1
|
Thapa S, Zaki SA. Investigation of indoor thermal comfort and energy demand in different locations along the sub-Himalayan belt - A simulation based study. J Therm Biol 2024; 120:103809. [PMID: 38364574 DOI: 10.1016/j.jtherbio.2024.103809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/18/2024]
Abstract
The sub-Himalayan region extends over 2500 km, extending over several countries. Though the effects of climate change is widely anticipated in the diverse but fragile ecosystem of the Himalayas, very less research has been conducted on the indoor environment of the buildings in these regions. In this study, a pre-validated model of 3-storey concrete residential building was used to study the indoor performance and thermal comfort in the face of climate change in the 8 (eight) different hill towns (hill stations) located from west to the east. Rise in ambient and indoor conditions were evident as a part of climate change with colder locations being affected the most. The thermal comfort assessment using both the climate chamber based PMV model and adaptive models revealed the decrease in cold related discomfort and increase in hot related discomfort. On an overall, the indoor conditions improved in these cold locations. The indoor and outdoor thermal condition and thermal comfort plummeted significantly with latitude and elevation. The heating demand in the future climate reduced by about 50-70 % in warmer locations, while the cooling demand increased by as much as 1000-2000 % in cold locations, respectively. Additionally, it was seen that the thermal environment and comfort both declined more rapidly with elevation in the locations lying in the western Himalayas as compared to those in the eastern Himalayas.
Collapse
Affiliation(s)
- Samar Thapa
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia (UTM), Jalan Sultan Yahya Petra, 54100 Kuala Lumpur, Malaysia; Land & Land Reforms and Refugee Relief & Rehabilitation Department, WB, India.
| | - Sheikh Ahmad Zaki
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia (UTM), Jalan Sultan Yahya Petra, 54100 Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Kapwata T, Abdelatif N, Scovronick N, Gebreslasie MT, Acquaotta F, Wright CY. Identifying heat thresholds for South Africa towards the development of a heat-health warning system. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:381-392. [PMID: 38157021 PMCID: PMC10794383 DOI: 10.1007/s00484-023-02596-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
Exposure to heatwaves may result in adverse human health impacts. Heat alerts in South Africa are currently based on defined temperature-fixed threshold values for large towns and cities. However, heat-health warning systems (HHWS) should incorporate metrics that have been shown to be effective predictors of negative heat-related health outcomes. This study contributes to the development of a HHWS for South Africa that can potentially minimize heat-related mortality. Distributed lag nonlinear models (DLNM) were used to assess the association between maximum and minimum temperature and diurnal temperature range (DTR) and population-adjusted mortality during summer months, and the effects were presented as incidence rate ratios (IRR). District-level thresholds for the best predictor from these three metrics were estimated with threshold regression. The mortality dataset contained records of daily registered deaths (n = 8,476,532) from 1997 to 2013 and data for the temperature indices were for the same period. Maximum temperature appeared to be the most statistically significant predictor of all-cause mortality with strong associations observed in 40 out of 52 districts. Maximum temperature was associated with increased risk of mortality in all but three of the districts. Our results also found that heat-related mortality was influenced by regional climate because the spatial distribution of the thresholds varied according to the climate zones across the country. On average, districts located in the hot, arid interior provinces of the Northern Cape and North West experienced some of the highest thresholds compared to districts located in temperate interior or coastal provinces. As the effects of climate change become more significant, population exposure to heat is increasing. Therefore, evidence-based HHWS are required to reduce heat-related mortality and morbidity. The exceedance of the maximum temperature thresholds provided in this study could be used to issue heat alerts as part of effective heat health action plans.
Collapse
Affiliation(s)
- Thandi Kapwata
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg, 2028, South Africa.
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa.
| | - Nada Abdelatif
- Biostatistics Research Unit, South African Medical Research Council, Durban, 4001, South Africa
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Michael T Gebreslasie
- School of Agriculture, Earth, and Environmental Sciences, University of KwaZulu-Natal, Durban, 3629, South Africa
| | | | - Caradee Y Wright
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, 0028, South Africa
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, 0084, South Africa
| |
Collapse
|
3
|
Murage P, Hajat S, Macintyre HL, Leonardi GS, Ratwatte P, Wehling H, Petrou G, Higlett M, Hands A, Kovats S. Indicators to support local public health to reduce the impacts of heat on health. ENVIRONMENT INTERNATIONAL 2024; 183:108391. [PMID: 38118211 DOI: 10.1016/j.envint.2023.108391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 12/22/2023]
Abstract
Heat exposure presents a significant weather-related health risk in England and Wales, and is associated with acute impacts on mortality and adverse effects on a range of clinical conditions, as well as increased healthcare costs. Most heat-related health outcomes are preventable with health protection measures such as behavioural changes, individual cooling actions, and strategies implemented at the landscape level or related to improved urban infrastructure. We review current limitations in reporting systems and propose ten indicators to monitor changes in heat exposures, vulnerabilities, heat-health outcomes, and progress on adaptation actions. These indicators can primarily inform local area decision-making in managing risks across multiple sectors such as public health, adult and social care, housing, urban planning, and education. The indicators can be used alongside information on other vulnerabilities relevant for heat and health such as underlying morbidity or housing characteristics, to prioritise the most effective adaptation actions for those who need it the most.
Collapse
Affiliation(s)
- Peninah Murage
- HPRU in Environmental Change and Health, London School of Hygiene and Tropical Medicine, United Kingdom.
| | - Shakoor Hajat
- HPRU in Environmental Change and Health, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | | | | | | | - Giorgos Petrou
- Institute of Environmental Design and Engineering, University College London (UCL), United Kingdom
| | | | - Angela Hands
- Office of Health Improvement and Disparities, United Kingdom
| | - Sari Kovats
- HPRU in Environmental Change and Health, London School of Hygiene and Tropical Medicine, United Kingdom
| |
Collapse
|
4
|
Tran HM, Lin YC, Tsai FJ, Lee KY, Chang JH, Chung CL, Chung KF, Chuang KJ, Chuang HC. Short-term mediating effects of PM 2.5 on climate-associated COPD severity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166523. [PMID: 37625725 DOI: 10.1016/j.scitotenv.2023.166523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023]
Abstract
The impact of short-term exposure to environmental factors such as temperature, relative humidity (RH), and fine particulate matter (PM2.5) on chronic obstructive pulmonary disease (COPD) remains unclear. The objective of this study is to investigate PM2.5 as a mediator in the relationship between short-term variations in RH and temperature and COPD severity. A cross-sectional study was conducted on 930 COPD patients in Taiwan from 2017 to 2022. Lung function, COPD Assessment Test (CAT) score, and modified Medical Research Council (mMRC) dyspnea scale were assessed. The mean and differences in 1-day, 7-day, and 30-day individual-level exposure to ambient RH, temperature, and PM2.5 were estimated. The associations between these factors and clinical outcomes were analyzed using linear regression models and generalized additive mixed models, adjusting for age, sex, smoking, and body mass index. In the total season, increases in RH difference were associated with increases in forced expiratory volume in 1 s (FEV1) / forced vital capacity (FVC), while increases in temperature difference were associated with decreases in FEV1 and FEV1/FVC. Increases in PM2.5 mean were associated with declines in FEV1. In the cold season, increases in temperature mean were associated with decreases in CAT and mMRC scores, while increases in PM2.5 mean were associated with declines in FEV1, FVC, and FEV1/FVC. In the warm season, increases in temperature difference were associated with decreases in FEV1 and FEV1/FVC, while increases in RH difference and PM2.5 mean were associated with decreases in CAT score. PM2.5 fully mediated the associations of temperature mean with FEV1/FVC in the cold season. In conclusion, PM2.5 mediates the effects of temperature and RH on clinical outcomes. Monitoring patients during low RH, extreme temperature, and high PM2.5 levels is crucial. Capsule of findings The significance of this study is that an increase in ambient RH and temperature, as well as PM2.5 exposure, were significantly associated with changes in lung function, and clinical symptoms in these patients. The novelty of this study is that PM2.5 plays a mediating role in the association of RH and temperature with COPD clinical outcomes in the short term.
Collapse
Affiliation(s)
- Huan Minh Tran
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan; Faculty of Public Health, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam.
| | - Yuan-Chien Lin
- Department of Civil Engineering, National Central University, Taoyuan City, Taiwan.
| | - Feng-Jen Tsai
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Jer-Hwa Chang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Chi-Li Chung
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Kian Fan Chung
- National Heart & Lung Institute, Imperial College London, UK.
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiao-Chi Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; National Heart & Lung Institute, Imperial College London, UK; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| |
Collapse
|
5
|
Arsenović D, Lužanin Z, Milošević D, Dunjić J, Nikitović V, Savić S. The effects of summer ambient temperature on total mortality in Serbia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1581-1589. [PMID: 37453990 DOI: 10.1007/s00484-023-02520-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 06/02/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
In the context of recent climate change, temperature-attributable mortality has become an important public health threat worldwide. A large number of studies in Europe have identified a relationship between temperature and mortality, while only a limited number of scholars provided evidence for Serbia. In order to provide more evidence for better management of health resources at the regional and local level, this study aims to assess the impact of summer temperature on the population in Serbia, using daily average temperature (Ta) and mortality (CDR (crude death rate) per 100,000). The analysis was done for five areas (Belgrade, Novi Sad, Niš, Loznica, and Vranje), covering the summer (June-August) period of 2001-2015. In order to quantify the Ta-related CDR, a generalized additive model (GAM) assuming a quasi-Poisson distribution with log as the link function was used. Five regression models were constructed, for each area, revealing a statistically significant positive relationship between Ta and CDR in four areas. The effect of Ta on CDR was defined as the relative risk (RR), which was obtained as the exponential regression coefficient of the models. RR indicates that a 1 °C increase in Ta at lag0 was associated with an increase in CDR of 1.7% for Belgrade, Novi Sad, and Niš and 2% for Loznica. The model for Vranje did not quantify a statistically significant increase in CDR due to Ta (RR=1.006, 95% CI 0.991-1.020). Similar results were confirmed for gender, with a slightly higher risk for women. Analysis across lag structure showed different exposure, but the highest effect of Ta mainly occurs over the short term and persists for 3 days.
Collapse
Affiliation(s)
- Daniela Arsenović
- Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, Novi Sad, 21000, Serbia.
| | - Zorana Lužanin
- Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, Novi Sad, 21000, Serbia
| | - Dragan Milošević
- Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, Novi Sad, 21000, Serbia
| | - Jelena Dunjić
- Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, Novi Sad, 21000, Serbia
| | - Vladimir Nikitović
- Institute of Social Sciences, Kraljice Natalije 45, Belgrade, 11000, Serbia
| | - Stevan Savić
- Faculty of Sciences, University of Novi Sad, Trg Dositeja Obradovića 3, Novi Sad, 21000, Serbia
| |
Collapse
|
6
|
Lo YTE, Mitchell DM, Buzan JR, Zscheischler J, Schneider R, Mistry MN, Kyselý J, Lavigne É, da Silva SP, Royé D, Urban A, Armstrong B, Gasparrini A, Vicedo‐Cabrera AM. Optimal heat stress metric for modelling heat-related mortality varies from country to country. INTERNATIONAL JOURNAL OF CLIMATOLOGY : A JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY 2023; 43:5553-5568. [PMID: 37874919 PMCID: PMC10410159 DOI: 10.1002/joc.8160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 10/26/2023]
Abstract
Combined heat and humidity is frequently described as the main driver of human heat-related mortality, more so than dry-bulb temperature alone. While based on physiological thinking, this assumption has not been robustly supported by epidemiological evidence. By performing the first systematic comparison of eight heat stress metrics (i.e., temperature combined with humidity and other climate variables) with warm-season mortality, in 604 locations over 39 countries, we find that the optimal metric for modelling mortality varies from country to country. Temperature metrics with no or little humidity modification associates best with mortality in ~40% of the studied countries. Apparent temperature (combined temperature, humidity and wind speed) dominates in another 40% of countries. There is no obvious climate grouping in these results. We recommend, where possible, that researchers use the optimal metric for each country. However, dry-bulb temperature performs similarly to humidity-based heat stress metrics in estimating heat-related mortality in present-day climate.
