Increase In Heat-related Mortality Research Articles

Projections and patterns of heat-related mortality impacts from climate change in Southeast Asia

This study aims to investigate the impact of climate change on heat-related mortality in Southeast Asia in the future. The ensemble mean from five General Circulation Models (GCMs) including the Flexible Global Ocean-Atmosphere-Land System Model: Grid-Point Version 3 (FGOALS-g3), Max Planck Institute Earth System Model Version 1.2 (MPI-ESM1-2-LR), EC-Earth3, The Meteorological Research Institute Earth System Model Version 2.0 (MRI-ESM2-0), and Geophysical Fluid Dynamics Laboratory Earth System Model Version 4 (GFDL-ESM4) was used to project severe temperatures and heat indices in Southeast Asia under the Coupled Model Intercomparison Projects Phase 6 (CMIP6). This data was used to correlate with mortality data from the Global Burden of Disease database to quantify heat-related mortality in the region. The ensemble mean results show a reasonable level of accuracy in capturing temperature patterns in the Southeast Asian region with an R2 of 0.96, root mean square error (RMSE) of 0.84 and a standard deviation of residual (SDR) of 0.02. When compared to the baseline (1990–2019), temperature extreme indices are rising across all climatic scenarios, with a substantial increase in the SSP3–7.0 and SSP5–8.5 scenarios, ranging from 10% to 50% over the regions, with the heat index predicted to peak in the middle of the century. The two low-emission scenarios, SSP1-2.6 and SSP2-4.5, on the other hand, anticipate more moderate increases, indicating a potentially less severe impact on the region. As a result, under high-emission scenarios, there is expected to be a significant increase in heat-related mortality across Southeast Asia. The expected impact is estimated to affect between 200 and 300 people per 100,000 people from 2030 to 2079, accordingly. Our results highlight the critical need to address health-related impacts of climate change in this region.

Future Temperature-Related Deaths in the U.S.: The Impact of Climate Change, Demographics, and Adaptation.

Mortality due to extreme temperatures is one of the most worrying impacts of climate change. In this analysis, we use historic mortality and temperature data from 106 cities in the United States to develop a model that predicts deaths attributable to temperature. With this model and projections of future temperature from climate models, we estimate temperature-related deaths in the United States due to climate change, changing demographics, and adaptation. We find that temperature-related deaths increase rapidly as the climate warms, but this is mainly due to an expanding and aging population. For global average warming below 3°C above pre-industrial levels, we find that climate change slightly reduces temperature-related mortality in the U.S. because the reduction of cold-related mortality exceeds the increase in heat-related deaths. Above 3°C warming, whether the increase in heat-related deaths exceeds the decrease in cold-related deaths depends on the level of adaptation. Southern U.S. cities are already well adapted to hot temperatures and the reduction of cold-related mortality drives overall lower mortality. Cities in the Northern U.S. are not well adapted to high temperatures, so the increase in heat-related mortality exceeds the reduction in cold-related mortality. Thus, while the total number of climate-related mortality may not change much, climate change will shift mortality in the U.S. to higher latitudes.

Prediction of climate change impacts on heatstroke cases in Japan's 47 prefectures with the effect of long-term heat adaptation

One of the negative consequences of increased air temperatures due to global warming is the associated increase in heat-related mortality and morbidity. Studies that focused on future predictions of heat-related morbidity do not consider the effect of long-term heat adaptation measures, nor do they use evidence-based methods. Therefore, this study aimed to predict the future heatstroke cases for all 47 prefectures of Japan, by considering long-term heat adaptation by translating current geographical differences in heat adaptation to future temporal heat adaptation. Predictions were conducted for age groups of 7–17, 18–64, and ≥65 years. The prediction period was set to a base period (1981–2000), mid-21st century (2031–2050), and the end of the 21st century (2081–2100). We found that the average heatstroke incidence (number of patients with heatstroke transported by ambulance per population) in Japan under five representative climate models and three greenhouse gas (GHG) emissions scenarios increased by 2.92- for 7–17 years, 3.66- for 18–64 years, and 3.26-fold for ≥65 years at the end of the 21st century without heat adaptation. The corresponding numbers were 1.57 for 7–17 years, 1.77 for 18–64 years, and 1.69 for ≥65 years with heat adaptation. Furthermore, the average number of patients with heatstroke transported by ambulance (NPHTA) under all climate models and GHG emissions scenarios increased by 1.02- for 7–17 years, 1.76- for 18–64 years, and 5.50-fold for ≥65 years at the end of 21st century without heat adaptation, where demographic changes were considered. The corresponding numbers were 0.55 for 7–17 years, 0.82 for 18–64 years, and 2.74 for ≥65 years with heat adaptation. The heatstroke incidence, as well as the NPHTA, substantially decreased when heat adaptation was considered. Our method could be applicable to other regions across the globe.

Updated projections of UK heat-related mortality using policy-relevant global warming levels and socio-economic scenarios

High temperatures and heatwaves are associated with significant impacts on human health. With continued global temperature increases, extreme thresholds relevant to health will be exceeded more frequently. This study provides an updated spatial analysis of heat-related mortality for the UK, using the UK Climate Projections (UKCP18) at 1.5 °C–4 °C global warming levels, and embedding population and demographic data from the recently released UK Shared Socioeconomic Pathways (UK-SSPs). Climate change will lead to an increase in heat-related mortality in the future, exacerbated by increased exposure due to increasing population. We find an increase from ∼1400 average annual deaths in the near-past (1990–2019) (95% CI: 1299–1485), to ∼2500 (2304–2794), ∼3700 (3280–4214), ∼8200 (7376–9072) and >18 000 (16 690–20 394) average annual deaths at 1.5 °C, 2 °C, 3 °C and 4 °C respectively (assuming no adaptation). This is considered a high-end estimate due to the assumption of high population growth (UK-SSP5). Older populations are shown to be most vulnerable. A large proportion of heat-related deaths (76% (74%–79%) with 1.5 °C global warming) are attributed to more moderate (1 °C–5 °C) increases above regional temperature thresholds as opposed to extremes. Our results provide a timely update that can serve as a first step to supporting future UK climate policy and risk assessments. Future research considering nonlinearity in the health response to heat exposure is vital.

Projecting future temperature-related mortality using annual time series data: An example from Hong Kong

BackgroundPrevious studies projecting future temperature-related mortality under climate change have mostly used short-term temperature-mortality associations based on daily time series data. The present study aimed to project mortality under different Representative Concentration Pathways (RCPs) in 21st century in Hong Kong by using analysis of annual data during 1976–2018. MethodsWe employed a degree-days approach, calculating the sum of daily degrees above or below certain temperature threshold within a relevant historical year. The yearly age-standardized mortality rates (ASMRs) were regressed on annual hot and cold degree-days in quasi-Poisson generalized additive models to assess the exposure-response function that was subsequently used to calculate future changes in ASMR. The projection was performed without and with certain human adaptation assumed. ResultsASMRs were projected to have net increases under RCPs 4.5, 6.0, and 8.5, with increased mortality attributable to excess hot days exceeding decreases attributable to excess cold days. The average net changes under RCP8.5 was estimated to be 0.12%, 12.44%, 38.99%, and 89.25% during 2030s, 2050s, 2070s, and 2090s, respectively. Higher projected ASMRs were estimated for those aged over 75 years and for cardiovascular deaths. When human adaptation was considered, slope reduction alone under RCP4.5 and 6.0 and all adaptation assumptions under RCP8.5 might still not offset its corresponding adverse impact. ConclusionsThe projected decreases in cold-related mortality do not compensate for projected increases in heat-related mortality in Hong Kong. Better public adaptations strategies are warranted for coping with the adverse health impacts of climate change on a local scale.

Variation in estimates of heat-related mortality reduction due to tree cover in U.S. cities

