Statistical Modeling of Health Effects on Climate-Sensitive Variables and Assessment of Environmental Burden of Diseases Attributable to Climate Change in Nepal

An ecological time-series study is conducted to quantify health-effect coefficients associated with climate-sensitive variables namely temperature, rainfall, relative humidity, and wind speed and estimate environmental burden of diseases attributed to temperature as the main climatic variable together with climate change in Nepal. The study is based upon daily data of climate-sensitive variables and hospitalizations collected for 5 years between 2009 and 2014. Generalized linear model is used to estimate health-effect coefficients accounting distributed lag effects. Results show 3.08%, 10.14%, and 3.27% rise in water-borne, vector-borne, and renal disease hospitalizations, respectively, and 3.67% rise in water- and vector-borne disease deaths per 1 degrees C rise in average temperature. Similarly, 2.45% and 1.44% rise in heart disease hospitalization and all-cause mortality, respectively per 1 degrees C rise in absolute difference of average temperature with its overall average (20 degrees C). The computed attributable fractions are 0.3759, 0.6696, 0.2909, and 0.1024 for water-borne, vector-borne, renal, and heart disease hospitalizations, respectively, and 0.0607 and 0.4335 for all-cause mortality and disease-specific mortality of water- and vector-borne diseases, respectively. The percent change in attributable burdens due to climate change are found to be 4.32%, 4.64%, 7.20%, and -2.29% for water-borne, vector-borne, renal, and heart disease hospitalizations, respectively, and -1.39% and 6.55% for all-cause deaths and water-borne and vector-borne disease deaths, respectively. In conclusion, climate-sensitive variables have significant effects on many major health burdens in Nepal. In the context of changing climatic scenarios around the world including that of Nepal, such changes are bound to affect the health burden of Nepalese people.