Association between Cold Spells and Mortality Risk and Burden: A Nationwide Study in China

Few multicity studies have evaluated the association between cold spells and mortality risk and burden.We aimed to estimate the association between cold spells and cause-specific mortality and to evaluate the mortality burden in China.We conducted a time-series analysis with a nationally representative Disease Surveillance Points System database during the cool seasons spanning from 2013 to 2015 in 272 Chinese cities. We used 12 cold-spell definitions and overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative association of cold spells over lags of 0-28 d. We controlled for the nonlinear and lagged effects of cold temperature over 0-28 d to evaluate the added effect estimates of cold spell. We also quantified the nationwide mortality burden and pooled the estimated association at national and different climatic levels with meta-regression models.For the cold-spell definition of daily mean temperatures ofOur study provides evidence for the significant relative risks of non-accidental, cardiovascular, and respiratory mortality associated with cold spells. The findings on vulnerable populations and differential risks in different climatic zones may help establish region-specific forecasting systems against the hazardous impact of cold spells. https://doi.org/10.1289/EHP9284.