Collapse
Affiliation(s)
- Y. T. Eunice Lo
- School of Geographical SciencesUniversity of BristolBristolUK
- Cabot Institute for the EnvironmentUniversity of BristolBristolUK
| | - Dann M. Mitchell
- School of Geographical SciencesUniversity of BristolBristolUK
- Cabot Institute for the EnvironmentUniversity of BristolBristolUK
| | - Jonathan R. Buzan
- Climate and Environmental Physics, Physics InstituteUniversity of BernBernSwitzerland
- Oeschger Center for Climate Change ResearchUniversity of BernBernSwitzerland
| | - Jakob Zscheischler
- Department of Computational HydrosystemsHelmholtz Centre for Environmental Research GmbH—UFZLeipzigGermany
| | - Rochelle Schneider
- Ф‐LabEuropean Space Agency (ESA‐ESRIN)FrascatiItaly
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
- Centre on Climate Change & Planetary HealthLondon School of Hygiene and Tropical MedicineLondonUK
- Forecast DepartmentEuropean Centre for Medium‐Range Weather Forecast (ECMWF)ReadingUK
| | - Malcolm N. Mistry
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
- Department of EconomicsCa' Foscari University of VeniceVeniceItaly
| | - Jan Kyselý
- Institute of Atmospheric PhysicsCzech Academy of SciencesPragueCzech Republic
- Faculty of Environmental SciencesCzech University of Life SciencesPragueCzech Republic
| | - Éric Lavigne
- School of Epidemiology & Public Health, Faculty of MedicineUniversity of OttawaOttawaCanada
- Air Health Science DivisionHeatlh CanadaOttawaCanada
| | | | - Dominic Royé
- Climate Research Foundation (FIC)MadridSpain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP)Spain
| | - Aleš Urban
- Institute of Atmospheric PhysicsCzech Academy of SciencesPragueCzech Republic
- Faculty of Environmental SciencesCzech University of Life SciencesPragueCzech Republic
| | - Ben Armstrong
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | | | - Antonio Gasparrini
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
- Centre on Climate Change & Planetary HealthLondon School of Hygiene and Tropical MedicineLondonUK
- Centre for Statistical MethodologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Ana M. Vicedo‐Cabrera
- Oeschger Center for Climate Change ResearchUniversity of BernBernSwitzerland
- Institute of Social and Preventive MedicineUniversity of BernBernSwitzerland
| |
Collapse
|
7
|
Choi HM, Bell ML. Heat-mortality relationship in North Carolina: Comparison using different exposure methods. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:637-645. [PMID: 37029251 PMCID: PMC10403356 DOI: 10.1038/s41370-023-00544-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Many studies have explored the heat-mortality relationship; however, comparability of results is hindered by the studies' use of different exposure methods. OBJECTIVE This study evaluated different methods for estimating exposure to temperature using individual-level data and examined the impacts on the heat-mortality relationship. METHODS We calculated different temperature exposures for each individual death by using a modeled, gridded temperature dataset and a monitoring station dataset in North Carolina for 2000-2016. We considered individual-level vs. county-level averages and measured vs. modeled temperature data. A case-crossover analysis was conducted to examine the heat-mortality risk under different exposure methods. RESULTS The minimum mortality temperature (MMT) (i.e., the temperature with the lowest mortality rate) for the monitoring station dataset was 23.87 °C and 22.67 °C (individual monitor and county average, respectively), whereas for the modeled temperature dataset the MMT was 19.46 °C and 19.61 °C (individual and county, respectively). We found higher heat-mortality risk while using temperature exposure estimated from monitoring stations compared to risk based on exposure using the modeled temperature dataset. Individual-aggregated monitoring station temperature exposure resulted in higher heat mortality risk (odds ratio (95% CI): 2.24 (95% CI: 2.21, 2.27)) for a relative temperature change comparing the 99th and 90th temperature percentiles, while modeled temperature exposure resulted in lower odds ratio of 1.27 (95% CI: 1.25, 1.29). SIGNIFICANCE Our findings indicate that using different temperature exposure methods can result in different temperature-mortality risk. The impact of using various exposure methods should be considered in planning health policies related to high temperatures, including under climate change. IMPACT STATEMENT: (1) We estimated the heat-mortality association using different methods to estimate exposure to temperature. (2) The mean temperature value among different exposure methods were similar although lower for the modeled data, however, use of the monitoring station temperature dataset resulted in higher heat-mortality risk than the modeled temperature dataset. (3) Differences in mortality risk from heat by urbanicity varies depending on the method used to estimate temperature exposure.
Collapse
Affiliation(s)
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| |
Collapse
|
8
|
Nakamura D, Kinoshita H, Asada K, Arimitsu T, Yasumatsu M, Ishiwata T. Trends in ambulance dispatches related to heat illness from 2010 to 2019: An ecological study. PLoS One 2022; 17:e0275641. [PMID: 36342929 PMCID: PMC9639828 DOI: 10.1371/journal.pone.0275641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/21/2022] [Indexed: 11/09/2022] Open
Abstract
Heatstroke is a serious heat-related illness that can even cause death. Heat alert systems play an important role in reducing the number of patients experiencing heat illness, as they encourage preventive actions such as the use of air conditioning, hydration, or other strategies. However, to date, the Japanese hazard classification has not considered seasonal and regional variations, despite clear differences in meteorological conditions across different regions in Japan. Moreover, several studies have reported a difference in thermoregulation between older and younger adults, implying that the hazard classification should also consider age differences. This study examined the relationship between the number of ambulance dispatches related to heat illness (ADRHI) and the Japanese heat hazard classification from 2010 to 2019, focusing on monthly and regional differences. Data from 47 prefectures during the 10-year period were collected and analyzed. ADRHI and wet bulb globe temperature (WBGT) data were collected from Japan’s Ministry of Internal Affairs and Communications and the Ministry of the Environment Heat Illness Prevention Information website, respectively. The findings showed a significant relationship between ADRHI and WBGTmax (p < 0.05, r = 0.74). ADRHI per 100,000 people showed significant differences across months. The post hoc test detected the first steep increase in ADRHI at a WBGTmax of 23°C than at 22°C in June, and at a WBGTmax of 26°C, 27°C, and 25°C in July, August, and September, respectively. Moreover, the first significant increase in ADRHI per 100,000 people at WBGTmax differed across each region, at a WBGTmax of 24°C in Hokkaido-Tohoku, 25°C in Kanto, Kansai, and Chugoku, 26°C in Chubu, 27°C in Shikoku, and 28°C in Kyushu-Okinawa. Further, Poisson regression analysis revealed that the relative risks differed across each region and month. These results imply that the hazard classification should be adjusted according to region and month in Japan.
Collapse
Affiliation(s)
- Daisuke Nakamura
- Weathernews Inc., Makuhari Techno Garden, Chiba, Japan
- Rikkyo Research Institute of Wellness, Rikkyo University, Tokyo, Japan
- Physical Fitness Project, Japan Football Association (JFA), Tokyo, Japan
- * E-mail:
| | | | - Kazuo Asada
- Weathernews Inc., Makuhari Techno Garden, Chiba, Japan
| | - Takuma Arimitsu
- Faculty of Health Care, Department of Human Health, Hachinohe Gakuin University, Aomori, Japan
| | - Mikinobu Yasumatsu
- Rikkyo Research Institute of Wellness, Rikkyo University, Tokyo, Japan
- Physical Fitness Project, Japan Football Association (JFA), Tokyo, Japan
- Department of Sport and Wellness, Rikkyo University, Saitama, Japan
| | - Takayuki Ishiwata
- Rikkyo Research Institute of Wellness, Rikkyo University, Tokyo, Japan
- Department of Sport and Wellness, Rikkyo University, Saitama, Japan
| |
Collapse
|
9
|
Wan K, Feng Z, Hajat S, Doherty RM. Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets. Environ Health 2022; 21:99. [PMID: 36284320 PMCID: PMC9594922 DOI: 10.1186/s12940-022-00912-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adverse health impacts have been found under extreme temperatures in many parts of the world. The majority of such research to date for the UK has been conducted on populations in England, whilst the impacts of ambient temperature on health outcomes in Scottish populations remain largely unknown. METHODS This study uses time-series regression analysis with distributed lag non-linear models to characterise acute relationships between daily mean ambient temperature and mortality in Scotland including the four largest cities (Aberdeen, Dundee, Edinburgh and Glasgow) and three regions during 1974-2018. Increases in mortality risk under extreme cold and heat in individual cities and regions were aggregated using multivariate meta-analysis. Cold results are summarised by comparing the relative risk (RR) of death at the 1st percentile of localised temperature distributions compared to the 10th percentile, and heat effects as the RR at the 99th compared to the 90th percentile. RESULTS Adverse cold effects were observed in all cities and regions, and heat effects were apparent in all cities and regions except northern Scotland. Aggregate all-cause mortality risk in Scotland was estimated to increase by 10% (95% confidence interval, CI: 7%, 13%) under extreme cold and 4% (CI: 2%, 5%) under extreme heat. People in urban areas experienced higher mortality risk under extreme cold and heat than those in rural regions. The elderly had the highest RR under both extreme cold and heat. Males experienced greater cold effects than females, whereas the reverse was true with heat effects, particularly among the elderly. Those who were unmarried had higher RR than those married under extreme heat, and the effect remained after controlling for age. The younger population living in the most deprived areas experienced higher cold and heat effects than in less deprived areas. Deaths from respiratory diseases were most sensitive to both cold and heat exposures, although mortality risk for cardiovascular diseases was also heightened, particularly in the elderly. Cold effects were lower in the most recent 15 years, which may be linked to policies and actions in preventing the vulnerable population from cold impacts. No temporal trend was found with the heat effect. CONCLUSIONS This study assesses mortality risk associated with extreme temperatures in Scotland and identifies those groups who would benefit most from targeted actions to reduce cold- and heat-related mortalities.
Collapse
Affiliation(s)
- Kai Wan
- School of GeoSciences, University of Edinburgh, Edinburgh, UK.
| | - Zhiqiang Feng
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
- Scottish Centre for Administrative Data Research, School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre On Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruth M Doherty
- School of GeoSciences, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
10
|
Choi HM, Lee W, Roye D, Heo S, Urban A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Gasparrini A, Analitis A, Tobias A, Armstrong B, Forsberg B, Íñiguez C, Åström C, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, Sera F, Orru H, Kim H, Kyselý J, Madueira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Diaz MH, Ragettli MS, Pascal M, Ryti N, Scovronick N, Osorio S, Tong S, Seposo X, Guo YL, Guo Y, Bell ML. Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study. EBioMedicine 2022; 84:104251. [PMID: 36088684 PMCID: PMC9471476 DOI: 10.1016/j.ebiom.2022.104251] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. METHODS We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. FINDINGS Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. INTERPRETATION Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change. FUNDING This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University's NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033 The funders had no role in the design, data collection, analysis, interpretation of results, manuscript writing, or decision to publication.
Collapse
Affiliation(s)
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA
| | - Dominic Roye
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Seulkee Heo
- School of the Environment, Yale University, New Haven, CT, USA
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Ene Indermitte
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Global Change Research Institute, Czech Academy of Sciences, Brno, Czech Republic
| | - Joana Madueira
- Department of Environmental Health, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; EPI Unit, Institute of Public Health, University of Porto, Lisbon, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mathilde Pascal
- Department of Environmental Health, French National Public Health Agency, Public Health France, Saint Maurice, France
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samuel Osorio
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yue Leon Guo
- National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
| |
Collapse
|
11
|
Short-Term Effects of Apparent Temperature on Cause-Specific Mortality in the Urban Area of Thessaloniki, Greece. ATMOSPHERE 2022. [DOI: 10.3390/atmos13060852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although there is a growing interest in the association between ambient temperatures and mortality, little evidence is available for Thessaloniki, the second largest city of Greece. In this study, we present an assessment of the effects of temperature on daily mortality from 2006 to 2016 in the urban area of Thessaloniki, by describing the exposure-lag-response association between temperature and cause-specific mortality with the use of a distributed lag non-linear model (DLNM). A J-shaped relationship was found between temperature and mortality. The highest values of risk were evident for respiratory (RR > 10) and cardiovascular causes (RR > 3), probably due to the fact that health status of individuals with chronic respiratory and cardiovascular diseases rapidly deteriorates during hot periods. Cold effects had longer lags of up to 15 days, whereas heat effects were short-lived, up to 4 days. Percentage change in all- and cause-specific mortality per 1 °C change above and below Minimum Mortality Temperature showed a larger increase for all-cause mortality in heat (1.95%, 95% CI: 1.07–2.84), in contrast to a smaller increase in cold (0.54%, 95% CI: 0, 1.09). Overall, 3.51% of all-cause deaths were attributable to temperature, whereas deaths attributed to heat (2.34%) were more than deaths attributed to cold (1.34%). The findings of this study present important evidence for planning public-health interventions, to reduce the health impact of extreme temperatures.
