Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis

Background: Diurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007-2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China. Methods: Poisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for dailymean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends. Results: The cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 degrees C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0-21 days was 1.03 (95% confidence interval: 0.95-1.11) and 1.33 (0.94-1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age <75 years than females and age >= 75 years. Conclusions: The effect of DTR on mortality was non-linear, with high DTR associated with increasedmortality. A DTR of 16 degrees C may be a cut-off point formortality prognosis and has implications for developing intervention strategies to address high DTR exposure. (C) 2015 Elsevier B. V. All rights reserved.