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Background: Few studies have been conducted to investigate the impact of extreme cold events on mortality in subtropical regions.
The 2008 cold spell increased mortality in subtropical China, which was mainly attributable to the low temperature rather than the sustained duration of the cold spell.
To our knowledge, this is the first multi-community study to investigate effects of the 2008 cold spell on mortality in subtropical China.
The 2008 cold spell significantly increased mortality in subtropical China, which was mainly explained by independent effects of low temperature rather than consecutive days of cold periods.
Firstly, these published studies only focused on a single city or province, which prevents an estimate of the total effect of this extreme cold spell on mortality in subtropical China [ 10].
This study aimed to estimate the effects of the 2008 cold spell on mortality in subtropical regions of China, spatial heterogeneity of the effects, stratification effect and added effects caused by sustained cold days.
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We assessed whether temperature change had an adverse impact on mortality in different subtropical climates and in different locations.
The 2008 cold spell was associated with an increase in daily mortality in three subtropical cities of Guangdong Province, China.
Our results confirmed that cold and hot temperatures were associated with increased risk of mortality in the subtropical city of Guangzhou, China.
To our knowledge, the present study is unique in estimating the short-term effects of a cold spell on mortality in multiple subtropical cities in China using distributed lag models.
In Hong Kong and Guangzhou (both relatively developed populations with gross domestic product per capita 7 and 3 times higher than that of Thailand), estimates were 11.1 and 10.6 per 100,000 population, respectively (4); another study estimated influenza-associated mortality in 5 subtropical Chinese cities to be 11.3 per 100,000 (27).
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