Collapse
|
12
|
Heatwave Mortality in Summer 2020 in England: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106123. [PMID: 35627660 PMCID: PMC9141696 DOI: 10.3390/ijerph19106123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/04/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023]
Abstract
High ambient temperatures pose a significant risk to health. This study investigates the heatwave mortality in the summer of 2020 during the SARS-CoV-2 coronavirus (COVID-19) pandemic and related countermeasures. The heatwaves in 2020 caused more deaths than have been reported since the Heatwave Plan for England was introduced in 2004. The total and cause-specific mortality in 2020 was compared to previous heatwave events in England. The findings will help inform summer preparedness and planning in future years as society learns to live with COVID-19. Heatwave excess mortality in 2020 was similar to deaths occurring at home, in hospitals, and in care homes in the 65+ years group, and was comparable to the increases in previous years (2016–2018). The third heatwave in 2020 caused significant mortality in the younger age group (0–64) which has not been observed in previous years. Significant excess mortality was observed for cardiovascular disease, respiratory disease, and Alzheimer’s and Dementia across all three heatwaves in persons aged 65+ years. There was no evidence that the heatwaves affected the proportional increase of people dying at home and not seeking heat-related health care. The most significant spike in daily mortality in August 2020 was associated with a period of high night-time temperatures. The results provide additional evidence that contextual factors are important for managing heatwave risks, particularly the importance of overheating in dwellings. The findings also suggest more action is also needed to address the vulnerability in the community and in health care settings during the acute response phase of a heatwave.
Collapse
|
13
|
Hatakeyama K, Seposo X. Heatstroke-related ambulance dispatch risk before and during COVID-19 pandemic: Subgroup analysis by age, severity, and incident place. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 821:153310. [PMID: 35085629 PMCID: PMC8784651 DOI: 10.1016/j.scitotenv.2022.153310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND In summer 2020 under the COVID-19 pandemic, the Ministry of Health, Labour and Welfare has made public warnings that specific preventive measures such as maskwearing and stay-at-home orders, may increase heatstroke risk. In our previous work, we found a lower risk of heatstroke-related ambulance dispatches (HSAD) during the COVID-19 period, however, it is uncertain whether similar risk reductions can be observed in different vulnerable subgroups. This study aimed to determine the HSAD risk during the COVID-19 pandemic by age, severity, and incident place subgroups. METHOD A summer-specific (June-September), time-series analysis was performed, using daily HSAD and meteorological data from 47 Japanese prefectures from 2017 to 2020. A two-stage analysis was applied to determine the association between HSAD and COVID-19 pandemic, adjusting for maximum temperature, humidity, seasonality, and relevant temporal adjustments. A generalized linear model was utilized in the first stage to estimate the prefecture-specific effect estimates. Thereafter, a fixed effect meta-analysis in the second stage was implemented to pool the first stage estimates. Subsequently, subgroup analysis via an interaction by age, severity, and incident place was used to analyze the HSAD risk among subgroups. RESULTS A total of 274,031 HSAD cases was recorded across 47 Japanese prefectures. The average total number of HSAD in the pre-COVID-19 period was 69,721, meanwhile, the COVID-19 period was 64,869. Highest reductions in the risks was particularly observed in the young category (ratio of relative risk (RRR) = 0.54, 95% Confidential Interval (CI): 0.51, 0.57) compared to the elderly category. Whereas highest increment in the risks were observed in severe/death (RRR = 1.25, 95% CI: 1.13, 1.37) compared to the mild category. CONCLUSION COVID-19 situation exhibited a non-uniform change in the HSAD risk for all subgroups, with the magnitude of the risks varying by age, severity, and incident place.
Collapse
Affiliation(s)
- Koya Hatakeyama
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Xerxes Seposo
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan.
| |
Collapse
|
14
|
Lo YTE, Mitchell DM, Thompson R, O’Connell E, Gasparrini A. Estimating heat-related mortality in near real time for national heatwave plans. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2022; 17:024017-24017. [PMID: 35341022 PMCID: PMC7612535 DOI: 10.1088/1748-9326/ac4cf4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Heatwaves are a serious threat to human life. Public health agencies that are responsible for delivering heat-health action plans need to assess and reduce the mortality impacts of heat. Statistical models developed in epidemiology have previously been used to attribute past observed deaths to high temperatures and project future heat-related deaths. Here, we investigate the novel use of summer temperature-mortality associations established by these models for monitoring heat-related deaths in regions in England in near real time. For four summers in the period 2011-2020, we find that coupling these associations with observed daily mean temperatures results in England-wide heatwave mortality estimates that are consistent with the excess deaths estimated by UK Health Security Agency. However, our results for 2013, 2018 and 2020 highlight that the lagged effects of heat and characteristics of individual summers contribute to disagreement between the two methods. We suggest that our method can be used for heatwave mortality monitoring in England because it has the advantages of including lagged effects and controlling for other risk factors. It could also be employed by health agencies elsewhere for reliably estimating the health burden of heat in near real time and near-term forecasts.
Collapse
Affiliation(s)
- Y T Eunice Lo
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Cabot Institute for the Environment, University of Bristol, Bristol, United Kingdom
- Author to whom any correspondence should be addressed.
| | - Dann M Mitchell
- School of Geographical Sciences, University of Bristol, Bristol, United Kingdom
- Cabot Institute for the Environment, University of Bristol, Bristol, United Kingdom
| | - Ross Thompson
- Extreme Events and Health Protection Team, UK Health Security Agency, London, United Kingdom
| | - Emer O’Connell
- Extreme Events and Health Protection Team, UK Health Security Agency, London, United Kingdom
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
15
|
Meng C, Ke F, Xiao Y, Huang S, Duan Y, Liu G, Yu S, Fu Y, Peng J, Cheng J, Yin P. Effect of Cold Spells and Their Different Definitions on Mortality in Shenzhen, China. Front Public Health 2022; 9:817079. [PMID: 35141195 PMCID: PMC8818748 DOI: 10.3389/fpubh.2021.817079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
A high premium has been put on researching the effects of cold spells because of their adverse influence on people's daily lives and health. The study aimed to find the most appropriate definition of the cold spell in Shenzhen and quantify the impact of cold spells on mortality. Based on the daily mortality data in Shenzhen from 2013 to 2017 and the meteorological and pollutant data from the same period, we quantified the effect of cold spells using eight different definitions in the framework of a distributed lag non-linear model with a quasi-Poisson distribution. In Shenzhen, low temperatures increase the risk of death more significantly than high temperatures (using the optimal temperature as the cut-off value). Comparing the quasi-Akaike information criterion value, attribution fraction (b-AF), and attribution number (b-AN) for all causes of deaths and non-accidental deaths, the optimal definition of the cold spell was defined as the threshold was 3rd percentile of the daily average temperature and duration for 3 or more consecutive days (all causes: b-AF = 2.31% [1.01–3.50%], b-AN = 650; non-accidental: b-AF = 1.92% [0.57–3.17%], b-AN = 471). For cardiovascular deaths, the best definition was the temperature threshold as the 3rd percentile of the daily average temperature with a duration of 4 consecutive days (cardiovascular: b-AF = 1.37% [0.05–2.51%], b-AN = 142). Based on the best definition in the model, mortality risk increased in cold spells, with a statistically significant lag effect occurring as early as the 4th day and the effect of a single day lasting for 6 days. The maximum cumulative effect occurred on the 14th day (all-cause: RR = 1.54 [95% CI, 1.20–1.98]; non-accidental: RR = 1.43 [95% CI, 1.11–1.84]; cardiovascular: RR = 1.58 [95% CI, 1.00–2.48]). The elderly and females were more susceptible to cold spells. Cold spells and their definitions were associated with an increased risk of death. The findings of this research provide information for establishing an early warning system, developing preventive measures, and protecting susceptible populations.
Collapse
Affiliation(s)
- Chengzhen Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Ke
- Children's Health Care Hospital, Wuhan, China
| | - Yao Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
- *Correspondence: Ji Peng
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Jinquan Cheng
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ping Yin
| |
Collapse
|
16
|
Gong J, Part C, Hajat S. Current and future burdens of heat-related dementia hospital admissions in England. ENVIRONMENT INTERNATIONAL 2022; 159:107027. [PMID: 34890899 PMCID: PMC8739554 DOI: 10.1016/j.envint.2021.107027] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/15/2021] [Accepted: 12/03/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The impacts of a changing climate on current and future dementia burdens have not been widely explored. METHODS Time-series negative binomial regression analysis was used to assess acute associations between daily ambient temperature and counts of emergency admissions for dementia in each Government region of England, adjusting for season and day-of-week. Using the latest climate and dementia projections data, we then estimate future heat-related dementia burdens under a high emission scenario (Representative Concentration Pathway (RCP8.5), where global greenhouse gas (GHG) emissions continue to rise, and a low emissions scenario (RCP2.6), where GHG emissions are sizeably reduced under a strong global mitigation policy. RESULTS A raised risk associated with high temperatures was observed in all regions. Nationally, a 4.5% (95% Confidence interval (CI) 2.9%-6.1%) increase in risk of dementia admission was observed for every 1 °C increase in temperature above 17 °C associated with current climate. Under a high emissions scenario, heat-related admissions are projected to increase by almost 300% by 2040 compared to baseline levels. CONCLUSIONS People living with dementia should be considered a high-risk group during hot weather. Our results support arguments for more stringent climate change mitigation policies.
Collapse
Affiliation(s)
- Jessica Gong
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Cherie Part
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
17
|
Taylor J, Symonds P, Heaviside C, Chalabi Z, Davies M, Wilkinson P. Projecting the impacts of housing on temperature-related mortality in London during typical future years. ENERGY AND BUILDINGS 2021; 249:None. [PMID: 34819713 PMCID: PMC8593871 DOI: 10.1016/j.enbuild.2021.111233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/09/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
Climate change means the UK will experience warmer winters and hotter summers in the future. Concurrent energy efficiency improvements to housing may modify indoor exposures to heat or cold, while population aging may increase susceptibility to temperature-related mortality. We estimate heat and cold mortality and energy consumption in London for typical (non-extreme) future climates, given projected changes in population and housing. Building physics models are used to simulate summertime and wintertime indoor temperatures and space heating energy consumption of London dwellings for 'baseline' (2005-2014) and future (2030s, 2050s) periods using data from the English Housing Survey, historical weather data, and projected future weather data with temperatures representative of 'typical' years. Linking to population projections, we calculate future heat and cold attributable mortality and energy consumption with demolition, construction, and alternative scenarios of energy efficiency retrofit. At current retrofit rates, around 168-174 annual cold-related deaths per million population would typically be avoided by the 2050s, or 261-269 deaths per million under ambitious retrofit rates. Annual heat deaths would typically increase by 1 per million per year under the current retrofit rate, and 12-13 per million under ambitious rates without population adaptation to heat. During typical future summers, an estimated 38-73% of heat-related deaths can be avoided using external shutters on windows, with their effectiveness lower during hotter weather. Despite warmer winters, ambitious retrofit rates are necessary to reduce typical annual energy consumption for heating below baseline levels, assuming no improvement in heating system efficiencies. Concerns over future overheating in energy efficient housing are valid but increases in heat attributable mortality during typical and hot (but not extreme) summers are more than offset by significant reductions in cold mortality and easily mitigated using passive measures. More ambitious retrofit rates are critical to reduce energy consumption and offer co-benefits for reducing cold-related mortality.