Heat-related mortality is one of the leading causes of weather-related deaths in the United States. With changing climates and an aging population, effective adaptive strategies to address public health and environmental justice issues associated with extreme heat will be increasingly important. One effective adaptive strategy for reducing heat-related mortality is increasing tree cover. Designing such a strategy requires decision-support tools that provide spatial and temporal information about impacts. We apply such a tool to estimate spatially and temporally explicit reductions in temperature and mortality associated with a 10% increase in tree cover in 10 U.S. cities with varying climatic, demographic, and land cover conditions. Two heat metrics were applied to represent tree impacts on moderately and extremely hot days (relative to historical conditions). Increasing tree cover by 10% reduced estimated heat-related mortality in cities significantly, with total impacts generally greatest in the most populated cities. Mortality reductions vary widely across cities, ranging from approximately 50 fewer deaths in Salt Lake City to about 3800 fewer deaths in New York City. This variation is due to differences in demographics, land cover, and local climatic conditions. In terms of per capita estimated impacts, hotter and drier cities experience higher percentage reductions in mortality due to increased tree cover across the season. Phoenix potentially benefits the most from increased tree cover, with an estimated 22% reduction in mortality from baseline levels. In cooler cities such as Minneapolis, trees can reduce mortality significantly on days that are extremely hot relative to historical conditions and therefore help mitigate impacts during heat wave conditions. Recent studies project highest increases in heat-related mortality in the cooler cities, so our findings have important implications for adaptation planning. Our estimated spatial and temporal distributions of mortality reductions for each city provide crucial information needed for promoting environmental justice and equity. More broadly, the methods and model can be applied by both urban planners and the public health community for designing targeted, effective policies to reduce heat-related mortality. Additionally, land use managers can use this information to optimize tree plantings. Public stakeholders can also use these impact estimates for advocacy.

Seasonality reversal of temperature attributable mortality projections due to previously unobserved extreme heat in Europe

Seasonality reversal of temperature attributable mortality projections due to previously unobserved extreme heat in Europe

Excess Mortality in England during the 2019 Summer Heatwaves

There is increasing evidence that rising temperatures and heatwaves in the United Kingdom are associated with an increase in heat-related mortality. However, the Public Health England (PHE) Heatwave mortality monitoring reports, which use provisional death registrations to estimate heat-related mortality in England during heatwaves, have not yet been evaluated. This study aims to retrospectively quantify the impact of heatwaves on mortality during the 2019 summer period using daily death occurrences. Second, using the same method, it quantifies the heat-related mortality for the 2018 and 2017 heatwave periods. Last, it compares the results to the estimated excess deaths for the same period in the PHE Heatwave mortality monitoring reports. The number of cumulative excess deaths during the summer 2019 heatwaves were minimal (161) and were substantially lower than during the summer 2018 heatwaves (1700 deaths) and summer 2017 heatwaves (1489 deaths). All findings were at variance with the PHE Heatwave mortality monitoring reports which estimated cumulative excess deaths to be 892, 863 and 778 during the heatwave periods of 2019, 2018 and 2017, respectively. Issues are identified in the use of provisional death registrations for mortality monitoring and the reduced reliability of the Office for National Statistics (ONS) daily death occurrences database before 2019. These findings may identify more reliable ways to monitor heat mortality during heatwaves in the future.

Climate Futures and Projected Mortality Due To Non-Optimal Temperature From 2020 To 2100: A Global Burden of Disease Forecasting Study

Background: A recent study estimated that 1·69 million (95% uncertainty interval [UI] 1·52–1·83) deaths were attributable to non-optimal temperature in 2019. Globally, most of this burden was attributed to low temperatures, but high heat-attributable mortality rates were observed in warmer regions such as south Asia, north Africa and the Middle East, and sub-Saharan Africa. The impact of increases in global temperatures and demographic trends on future temperature-related mortality is unclear. Methods: We linked cause-specific temperature-mortality risk curves to daily temperature forecasts from the NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP) dataset. The NEX-GDDP dataset comprises 21 individual General Circulation Models (GCM) that were spatially downscaled for two Representative Concentration Pathways (RCPs): RCP4.5 and RCP8.5. For each pixel, day, and cause, we estimated the population attributable fraction (PAF) based on the risk of cause-specific mortality at a given temperature relative to the theoretical minimum risk exposure level (TMREL); we then estimated temperature-attributable deaths by multiplying these PAFs by location and cause-specific mortality estimates for the 1990 to 2020 reference period and by forecasted mortality estimates for the period from 2020 to 2100. Other upstream drivers in the mortality forecast model, including the Socio-demographic Index and air pollution levels, were held constant. We additionally estimated PAFs for a temperature scenario based on the 2015 Paris Agreement, assuming that countries meet their nationally determined contributions and continue to reduce emissions at the same rate after 2030. Findings: Globally, we estimate increases in the number and rate of deaths attributable to non-optimal temperature, with 2·26 million (1·66–2·94), 2·54 million (1·86–3·31) and 3·17 million (2·11–4·35) annual deaths by the end of the century, for the Paris scenario, and the RCP4.5 and RCP8.5, respectively. These increases are driven largely by heat-attributable burden, with smaller and more variable changes in cold-attributable deaths. Warm, low-latitude regions will be disproportionally affected, with the largest increases in temperature-attributable mortality expected in sub-Saharan Africa, south Asia, and Latin America and the Caribbean. Heat-attributable mortality was reduced by half for the Paris scenario relative to the RCP8.5 with 1·02 million (0·64–1·48) deaths versus 2·08 million (1·13–3·13) deaths in 2100. As our study accounts for adaptation and does not extrapolate relative risks beyond the exposures currently experienced, these estimates are likely conservative. Interpretation: Globally increasing temperatures are projected to substantially increase the mortality burden attributable to non-optimal temperature. Higher global temperatures only lead to minor decreases in cold-related mortality which do not offset increases in heat-related mortality. Funding: Bill & Melinda Gates Foundation Declaration of Interest: The authors declare that there are no conflicts of interest.

