University of Oulu

Tiina M. Ikäheimo, Jari Jokelainen, Simo Näyhä, Tiina Laatikainen, Pekka Jousilahti, Jari Laukkanen, Jouni J.K. Jaakkola, Cold weather-related cardiorespiratory symptoms predict higher morbidity and mortality, Environmental Research, Volume 191, 2020, 110108, ISSN 0013-9351,

Cold weather-related cardiorespiratory symptoms predict higher morbidity and mortality

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Author: Ikäheimo, Tiina M.1,2; Jokelainen, Jari3,4; Näyhä, Simo1;
Organizations: 1Center for Environmental and Respiratory Health Research, University of Oulu, FI-90014, Oulu, Finland
2Medical Research Center, University of Oulu, University Hospital of Oulu, Oulu, Finland
3Medical Faculty, P.O. Box 5000, University of Oulu, FI-90014, Oulu, Finland
4Unit of General Practice, Oulu University Hospital, FI-90029, Oulu, Finland
5Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), FI-00271, Helsinki, Finland
6Institute of Public Health and Clinical Nutrition, University of Eastern Finland, FI-70211, Kuopio, Finland
7Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), FI-80210, Joensuu, Finland
8Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Elsevier, 2020
Publish Date: 2020-12-18


Symptoms perceived in cold weather reflect physiological responses to body cooling and may worsen the course of a pre-existing disease or precipitate disease events in ostensibly healthy individuals. However, the associations between cold-related symptoms and their health effects have remained unknown. We examined whether cold-related cardiac and respiratory symptoms perceived in cold weather predict future morbidity and mortality. Methods: Cold-related symptoms were inquired in four national FINRISK surveys conducted in 1997, 2002, 2007, 2012 in Finland including altogether 17 040 respondents. A record linkage was made to national hospital discharge and cause-of-death registers. The participants were followed up until the first hospital admission due to a cardiovascular or respiratory disease or death, or until the end of 2015. The individual follow-up times ranged from 0 to 18 years (mean 11 years). The association of cold-related symptoms with morbidity and mortality was examined by Kaplan-Meyer and Cox-regression analyses. Results: Cold-related cardiac [hazard ratio (HR), 1.76 and its 95% confidence interval (95% CI), 1.44–2.15] and combined cardiac and respiratory symptoms [1.50 (1.29–1.73)] were associated with hospitalization due to cardiovascular causes. The respective HRs for admissions due to respiratory causes were elevated for cold-related respiratory [1.22 (1.07–1.40)], cardiac [1.24 (0.88–1.75)] and cardiorespiratory [1.82 (1.50–2.22)] symptoms. Cold-related cardiorespiratory symptoms were associated with deaths from all natural [1.38 (1.11–1.72)], cardiovascular [1.77 (1.28–2.44)] and respiratory [2.19 (0.95–5.06)] causes. Interpretation: Cold weather-related symptoms predict a higher occurrence of hospital admissions and mortality. The information may prove useful in planning measures to reduce cold-related adverse health effects.

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Series: Environmental research
ISSN: 0013-9351
ISSN-E: 1096-0953
ISSN-L: 0013-9351
Volume: 191
Article number: 110108
DOI: 10.1016/j.envres.2020.110108
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Copyright information: © 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (