Abstract
BackgroundExcessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period.MethodsAfter ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5) and the evolution of the city population in two future time periods: 2026–2045 and 2081–2100, and in a past time period (1986–2005) to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact.ResultsOur estimates suggest that, compared to the baseline period (1986–2005), heat-related mortality in Skopje would more than double in 2026–2045, and more than quadruple in 2081–2100. When considering the impact in 2081–2100, sampling variability around the heat–mortality relationship and climate model explained 40.3 and 46.6 % of total variability.ConclusionThese results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3077-y) contains supplementary material, which is available to authorized users.
Highlights
Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia
The model has been subjected to exhaustive validation; within the scope of the European Reconciling Adaptation (RAMSES) and North Atlantic Climate Collaborative Project (NACLIM) projects, model results have been compared with hourly temperature measurements for, amongst others, London (United Kingdom), Bilbao (Spain), Antwerp (Belgium), Berlin (Germany), Almada (Portugal) and Paris (France) [9, 28, 29]
The heat–mortality relationship estimated for Skopje for the sample period 2007–2011 is consistent with the results reported in the literature for other European cities
Summary
Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. The epidemiologic evidence on the association between heat and health impacts in major cities of western Europe is robust [1,2,3,4], especially concerning the observed increase in mortality and the risk factors that increase population vulnerability [5, 6]. For each 1 °C increase above a city-specific threshold in maximum apparent temperature, respiratory admissions increased by up to 4.5 % in Mediterranean cities compared to 3.1 % in north-continental cities. There is, some evidence on the association between heat and health from urban settings in Serbia and the former Yugoslav Republic of Macedonia. Intensity and duration of heat waves were the two main factors predicting episodes of excess mortality in Skopje and Belgrade, and both of these coincided during the heat waves in summer 2007 making that summer the most severe in the researched period [25]
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