Association between ambient temperature and chronic obstructive pulmonary disease: a population-based study of the years of life lost

Limited evidence on the burden of chronic obstructive pulmonary disease (COPD) attributable to ambient temperature. We aim to explore the association between ambient temperature and years of life lost (YLL), and to get a more intuitive understanding of the dangers of COPD in China. Death and meteorological data of 31 Chinese provincial capital cities during 2008-2013 was analyzed in this study. Distributed Lag Non-linear Model (DLNM) was used to estimate the association between ambient temperature and mortality. The attributable fraction (AF) to cold effect ranged from 8.19 (95%CI: -8.52,19.38) to 28.98 (95%CI: -64.78,67.59), while the AF to heat effect varied from 0.02 (95%CI: -0.13,0.05) to 5.73 (95%CI: 0.31,10.22). Cold effect was higher than heat effect on COPD in women and elderly, heat effect was higher in men and younger. Low temperature can cause more serious disease burden of COPD than high temperature.