Mortality Related to Air Temperature in European Cities, Based on Threshold Regression Models

Dimitriadou, Lida; Nastos, Panagiotis T.; Eleftheratos, Kostas; Kapsomenakis, John; Zerefos, C. S.

doi:10.3390/ijerph19074017

Cited by 10 publications

(11 citation statements)

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“…In JJA, mortality risk started increasing as the temperatures increase above around 14.5 °C in Scotland. This is comparable to the temperature thresholds corresponding to the lowest mortality risk (heat threshold thereafter) in Scotland found in another study [ 29 ] but lower than previous studies in other places [ 13 , 38 , 39 ]. This indicates that the heat-health impacts can also be observed at relatively low temperatures in places with a cool climate.…”

Section: Discussionsupporting

confidence: 84%

“…There are few studies from Scotland: a literature search in 2019 only yielded 8 potentially relevant journal articles (See search terms, exclusion criteria and literature list in Appendix 1 ) and of these, only one paper looked explicitly at cold effects on daily mortality in Scotland [ 22 ]. Another paper studying temperature thresholds corresponding to the lowest mortality risk in three European countries including Scotland was published recently [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets

et al. 2022

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Background Adverse health impacts have been found under extreme temperatures in many parts of the world. The majority of such research to date for the UK has been conducted on populations in England, whilst the impacts of ambient temperature on health outcomes in Scottish populations remain largely unknown. Methods This study uses time-series regression analysis with distributed lag non-linear models to characterise acute relationships between daily mean ambient temperature and mortality in Scotland including the four largest cities (Aberdeen, Dundee, Edinburgh and Glasgow) and three regions during 1974–2018. Increases in mortality risk under extreme cold and heat in individual cities and regions were aggregated using multivariate meta-analysis. Cold results are summarised by comparing the relative risk (RR) of death at the 1st percentile of localised temperature distributions compared to the 10th percentile, and heat effects as the RR at the 99th compared to the 90th percentile. Results Adverse cold effects were observed in all cities and regions, and heat effects were apparent in all cities and regions except northern Scotland. Aggregate all-cause mortality risk in Scotland was estimated to increase by 10% (95% confidence interval, CI: 7%, 13%) under extreme cold and 4% (CI: 2%, 5%) under extreme heat. People in urban areas experienced higher mortality risk under extreme cold and heat than those in rural regions. The elderly had the highest RR under both extreme cold and heat. Males experienced greater cold effects than females, whereas the reverse was true with heat effects, particularly among the elderly. Those who were unmarried had higher RR than those married under extreme heat, and the effect remained after controlling for age. The younger population living in the most deprived areas experienced higher cold and heat effects than in less deprived areas. Deaths from respiratory diseases were most sensitive to both cold and heat exposures, although mortality risk for cardiovascular diseases was also heightened, particularly in the elderly. Cold effects were lower in the most recent 15 years, which may be linked to policies and actions in preventing the vulnerable population from cold impacts. No temporal trend was found with the heat effect. Conclusions This study assesses mortality risk associated with extreme temperatures in Scotland and identifies those groups who would benefit most from targeted actions to reduce cold- and heat-related mortalities.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets

et al. 2022

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“…According to the census of 2021 (Hellenic Statistical Authority; https://www.statistics.gr/ statistics/pop (accessed on 21 December 2022)), the total population of the region is 562,069, of which 51% are females. In terms of the populace, the largest cities in EMT are Alexandroupolis (72,959 residents), Xanthi (66,162), Kavala (65,857 residents), Komotini (65,107), Drama (55,593), and Orestiada (37,695 residents). One-fifth of the population in EMT has an age of 65 years and over and this region has the lowest per capita income in Greece.…”

Section: Methodsmentioning

confidence: 99%

“…Specifically, the Mediterranean basin already experiences 1.5 • C higher surface temperature compared to pre-industrial times and future projections demonstrate steadily increasing temperatures, more intense, frequent, and long heat waves, as well as a decrease, but no elimination, of cold spells [37,59,60]. Regarding Greece, the vast majority of existing literature is focused on the two largest urban centers, Athens and Thessaloniki e.g., [4,[61][62][63][64][65][66][67][68]. However, the impact of thermal stress has not been explored in other parts of the country.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Ambient Temperature on Cardiorespiratory Mortality in Northern Greece

