Quantification of the Heat-Related Risk and Burden of Hospitalizations for Cause-Specific Injuries and Contribution of Human-Induced Climate Change: A Time-Stratified Case-Crossover Study in China.

LEG injuries; INJURY risk factors; ARM injuries; RISK assessment; ENVIRONMENTAL health; NECK injuries; GREENHOUSE effect; DATA analysis; BURNS & scalds; RESEARCH funding; HOSPITAL care; CLIMATE change; SEX distribution; LOGISTIC regression analysis; DESCRIPTIVE statistics; RELATIVE medical risk; POPULATION geography; GLOBAL burden of disease; HEAT; ANTHROPOGENIC effects on nature; CROSSOVER trials; ELECTRONIC health records; STATISTICS; TEMPERATURE; ATTRIBUTION (Social psychology); CONFIDENCE intervals; DATA analysis software; TORSO; IMPACT of Event Scale; PSYCHOLOGICAL vulnerability; HEAD injuries; POISONING

BACKGROUND: Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES: Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS: We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000–2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS: Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (-12:1°C), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (<18 years of age) or middle-aged (45–64 years of age) individuals, and those living in the North. The heatrelated attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of humaninduced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with humaninduced change accounting for 6.7% to 10.6% of the burden. DISCUSSION: This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. [ABSTRACT FROM AUTHOR]

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