Health Effects of Cyclones: A Systematic Review and Meta-Analysis of Epidemiological Studies

Abstract

Background: More intense cyclones are expected in the future as a result of climate change. A comprehensive review is urgently needed to summarize and update the evidence on the health effects of cyclones. Objectives: We aimed to provide a systematic review with meta-analysis of current evidence on the risks of all reported health outcomes related to cyclones and to identify research gaps and make recommendations for further research. Methods: We systematically searched five electronic databases (MEDLINE, Embase, PubMed, Scopus, and Web of Science) for relevant studies in English published before 21 December 2022. Following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we developed inclusion criteria, screened the literature, and included epidemiological studies with a quantitative risk assessment of any mortality or morbidity-related outcomes associated with cyclone exposures. We extracted key data and assessed study quality for these studies and applied meta-analyses to quantify the overall effect estimate and the heterogeneity of comparable studies. Results: In total, 71 studies from eight countries (the United States, China, India, Japan, the Philippines, South Korea, Australia, Brazil), mostly the United States, were included in the review. These studies investigated the all-cause and cause-specific mortality, as well as morbidity related to injury, cardiovascular diseases (CVDs), respiratory diseases, infectious diseases, mental disorders, adverse birth outcomes, cancer, diabetes, and other outcomes (e.g., suicide rates, gender-based violence). Studies mostly included only one high-amplitude cyclone (cyclones with a Saffir–Simpson category of 4 or 5, i.e., Hurricanes Katrina or Sandy) and focused on mental disorders morbidity and all-cause mortality and hospitalizations. Consistently elevated risks of overall mental health morbidity, post-traumatic stress disorder (PTSD), as well as all-cause mortality or hospitalizations, were found to be associated with cyclones. However, the results for other outcomes were generally mixed or limited. A statistically significant overall relative risk of 1.09 [95% confidence interval (CI): 1.04, 1.13], 1.18 (95% CI: 1.12, 1.25), 1.15 (95% CI: 1.13, 1.18), 1.26 (95% CI: 1.05, 1.50) was observed for all-cause mortality, all-cause hospitalizations, respiratory disease, and chronic obstructive pulmonary disease hospitalizations, respectively, after cyclone exposures, whereas no statistically significant risks were identified for diabetes mortality, heart disease mortality, and preterm birth. High between-study heterogeneity was observed. Conclusions: There is generally consistent evidence supporting the notion that high-amplitude cyclones could significantly increase risks of mental disorders, especially for PTSD, as well as mortality and hospitalizations, but the evidence for other health outcomes, s...

Tropical cyclone-specific mortality risks and the periods of concern: A multicountry time-series study

“…Two major and distinct causes of death, cardiovascular (ICD-10 codes I00–I99) and respiratory (ICD-10 codes J00–J99) mortality were also collected for each location. Cardiovascular and respiratory mortality, largely attributable to the indirect consequences of TCs, such as property loss, resource depletion, and disruptions in medical support, constitute a major part of the TC-associated mortality burden [ 17 ]. Except for the MCC data, we also collected data on all individual deaths (date, cause, and location of death) in Australia between 2009 and 2017 from the Australian Cause of Death Unit Record File [ 30 ], in New Zealand between 2000 and 2018 from the New Zealand Ministry of Health [ 31 ], in Brazil between 1996 and 2019 from the Brazil Mortality Information System (Sistema de Informação sobre Mortalidade, SIM) [ 32 ], and in Canada between 1986 and 2015 from the Vital Statistics Deaths Database of Statistics Canada [ 33 ].…”

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