Projecting Global Mortality Due to Non-Optimal Temperature From 2020 to 2100: A Global Burden of Disease Forecasting Study

Background: The Global Burden of Disease Study 2019 (GBD 2019) estimated that approximately 2 million (95% uncertainty interval [UI] 1·7–2·3) deaths and 37·8 million (32·2–47·6) DALYs were attributable to non-optimal temperature in 2019. Globally, most of this burden was attributed to low temperatures, but high heat-attributable mortality rates were observed in warmer regions such as south Asia, north Africa and the Middle East, and sub-Saharan Africa. The impact of increases in global temperatures and demographic trends on future temperature-related mortality is unclear. Methods: We linked cause-specific temperature-mortality risk curves to daily temperature forecasts from the NEX-GDDP dataset. The NEX-GDDP data set comprises 21 individual General Circulation Models (GCM) that were spatially downscaled for two Representative Concentration Pathways (RCPs): RCP4.5 and RCP8.5. For each pixel, day, and cause, we estimated the population attributable fraction (PAF) based on the risk of cause-specific mortality at a given temperature relative to the theoretical minimum risk exposure level (TMREL); we then estimated temperature-attributable deaths by multiplying these PAFs with location-specific mortality estimates for the reference period from 1990 to 2020 and for the forecasted period from 2020 to 2100. Other upstream drivers in the model, including the Socio-demographic Index and air pollution levels, were held constant. Findings: Globally, we estimate increases in the number and rate of deaths attributable to non-optimal temperature, with 3.27 (2.11 – 4.70) million and 4.08 (2.67 – 5.86) million annual deaths by the end of the century, for RCP4.5 and RCP8.5, respectively. These increases are driven largely by heat-attributable burden, with smaller and more variable changes in cold-attributable deaths. Warm, low-latitude regions will be disproportionally affected, with the largest increases in temperature-attributable mortality expected in sub-Saharan Africa, south Asia, and Latin America and the Caribbean. As our study accounts for adaptation and does not extrapolate relative risks beyond the exposure currently experienced, these estimates are likely conservative. Interpretation: Globally increasing temperatures are projected to substantially increase the mortality burden attributable to non-optimal temperature. Higher global temperatures only lead to minor decreases in cold-related mortality which do not offset increases in heat-related mortality. Funding Statement: Bill & Melinda Gates Foundation Declaration of Interests: None to declare.

What is cold-related mortality? A multi-disciplinary perspective to inform climate change impact assessments