Psistaki

Dokas

Paschalidou

2022

IJERPH

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It is well-established that exposure to non-optimum temperatures adversely affects public health, with the negative impact varying with latitude, as well as various climatic and population characteristics. This work aims to assess the relationship between ambient temperature and mortality from cardiorespiratory diseases in Eastern Macedonia and Thrace, in Northern Greece. For this, a standard time-series over-dispersed Poisson regression was fit, along with a distributed lag nonlinear model (DLNM), using a maximum lag of 21 days, to capture the non-linear and delayed temperature-related effects. A U-shaped relationship was found between temperature and cardiorespiratory mortality for the overall population and various subgroups and the minimum mortality temperature was observed around the 65th percentile of the temperature distribution. Exposure to extremely high temperatures was found to put the highest risk of cardiorespiratory mortality in all cases, except for females which were found to be more sensitive to extreme cold. It is remarkable that the highest burden of temperature-related mortality was attributed to moderate temperatures and primarily to moderate cold. The elderly were found to be particularly susceptible to both cold and hot thermal stress. These results provide new evidence on the health response of the population to low and high temperatures and could be useful to local authorities and policy-makers for developing interventions and prevention strategies for reducing the adverse impact of ambient temperature.

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“…In the area of climate change, physical studies of risks associated with natural disasters, including the highest temperature of the year ( Papalexiou et al, 2018 ) and hydro-meteorological hazards ( Debele et al, 2019 ), have been extensively conducted, but there have been relatively few studies of health-related outcomes. The small number of health-related studies include predictive analyses of the health effects—particularly mortality, as well as heat stress disorder—of uncomfortable temperatures; these have been conducted on a national scale ( Barnett, Tong & Clements, 2010 ; Fouillet et al, 2007 ; Kim et al, 2019 ; Lee, Röösli & Ragettli, 2021 ; Weinberger et al, 2019 ), at a regional level ( Dimitriadou et al, 2022 ; Scovronick et al, 2018 ), and on a global scale ( Guo et al, 2017 ; Mistry et al, 2022 ). Heat-related health events are usually observed among elderly people, and therefore more effective countermeasures for protecting elderly people are required ( Rodrigues, Santana & Rocha, 2020 ; Ragettli et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Baseline scenarios of heat-related ambulance transportations under climate change in Tokyo, Japan

Fujimoto

Nishiura

2022

PeerJ

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Background Predictive scenarios of heatstroke over the long-term future have yet to be formulated. The purpose of the present study was to generate baseline scenarios of heat-related ambulance transportations using climate change scenario datasets in Tokyo, Japan. Methods Data on the number of heat-related ambulance transportations in Tokyo from 2015 to 2019 were examined, and the relationship between the risk of heat-related ambulance transportations and the daily maximum wet-bulb globe temperature (WBGT) was modeled using three simple dose–response models. To quantify the risk of heatstroke, future climatological variables were then retrieved to compute the WBGT up to the year 2100 from climate change scenarios (i.e., RCP2.6, RCP4.5, and RCP8.5) using two scenario models. The predicted risk of heat-related ambulance transportations was embedded onto the future age-specific projected population. Results The proportion of the number of days with a WBGT above 28°C is predicted to increase every five years by 0.16% for RCP2.6, 0.31% for RCP4.5, and 0.68% for RCP8.5. In 2100, compared with 2000, the number of heat-related ambulance transportations is predicted to be more than three times greater among people aged 0–64 years and six times greater among people aged 65 years or older. The variance of the heatstroke risk becomes greater as the WBGT increases. Conclusions The increased risk of heatstroke for the long-term future was demonstrated using a simple statistical approach. Even with the RCP2.6 scenario, with the mildest impact of global warming, the risk of heatstroke is expected to increase. The future course of heatstroke predicted by our approach acts as a baseline for future studies.

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Mortality Related to Air Temperature in European Cities, Based on Threshold Regression Models

Cited by 10 publications

References 50 publications

Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets

Temperature-related mortality and associated vulnerabilities: evidence from Scotland using extended time-series datasets

The Impact of Ambient Temperature on Cardiorespiratory Mortality in Northern Greece

Baseline scenarios of heat-related ambulance transportations under climate change in Tokyo, Japan

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