Impacts of weather and climate on mortality and self-harm in Finland

Human beings are able to adapt to their climatic normal conditions, but weather extremes may pose a substantial health risks. The aims of this dissertation were to model the dependence of all-cause mortality on thermal conditions in Finland, and to assess changes in the relationship over the decades and regional differences in the relationships between hospital districts. Another aim was to assess impacts of weather and climate on committed and attempted suicides Finland. Various methods were applied in these studies. Time series of all-cause mortality in three age groups in Helsinki-Uusimaa hospital district were made stationary, and thus the weather impacts were comparable over the 43-year long time period regardless of changes in population and life-expectancy. The increase in relative mortality due to hot extreme was more than due to cold extreme, when compared to seasonally varying expected mortality. However, a decrease in relative mortality in extreme temperatures over the decades was found in all age-groups, even among the 75 years and older, indicating decreased sensitivity to thermal stress in the population. Regional differences in temperature‒mortality relationships between 21 hospital districts were studied using distributed lag non-linear models (DLNM), and the differences were assessed by meta-regression with selected climatic and sociodemographic covariates. Regional differences in the relationships were not statistically significant indicating that the same temperature-mortality relationship can be applied in different parts of the country. On the other hand, the meta-regression suggested that the morbidity indices and population in the hospital districts could explain part of the small heterogeneity in the temperature‒mortality relationships. The study on committed suicides on the basis of 33-year long time series showed a significant negative association between suicides and solar radiation in the period from November to March, thus, a lack of solar radiation would increase suicide risk in winter. Men appeared to be more sensitive to variation in solar radiation than women. The study on weather dependence of attempted suicides in Helsinki on the basis of two shorter periods showed another difference between genders. The risk of suicide attempts of men increased with decreasing atmospheric pressure, while the risk of suicide attempts of women increased with increasing pressure. The outcomes of this thesis can be utilized e.g. in preparedness to weather extremes in health sector and in further studies on impacts of climate change on human health.Ihmiset sopeutuvat ilmastonsa tyypillisiin olosuhteisiin, mutta äärevät säätilanteet voivat aiheuttaa merkittäviä terveysriskejä. Tämän väitöstyön tavoitteena oli mallittaa kuolleisuuden riippuvuutta lämpöolosuhteista Suomessa ja arvioida siinä tapahtuneita muutoksia vuosikymmenien kuluessa sekä selvittää mahdollisia alueellisia eroja sairaanhoitopiireittäin. Lisäksi tavoitteena oli arvioida sään ja ilmaston vaikutuksia itsemurhiin Suomessa ja itsemurhayrityksiin Helsingissä. Tutkimuksissa sovellettiin useita erilaisia menetelmiä. Helsingin ja Uudenmaan sairaanhoitopiirin kuolleisuuden 43 vuoden mittaiset aikasarjat kolmessa ikäryhmässä muunnettiin stationaarisiksi, jolloin lämpötilan vaikutukset kuolleisuuteen olivat vertailukelpoisia väkiluvussa ja eliniässä tapahtuneista muutoksista huolimatta. Kun kuolleisuusriskiä verrattiin vuodenajan odotusarvioihin, kuumuuden aiheuttama kuolleisuuden nousu oli suurempi kuin kylmyyden. Kuolleisuusriski äärilämpötiloissa on kuitenkin alentunut vuosikymmenien aikana kaikissa ikäryhmissä ‒ jopa yli 75-vuotiaiden keskuudessa, mikä viittaa siihen, että väestön herkkyys äärilämpötiloille on pienentynyt. Kuolleisuuden lämpötilariippuvuuden eroja 21 sairaanhoitopiirin välillä tutkittiin käyttäen viiveellisiä epälineaarisia malleja (DLNM), ja eroja arvioitiin meta-regression avulla käyttäen kovariaatteina valittuja ilmastollisia ja sosiodemografisia tekijöitä. Tutkimuksen mukaan alueelliset erot eivät olleet tilastollisesti merkitseviä, joten samaa kuolleisuuden lämpötilariippuvuutta voidaan käyttää eri puolilla Suomea. Toisaalta meta-regressio antoi viitteitä siitä, että sairaanhoitopiirien sairastavuusindeksit ja väestömäärät voivat selittää pientä heterogeenisyyttä kuolleisuuden lämpötilariippuvuudessa. Tarkasteltaessa 33 vuoden ajanjaksoa Suomessa toteutuneiden itsemurhien ja globaalisäteilyn välillä oli negatiivinen korrelaatio marras-maaliskuun välisellä jaksolla, eli auringonvalon vähäisyys lisäisi itsemurhien riskiä. Miehet olivat herkempiä auringonsäteilyn vaihtelulle kuin naiset. Tutkimus Helsingin itsemurhayritysten sääriippuvuudesta kahdella lyhemmällä jaksolla toi esiin toisen sukupuolten välisen eron. Miesten itsemurhayritysten riski kasvoi matalapaineen vallitessa, kun naisten itsemurha-yritysten riski kasvoi ilmanpaineen myötä. Näitä tutkimustuloksia voidaan hyödyntää muun muassa terveydenhuollon varautumisessa sään ääri-ilmiöihin ja tutkimuksissa ilmastonmuutoksen vaikutuksista ihmisten terveyteen