BackgroundThere is a growing discussion regarding the mortality burdens of hot and cold weather and how the balance between these may alter as a result of climate change. Net effects of climate change are often presented, and in some settings these may suggest that reductions in cold-related mortality will outweigh increases in heat-related mortality. However, key to these discussions is that the magnitude of temperature-related mortality is wholly sensitive to the placement of the temperature threshold above or below which effects are modelled. For cold exposure especially, where threshold effects are often ill-defined, choices in threshold placement have varied widely between published studies, even within the same location. Despite this, there is little discussion around appropriate threshold selection and whether reported associations reflect true causal relationships – i.e. whether all deaths occurring below a given temperature threshold can be regarded as cold-related and are therefore likely to decrease as climate warms. ObjectivesOur objectives are to initiate a discussion around the importance of threshold placement and examine evidence for causality across the full range of temperatures used to quantify cold-related mortality. We examine whether understanding causal mechanisms can inform threshold selection, the interpretation of current and future cold-related health burdens and their use in policy formation. MethodsUsing Greater London data as an example, we first illustrate the sensitivity of cold related mortality to threshold selection. Using the Bradford Hill criteria as a framework, we then integrate knowledge and evidence from multiple disciplines and areas- including animal and human physiology, epidemiology, biomarker studies and population level studies. This allows for discussion of several possible direct and indirect causal mechanisms operating across the range of ‘cold’ temperatures and lag periods used in health impact studies, and whether this in turn can inform appropriate threshold placement. ResultsEvidence from a range of disciplines appears to support a causal relationship for cold across a range of temperatures and lag periods, although there is more consistent evidence for a causal effect at more extreme temperatures. It is plausible that ‘direct’ mechanisms for cold mortality are likely to occur at lower temperatures and ‘indirect’ mechanisms (e.g. via increased spread of infection) may occur at milder temperatures. ConclusionsSeparating the effects of ‘extreme’ and ‘moderate’ cold (e.g. temperatures between approximately 8–9 °C and 18 °C in the UK) could help the interpretation of studies quoting attributable mortality burdens. However there remains the general dilemma of whether it is better to use a lower cold threshold below which we are more certain of a causal relationship, but at the risk of under-estimating deaths attributable to cold.

Cold-related mortality vs heat-related mortality in a changing climate: A case study in Vilnius (Lithuania)

IntroductionDirect health effects of extreme temperatures are a significant environmental health problem in Lithuania, and could worsen further under climate change. This paper attempts to describe the change in environmental temperature conditions that the urban population of Vilnius could experience under climate change, and the effects such change could have on excess heat-related and cold-related mortality in two future periods within the 21st century. MethodsWe modelled the urban climate of Vilnius for the summer and winter seasons during a sample period (2009–2015) and projected summertime and wintertime daily temperatures for two prospective periods, one in the near (2030–2045) and one in the far future (2085–2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the historical relationship between temperature and mortality for the period 2009–2015, and estimated the projected mortality in the near future and far future periods under a changing climate and population, assuming alternatively no acclimatisation and acclimatisation to heat and cold based on a constant-percentile threshold temperature. ResultsDuring the sample period 2009–2015 in summertime we observed an increase in daily mortality from a maximum daily temperature of 30 °C (the 96th percentile of the series), with an average of around 7 deaths per year. Under a no acclimatisation scenario, annual average heat-related mortality would rise to 24 deaths/year (95% CI: 8.4–38.4) in the near future and to 46 deaths/year (95% CI: 16.4–74.4) in the far future. Under a heat acclimatisation scenario, mortality would not increase significantly in the near or in the far future. Regarding wintertime cold-related mortality in the sample period 2009–2015, we observed increased mortality on days on which the minimum daily temperature fell below − 12 °C (the 7th percentile of the series), with an average of around 10 deaths a year. Keeping the threshold temperature constant, annual average cold-related mortality would decrease markedly in the near future, to 5 deaths/year (95% CI: 0.8–7.9) and even more in the far future, down to 0.44 deaths/year (95% C: 0.1–0.8). Assuming a “middle ground” between the acclimatisation and non-acclimatisation scenarios, the decrease in cold-related mortality will not compensate the increase in heat-related mortality. ConclusionThermal extremes, both heat and cold, constitute a serious public health threat in Vilnius, and in a changing climate the decrease in mortality attributable to cold will not compensate for the increase in mortality attributable to heat. Study results reinforce the notion that public health prevention against thermal extremes should be designed as a dynamic, adaptive process from the inception.

Heat stress mortality and desired adaptation responses of healthcare system in Poland.

Heat stress is one of the environmental factors influencing the health of individuals and the wider population. There is a large body of research to document significant increases in mortality and morbidity during heat waves all over the world. This paper presents key results of research dealing with heat-related mortality (HRM) in various cities in Poland which cover about 25% of the country's population. Daily mortality and weather data reports for the years 1991-2000 were used. The intensity of heat stress was assessed by the universal thermal climate index (UTCI). The research considers also the projections of future bioclimate to the end of twenty-first century. Brain storming discussions were applied to find necessary adaptation strategies of healthcare system (HCS) in Poland, to minimise negative effects of heat stress. In general, in days with strong and very strong heat stress, ones must expect increase in mortality (in relation to no thermal stress days) of 12 and 47%, respectively. Because of projected rise in global temperature and heat stress frequency, we must expect significant increase in HRM to the end of twenty-first century of even 165% in comparison to present days. The results of research show necessity of urgent implementation of adaptation strategies to heat in HCS.