Collapse
Affiliation(s)
- Jonathon Taylor
- Department of Civil Engineering, Tampere University, Tampere, Finland
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Phil Symonds
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Clare Heaviside
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Zaid Chalabi
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
18
|
Choi HM, Chen C, Son JY, Bell ML. Temperature-mortality relationship in North Carolina, USA: Regional and urban-rural differences. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 787:147672. [PMID: 34000533 PMCID: PMC8214419 DOI: 10.1016/j.scitotenv.2021.147672] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Health disparities exist between urban and rural populations, yet research on rural-urban disparities in temperature-mortality relationships is limited. As inequality in the United States increases, understanding urban-rural and regional differences in the temperature-mortality association is crucial. OBJECTIVE We examined regional and urban-rural differences of the temperature-mortality association in North Carolina (NC), USA, and investigated potential effect modifiers. METHODS We applied time-series models allowing nonlinear temperature-mortality associations for 17 years (2000-2016) to generate heat and cold county-specific estimates. We used second-stage analysis to quantify the overall effects. We also explored potential effect modifiers (e.g. social associations, greenness) using stratified analysis. The analysis considered relative effects (comparing risks at 99th to 90th temperature percentiles based on county-specific temperature distributions for heat, and 1st to 10th percentiles for cold) and absolute effects (comparing risks at specific temperatures). RESULTS We found null effects for heat-related mortality (relative effect: 1.001 (95% CI: 0.995-1.007)). Overall cold-mortality risk for relative effects was 1.019 (1.015-1.023). All three regions had statistically significant cold-related mortality risks for relative and absolute effects (relative effect: 1.019 (1.010-1.027) for Coastal Plains, 1.021 (1.015-1.027) for Piedmont, 1.014 (1.006-1.023) for Mountains). The heat mortality risk was not statistically significant, whereas the cold mortality risk was statistically significant, showing higher cold-mortality risks in urban areas than rural areas (relative effect for heat: 1.006 (0.997-1.016) for urban, 1.002 (0.988-1.017) for rural areas; relative effect for cold: 1.023 (1.017-1.030) for urban, 1.012 (1.001-1.023) for rural areas). Findings are suggestive of higher relative cold risks in counties with the less social association, higher population density, less green-space, higher PM2.5, lower education level, higher residential segregation, higher income inequality, and higher income (e.g., Ratio of Relative Risks 1.72 (0.68, 4.35) comparing low to high education). CONCLUSION Results indicate cold-mortality risks in NC, with potential differences by regional, urban-rural areas, and community characteristics.
Collapse
Affiliation(s)
| | - Chen Chen
- School of the Environment, Yale University, New Haven, CT, USA
| | - Ji-Young Son
- School of the Environment, Yale University, New Haven, CT, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA.
| |
Collapse
|
19
|
de Schrijver E, Folly CL, Schneider R, Royé D, Franco OH, Gasparrini A, Vicedo‐Cabrera AM. A Comparative Analysis of the Temperature-Mortality Risks Using Different Weather Datasets Across Heterogeneous Regions. GEOHEALTH 2021; 5:e2020GH000363. [PMID: 34084982 PMCID: PMC8143899 DOI: 10.1029/2020gh000363] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 06/01/2023]
Abstract
New gridded climate datasets (GCDs) on spatially resolved modeled weather data have recently been released to explore the impacts of climate change. GCDs have been suggested as potential alternatives to weather station data in epidemiological assessments on health impacts of temperature and climate change. These can be particularly useful for assessment in regions that have remained understudied due to limited or low quality weather station data. However to date, no study has critically evaluated the application of GCDs of variable spatial resolution in temperature-mortality assessments across regions of different orography, climate, and size. Here we explored the performance of population-weighted daily mean temperature data from the global ERA5 reanalysis dataset in the 10 regions in the United Kingdom and the 26 cantons in Switzerland, combined with two local high-resolution GCDs (HadUK-grid UKPOC-9 and MeteoSwiss-grid-product, respectively) and compared these to weather station data and unweighted homologous series. We applied quasi-Poisson time series regression with distributed lag nonlinear models to obtain the GCD- and region-specific temperature-mortality associations and calculated the corresponding cold- and heat-related excess mortality. Although the five exposure datasets yielded different average area-level temperature estimates, these deviations did not result in substantial variations in the temperature-mortality association or impacts. Moreover, local population-weighted GCDs showed better overall performance, suggesting that they could be excellent alternatives to help advance knowledge on climate change impacts in remote regions with large climate and population distribution variability, which has remained largely unexplored in present literature due to the lack of reliable exposure data.
Collapse
Affiliation(s)
- Evan de Schrijver
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Oeschger Center for Climate Change Research (OCCR)University of BernBernSwitzerland
- Graduate school of Health Sciences (GHS)University of BernBernSwitzerland
| | - Christophe L. Folly
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Graduate school of Health Sciences (GHS)University of BernBernSwitzerland
| | - Rochelle Schneider
- Ф‐LabEuropean Space Agency (ESA/ESRIN)FrascatiItaly
- Forecast DepartmentEuropean Centre for Medium‐Range Weather Forecast (ECMWF)ReadingUK
- Centre on Climate Change and Planetary HealthLondon School of Hygiene & Tropical Medicine, London (LSHTM)LondonUK
- Department of Public HealthEnvironments and Society, London School of Hygiene & Tropical MedicineLondonUK
| | - Dominic Royé
- Department of GeographyUniversity of Santiago de CompostelaSantiago de CompostelaSpain
- CIBER of Epidemiology and Public Health (CIBERESP)Spain
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Antonio Gasparrini
- Centre on Climate Change and Planetary HealthLondon School of Hygiene & Tropical Medicine, London (LSHTM)LondonUK
- Department of Public HealthEnvironments and Society, London School of Hygiene & Tropical MedicineLondonUK
- Centre for Statistical MethodologyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Ana M. Vicedo‐Cabrera
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Oeschger Center for Climate Change Research (OCCR)University of BernBernSwitzerland
| |
Collapse
|
20
|
Impact of Extreme Temperatures on Ambulance Dispatches Due to Cardiovascular Causes in North-West Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239001. [PMID: 33287148 PMCID: PMC7729967 DOI: 10.3390/ijerph17239001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022]
Abstract
Introduction and objectives. The increase in mortality and hospital admissions associated with high and low temperatures is well established. However, less is known about the influence of extreme ambient temperature conditions on cardiovascular ambulance dispatches. This study seeks to evaluate the effects of minimum and maximum daily temperatures on cardiovascular morbidity in the cities of Vigo and A Coruña in North-West Spain, using emergency medical calls during the period 2005–2017. Methods. For the purposes of analysis, we employed a quasi-Poisson time series regression model, within a distributed non-linear lag model by exposure variable and city. The relative risks of cold- and heat-related calls were estimated for each city and temperature model. Results. A total of 70,537 calls were evaluated, most of which were associated with low maximum and minimum temperatures on cold days in both cities. At maximum temperatures, significant cold-related effects were observed at lags of 3–6 days in Vigo and 5–11 days in A Coruña. At minimum temperatures, cold-related effects registered a similar pattern in both cities, with significant relative risks at lags of 4 to 12 days in A Coruña. Heat-related effects did not display a clearly significant pattern. Conclusions. An increase in cardiovascular morbidity is observed with moderately low temperatures without extremes being required to establish an effect. Public health prevention plans and warning systems should consider including moderate temperature range in the prevention of cardiovascular morbidity.
Collapse
|
21
|
Evaluating Mortality Response Associated with Two Different Nordic Heat Warning Systems in Riga, Latvia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217719. [PMID: 33105717 PMCID: PMC7672594 DOI: 10.3390/ijerph17217719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/31/2022]
Abstract
Background and objectives: Progressing climate change is accompanied by a worldwide increase in the intensity, frequency, and duration of heat wave events. Research has shown that heat waves are an emerging public health problem, as they have a significant impact on mortality. As studies exploring this relationship are scarce for Latvia, this study aims to investigate the short-term associations between heat waves and all-cause mortality as well as cause-specific mortality, during the summer months (May-September) in Riga. Materials and Methods: An ecological time series study using daily reported mortality and temperature data from Riga between 2009 and 2015 was employed. Heat waves were defined based on the categories of the Latvian and Swedish heat warning system. Using a Quasi-Poisson regression, the relationships between heat waves and all-cause as well as cause-specific mortality were investigated. Results: Heat waves in Riga were associated with a 10% to 20% increase in the risk of all-cause mortality, depending on the applied heat wave definition, compared to days with normal temperature. In addition, heat-related mortality was found to increase significantly in the ≥65 age group between 12% and 22% during heat waves. In terms of cause-specific mortality, a significant increase of approximately 15% to 26% was observed for cardiovascular mortality. No significant associations were found between heat waves and respiratory or external causes of mortality. Conclusion: These results indicate that there are short-term associations between heat waves and all-cause as well as cardiovascular mortality in Riga and that heat waves therefore represent a public health problem in this Baltic city.
Collapse
|
22
|
Assessing the Magnitude and Likely Causes of Summertime Overheating in Modern Flats in UK. ENERGIES 2020. [DOI: 10.3390/en13195202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There has been increasing recognition that climate change may lead to risk of summertime overheating in UK dwellings with potentially adverse consequences for human comfort and health. This paper investigates the magnitude of summertime overheating over one month in 2017, in four new flats built to identical thermal standards, with similar occupancy patterns and located in the same block in a development in Southeast England. Both static and adaptive methods were used to assess the overheating risk, while the variation in indoor temperatures across the flats was examined through key building characteristics including floor level, glazing orientation, exposed surface area to floor area ratio (SA/FA), glazing area to floor area ratio, and ventilation. Data collection included continuous monitoring of indoor and outdoor temperature, relative humidity, CO2 levels and opening/closing of windows. Summertime overheating was found to be prevalent in all four flats but was most pronounced in two top floor flats with high SA/FA ratio and east/west facing glazing. Due to limited window opening and locational limitations of one flat, some conclusions were derived from three flats. Though the study sample is small, it is clear that overheating in new housing is a current issue and designing for avoidance of summertime overheating should become mainstream.
Collapse
|
23
|
Public Health Implications of Solar UV Exposure during Extreme Cold and Hot Weather Episodes in 2018 in Chilton, South East England. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020. [DOI: 10.1155/2020/2589601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Consideration of the implications of solar UV exposure on public health during extreme temperature events is important due to their increasing frequency as a result of climate change. In this paper public health impacts of solar UV exposure, both positive and negative, during extreme hot and cold weather in England in 2018 were assessed by analysing environmental variations in UV and temperature. Consideration was given to people’s likely behaviour, the current alert system and public health advice. During a period of severe cold weather in February-March 2018 UV daily doses were around 25–50% lower than the long-term average (1991–2017); however, this would not impact on sunburn risk or the benefit of vitamin D production. In spring 2018 unseasonably high temperatures coincided with high UV daily doses (40–75% above long-term average) on significant days: the London Marathon (22 April) and UK May Day Bank Holiday weekend, which includes a public holiday on the Monday (5–7 May). People were likely to have intermittent excess solar UV exposure on unacclimatised skin, causing sunburn and potentially increasing the risk of skin cancers. No alerts were raised for these events since they occurred outside the alerting period. During a heat-wave in summer 2018 the environmental availability of UV was high—on average of 25% above the long-term average. The public health implications are complex and highly dependent on behaviour and sociodemographic variables such as skin colour. For all three periods Pearson’s correlation analysis showed a statistically significant (p<0.05) positive correlation between maximum daily temperature and erythema-effective UV daily dose. Public health advice may be improved by taking account of both temperature and UV and their implications for behaviour. A health impact-based alert system would be of benefit throughout the year, particularly in spring and summer.
