Integrated causal-predictive machine learning models for tropical cyclone epidemiology

Nethery, Rachel C.; Katz-Christy, Nina; Kioumourtzoglou, Marianthi-Anna; Parks, Robbie M.; Schumacher, Andrea; Anderson, G. Brooke

doi:10.1093/biostatistics/kxab047

Cited by 11 publications

(25 citation statements)

References 36 publications

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“…These studies also utilized a wind field model to quantify the TC exposure for a large number of TCs and found an elevated risk of mortality [ 9 , 27 ], hospitalization [ 10 , 11 ], and preterm birth [ 26 ] associated with TCs in the USA for the past decades. To our knowledge, only 1 study has estimated the TC-specific health risks, which included all TCs in the USA from 1999 to 2015 and also observed large variations in the TC-related excess mortality across and within TCs [ 27 ]. However, this study did not estimate the TC-specific POC, but instead used an 11-day post-TC period as a hypothetical POC and calculated the excess deaths within this period for all TCs.…”

Section: Discussionmentioning

confidence: 99%

“…We observed an overall monotonically increasing, non-threshold and approximately linear curve of TC-related maximum sustained windspeed and cumulative rainfall with all-cause, cardiovascular, and respiratory mortality risks. Only 1 prior study has estimated the ER curves of TC characteristics with health outcomes and observed a similar monotonically increasing ER relationship with an approximately linear shape between TC-related maximum sustained windspeed and all-cause mortality, hospitalizations for respiratory diseases, chronic obstructive pulmonary diseases, and cardiovascular diseases in the USA [ 27 ]. Stronger TCs with higher windspeed and rainfall were more likely to induce adverse events such as flood, displacement and power outage, there having higher risks causing mortality and morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Stronger TCs with higher windspeed and rainfall were more likely to induce adverse events such as flood, displacement and power outage, there having higher risks causing mortality and morbidity. Prior epidemiological studies on multiple TCs generally assessed the potential hazard of TCs only based on a binary variable of exposure (exposed versus unexposed) in terms of the maximum sustained windspeed [ 9 – 11 , 26 , 27 , 41 , 51 ]. The established ER curves with TC-related windspeed and rainfall in the current study could inform the potential risks of various mortality outcomes associated with different TC intensities.…”

Section: Discussionmentioning

confidence: 99%

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

Huang,

Yang,

Zhang

et al. 2024

PLoS Med

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Background More intense tropical cyclones (TCs) are expected in the future under a warming climate scenario, but little is known about their mortality effect pattern across countries and over decades. We aim to evaluate the TC-specific mortality risks, periods of concern (POC) and characterize the spatiotemporal pattern and exposure-response (ER) relationships on a multicountry scale. Methods and findings Daily all-cause, cardiovascular, and respiratory mortality among the general population were collected from 494 locations in 18 countries or territories during 1980 to 2019. Daily TC exposures were defined when the maximum sustained windspeed associated with a TC was ≥34 knots using a parametric wind field model at a 0.5° × 0.5° resolution. We first estimated the TC-specific mortality risks and POC using an advanced flexible statistical framework of mixed Poisson model, accounting for the population changes, natural variation, seasonal and day of the week effects. Then, a mixed meta-regression model was used to pool the TC-specific mortality risks to estimate the overall and country-specific ER relationships of TC characteristics (windspeed, rainfall, and year) with mortality. Overall, 47.7 million all-cause, 15.5 million cardiovascular, and 4.9 million respiratory deaths and 382 TCs were included in our analyses. An overall average POC of around 20 days was observed for TC-related all-cause and cardiopulmonary mortality, with relatively longer POC for the United States of America, Brazil, and Taiwan (>30 days). The TC-specific relative risks (RR) varied substantially, ranging from 1.04 to 1.42, 1.07 to 1.77, and 1.12 to 1.92 among the top 100 TCs with highest RRs for all-cause, cardiovascular, and respiratory mortality, respectively. At country level, relatively higher TC-related mortality risks were observed in Guatemala, Brazil, and New Zealand for all-cause, cardiovascular, and respiratory mortality, respectively. We found an overall monotonically increasing and approximately linear ER curve of TC-related maximum sustained windspeed and cumulative rainfall with mortality, with heterogeneous patterns across countries and regions. The TC-related mortality risks were generally decreasing from 1980 to 2019, especially for the Philippines, Taiwan, and the USA, whereas potentially increasing trends in TC-related all-cause and cardiovascular mortality risks were observed for Japan. Conclusions The TC mortality risks and POC varied greatly across TC events, locations, and countries. To minimize the TC-related health burdens, targeted strategies are particularly needed for different countries and regions, integrating epidemiological evidence on region-specific POC and ER curves that consider across-TC variability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Huang,

Yang,

Zhang

et al. 2024

PLoS Med

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“…Although this is a limitation in future work focused on understanding the mechanistic pathway linking CVD and hurricanes, novel, validated causal inference methods that allow identification are now available, making this work possible. 76 Future research should seek to use these tools and large data sources to develop an understanding of potential mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Impact of Hurricanes and Associated Extreme Weather Events on Cardiovascular Health: A Scoping Review

Ghosh

Demetres

Geisler

et al. 2022

Environ Health Perspect

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Background: The frequency and destructiveness of hurricanes and related extreme weather events (e.g., cyclones, severe storms) have been increasing due to climate change. A growing body of evidence suggests that victims of hurricanes have increased incidence of cardiovascular disease (CVD), likely due to increased stressors around time of the hurricane and in their aftermath. Objectives: The objective was to systematically examine the evidence of the association between hurricanes (and related extreme weather events) and adverse CVD outcomes with the goal of understanding the gaps in the literature. Methods: A comprehensive literature search of population-level and cohort studies focused on CVD outcomes (i.e., myocardial infarction, stroke, and heart failure) related to hurricanes, cyclones, and severe storms was performed in the following databases from inception to December 2021: Ovid MEDLINE, Ovid EMBASE, Web of Science, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. Studies were then qualitatively synthesized based on the time frame of the CVD outcomes studied and special populations that were studied. Gaps in the literature were identified based on this synthesis. Results: Of the 1,103 citations identified, 48 met our overall inclusion criteria. We identified articles describing the relationship between CVD and extreme weather, primarily hurricanes, based on data from the United States (42), Taiwan (3), Japan (2), and France (1). Outcomes included CVD and myocardial infarction–related hospitalizations (30 studies) and CVVD-related mortality (7 studies). Most studies used a retrospective study design, including one case–control study, 39 cohort studies, and 4 time-series studies. Discussion: Although we identified a number of papers that reported evaluations of extreme weather events and short-term adverse CVD outcomes, there were important gaps in the literature. These gaps included a ) a lack of rigorous long-term evaluation of hurricane exposure, b ) lack of investigation of hurricane exposure on vulnerable populations regarding issues related to environmental justice, c ) absence of research on the exposure of multiple hurricanes on populations, and d ) absence of an exploration of mechanisms leading to worsened CVD outcomes. Future research should attempt to fill these gaps, thus providing an important evidence base for future disaster-related policy. https://doi.org/10.1289/EHP11252

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“… 31 Furthermore, several recent important studies on the associations of cyclones with health were published after these reviews. 7 , 13 – 15 , 17 , 22 , 32 …”

Section: Introductionmentioning

confidence: 99%

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

Huang,

Gao,

et al. 2023

Environ Health Perspect

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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...

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Integrated causal-predictive machine learning models for tropical cyclone epidemiology

Cited by 11 publications

References 36 publications

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

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

Impact of Hurricanes and Associated Extreme Weather Events on Cardiovascular Health: A Scoping Review

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

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