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The health impact of climate change depends on various conditions at any given time and place, as well as on the person. Temporal variations in the relationship between high temperature and mortality need to be explored in depth to explain how changes in the level of exposure and public health interventions modify the temperature-mortality relationship. We examined changes in the relationship between human mortality and temperature in Seoul, which has the highest population in South Korea, considering the change in population structure from 1993-2009. Poisson regression models were used to estimate short-term temperature-related mortality impacts. Temperature-related risks were divided into two "time periods" of approximately equal length (1993 and 1995-2000, and 2001-2009), and were also examined according to early summer and late summer. Temperature-related mortality in summer over the past 17 years has declined. These decreasing patterns were stronger for cardiovascular disease-related mortality than for all non-accidental deaths. The novel finding is that declines in temperature-related mortality were particularly noteworthy in late summer. Our results indicate that temperature-related mortality is decreasing in Seoul, particularly during late summer and, to a lesser extent, during early summer. This information would be useful for detailed public health preparedness for hot weather.

The authors conducted a time-series analysis to estimate the acute effects of high temperature in 6 cities in Korea and to compare thresholds of temperature on daily mortality among the cities. They examined the association between total mortality and the daily mean temperature and heat index during the summers in Korea from 1994 to 2003. The threshold temperature was estimated to be between 27.0 degrees C and 29.7 degrees C for 4 cities. For a daily mean temperature increase of 1 degrees C above the thresholds in Seoul, Daegu, Incheon, and Gwangju, estimated percentage increases in daily mortality were 16.3 (95% confidence interval [CI] = 14.2-18.4), 9.10 (CI = 5.12-13.2), 7.01 (CI = 4.42-9.66), and 6.73 (CI = 2.47-11.2), respectively. These city-specific threshold temperatures and the magnitude of the effects of hot temperature indicate that any analysis of the impact of climate change should take into account regional differences.

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