Collapse
|
24
|
Psistaki K, Paschalidou AK, McGregor G. Weather patterns and all-cause mortality in England, UK. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:123-136. [PMID: 31707494 DOI: 10.1007/s00484-019-01803-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/30/2019] [Accepted: 09/12/2019] [Indexed: 06/10/2023]
Abstract
Cold- and heat-related mortality poses significant public health concerns worldwide. Although there are numerous studies dealing with the association between extreme ambient temperature and mortality, only a small number adopt a synoptic climatological approach in order to understand the nature of weather systems that precipitate increases in cold- or heat-related mortality. In this paper, the Lamb Weather Type synoptic classification is used to examine the relationship between daily mortality and weather patterns across nine regions of England. Analysis results revealed that the population in England is more susceptible to cold weather. Furthermore, it was found that the Easterly weather types are the most hazardous for public health all-year-long; however, during the cold period, the results are more evident and spatially homogenous. Nevertheless, it is noteworthy that the most dangerous weather conditions are not always associated with extreme (high or low) temperatures, a finding which points to the complexity of weather-related health effects and highlights the importance of a synoptic climatological approach in elucidating the relationship between temperature and mortality.
Collapse
Affiliation(s)
- Kyriaki Psistaki
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece
| | - Anastasia K Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece.
| | | |
Collapse
|
25
|
Zhang Y, Xiang Q, Yu C, Bao J, Ho HC, Sun S, Ding Z, Hu K, Zhang L. Mortality risk and burden associated with temperature variability in China, United Kingdom and United States: Comparative analysis of daily and hourly exposure metrics. ENVIRONMENTAL RESEARCH 2019; 179:108771. [PMID: 31574448 DOI: 10.1016/j.envres.2019.108771] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/12/2019] [Accepted: 09/22/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Temperature variability (TV) is closely associated with climate change, but there is no unified TV definition worldwide. Two novel composite TV indexes were developed recently by calculating the standard deviations of several days' daily maximum and minimum temperatures (TVdaily), or hourly mean temperatures (TVhourly). OBJECTIVES This study aimed to compare the mortality risks and burden associated with TVdaily and TVhourly using large time-series datasets collected from multiple locations in China, United Kingdom and United States. METHODS We collected daily mortality and hourly temperature data through 1987 to 2012 from 63 locations in China (8 communities, 2006-2012), United Kingdom (10 regions, 1990-2012), and USA (45 cities, 1987-2000). TV-mortality associations were investigated using a three-stage analytic approach separately for China, UK, and USA. First, we applied a time-series regression for each location to derive location-specific TV-mortality curves. A second-stage meta-analysis was then performed to pool these estimated associations for each country. Finally, we calculated mortality fraction attributable to TV based on above-described location-specific and pooled estimates. RESULTS Our dataset totally consisted of 23, 089, 328 all-cause death cases, including 93, 750 from China, 7,573,716 from UK and 15, 421, 862 from USA, respectively. In despite of a relatively wide uncertainty in China, approximately linear relationships were consistently identified for TVdaily and TVhourly. In the three countries, generally similar lag patterns of TV effects were consistently observed for TVdaily and TVhourly. A 1 °C rise in TVdaily and TVhourly at lag 0-7 days was associated with mortality increases of 0.93% (95% confidence interval [CI]: 0.12, 1.74) and 0.97% (0.18, 1.77) in China, 0.33% (0.15, 0.51) and 0.41% (0.21, 0.60) in UK, and 0.55% (0.41, 0.70) and 0.51% (0.35, 0.66) in USA, respectively. Larger attributable fractions were estimated using TVdaily than those using TVhourly, with estimates at 0-10 days of 3.69% (0.51, 6.75) vs. 2.59% (0.10, 5.01) in China, 1.14% (0.54, 1.74) vs. 0.98% (0.55, 1.42) in UK, and 2.57% (1.97, 3.16) vs. 1.67% (1.15, 2.18) in USA, respectively. Our meta-regression analyses indicated higher vulnerability to TV-induced mortality risks in warmer locations. CONCLUSIONS Our study added multi-country evidence for increased mortality risk associated with short-term exposure to large temperature variability. Daily and hourly TV exposure metrics produced generally comparable risk effects, but the attributable mortality burden tended to be higher using TVdaily instead of TVhourly.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan, 430071, China
| | - Junzhe Bao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
| | - Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518102, China
| | - Kejia Hu
- Department of Precision Health and Data Science, School of Public Health, Zhejiang University, Hangzhou, 310003, China
| | - Ling Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China; Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China
| |
Collapse
|
26
|
Zafeiratou S, Analitis A, Founda D, Giannakopoulos C, Varotsos KV, Sismanidis P, Keramitsoglou I, Katsouyanni K. Spatial Variability in the Effect of High Ambient Temperature on Mortality: An Analysis at Municipality Level within the Greater Athens Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193689. [PMID: 31575034 PMCID: PMC6801795 DOI: 10.3390/ijerph16193689] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/02/2019] [Accepted: 09/27/2019] [Indexed: 01/03/2023]
Abstract
Spatial variability in temperature exists within metropolitan areas but very few studies have investigated intra-urban differentiation in the temperature-mortality effects. We investigated whether local characteristics of 42 Municipalities within the Greater Athens Area lead to modified temperature effects on mortality and if effect modifiers can be identified. Generalized Estimating Equations models were used to assess the effect of high ambient temperature on the total and cause-specific daily number of deaths and meta-regression to investigate effect modification. We found significant effects of daily temperature increases on all-cause, cardiovascular, and respiratory mortality (e.g., for all ages 4.16% (95% CI: 3.73,4.60%) per 1 °C increase in daily temperature (lags 0–3). Heterogeneity in the effect estimates between Municipalities was observed in several outcomes and environmental and socio-economic effect modifying variables were identified, such as % area coverage of buildings, length of roads/km2, population density, % unemployed, % born outside the EU countries and mean daily temperature. To further examine the role of temperature, we alternatively used modelled temperature per Municipality and calculated the effects. We found that heterogeneity was reduced but not eliminated. It appears that there are socioeconomic status and environmental determinants of the magnitude of heat-related effects on mortality, which are detected with some consistency and should be further investigated.
Collapse
Affiliation(s)
- Sofia Zafeiratou
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens GR11527, Greece.
| | - Antonis Analitis
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens GR11527, Greece.
| | - Dimitra Founda
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens GR15236, Greece.
| | - Christos Giannakopoulos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens GR15236, Greece.
| | - Konstantinos V Varotsos
- Institute for Environmental Research and Sustainable Development, National Observatory of Athens, Athens GR15236, Greece.
| | - Panagiotis Sismanidis
- Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing, National Observatory of Athens, Athens GR15236, Greece.
| | - Iphigenia Keramitsoglou
- Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing, National Observatory of Athens, Athens GR15236, Greece.
| | - Klea Katsouyanni
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens GR11527, Greece.
- School of Population Health & Environmental Sciences, King's College London, London SE1 9NH, UK.
| |
Collapse
|
27
|
Macintyre HL, Heaviside C. Potential benefits of cool roofs in reducing heat-related mortality during heatwaves in a European city. ENVIRONMENT INTERNATIONAL 2019; 127:430-441. [PMID: 30959308 DOI: 10.1016/j.envint.2019.02.065] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
Hot weather can exacerbate health conditions such as cardiovascular and respiratory diseases, and lead to heat stroke and death. In built up areas, temperatures are commonly observed to be higher than those in surrounding rural areas, due to the Urban Heat Island (UHI) effect. Climate change and increasing urbanisation mean that future populations are likely to be at increased risk of overheating in cities, although building and city scale interventions have the potential to reduce this risk. We use a regional weather model to assess the potential effect of one type of urban intervention - reflective 'cool' roofs - to reduce local ambient temperatures, and the subsequent impact on heat-related mortality in the West Midlands, UK, with analysis undertaken for the summer of 2006, as well as two shorter heatwave periods in 2006 and 2003. We show that over a summer season, the population-weighted UHI intensity (the difference between simulated urban and rural temperature) was 1.1 °C on average, but 1.8 °C when including only night times, and reached a maximum of 9 °C in the West Midlands. Our results suggest that the UHI contributes up to 40% of heat related mortality over the summer period and that cool roofs implemented across the whole city could potentially offset 18% of seasonal heat-related mortality associated with the UHI (corresponding to 7% of total heat-related mortality). For heatwave periods, our modelling suggests that cool roofs could reduce city centre daytime 2 m air temperature by 0.5 °C on average, and up to a maximum of ~3 °C. Cool roofs reduced average UHI intensity by ~23%, and reduced heat related mortality associated with the UHI by ~25% during a heatwave. Cool roofs were most effective at reducing peak temperatures during the daytime, and therefore have the potential to limit dangerous extreme temperatures during heatwaves. Temperature reductions were dependent on the category of buildings where cool roofs were applied; targeting only commercial and industrial type buildings contributed more than half of the reduction for heatwave periods. Our modelling suggested that modifying half of all industrial/commercial urban buildings could have the same impact as modifying all high-intensity residential buildings in the West Midlands.
Collapse
Affiliation(s)
- H L Macintyre
- Chemicals and Environmental Effects Department, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - C Heaviside
- Chemicals and Environmental Effects Department, Centre for Radiation Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; Environmental Change Institute, University of Oxford, OX1 3QY, UK
| |
Collapse
|
28
|
Aboubakri O, Khanjani N, Jahani Y, Bakhtiari B. Attributable risk of mortality associated with heat and heat waves: A time-series study in Kerman, Iran during 2005–2017. J Therm Biol 2019; 82:76-82. [DOI: 10.1016/j.jtherbio.2019.03.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/17/2019] [Accepted: 03/19/2019] [Indexed: 12/18/2022]
|
29
|
Jiao A, Yu C, Xiang Q, Zhang F, Chen D, Zhang L, Hu K, Zhang L, Zhang Y. Impact of summer heat on mortality and years of life lost: Application of a novel indicator of daily excess hourly heat. ENVIRONMENTAL RESEARCH 2019; 172:596-603. [PMID: 30875513 DOI: 10.1016/j.envres.2019.01.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Previous studies have widely assessed heat-mortality relationships across global regions, while the epidemiological evidence regarding the heat effect on years of life lost (YLL) is relatively sparse. Current investigations using daily mean data cannot take hourly temperature variation into consideration and may underestimate heat effects. We developed a novel indicator, daily excess hourly heat (DEHH), to precisely evaluate the potential heat effects on mortality and YLL. METHODS Hourly data on temperature and daily information, including concentrations of air pollutants, relative humidity, and records of all registered deaths were obtained in Wuhan, China during the warm seasons (May-September) of 2009-2012. DEHH, developed in this study, is defined as daily total hourly temperatures that exceed a specific heat threshold. By performing time series regression analyses, we assessed the changes in daily mortality and YLL per interquartile range (IQR) increase in DEHH across different lag days. RESULTS The heat threshold evaluated by the Akaike Information Criterion for DEHH calculation is 30 °C (92th percentile of whole-year mean temperature distribution). Daily average DEHH was 13.9 °C, with an IQR of 19.9 °C. Linear exposure-response curves were found between DEHH and two health outcomes. Generally, heat effects lasted for 2-3 days and DEHH at lag 0-1 was most strongly associated with increased mortality and YLL. The effects were especially remarkable for stroke and ischemic heart disease mortality. Most intense effect on YLL was found in non-accidental deaths (20.11, 95% confidence interval: 8.90-31.33) at lag 0-1. More DEHH-related mortality and YLL from cardiovascular deaths were observed among males. People aged 0-74 years and males suffered more from YLL burden due to high temperatures. CONCLUSIONS Our study demonstrated that DEHH may be an alternative indicator to precisely measure heat effects on daily mortality and YLL. Further DEHH-based evidence from large scale investigations is needed so as to better understand heat-associated health burden and improve public response to extremely high temperatures.
