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Pneumonia and chronic obstructive pulmonary diseases (COPD) are the commonest causes of respiratory hospitalization among older adults. Both diseases have been reported to be associated with ambient temperature, but the associations have not been compared between the diseases. Their associations with other meteorological variables have also not been well studied. This study aimed to evaluate the associations between meteorological variables, pneumonia, and COPD hospitalization among adults over 60 and to compare these associations between the diseases. Daily cause-specific hospitalization counts in Hong Kong during 2004-2011 were regressed on daily meteorological variables using distributed lag nonlinear models. Associations were compared between diseases by ratio of relative risks. Analyses were stratified by season and age group (60-74 vs. ≥ 75). In hot season, high temperature (> 28 °C) and high relative humidity (> 82%) were statistically significantly associated with more pneumonia in lagged 0-2 and lagged 0-10 days, respectively. Pneumonia hospitalizations among the elderly (≥ 75) also increased with high solar radiation and high wind speed. During the cold season, consistent hockey-stick associations with temperature and relative humidity were found for both admissions and both age groups. The minimum morbidity temperature and relative humidity were at about 21-22 °C and 82%. The lagged effects of low temperature were comparable for both diseases (lagged 0-20 days). The low-temperature-admissions associations with COPD were stronger and were strongest among the elderly. This study found elevated pneumonia and COPD admissions risks among adults ≥ 60 during periods of extreme weather conditions, and the associations varied by season and age group. Vulnerable groups should be advised to avoid exposures, such as staying indoor and maintaining satisfactory indoor conditions, to minimize risks.

Original publication




Journal article


Int J Biometeorol

Publication Date





1447 - 1460


Ambient temperature, COPD, Meteorological factors, Pneumonia, The elderly, Time series, Aged, Air Pollution, Hong Kong, Hospitalization, Humans, Middle Aged, Pneumonia, Pulmonary Disease, Chronic Obstructive, Seasons, Weather