The Effects of Intra‐Day Temperature Variability on Cause‐Specific Mortality: A Time‐Stratified Case‐Crossover Study in Chongqing, China
6 affiliations
- 1School of Public Health and Emergency Management School of Medicine Southern University of Science and Technology Shenzhen China.
- 2School of Public Health Nanjing Medical University Nanjing China.
- 3Center for Disease Control and Prevention of Jiulongpo District Chongqing China.
- 4Department of Clinical Epidemiology and Biostatistics Children's Hospital of Chongqing Medical University National Clinical Research Center for Children and Adolescents' Health and Diseases Ministry of Education Key Laboratory of Child Development and Disorders Chongqing Municipal Health Commission Key Laboratory of Children's Vital Organ Development and Diseases Chongqing China.
- 5SUSTech Homeostatic Medicine Institute School of Medicine Southern University of Science and Technology Shenzhen China.
- 6School of Environmental Science and Engineering Southern University of Science and Technology Shenzhen China.
Abstract
Although temperature variability (TV) has been linked to an increased mortality risk, the independent effect of intra-day TV remains insufficiently understood. This study aimed to examine the association between intra-day TV exposure and cause-specific mortality in a Chinese population. We collected daily mortality data and meteorological variables from 2016 to 2022 in Jiulongpo District, Chongqing, China. A time-stratified case-crossover design combined with a conditional logistic regression model was used to assess the association between TV exposure and the risk of cause-specific mortality. A natural spline function was used to derive the exposure-response (E-R) relationship between intra-day TV and the percentage change in mortality risk. We recorded 47,189 all-cause mortality cases, including 19,152 cardiovascular deaths and 8126 respiratory deaths. Overall, there was a positive association between intra-day TV and mortality. Specifically, each 1°C increase in intra-day TV₀₋₇ was associated with an increased risk of 5.20% (95% CI: 3.87%, 6.54%) for all-cause mortality, 6.20% (95% CI: 4.14%, 8.31%) for cardiovascular mortality, and 9.24% (95% CI: 5.98%, 12.60%) for respiratory mortality. The E-R curves for cardiovascular mortality were approximately linear, whereas all-cause mortality at TV₀₋₁ to TV₀₋₅ and respiratory mortality at all lag windows exhibited nonlinear curves. The respiratory mortality curve rose steeply at lower TV levels and plateaued thereafter at higher levels. Intra-day TV was positively associated with all-causes, cardiovascular, and respiratory mortality, with the strongest association observed for respiratory mortality. Incorporating intra-day TV into early warning systems may help reduce the mortality burden.
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BibTeX
@article{yin2026effects,
title = {{The Effects of Intra‐Day Temperature Variability on Cause‐Specific Mortality: A Time‐Stratified Case‐Crossover Study in Chongqing, China}},
author = {Zhouxin Yin and Yu Lan and Cheng Tang and Wenjie Li and Xizhou An and Chunlan Qiu and Xiaohua Liang and Fengchao Liang},
journal = {GeoHealth},
year = {2026},
month = nov,
doi = {10.1029/2026gh002088},
url = {https://europepmc.org/article/PMC/PMC13725840},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - The Effects of Intra‐Day Temperature Variability on Cause‐Specific Mortality: A Time‐Stratified Case‐Crossover Study in Chongqing, China
AU - Zhouxin Yin
AU - Yu Lan
AU - Cheng Tang
AU - Wenjie Li
AU - Xizhou An
AU - Chunlan Qiu
AU - Xiaohua Liang
AU - Fengchao Liang
PY - 2026
DA - 2026/11/01
JO - GeoHealth
DO - 10.1029/2026gh002088
UR - https://europepmc.org/article/PMC/PMC13725840
AB - Although temperature variability (TV) has been linked to an increased mortality risk, the independent effect of intra-day TV remains insufficiently understood. This study aimed to examine the association between intra-day TV exposure and cause-specific mortality in a Chinese population. We collected daily mortality data and meteorological variables from 2016 to 2022 in Jiulongpo District, Chongqing, China. A time-stratified case-crossover design combined with a conditional logistic regression model was used to assess the association between TV exposure and the risk of cause-specific mortality. A natural spline function was used to derive the exposure-response (E-R) relationship between intra-day TV and the percentage change in mortality risk. We recorded 47,189 all-cause mortality cases, including 19,152 cardiovascular deaths and 8126 respiratory deaths. Overall, there was a positive association between intra-day TV and mortality. Specifically, each 1°C increase in intra-day TV₀₋₇ was associated with an increased risk of 5.20% (95% CI: 3.87%, 6.54%) for all-cause mortality, 6.20% (95% CI: 4.14%, 8.31%) for cardiovascular mortality, and 9.24% (95% CI: 5.98%, 12.60%) for respiratory mortality. The E-R curves for cardiovascular mortality were approximately linear, whereas all-cause mortality at TV₀₋₁ to TV₀₋₅ and respiratory mortality at all lag windows exhibited nonlinear curves. The respiratory mortality curve rose steeply at lower TV levels and plateaued thereafter at higher levels. Intra-day TV was positively associated with all-causes, cardiovascular, and respiratory mortality, with the strongest association observed for respiratory mortality. Incorporating intra-day TV into early warning systems may help reduce the mortality burden.
SN - 2471-1403
ER -