Collapse
Affiliation(s)
- Anqi Jiao
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China; Global Health Institute, Wuhan University, Wuhan 430072, China
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Faxue Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Dieyi Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, China
| | - Lan Zhang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Ling Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yunquan Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China; Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan 430071, China.
| |
Collapse
|
30
|
Murage P, Hajat S, Bone A. Variation in Cold-Related Mortality in England Since the Introduction of the Cold Weather Plan: Which Areas Have the Greatest Unmet Needs? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2588. [PMID: 30463273 PMCID: PMC6265768 DOI: 10.3390/ijerph15112588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 12/31/2022]
Abstract
: The Cold Weather Plan (CWP) in England was introduced to prevent the adverse health effects of cold weather; however, its impact is currently unknown. This study characterizes cold-related mortality and fuel poverty at STP (Sustainability and Transformation Partnership) level, and assesses changes in cold risk since the introduction of the CWP. Time series regression was used to estimate mortality risk for up to 28 days following exposure. Area level fuel poverty was used to indicate mitigation against cold exposure and mapped alongside area level risk. We found STP variations in mortality risk, ranging from 1.74, 1.44⁻2.09 (relative risk (RR), 95% CI) in Somerset, to 1.19, 1.01⁻1.40 in Cambridge and Peterborough. Following the introduction of the CWP, national-level mortality risk declined significantly in those aged 0⁻64 (1.34, 1.23⁻1.45, to 1.09, 1.00⁻1.19), but increased significantly among those aged 75+ (1.36, 1.28⁻1.44, to 1.58, 1.47⁻1.70) and for respiratory conditions (1.78, 1.56⁻2.02, to 2.4, 2.10⁻2.79). We show how spatial variation in cold mortality risk has increased since the introduction of the CWP, which may reflect differences in implementation of the plan. Combining risk with fuel poverty information identifies 14 STPs with the greatest need to address the cold effect, and that would gain most from enhanced CWP activity or additional intervention measures.
Collapse
Affiliation(s)
- Peninah Murage
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, 15⁻17 Tavistock Place, London, WC1H 9SH, UK.
| | - Shakoor Hajat
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, 15⁻17 Tavistock Place, London, WC1H 9SH, UK.
| | - Angie Bone
- European Centre for Environment and Human Health, University of Exeter College of Medicine and Health, Heavitree Road, Exeter, EX1 2LU, UK.
| |
Collapse
|
31
|
Armstrong B, Bonnington O, Chalabi Z, Davies M, Doyle Y, Goodwin J, Green J, Hajat S, Hamilton I, Hutchinson E, Mavrogianni A, Milner J, Milojevic A, Picetti R, Rehill N, Sarran C, Shrubsole C, Symonds P, Taylor J, Wilkinson P. The impact of home energy efficiency interventions and winter fuel payments on winter- and cold-related mortality and morbidity in England: a natural equipment mixed-methods study. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
England, and the UK more generally, has a large burden of winter- and cold-related mortality/morbidity in comparison with nearby countries in continental Europe. Improving the energy efficiency of the housing stock may help to reduce this, as well as being important for climate change and energy security objectives.
Objectives
To evaluate the impact of home energy efficiency (HEE) interventions on winter- and cold-related mortality/morbidity, including assessing the impact of winter fuel payments (WFPs) and fuel costs.
Design
A mixed-methods study – an epidemiological time-series analysis, an analysis of data on HEE interventions, the development and application of modelling methods including a multicriteria decision analysis and an in-depth interview study of householders.
Setting
England, UK.
Participants
The population of England. In-depth interviews were conducted with 12 households (2–4 participants each) and 41 individuals in three geographical regions.
Interventions
HEE interventions.
Main outcome measures
Mortality, morbidity and intervention-related changes to the home indoor environment.
Data sources
The Homes Energy Efficiency Database, mortality and hospital admissions data and weather (temperature) data.
Results
There has been a progressive decline in cold-related deaths since the mid-1970s. Since the introduction of WFPs, the gradient of association between winter cold and mortality [2.00%, 95% confidence interval (CI) 1.74% to 2.28%] per degree Celsius fall in temperature is somewhat weaker (i.e. that the population is less vulnerable to cold) than in earlier years (2.37%, 95% CI 0.22% to 2.53%). There is also evidence that years with above-average fuel costs were associated with higher vulnerability to outdoor cold. HEE measures installed in England in 2002–10 have had a relatively modest impact in improving the indoor environment. The gains in winter temperatures (around +0.09 °C on a day with maximum outdoor temperature of 5 °C) are associated with an estimated annual reduction of ≈280 cold-related deaths in England (an eventual maximum annual impact of 4000 life-years gained), but these impacts may be appreciably smaller than those of changes in indoor air quality. Modelling studies indicate the potential importance of the medium- and longer-term impacts that HEE measures have on health, which are not observable in short-term studies. They also suggest that HEE improvements of similar annualised cost to current WFPs would achieve greater improvements in health while reducing (rather than increasing) carbon dioxide emissions. In-depth interviews suggest four distinct householder framings of HEE measures (as home improvement, home maintenance, subsidised public goods and contributions to sustainability), which do not dovetail with current ‘consumerist’ national policy and may have implications for the uptake of HEE measures.
Limitations
The quantification of intervention impacts in this national study is reliant on various indirect/model-based assessments.
Conclusions
Larger-scale changes are required to the housing stock in England if the full potential benefits for improving health and for reaching increasingly important climate change mitigation targets are to be realised.
Future work
Studies based on data linkage at individual dwelling level to examine health impacts. There is a need for empirical assessment of HEE interventions on indoor air quality.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 11. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Ben Armstrong
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Oliver Bonnington
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaid Chalabi
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - James Goodwin
- Design School, Loughborough University, Loughborough, UK
- Energy Institute, University College London, London, UK
| | - Judith Green
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Shakoor Hajat
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Emma Hutchinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Mavrogianni
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - James Milner
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Milojevic
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Roberto Picetti
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Nirandeep Rehill
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Clive Shrubsole
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
32
|
Thompson R, Hornigold R, Page L, Waite T. Associations between high ambient temperatures and heat waves with mental health outcomes: a systematic review. Public Health 2018; 161:171-191. [DOI: 10.1016/j.puhe.2018.06.008] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 02/02/2023]
|
33
|
Zhang Y, Yu Y, Peng M, Meng R, Hu K, Yu C. Temporal and seasonal variations of mortality burden associated with hourly temperature variability: A nationwide investigation in England and Wales. ENVIRONMENT INTERNATIONAL 2018; 115:325-333. [PMID: 29626694 DOI: 10.1016/j.envint.2018.03.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/24/2018] [Accepted: 03/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sudden temperature change may elevate short-term mortality and remains an important global health threat in the context of climate change. To date, however, little available temperature-mortality evidence has taken into account both intra- and inter-day temperature variability (TV), thus largely limiting the comprehensive understanding of mortality burden due to unstable weather. Moreover, seasonal and temporal patterns in TV-mortality associations were sparsely discussed, nationally and regionally. OBJECTIVES We aimed to assess the nationwide association of all-cause mortality with hourly temperature variability (HTV), quantify HTV-attributable mortality, and further explore the temporal and seasonal variations of mortality burden due to HTV in United Kingdom. METHODS Fourteen-year time-series data on temperature and mortality were collected from 10 regions in England and Wales during 1993-2006, totally including 7,573,716 all-cause deaths. HTV was calculated from the standard deviation of hourly temperature records within two neighboring days. A three-stage analytic approach was adopted to assess HTV-associated mortality burden. We first applied a time-series quasi-Poisson regression to estimate region-specific HTV-mortality associations, then pooled these associations at the national level using a multivariate meta-analysis, and finally estimated the HTV-attributable mortality fraction and illustrated its seasonal and temporal variations by conducting season- and period-specific analyses based on time-varying distributed lag models. RESULTS We found strong evidence that large HTV exposure elevated short-term mortality risk in England and Wales, with a pooled estimate of 1.13% (95% confidence interval (CI): 0.88, 1.39) associated with a 1-°C increase in HTV. During the whole study period, HTV accounted for a national average attributable fraction of 2.52% (95% empirical confidence interval (eCI): 2.27, 2.76) of the total deaths. This HTV-attributable mortality estimate showed a significant temporal decrease (p < 0.001) from 2.72% (95% eCI: 2.58, 2.87) in 1993-99 to 2.28% (95% eCI: 2.13, 2.43) in 2000-06. Additionally, clear seasonal variations were observed for HTV-attributable mortality burden, with the largest estimate of 3.08% (95% eCI: 2.80, 3.38) in summer, followed by 2.71% (95% eCI: 2.44, 2.98) in spring, 2.40% (95% eCI: 2.16, 2.63) in autumn, and 2.00% (95% eCI: 1.81, 2.20) in winter. CONCLUSIONS Despite clear evidence observed for the reduction, mortality burden caused by temperature variability remained a great public health threat, especially in warm seasons. It highlighted the importance of specific interventions targeted to unstable weather as well as temperature extremes, so as to reduce climate-related mortality burden.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China.
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, China
| | - Minjin Peng
- Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Runtang Meng
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China
| | - Kejia Hu
- Institute of Island and Coastal Ecosystems, Ocean College, Zhejiang University, Zhoushan 316021, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuhan 430072, China.
| |
Collapse
|
34
|
Estimating the Influence of Housing Energy Efficiency and Overheating Adaptations on Heat-Related Mortality in the West Midlands, UK. ATMOSPHERE 2018. [DOI: 10.3390/atmos9050190] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
35
|
Kenny GP, Flouris AD, Yagouti A, Notley SR. Towards establishing evidence-based guidelines on maximum indoor temperatures during hot weather in temperate continental climates. Temperature (Austin) 2018; 6:11-36. [PMID: 30906809 PMCID: PMC6422495 DOI: 10.1080/23328940.2018.1456257] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/15/2018] [Indexed: 11/09/2022] Open
Abstract
Rising environmental temperatures represent a major threat to human health. The activation of heat advisories using evidence-based thresholds for high-risk outdoor ambient temperatures have been shown to be an effective strategy to save lives during hot weather. However, although the relationship between weather and human health has been widely defined by outdoor temperature, corresponding increases in indoor temperature during heat events can also be harmful to health especially in vulnerable populations. In this review, we discuss our current understanding of the relationship between outdoor temperature and human health and examine how human health can also be adversely influenced by high indoor temperatures during heat events. Our assessment of the existing literature revealed a high degree of variability in what can be considered an acceptable indoor temperature because there are differences in how different groups of people may respond physiologically and behaviorally to the same living environment. Finally, we demonstrate that both non-physiological (e.g., geographical location, urban density, building design) and physiological (e.g., sex, age, fitness, state of health) factors must be considered when defining an indoor temperature threshold for preserving human health in a warming global climate.
Collapse
Affiliation(s)
- Glen P. Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | | | - Sean R. Notley
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
36
|
Zhang Y, Peng M, Wang L, Yu C. Association of diurnal temperature range with daily mortality in England and Wales: A nationwide time-series study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 619-620:291-300. [PMID: 29154047 DOI: 10.1016/j.scitotenv.2017.11.056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/18/2017] [Accepted: 11/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Diurnal temperature range (DTR) reflects within-day temperature variability and is closely associated with climate change. In comparison to temperature extremes, up-to-date DTR-health evidence at the regional and national scales has been still very limited worldwide, especially in Europe. OBJECTIVES This study aimed to provide nationwide estimates for DTR-associated effects on mortality, and explore whether season and regional-level characteristics modify DTR-mortality relation in United Kingdom. METHODS Fourteen-year time-series data on weather and mortality were collected from 10 regions in England and Wales during 1993-2006, including 7,573,716 total deaths. A quasi-Poisson regression incorporated with distributed lag non-linear model was first applied to estimate region-specific DTR-mortality relationships. Then, a multivariate meta-analysis was employed to derive the pooled DTR effects at the national level. Also, the modifying effects of some regional characteristics (e.g., geographical and climatological) were examined by conducting multivariate meta-regression. RESULTS A non-linear DTR-mortality relationship was identified in UK. At the national level, increasing DTR raised the mortality risk observably when DTR exposure was below 25th percentile or above 90th percentile of DTR distribution, with an intermediate risk plateau indicating no associations. Extremely high DTR exhibited greater adverse effect estimates in hot season compared with in cold and transitional season, whereas entirely different association patterns were observed for the season-specific effects of extremely low DTR. In addition to season, regional latitudes, average temperature and humidity were also found to significantly modify DTR-mortality relationship. CONCLUSIONS Our study added strong evidence that extremely high DTR increased short-term mortality, whereas the effects of extremely low DTR exhibited entirely different seasonal patterns. Also, mortality vulnerability to DTR extremes varied greatly by regional latitudes and climate conditions.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China.
| | - Minjin Peng
- Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Lu Wang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China
| | - Chuanhua Yu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, 185 Donghu Road, Wuhan 430071, China; Global Health Institute, Wuhan University, 8 Donghunan Road, Wuhan 430072, China.
| |
Collapse
|
37
|
Luan G, Yin P, Wang L, Zhou M. The temperature-mortality relationship: an analysis from 31 Chinese provincial capital cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2018; 28:192-201. [PMID: 29562755 DOI: 10.1080/09603123.2018.1453056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 02/22/2018] [Indexed: 06/08/2023]
Abstract
We aim to explore the Minimum Mortality Temperature (MMT) of different cities and regions, and that provides evidence for developing reasonable heat wave definition in China. The death data of 31 Chinese provincial capital cities from seven geographical regions during 2008-2013 was included in this study. In the first stage, a DLNM (Distributed Lag Non-linear Model) was used to estimate the association between mean temperature and mortality in a single city, then we pooled them with a multivariate meta-analysis to estimate the region-specific effects. The range of MMT was from 17.4 °C (Shijiazhuang) to 28.4 °C (Haikou), and the regional MMT increased as the original latitude decreased. Different cities and regions have their own specialized MMT due to geography and demographic characteristics. These findings indicate that the government deserves to adjust measures to local conditions to develop public health policies.
