Imperial College London

Dr Frédéric B. Piel

Faculty of MedicineSchool of Public Health

Senior Lecturer



+44 (0)20 7594 3346f.piel




Praed StreetSt Mary's Campus






BibTex format

author = {Piel, FB and Tewari, S and Brousse, V and Analitis, A and Font, A and Menzel, S and Chakravorty, S and Thein, SL and Inusa, B and Telfer, P and de, Montalembert M and Fuller, GW and Katsouyanni, K and Rees, DC},
doi = {10.3324/haematol.2016.154245},
journal = {Haematologica - the Hematology Journal},
pages = {666--675},
title = {Associations between environmental factors and hospital admissions for sickle cell disease},
url = {},
volume = {102},
year = {2016}

RIS format (EndNote, RefMan)

AB - Sickle cell disease (SCD) is an increasing global health burden. This inherited disease is characterised by a remarkable phenotypic heterogeneity, which can only partly be explained by genetic factors. Environmental factors are likely to play an important role but studies of their impact on disease severity are limited and their results are often inconsistent. This study investigated associations between a range of environmental factors and hospital admissions of young patients with SCD in London and in Paris between 2008 and 2012. Specific analyses were conducted for sub-groups of patients with different genotypes and for the main reasons of admissions. Generalized additive models and distributed lag non-linear models were used to assess the magnitude of the associations and to calculate relative risks. Some environmental factors significantly influence the numbers of hospital admissions of children with SCD, although the associations identified are complicated. Our study suggests that meteorological factors are more likely to be associated with hospital admissions for SCD than air pollutants. It confirms previous reports of risks associated with wind speed (RR: 1.06/SD [95% confidence interval (CI): 1.00-1.12]) and also with rainfall (RR: 1.06/SD [95%CI: 1.01-1.12]). Maximum atmospheric pressure was found to be a protective factor (RR: 0.93/SD [95%CI: 0.88-0.99]). Weak or no associations were found with temperature. Divergent associations were identified for different genotypes or reasons of admissions, which could partly explain the lack of consistency in earlier studies. Advice to patients with SCD usually includes avoiding a range of environmental conditions that are believed to trigger acute complications, including extreme temperatures and high altitudes. Scientific evidence to support such advice is limited and sometimes confusing. This study shows that environmental factors do explain some of the variations in rates of admission to hospital with acute sympt
AU - Piel,FB
AU - Tewari,S
AU - Brousse,V
AU - Analitis,A
AU - Font,A
AU - Menzel,S
AU - Chakravorty,S
AU - Thein,SL
AU - Inusa,B
AU - Telfer,P
AU - de,Montalembert M
AU - Fuller,GW
AU - Katsouyanni,K
AU - Rees,DC
DO - 10.3324/haematol.2016.154245
EP - 675
PY - 2016///
SN - 0390-6078
SP - 666
TI - Associations between environmental factors and hospital admissions for sickle cell disease
T2 - Haematologica - the Hematology Journal
UR -
UR -
UR -
VL - 102
ER -