Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis

•The effect of DTR on daily mortality was estimated in a high plateau city with a large DTR in China.•A time-series analysis with 7 years of daily mortality data was used to assess the effect of DTR.•The effect of DTR on mortality was non-linear, with J- or U-shaped curves.•Relative risk assessments showed strong monotonic increases starting at DTR 16 °C.•Males and people < 75 years old were more susceptible to extreme high DTR than females and older people.

BackgroundDiurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007–2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China.MethodsPoisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for daily mean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends.ResultsThe cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 °C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0–21 days was 1.03 (95% confidence interval: 0.95–1.11) and 1.33 (0.94–1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age < 75 years than females and age ≥ 75 years.ConclusionsThe effect of DTR on mortality was non-linear, with high DTR associated with increased mortality. A DTR of 16 °C may be a cut-off point for mortality prognosis and has implications for developing intervention strategies to address high DTR exposure.