Collapse
Affiliation(s)
- Guijie Luan
- a Shandong Center for Disease Control and Prevention , Jinan , China
| | - Peng Yin
- b National Center for Chronic and Noncommunicable Disease Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Lijun Wang
- b National Center for Chronic and Noncommunicable Disease Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , China
| | - Maigeng Zhou
- b National Center for Chronic and Noncommunicable Disease Control and Prevention , Chinese Center for Disease Control and Prevention , Beijing , China
| |
Collapse
|
38
|
Brief Report: Investigating Uncertainty in the Minimum Mortality Temperature: Methods and Application to 52 Spanish Cities. Epidemiology 2018; 28:72-76. [PMID: 27748681 PMCID: PMC5380105 DOI: 10.1097/ede.0000000000000567] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The minimum mortality temperature from J- or U-shaped curves varies across cities with different climates. This variation conveys information on adaptation, but ability to characterize is limited by the absence of a method to describe uncertainty in estimated minimum mortality temperatures. METHODS We propose an approximate parametric bootstrap estimator of confidence interval (CI) and standard error (SE) for the minimum mortality temperature from a temperature-mortality shape estimated by splines. RESULTS The coverage of the estimated CIs was close to nominal value (95%) in the datasets simulated, although SEs were slightly high. Applying the method to 52 Spanish provincial capital cities showed larger minimum mortality temperatures in hotter cities, rising almost exactly at the same rate as annual mean temperature. CONCLUSIONS The method proposed for computing CIs and SEs for minimums from spline curves allows comparing minimum mortality temperatures in different cities and investigating their associations with climate properly, allowing for estimation uncertainty.
Collapse
|
39
|
Taylor J, Wilkinson P, Picetti R, Symonds P, Heaviside C, Macintyre HL, Davies M, Mavrogianni A, Hutchinson E. Comparison of built environment adaptations to heat exposure and mortality during hot weather, West Midlands region, UK. ENVIRONMENT INTERNATIONAL 2018; 111:287-294. [PMID: 29153471 DOI: 10.1016/j.envint.2017.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/26/2017] [Accepted: 11/08/2017] [Indexed: 06/07/2023]
Abstract
There is growing recognition of the need to improve protection against the adverse health effects of hot weather in the context of climate change. We quantify the impact of the Urban Heat Island (UHI) and selected adaptation measures made to dwellings on temperature exposure and mortality in the West Midlands region of the UK. We used 1) building physics models to assess indoor temperatures, initially in the existing housing stock and then following adaptation measures (energy efficiency building fabric upgrades and/or window shutters), of representative dwelling archetypes using data from the English Housing Survey (EHS), and 2) modelled UHI effect on outdoor temperatures. The ages of residents were combined with evidence on the heat-mortality relationship to estimate mortality risk and to quantify population-level changes in risk following adaptations to reduce summertime heat exposure. Results indicate that the UHI effect accounts for an estimated 21% of mortality. External shutters may reduce heat-related mortality by 30-60% depending on weather conditions, while shutters in conjunction with energy-efficient retrofitting may reduce risk by up to 52%. The use of shutters appears to be one of the most effective measures providing protection against heat-related mortality during periods of high summer temperatures, although their effectiveness may be limited under extreme temperatures. Energy efficiency adaptations to the dwellings and measures to increase green space in the urban environment to combat the UHI effect appear to be less beneficial for reducing heat-related mortality.
Collapse
Affiliation(s)
- Jonathon Taylor
- UCL Institute for Environmental Design and Engineering, Central House, 14 Upper Woburn Place, London WC1H 0NN, UK.
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Roberto Picetti
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Phil Symonds
- UCL Institute for Environmental Design and Engineering, Central House, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Clare Heaviside
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, OX11 0RQ, UK; School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Helen L Macintyre
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, OX11 0RQ, UK
| | - Michael Davies
- UCL Institute for Environmental Design and Engineering, Central House, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Anna Mavrogianni
- UCL Institute for Environmental Design and Engineering, Central House, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Emma Hutchinson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
40
|
The Excess Winter Deaths Measure: Why Its Use Is Misleading for Public Health Understanding of Cold-related Health Impacts. Epidemiology 2018; 27:486-91. [PMID: 26986872 PMCID: PMC4890842 DOI: 10.1097/ede.0000000000000479] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Excess winter deaths, the ratio between average daily deaths in December–March versus other months, is a measure commonly used by public health practitioners and analysts to assess health burdens associated with wintertime weather. We seek to demonstrate that this measure is fundamentally biased and can lead to misleading conclusions about health impacts associated with current and future winter climate. Methods: Time series regression analysis of 779,372 deaths from natural causes in London over 15 years (1 August 1997–31 July 2012),collapsed by day of death and linked to daily temperature values. The outcome measures were the excess winter deaths index, and daily and annual deaths attributable specifically to cold. Results: Most of the excess winter deaths are driven by cold: The excess winter deaths index decreased from 1.19 to 1.07 after excluding deaths attributable to low temperatures. Over 40% of cold-attributable deaths occurred outside of the December–March period, leading to bias in the excess winter deaths measure. Although there was no relationship between winter severity and annual excess winter deaths, there was a clear correlation with annual cold-attributable deaths. Conclusions: Excess winter deaths is not an appropriate indicator of cold-related health impacts, and its use should be discontinued. We advocate alternative measures. The findings we present bring into doubt previous claims that cold-related deaths in the UK will not reduce in future as a result of climate change.
Collapse
|
41
|
Sharafkhani R, Khanjani N, Bakhtiari B, Jahani Y, Sadegh Tabrizi J. Physiological Equivalent Temperature Index and mortality in Tabriz (The northwest of Iran). J Therm Biol 2018; 71:195-201. [DOI: 10.1016/j.jtherbio.2017.11.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/11/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
|
42
|
Arbuthnott KG, Hajat S. The health effects of hotter summers and heat waves in the population of the United Kingdom: a review of the evidence. Environ Health 2017; 16:119. [PMID: 29219088 PMCID: PMC5773858 DOI: 10.1186/s12940-017-0322-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
It is widely acknowledged that the climate is warming globally and within the UK. In this paper, studies which assess the direct impact of current increased temperatures and heat-waves on health and those which project future health impacts of heat under different climate change scenarios in the UK are reviewed.This review finds that all UK studies demonstrate an increase in heat-related mortality occurring at temperatures above threshold values, with respiratory deaths being more sensitive to heat than deaths from cardiovascular disease (although the burden from cardiovascular deaths is greater in absolute terms). The relationship between heat and other health outcomes such as hospital admissions, myocardial infarctions and birth outcomes is less consistent. We highlight the main populations who are vulnerable to heat. Within the UK, these are older populations, those with certain co-morbidities and those living in Greater London, the South East and Eastern regions.In all assessments of heat-related impacts using different climate change scenarios, deaths are expected to increase due to hotter temperatures, with some studies demonstrating that an increase in the elderly population will also amplify burdens. However, key gaps in knowledge are found in relation to how urbanisation and population adaptation to heat will affect health impacts, and in relation to current and future strategies for effective, sustainable and equitable adaptation to heat. These and other key gaps in knowledge, both in terms of research needs and knowledge required to make sound public- health policy, are discussed.
Collapse
Affiliation(s)
- Katherine G Arbuthnott
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon, OX11 0RQ, UK.
| | - Shakoor Hajat
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| |
Collapse
|
43
|
The years of life lost on cardiovascular disease attributable to ambient temperature in China. Sci Rep 2017; 7:13531. [PMID: 29051518 PMCID: PMC5648808 DOI: 10.1038/s41598-017-13225-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 09/20/2017] [Indexed: 11/15/2022] Open
Abstract
Few studies have examined the association between ambient temperature and years of life lost (YLL). We aim to explore the burden of cardiovascular disease attributed to non-optimum temperature in China. YLL provides a complementary measure for examining the burden of disease due to ambient temperature. Non-optimal temperature leads to the increase of YLL. The mortality of fourteen cities in China during 2008–2013 was included in this study. We used the Distributed Lag Non-linear Model (DLNM) to estimate the association between daily mean temperature and YLL, controlling for long term trends, day of the week, seasonality and relative humidity. The daily YLL varied from 807 in Changchun to 2751 in Chengdu, with males higher than females. Extreme high and low temperatures were associated with higher YLL. The attributable fraction (AF) to cold effect is from 2.67 (95%CI: −1.63, 6.70) to 8.55 (95%CI: 5.05, 11.90), while the AF to heat effect is from 0.16 (95%CI: 0.06, 0.26) to 2.29 (95%CI: 1.29, 3.19). Cold effect was significantly higher than heat effect on cardiovascular disease in both men and women and for different age groups.
Collapse
|
44
|
Osborne NJ, Alcock I, Wheeler BW, Hajat S, Sarran C, Clewlow Y, McInnes RN, Hemming D, White M, Vardoulakis S, Fleming LE. Pollen exposure and hospitalization due to asthma exacerbations: daily time series in a European city. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1837-1848. [PMID: 28500390 PMCID: PMC5643363 DOI: 10.1007/s00484-017-1369-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/17/2017] [Accepted: 04/27/2017] [Indexed: 05/03/2023]
Abstract
Exposure to pollen can contribute to increased hospital admissions for asthma exacerbation. This study applied an ecological time series analysis to examine associations between atmospheric concentrations of different pollen types and the risk of hospitalization for asthma in London from 2005 to 2011. The analysis examined short-term associations between daily pollen counts and hospital admissions in the presence of seasonal and long-term patterns, and allowed for time lags between exposure and admission. Models were adjusted for temperature, precipitation, humidity, day of week, and air pollutants. Analyses revealed an association between daily counts (continuous) of grass pollen and adult hospital admissions for asthma in London, with a 4-5-day lag. When grass pollen concentrations were categorized into Met Office pollen 'alert' levels, 'very high' days (vs. 'low') were associated with increased admissions 2-5 days later, peaking at an incidence rate ratio of 1.46 (95%, CI 1.20-1.78) at 3 days. Increased admissions were also associated with 'high' versus 'low' pollen days at a 3-day lag. Results from tree pollen models were inconclusive and likely to have been affected by the shorter pollen seasons and consequent limited number of observation days with higher tree pollen concentrations. Future reductions in asthma hospitalizations may be achieved by better understanding of environmental risks, informing improved alert systems and supporting patients to take preventive measures.
Collapse
Affiliation(s)
- Nicholas J Osborne
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK.