Climate change and mental health

There is a gap in the knowledge concerning the long-term and gradual impacts of climate change on mental health. This discussion paper summarises the expected impacts of the ongoing climate change on mental health in Finland. This discussion paper is intended to open the discussion concerning mental health on the actions and concrete measures we need for mitigation and adaptation to the ongoing climate change in Finland. It provides nine science-based recommendations for implementation in the integrated services for social affairs and health in Finland

Seasonal Variation in Generic and Disease-Specific Health-Related Quality of Life in Rhinologic Patients in Southern Finland

Background: Seasonal variation in exacerbations, hospitalisations, and mortality statistics has been reported for some diseases. To our knowledge, however, no published studies exist on the seasonality of health-related quality of life (HRQoL) amongst rhinologic patients. Aims/Objectives: This study, therefore, aimed to investigate the possible seasonal variation in rhinologic patients’ HRQoL using the rhinologic disease-specific Sino-Nasal Outcome Test-22 (SNOT-22) and the generic 15D HRQoL instrument. Material and Methods: We enrolled unselected adult rhinologic patients requiring specialist care at the Helsinki University Hospital in this cross-sectional, questionnaire-based prospective study during four seasons: February (winter), May (spring), August (summer), and November (autumn). Patients received SNOT-22 and 15D questionnaires via post. The Finnish Meteorological Institute supplied climate data from these months. Results: SNOT-22 and 15D data were available for 301 and 298 patients, respectively. We found no statistically significant differences (p = 0.948) between the mean monthly 15D scores or mean SNOT-22 scales. Furthermore, the mean SNOT-22 subscales did not differ between the monthly study periods. Conclusions and Significance: Our study shows that seasonality did not impact rhinologic patients’ SNOT-22 or 15D HRQoL scores. Thus, these questionnaires can be used for follow-up amongst rhinologic patients regardless of season

Seasonal Variation in Generic and Disease-Specific Health-Related Quality of Life in Rhinologic Patients in Southern Finland

Background: Seasonal variation in exacerbations, hospitalisations, and mortality statistics has been reported for some diseases. To our knowledge, however, no published studies exist on the seasonality of health-related quality of life (HRQoL) amongst rhinologic patients. Aims/Objectives: This study, therefore, aimed to investigate the possible seasonal variation in rhinologic patients’ HRQoL using the rhinologic disease-specific Sino-Nasal Outcome Test-22 (SNOT-22) and the generic 15D HRQoL instrument. Material and Methods: We enrolled unselected adult rhinologic patients requiring specialist care at the Helsinki University Hospital in this cross-sectional, questionnaire-based prospective study during four seasons: February (winter), May (spring), August (summer), and November (autumn). Patients received SNOT-22 and 15D questionnaires via post. The Finnish Meteorological Institute supplied climate data from these months. Results: SNOT-22 and 15D data were available for 301 and 298 patients, respectively. We found no statistically significant differences (p = 0.948) between the mean monthly 15D scores or mean SNOT-22 scales. Furthermore, the mean SNOT-22 subscales did not differ between the monthly study periods. Conclusions and Significance: Our study shows that seasonality did not impact rhinologic patients’ SNOT-22 or 15D HRQoL scores. Thus, these questionnaires can be used for follow-up amongst rhinologic patients regardless of season

Climatic exposures in childhood and the risk of schizophrenia from childhood to early adulthood