Cold- and heat-related mortality: a cautionary note on current damage functions with net benefits from climate change

Several economic assessments of climate change build on the assumption that reductions of cold-related mortality will overcompensate increases in heat-related mortality at least for moderate levels of global warming. Due to the lack of suitable epidemiological studies with sufficient spatial coverage, many of these assessments rely on one particular dataset: projections of temperature-related mortality in 17 countries published almost 20 years ago. Here, we reanalyse this dataset with a focus on cardiovascular mortality and present evidence for two flaws in the original analysis, which would imply a significant bias towards finding net mortality benefits from climate change: (i) the combination of mortality data for all ages with data specific to the elderly and (ii) the confounding of seasonal effects with direct temperature effects on mortality. This bias appears to be further amplified in the integrated assessment models FUND and ENVISAGE, and related economic assessment tools relying on the same calibration scheme, because heat-related cardiovascular mortality is assumed to affect urban populations only in these models. In an exemplary calculation, we show that while FUND currently projects a net reduction of approximately 380,000 deaths from cardiovascular diseases globally per year at 1 °C of global warming, correcting for the two potential flaws and assuming equal vulnerability of urban and rural populations would result in a net increase of cardiovascular mortality, with approximately 150,000 net additional deaths globally per year. Our findings point to the urgent need of renewing damage functions on temperature-related mortality currently applied in some of the most widely used integrated assessment models.

Estimating the health impact of housing adaptations on heat-related risks in the West Midlands region (UK)

BACKGROUND The home indoor environment is likely to play an important role in determining an individual’s exposure to high temperatures during hot weather, especially for the elderly and vulnerable groups. We describe a model for quantifying the potential impact on health of passive housing adaptations. METHODS A metamodel derived from EnergyPlus 8.1 dynamic thermal building simulations was used to estimate indoor overheating metrics during periods of high temperatures (using standard weather files representative of warm UK summers) for sets of representative dwelling archetypes of the West Midlands housing stock. Impacts on mortality risk were estimated using epidemiologically-defined region-specific temperature-mortality relationships, using the indoor temperature anomaly with respect to the regional mean to quantify variations in risk from dwelling to dwelling. RESULTS We quantified the effect of two adaptation measures: external shutters, and energy efficiency improvements. Initial results suggest that external shutters used throughout the day on days with maximum temperature above 23ºC could reduce the median indoor temperature from 27.2ºC to 24.3ºC, and heat-related mortality by up to 90% under the modelled warm, but not extreme, summer. The largest impact of use of shutters was on semi-detached dwellings (a mean decrease of 3.85ºC (95%CI 3.81-3.88ºC), while highrise flats saw the smallest decrease (1.31ºC, 1.28-1.45ºC). Residents in bungalows, who are disproportionately an elderly population in the UK, carried the greatest overall risk of heat death. Energy-efficiency adaptations in contrast led to a small increase in median temperature with an associated 2.6% increase in heat related mortality. Conclusions Our model for estimating the impact of passive housing adaptations on heat-related mortality suggests substantial benefit from use of external shutters under moderate high temperatures, but potentially negative impacts of energy efficiency adaptations.

Effect of heat waves on morbidity and mortality due to Parkinson's disease in Madrid: A time-series analysis

BackgroundParkinson's disease (PD) is one of the factors which are associated with a higher risk of mortality during heat waves. The use of certain neuroleptic medications to control some of this disease's complications would appear to be related to an increase in heat-related mortality. ObjectiveTo analyse the relationship and quantify the short-term effect of high temperatures during heat wave episodes in Madrid on daily mortality and PD-related hospital admissions. MethodsWe used an ecological time-series study and fit Poisson regression models. We analysed the daily number of deaths due to PD and the number of daily PD-related emergency hospital admissions in the city of Madrid, using maximum daily temperature (°C) as the main environmental variable and chemical air pollution as covariates. We controlled for trend, seasonalities, and the autoregressive nature of the series. ResultsThere was a maximum daily temperature of 30°C at which PD-related admissions were at a minimum. Similarly, a temperature of 34°C coincides with an increase in the number of admissions. For PD-related admissions, the Relative Risk (RR) for every increase of 1°C above the threshold temperature was 1.13 IC95%:(1.03–1.23) at lags 1 and 5; and for daily PD-related mortality, the RR was 1.14 IC95%:(1.01–1.28) at lag 3. ConclusionOur results indicate that suffering from PD is a risk factor that contributes to the excess morbidity and mortality associated with high temperatures, and is relevant from the standpoint of public health prevention plans.

