Association between cold spells and chronic lung disease: a nationwide spatial machine learning analysis
1Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Frontiers in Medicine
|May 29, 2026
Summary
Cold spells are linked to a slightly higher risk of developing chronic lung disease (CLD) in older Chinese adults. Northern China is a high-risk area, but air pollution and location are stronger predictors of CLD spatial patterns.
Area of Science:
- Environmental Epidemiology
- Public Health
- Respiratory Medicine
Background:
- Chronic lung disease (CLD) poses a significant health burden.
- Understanding environmental risk factors for CLD is crucial for prevention.
- Cold spells represent a potential, understudied environmental exposure.
Purpose of the Study:
- To examine the longitudinal association between cold spells and incident CLD risk in Chinese adults.
- To map the spatial distribution of CLD risk in relation to cold spells.
- To identify key factors contributing to the spatial patterns of CLD.
Main Methods:
- Utilized data from the China Health and Retirement Longitudinal Study (2011-2020).
- Employed Cox proportional hazards models and logistic regression to assess cold spell impact.
- Applied Geographically Weighted Regression (GWR) and GeoShapley decomposition for spatial analysis.
Main Results:
- Baseline cold spell exposure showed a modest, positive association with incident CLD (HRs 1.10-1.13).
- Northern China emerged as a consistent high-risk region for CLD across various cold spell definitions.
- Air pollutants and geographic coordinates were stronger predictors of spatial CLD risk than cold spells.
Conclusions:
- Cold spells are associated with a modestly increased risk of incident CLD in older Chinese adults.
- While not the dominant spatial factor, cold spells may act as an environmental trigger for CLD.
- Regional factors like air pollution significantly influence the spatial distribution of CLD.
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