@article{ref1,
title="COVID-19 pandemic modifies temperature and heat-related illness ambulance transport association in Japan: a nationwide observational study",
journal="Environmental health",
year="2021",
author="Seposo, Xerxes and Madaniyazi, Lina and Ng, Chris Fook Sheng and Hashizume, Masahiro and Honda, Yasushi",
volume="20",
number="1",
pages="e122-e122",
abstract="BACKGROUND: During the COVID-19 pandemic, several illnesses were reduced. In Japan, heat-related illnesses were reduced by 22% compared to pre-pandemic period. However, it is uncertain as to what has led to this reduction. Here, we model the association of maximum temperature and heat-related illnesses in the 47 Japanese prefectures. We specifically examined how the exposure and lag associations varied before and during the pandemic. <br><br>METHODS: We obtained the summer-specific, daily heat-related illness ambulance transport (HIAT), exposure variable (maximum temperature) and covariate data from relevant data sources. We utilized a stratified (pre-pandemic and pandemic), two-stage approach. In each stratified group, we estimated the 1) prefecture-level association using a quasi-Poisson regression coupled with a distributed lag non-linear model, which was 2) pooled using a random-effects meta-analysis. The difference between pooled pre-pandemic and pandemic associations was examined across the exposure and the lag dimensions. <br><br>RESULTS: A total of 321,655 HIAT cases was recorded in Japan from 2016 to 2020. We found an overall reduction of heat-related risks for HIAT during the pandemic, with a wide range of reduction (10.85 to 57.47%) in the HIAT risk, across exposure levels ranging from 21.69 °C to 36.31 °C. On the contrary, we found an increment in the delayed heat-related risks during the pandemic at Lag 2 (16.33%; 95% CI: 1.00, 33.98%). <br><br>CONCLUSION: This study provides evidence of the impact of COVID-19, particularly on the possible roles of physical interventions and behavioral changes, in modifying the temperature-health association. These findings would have implications on subsequent policies or heat-related warning strategies in light of ongoing or future pandemics.<p /> <p>Language: en</p>",
language="en",
issn="1476-069X",
doi="10.1186/s12940-021-00808-w",
url="http://dx.doi.org/10.1186/s12940-021-00808-w"
}