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Ian Alcock
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Shakoor Hajat
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Rachel N McInnes
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
- Met Office Hadley Centre, Fitzroy Road, Exeter, EX1 3PB, UK
| | | | - Mathew White
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Sotiris Vardoulakis
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon, OX11 0RQ, UK
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| |
Collapse
|
45
|
Sanderson M, Arbuthnott K, Kovats S, Hajat S, Falloon P. The use of climate information to estimate future mortality from high ambient temperature: A systematic literature review. PLoS One 2017; 12:e0180369. [PMID: 28686743 PMCID: PMC5501532 DOI: 10.1371/journal.pone.0180369] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/14/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Heat related mortality is of great concern for public health, and estimates of future mortality under a warming climate are important for planning of resources and possible adaptation measures. Papers providing projections of future heat-related mortality were critically reviewed with a focus on the use of climate model data. Some best practice guidelines are proposed for future research. METHODS The electronic databases Web of Science and PubMed/Medline were searched for papers containing a quantitative estimate of future heat-related mortality. The search was limited to papers published in English in peer-reviewed journals up to the end of March 2017. Reference lists of relevant papers and the citing literature were also examined. The wide range of locations studied and climate data used prevented a meta-analysis. RESULTS A total of 608 articles were identified after removal of duplicate entries, of which 63 were found to contain a quantitative estimate of future mortality from hot days or heat waves. A wide range of mortality models and climate model data have been used to estimate future mortality. Temperatures in the climate simulations used in these studies were projected to increase. Consequently, all the papers indicated that mortality from high temperatures would increase under a warming climate. The spread in projections of future climate by models adds substantial uncertainty to estimates of future heat-related mortality. However, many studies either did not consider this source of uncertainty, or only used results from a small number of climate models. Other studies showed that uncertainty from changes in populations and demographics, and the methods for adaptation to warmer temperatures were at least as important as climate model uncertainty. Some inconsistencies in the use of climate data (for example, using global mean temperature changes instead of changes for specific locations) and interpretation of the effects on mortality were apparent. Some factors which have not been considered when estimating future mortality are summarised. CONCLUSIONS Most studies have used climate data generated using scenarios with medium and high emissions of greenhouse gases. More estimates of future mortality using climate information from the mitigation scenario RCP2.6 are needed, as this scenario is the only one under which the Paris Agreement to limit global warming to 2°C or less could be realised. Many of the methods used to combine modelled data with local climate observations are simplistic. Quantile-based methods might offer an improved approach, especially for temperatures at the ends of the distributions. The modelling of adaptation to warmer temperatures in mortality models is generally arbitrary and simplistic, and more research is needed to better quantify adaptation. Only a small number of studies included possible changes in population and demographics in their estimates of future mortality, meaning many estimates of mortality could be biased low. Uncertainty originating from establishing a mortality baseline, climate projections, adaptation and population changes is important and should be considered when estimating future mortality.
Collapse
Affiliation(s)
| | - Katherine Arbuthnott
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, United Kingdom
| | - Sari Kovats
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shakoor Hajat
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | |
Collapse
|
46
|
Heaviside C, Tsangari H, Paschalidou A, Vardoulakis S, Kassomenos P, Georgiou KE, Yamasaki EN. Heat-related mortality in Cyprus for current and future climate scenarios. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 569-570:627-633. [PMID: 27376918 DOI: 10.1016/j.scitotenv.2016.06.138] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/17/2016] [Accepted: 06/17/2016] [Indexed: 05/28/2023]
Abstract
Extreme temperatures have long been associated with adverse health impacts, ranging from minor illness, to increased hospitalizations and mortality. Heat-related mortality during summer months is likely to become an increasing public health problem in future due to the effects of climate change. We performed a health impact assessment for heat-related mortality for the warm months of April-September for the years 2004 to 2009 inclusive, for the city of Nicosia and for Cyprus as a whole, based on separately derived exposure-response functions. We further estimated the potential future heat-related mortality by including climate projections for southern Europe, which suggest changes in temperature of between 1°C and 5°C over the next century. There were 32 heat-related deaths per year in Cyprus over the study period. When adding the projected increase in temperature due to climate change, there was a substantial increase in mortality: for a 1°C increase in temperature, heat related mortality in Cyprus was estimated to double to 64 per year, and for a 5°C increase, heat-related mortality was expected to be 8 times the baseline rate for the warm season (281 compared with 32). This analysis highlights the importance of preparing for potential health impacts due to heat in Cyprus, particularly under a changing climate.
Collapse
Affiliation(s)
- Clare Heaviside
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, United Kingdom
| | | | - Anastasia Paschalidou
- Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, GR-68200 Orestiada, Greece
| | - Sotiris Vardoulakis
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, United Kingdom
| | - Pavlos Kassomenos
- Laboratory of Meteorology, Department of Physics, University of Ioannina, GR-45110 Ioannina, Greece
| | - Kyriakos E Georgiou
- Cyprus Centre for European and International Affairs, University of Nicosia, Nicosia, Cyprus
| | - Edna N Yamasaki
- University of Nicosia, 46 Makedonitissas Ave, 1700 Nicosia, Cyprus
| |
Collapse
|
47
|
Ding Z, Li L, Wei R, Dong W, Guo P, Yang S, Liu J, Zhang Q. Association of cold temperature and mortality and effect modification in the subtropical plateau monsoon climate of Yuxi, China. ENVIRONMENTAL RESEARCH 2016; 150:431-437. [PMID: 27376930 DOI: 10.1016/j.envres.2016.06.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/11/2016] [Accepted: 06/17/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Consistent evidence has shown excess mortality associated with cold temperature, but some important details of the cold-mortality association (e.g. slope and threshold) have not been adequately investigated and few studies focused on the cold effect in high-altitude areas of developing countries. We attempted to quantify the cold effect on mortality, identify the details, and evaluate effect modification in the distinct subtropical plateau monsoon climate of Yuxi, a high plateau region in southwest China. METHODS From daily mortality and meteorological data during 2009-2014, we used a quasi-Poisson model combined with a "natural cubic spline-natural cubic spline" distributed lag non-linear model to estimate the temperature-mortality relationship and then a simpler "hockey-stick" model to investigate the cold effect and details. RESULTS Cold temperature was associated with increased mortality, and the relative risk of cold effect (1st relative to 10th temperature percentile) on non-accidental, cardiovascular, and respiratory mortality for lag 0-21 days was 1.40 (95% confidence interval: 1.19-1.66), 1.61 (1.28-2.02), and 1.13 (0.78-1.64), respectively. A 1°C decrease below a cold threshold of 9.1°C (8th percentile) for lags 0-21 was associated with a 7.35% (3.75-11.09%) increase in non-accidental mortality. The cold-mortality association was not significantly affected by cause-specific mortality, gender, age, marital status, ethnicity, occupation, or previous history of hypertension. CONCLUSIONS There is an adverse impact of cold on mortality in Yuxi, China, and a temperature of 9.1°C is an important cut-off for cold-related mortality for residents.
Collapse
Affiliation(s)
- Zan Ding
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China; Yuxi Center for Disease Control and Prevention, Yuxi, Yunnan 653000, China
| | - Liujiu Li
- Yuxi Center for Disease Control and Prevention, Yuxi, Yunnan 653000, China
| | - Ruqin Wei
- Yuxi Center for Disease Control and Prevention, Yuxi, Yunnan 653000, China
| | - Wenya Dong
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Shaoyi Yang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Ju Liu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China.
| |
Collapse
|
48
|
Heo S, Lee E, Kwon BY, Lee S, Jo KH, Kim J. Long-term changes in the heat-mortality relationship according to heterogeneous regional climate: a time-series study in South Korea. BMJ Open 2016; 6:e011786. [PMID: 27489155 PMCID: PMC4985795 DOI: 10.1136/bmjopen-2016-011786] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Several studies identified a heterogeneous impact of heat on mortality in hot and cool regions during a fixed period, whereas less evidence is available for changes in risk over time due to climate change in these regions. We compared changes in risk during periods without (1996-2000) and with (2008-2012) heatwave warning forecasts in regions of South Korea with different climates. METHODS Study areas were categorised into 3 clusters based on the spatial clustering of cooling degree days in the period 1993-2012: hottest cluster (cluster H), moderate cluster (cluster M) and cool cluster (cluster C). The risk was estimated according to increases in the daily all-cause, cardiovascular and respiratory mortality per 1°C change in daily temperature above the threshold, using a generalised additive model. RESULTS The risk of all types of mortality increased in cluster H in 2008-2012, compared with 1996-2000, whereas the risks in all-combined regions and cooler clusters decreased. Temporal increases in mortality risk were larger for some vulnerable subgroups, including younger adults (<75 years), those with a lower education and blue-collar workers, in cluster H as well as all-combined regions. Different patterns of risk change among clusters might be attributable to large increases in heatwave frequency or duration during study periods and the degree of urbanisation in cluster H. CONCLUSIONS People living in hotter regions or with a lower socioeconomic status are at higher risk following an increasing trend of heat-related mortality risks. Continuous efforts are needed to understand factors which affect changes in heat-related mortality risks.
Collapse
Affiliation(s)
- Seulkee Heo
- Department of Public Health, Graduate School, Korea University, Seoul, South Korea
| | - Eunil Lee
- Department of Public Health, Graduate School, Korea University, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
- Graduate School of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Bo Yeon Kwon
- Department of Public Health, Graduate School, Korea University, Seoul, South Korea
| | - Suji Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Kyung Hee Jo
- Graduate School of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Jinsun Kim
- Graduate School of Public Health, Graduate School, Korea University, Seoul, Korea
| |
Collapse
|
49
|
Hajat S, Chalabi Z, Wilkinson P, Erens B, Jones L, Mays N. Public health vulnerability to wintertime weather: time-series regression and episode analyses of national mortality and morbidity databases to inform the Cold Weather Plan for England. Public Health 2016; 137:26-34. [DOI: 10.1016/j.puhe.2015.12.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 12/22/2015] [Accepted: 12/30/2015] [Indexed: 11/26/2022]
|
50
|
Milojevic A, Armstrong BG, Gasparrini A, Bohnenstengel SI, Barratt B, Wilkinson P. Methods to Estimate Acclimatization to Urban Heat Island Effects on Heat- and Cold-Related Mortality. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1016-22. [PMID: 26859738 PMCID: PMC4937865 DOI: 10.1289/ehp.1510109] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/19/2015] [Accepted: 01/22/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND Investigators have examined whether heat mortality risk is increased in neighborhoods subject to the urban heat island (UHI) effect but have not identified degrees of difference in susceptibility to heat and cold between cool and hot areas, which we call acclimatization to the UHI. OBJECTIVES We developed methods to examine and quantify the degree of acclimatization to heat- and cold-related mortality in relation to UHI anomalies and applied these methods to London, UK. METHODS Case-crossover analyses were undertaken on 1993-2006 mortality data from London UHI decile groups defined by anomalies from the London average of modeled air temperature at a 1-km grid resolution. We estimated how UHI anomalies modified excess mortality on cold and hot days for London overall and displaced a fixed-shape temperature-mortality function ("shifted spline" model). We also compared the observed associations with those expected under no or full acclimatization to the UHI. RESULTS The relative risk of death on hot versus normal days differed very little across UHI decile groups. A 1°C UHI anomaly multiplied the risk of heat death by 1.004 (95% CI: 0.950, 1.061) (interaction rate ratio) compared with the expected value of 1.070 (1.057, 1.082) if there were no acclimatization. The corresponding UHI interaction for cold was 1.020 (0.979, 1.063) versus 1.030 (1.026, 1.034) (actual versus expected under no acclimatization, respectively). Fitted splines for heat shifted little across UHI decile groups, again suggesting acclimatization. For cold, the splines shifted somewhat in the direction of no acclimatization, but did not exclude acclimatization. CONCLUSIONS We have proposed two analytical methods for estimating the degree of acclimatization to the heat- and cold-related mortality burdens associated with UHIs. The results for London suggest relatively complete acclimatization to the UHI effect on summer heat-related mortality, but less clear evidence for cold-related mortality. CITATION Milojevic A, Armstrong BG, Gasparrini A, Bohnenstengel SI, Barratt B, Wilkinson P. 2016. Methods to estimate acclimatization to urban heat island effects on heat- and cold-related mortality. Environ Health Perspect 124:1016-1022; http://dx.doi.org/10.1289/ehp.1510109.
Collapse
Affiliation(s)
- Ai Milojevic
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Address correspondence to A. Milojevic, Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15–17 Tavistock Place, London WC1H 9SH. Telephone: 44-(0)20-7927-2054. E-mail:
| | - Ben G. Armstrong
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Benjamin Barratt
- Environmental Research Group, King’s College London, London, United Kingdom
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|