderstorms and POs on respiratory diseases, to identify disparities by demographics, and to examine the modifications and mediations by meteorological factors and air pollution. METHODS: Distributed lag nonlinear models were used to examine exposures during three periods (i.e., days with both thunderstorms and POs, thunderstorms only, and POs only) in relation to emergency department visits for respiratory diseases (2005-2018) compared to controls (no thunderstorm/no PO) in New York State (NYS) while controlling for confounders. Interactions between thunderstorms and weather factors or air pollutants on health were assessed. The disparities by demographics and seasons and the mediative effects by particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) and relative humidity (RH) were also evaluated. RESULTS: Thunderstorms and POs were independently associated with total and six subtypes of respiratory diseases in NYS [highest risk ratio (RR) = 1.12; 95% confidence interval (CI): 1.08, 1.17], but the impact was stronger when they co-occurred (highest RR = 1.44; 95% CI: 1.22, 1.70), especially during grass weed, ragweed, and tree pollen seasons. The stronger thunderstorm/PO joint effects were observed on chronic obstructive pulmonary diseases, bronchitis, and asthma (lasted 0–10 d) and were higher among residents who lived in rural areas, were uninsured, were of Hispanic ethnicity, were 6–17 or over 65 years old, and during spring and summer. The number of comorbidities was significantly higher by 0.299–0.782/case. Extreme cold/heat, high RH, PM2.5, and ozone concentrations significantly modified the thunderstorm–health effect on both multiplicative and additive scales. Over 35% of the thunderstorm effects were mediated by PM2.5 and RH. CONCLUSION: Thunderstorms accompanied by POs showed the strongest respiratory effects. There were large disparities in thunderstorm-health associations by demographics. Meteorological factors and air pollution levels modified and mediated the thunderstorm-health effects. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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    Identifiers:
      – Type: doi
        Value: 10.1289/EHP13237
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 067002-1
    Subjects:
      – SubjectFull: Air pollution
        Type: general
      – SubjectFull: Electricity
        Type: general
      – SubjectFull: Weather
        Type: general
      – SubjectFull: Particulate matter
        Type: general
      – SubjectFull: Respiratory disease risk factors
        Type: general
      – SubjectFull: Seasons
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Medical emergencies
        Type: general
      – SubjectFull: Obstructive lung diseases
        Type: general
      – SubjectFull: Medical appointments
        Type: general
      – SubjectFull: Sociodemographic factors
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      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Comorbidity
        Type: general
    Titles:
      – TitleFull: The Joint Effects of Thunderstorms and Power Outages on Respiratory-Related Emergency Visits and Modifying and Mediating Factors of This Relationship.
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            NameFull: Shao Lin
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            – D: 01
              M: 06
              Text: Jun2024
              Type: published
              Y: 2024
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