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Ambient high temperature is a worldwide trigger for hypertension events. However, the effects of heat exposure on hypertension and years of life lost (YLL) due to heat remain largely unknown. We conducted a multicenter study in 13 cities in Jiangsu Province, China, to investigate 9727 individuals who died from hypertension during the summer months (May to September) between 2016 and 2017. Meteorological observation data (temperature and rainfall) and air pollutants (fine particulate matter and ozone) were obtained for each decedent by geocoding the residential addresses. A time-stratified case-crossover design was used to quantify the association between heat and different types of hypertension and further explore the modification effect of individual and hospital characteristics. Meanwhile, the YLL associated with heat exposure was estimated. Our results show that summer heat exposure shortens the YLL of hypertensive patients by a total of 14,74 years per month. Of these, 77.9% of YLL was mainly due to hypertensive heart disease. YLL due to heat was pronounced for essential hypertension (5.1 years (95% empirical confidence intervals (eCI): 4.1–5.8)), hypertensive heart and renal disease with heart failure (4.4 years (95% eCI: 0.9–5.9)), and hypertensive heart and renal disease (unspecified, 3.5 years (95% eCI: 1.8–4.5)). Moderate heat was associated with a larger YLL than extreme heat. The distance between hospitals and patients and the number of local first-class hospitals can significantly mitigate the adverse effect of heat exposure on longevity. Besides, unmarried people and those under 65 years of age were potentially susceptible groups, with average reduced YLL of 3.5 and 3.9 years, respectively. Our study reveals that heat exposure increases the mortality risk from many types of hypertension and YLL. In the context of climate change, if effective measures are not taken, hot weather may bring a greater burden of disease to hypertension due to premature death. • Heat exposure can significantly shorten life expectancy in patients with hypertension. • Hypertensive heart disease mortality was significantly higher than hypertensive renal disease mortality. • Increasing the number and altering location of first-class hospitals may protect people with hypertension. [ABSTRACT FROM AUTHOR]

Considering the serious health burden caused by adverse weather events, increasing researches focused on the relationship between temperature variability (TV) and cause-specific mortality, but its association with cancer was not well explored. We aimed to investigate the impacts of TV on cancer mortality and examine the modifying effects of weather type and geographical location as well as other characteristics. Daily city-specific data of cancer deaths, mean temperature (Tmean), maximum and minimum temperatures (Tmax and Tmin), relative humidity (RH), rainfall, and air pollutants were collected during 2016–2017 in 13 cities in Jiangsu Province, China. TV 0-t was defined as the standard deviation of the daily Tmax and Tmin on the exposure 0-t days. A two-stage analysis was applied. First, a time-stratified case-crossover design was used to examine the odds ratio (OR) and attributable fraction of cancer mortality per 1 °C increase in TV by adjusting for potential confounders. Random effect meta-analysis was used to summarize the pooled ORs. Second, stratified analysis was performed for weather type, geographical location, demographics, and other city-level characteristics. The weather was defined as four types according to days during warm or cold season combined with high or low RH. A total of 303670 cases were included in our study. Meta-analysis showed that the ORs of cancer mortality per 1 °C increase in TV 0-t significantly increased and peaked in TV 0-2 (OR=1.0098, 95% CI: 1.0039–1.0157). The attributable fraction of TV 0-2 on cancer mortality was 4.74%, accounting for 14395 deaths in the study period. Significant ORs of TV-related cancer mortality were found during the warm season combined with high RH and in the northern region of Jiangsu. Susceptible groups of TV-related cancer mortality were identified as female patients, patients aged 45–65 years, and those living in cities with lower per capita green area. TV can significantly increase the risk of cancer mortality, especially during warm and humid days and in the northern region of Jiangsu. Findings are of great significance to formulate urban planning, resource allocation, and health intervention to prolong the life of cancer patients. • Temperature variability (TV) significantly increased the risk of cancer mortality. • TV-related cancer deaths were higher on warm and humid days and northern region. • Females patients and patients aged 45–65 years were more susceptible to TV. • A high level of per capita green area decreased the impacts of TV on cancer death. [ABSTRACT FROM AUTHOR]

Studies have shown that ambient air pollution is associated with obesity in adults, but epidemiological evidence is scarce for children and adolescents. This study sought to examine the association between long-term exposure to ambient air pollution and obesity in a large population of children and adolescents in China. A cross-sectional analysis was performed from a school-based health lifestyles intervention project between September 1, 2019 and November 31, 2019, including 36,456 participants aged 9–17 years in Jiangsu province of China. Exposure to air pollutants (nitrogen dioxide (NO 2), ozone (O 3), particulate matter with aerodynamic diameters ≤10 μm (PM 10), and ≤2.5 μm (PM 2.5)) were measured based on the nearest air monitoring station for each selected school. Data on each participant's weight and height was also recorded. Demographic and obesity-related behavioral information was collected using a self-reported questionnaire. We used the multivariate regression model to estimate the effects of three-year (2016–2018) average concentrations and the exceedance concentration days (ECD) of air pollutants on obesity after adjusting potential confounders. The ECD was defined as daily concentration exceeding the Chinese National Ambient Air Quality Standard and World Health Organization Ambient Air Quality Guidelines. We observed that higher concentrations of PM 2.5 , NO 2 , and O 3 were associated with elevated likelihood of obesity. For each 10 μg/m3 increment in concentration, odds ratio of obesity was 1.185 (95% confidence interval (CI): 1.054, 1.333) for PM 2.5 , 1.127 (95%CI: 1.042, 1.219) for NO 2 , and 1.041 (95%CI: 1.001, 1.082) for O 3 , respectively. A significant association between the ECD and obesity was also found for PM 2.5 and O 3. Effects of air pollutants on obesity were stronger in males, low economic level regions, and age subgroups of 9–11 and 15–17 years. Our findings suggest that long-term exposures to PM 2.5 , NO 2 , and O 3 were associated with higher prevalence of obesity in children and adolescents. Continuous efforts to reduce air pollution level could help ease the increasing prevalence of obesity within a region. • We examine the impact of ambient air pollutants on obesity in Chinese children and adolescents. • Exposure to PM 2.5 , NO 2 , and O 3 is positively associated with obesity, and PM 2.5 has the largest effect. • Associations are more apparent in males, low economic level regions, and different age subgroups. [ABSTRACT FROM AUTHOR]