Current and Projected Heat-Related Morbidity and Mortality in Rhode Island.

Background:Climate change is expected to cause increases in heat-related mortality, especially among the elderly and very young. However, additional studies are needed to clarify the effects of heat on morbidity across all age groups and across a wider range of temperatures.Objectives:We aimed to estimate the impact of current and projected future temperatures on morbidity and mortality in Rhode Island.Methods:We used Poisson regression models to estimate the association between daily maximum temperature and rates of all-cause and heat-related emergency department (ED) admissions and all-cause mortality. We then used downscaled Coupled Model Intercomparison Project Phase 5 (CMIP5; a standardized set of climate change model simulations) projections to estimate the excess morbidity and mortality that would be observed if this population were exposed to the temperatures projected for 2046–2053 and 2092–2099 under two representative concentration pathways (RCP): RCP 8.5 and 4.5.Results:Between 2005 and 2012, an increase in maximum daily temperature from 75 to 85°F was associated with 1.3% and 23.9% higher rates of all-cause and heat-related ED visits, respectively. The corresponding effect estimate for all-cause mortality from 1999 through 2011 was 4.0%. The association with all-cause ED admissions was strongest for those < 18 or ≥ 65 years of age, whereas the association with heat-related ED admissions was most pronounced among 18- to 64-year-olds. If this Rhode Island population were exposed to temperatures projected under RCP 8.5 for 2092–2099, we estimate that there would be 1.2% (range, 0.6–1.6%) and 24.4% (range, 6.9–41.8%) more all-cause and heat-related ED admissions, respectively, and 1.6% (range, 0.8–2.1%) more deaths annually between April and October.Conclusions:With all other factors held constant, our findings suggest that the current population of Rhode Island would experience substantially higher morbidity and mortality if maximum daily temperatures increase further as projected.Citation:Kingsley SL, Eliot MN, Gold J, Vanderslice RR, Wellenius GA. 2016. Current and projected heat-related morbidity and mortality in Rhode Island. Environ Health Perspect 124:460–467; http://dx.doi.org/10.1289/ehp.1408826

Rising Temperatures, Human Health, and the Role of Adaptation

There is near consensus in the scientific community that humans will experience higher future temperatures due to the ongoing accumulation of greenhouse gases in the atmosphere. The human response to this climatic change, particularly if accompanied by a surge in extreme heat events, is a key topic being addressed by scientists across many disciplines. In this article, we review recent (2012–2015) research on human health impacts of observed and projected increases in summer temperature. We find that studies based on projected changes in climate indicate substantial increases in heat-related mortality and morbidity in the future, while observational studies based on historical climate and health records show a decrease in negative impacts during recent warming. The discrepancy between the two groups of studies generally involves how well and how quickly humans can adapt to changes in climate via physiological, behavioral, infrastructural, and/or technological adaptation, and how such adaptation is quantified.

Avoided heat-related mortality through climate adaptation strategies in three US cities.

Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1) climate forcings from changing global atmospheric composition; and 2) local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

The Impact of the July 2007 Heat Wave on Daily Mortality in Belgrade, Serbia

Mortality has been shown to increase with heat waves. Serbia experienced the hottest heat wave in July 2007. In this study, we examined patterns of non-traumatic excess mortality in Belgrade during this event. The numbers of deaths observed during the 9-day heat wave were compared to those expected on the basis of mortality rates reported for the previous eight years and two following years. Excess mortality was analyzed by age, gender and cause of death. There was a total of 167 excess deaths (38%) between 16 and 24 July. People aged 75 years and older accounted for 151 (90%) of all excess deaths. An increase of mortality among elderly was 76% in comparison to the baseline mortality. Excess female mortality was over two times higher than excess male mortality (54% : 23%). The biggest increase in mortality was from diabetes mellitus (286%), chronic kidney disease (200%), respiratory system diseases (73%), and nervous system diseases (67%). Cardiovascular and malignant neoplasms mortality accounted for the highest absolute numbers of excess deaths (77 and 49, respectively). There was no decrease in mortality in the 60-day period after the heat wave. There are several causes of an increase in heat-related mortality. The most vulnerable population group is the elderly females.