Background: Season of birth is a risk factor of schizophrenia, and it is possible that cumulative exposure to cli-matic factors during childhood affects the risk of schizophrenia. We conducted a cohort study among 365,482 persons born in Finland in 1990-1995 to examine associations of 10-year cumulative exposure to global solar radiation and ambient temperature in childhood with schizophrenia. Methods: Data on schizophrenia diagnoses and sociodemographic factors from the Finnish population register and health care register were linked to daily meteorological data using residential information. The study population was followed from age 10 until the first schizophrenia diagnosis, death, emigration or December 31, 2017, whichever came first. Hazard ratios (HR) for the risk of schizophrenia were estimated using Cox pro-portional hazards model.Results: Compared to the lowest quintile of global solar radiation or ambient temperature, growing up in the second highest quintile (Q4) was associated with greater risk of schizophrenia. These hazard ratios were attenuated after adjustment for parental mental disorder, parental education, parental income, area-level so-cioeconomic characteristics and urbanicity (HR = 1.29, 95 % CI 1.06-1.58 for radiation; HR = 1.24, 95 % CI, 1.02-1.52 for temperature). Continuous linear terms evaluated in secondary models suggested a greater risk of schizophrenia at greater childhood exposure to global radiation and ambient temperature, but these associations did not remain in fully adjusted models.Conclusions: We found no consistent evidence that cumulative exposure to sunlight and ambient temperature in childhood is associated with the risk of developing schizophrenia. Studies in other populations residing in different latitudes are needed.Peer reviewe

Impact of Selected Meteorological Factors on COVID-19 Incidence in Southern Finland during 2020-2021

We modelled the impact of selected meteorological factors on the daily number of new cases of the coronavirus disease 2019 (COVID-19) at the Hospital District of Helsinki and Uusimaa in southern Finland from August 2020 until May 2021. We applied a DLNM (distributed lag non-linear model) with and without various environmental and non-environmental confounding factors. The relationship between the daily mean temperature or absolute humidity and COVID-19 morbidity shows a non-linear dependency, with increased incidence of COVID-19 at low temperatures between 0 to -10 degrees C or at low absolute humidity (AH) values below 6 g/m3. However, the outcomes need to be interpreted with caution, because the associations found may be valid only for the study period in 2020-2021. Longer study periods are needed to investigate whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a seasonal pattern similar such as influenza and other viral respiratory infections. The influence of other non-environmental factors such as various mitigation measures are important to consider in future studies. Knowledge about associations between meteorological factors and COVID-19 can be useful information for policy makers and the education and health sector to predict and prepare for epidemic waves in the coming winters.</p

Associations of long-term solar insolation with specific depressive symptoms : Evidence from a prospective cohort study

Publisher Copyright: © 2022 The AuthorsEvidence suggests that sunlight counteracts depression, but the associations of long-term sunlight exposure with specific symptoms of depression are not well known. We evaluated symptom-specific associations of average 1-year solar insolation with DSM-5 depressive symptoms in a representative cohort of Finnish adults. The sample included 1,845 participants from the Cardiovascular Risk in Young Finns Study with data on DSM-5 depressive symptoms, place of residence and covariates. Daily recordings of global solar radiation were obtained from the Finnish Meteorological Institute. Each participant's residential zip code on each day one year prior to the assessment of depressive symptoms was linked to the solar radiation data, and 1-year average daily solar insolation was calculated. Associations of the average 1-year solar insolation with depressive symptoms were assessed with linear and logistic regression analyses adjusting for season, sex, age, as well as individual- and neighborhood-level socioeconomic characteristics. Average daily solar insolation over one year prior to the depressive symptom assessment was not associated with the total number of depressive symptoms reported by participants. In symptom-specific analyses, participants exposed to higher levels of solar insolation in their residential neighborhood were less likely to report suicidal thought (OR = 0.61, 95% CI, 0.39–0.94), and more likely to report changes in appetite (OR = 1.24, 95% CI, 1.00–1.54), changes in sleep (OR = 1.30, 95% CI, 1.06–1.59) and feelings of worthlessness/guilt (OR = 1.33, 95% CI = 1.07–1.65). These findings suggest that solar insolation may contribute to symptom-specific differences in depression. Studies in other populations residing in different geographical locations are needed.Peer reviewe