TY - JOUR
T1 - Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019
T2 - a three-stage modelling study
AU - Zhao, Qi
AU - Guo, Yuming
AU - Ye, Tingting
AU - Gasparrini, Antonio
AU - Tong, Shilu
AU - Overcenco, Ala
AU - Urban, Aleš
AU - Schneider, Alexandra
AU - Entezari, Alireza
AU - Vicedo-Cabrera, Ana Maria
AU - Zanobetti, Antonella
AU - Analitis, Antonis
AU - Zeka, Ariana
AU - Tobias, Aurelio
AU - Nunes, Baltazar
AU - Alahmad, Barrak
AU - Armstrong, Ben
AU - Forsberg, Bertil
AU - Pan, Shih Chun
AU - Íñiguez, Carmen
AU - Ameling, Caroline
AU - De la Cruz Valencia, César
AU - Åström, Christofer
AU - Houthuijs, Danny
AU - Dung, Do Van
AU - Royé, Dominic
AU - Indermitte, Ene
AU - Lavigne, Eric
AU - Mayvaneh, Fatemeh
AU - Acquaotta, Fiorella
AU - de'Donato, Francesca
AU - Di Ruscio, Francesco
AU - Sera, Francesco
AU - Carrasco-Escobar, Gabriel
AU - Kan, Haidong
AU - Orru, Hans
AU - Kim, Ho
AU - Holobaca, Iulian Horia
AU - Kyselý, Jan
AU - Madureira, Joana
AU - Schwartz, Joel
AU - Jaakkola, Jouni J.K.
AU - Katsouyanni, Klea
AU - Hurtado Diaz, Magali
AU - Ragettli, Martina S.
AU - Hashizume, Masahiro
AU - Pascal, Mathilde
AU - de Sousa Zanotti Stagliorio Coélho, Micheline
AU - Valdés Ortega, Nicolás
AU - Ryti, Niilo
AU - Scovronick, Noah
AU - Michelozzi, Paola
AU - Matus Correa, Patricia
AU - Goodman, Patrick
AU - Nascimento Saldiva, Paulo Hilario
AU - Abrutzky, Rosana
AU - Osorio, Samuel
AU - Rao, Shilpa
AU - Fratianni, Simona
AU - Dang, Tran Ngoc
AU - Colistro, Valentina
AU - Huber, Veronika
AU - Lee, Whanhee
AU - Seposo, Xerxes
AU - Honda, Yasushi
AU - Guo, Yue Leon
AU - Bell, Michelle L.
AU - Li, Shanshan
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2021/7
Y1 - 2021/7
N2 - Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. Interpretation: Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios. Funding: Australian Research Council and the Australian National Health and Medical Research Council.
AB - Background: Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods: In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings: Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. Interpretation: Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios. Funding: Australian Research Council and the Australian National Health and Medical Research Council.
UR - http://www.scopus.com/inward/record.url?scp=85109426619&partnerID=8YFLogxK
U2 - 10.1016/S2542-5196(21)00081-4
DO - 10.1016/S2542-5196(21)00081-4
M3 - Article
C2 - 34245712
AN - SCOPUS:85109426619
SN - 2542-5196
VL - 5
SP - e415-e425
JO - The Lancet Planetary Health
JF - The Lancet Planetary Health
IS - 7
ER -