Declining impacts of hot spells on mortality in the Czech Republic, 1986–2009: adaptation to climate change?

The study examines temporal changes in mortality associated with spells of large positive temperature anomalies (hot spells) in extended summer season in the population of the Czech Republic (Central Europe) during 1986?C2009. Declining trends in the mortality impacts are found in spite of rising temperature trends. The finding remains unchanged if possible confounding effects of within-season acclimatization to heat and the mortality displacement effect are taken into account. Recent positive socioeconomic development, following the collapse of communism in Central and Eastern Europe in 1989, and better public awareness of heat-related risks are likely the primary causes of the declining vulnerability. The results suggest that climate change may have relatively little influence on heat-related deaths, since changes in other factors that affect vulnerability of the population are dominant instead of temperature trends. It is essential to better understand the observed nonstationarity of the temperature-mortality relationship and the role of adaptation and its limits, both physiological and technological, and to address associated uncertainties in studies dealing with climate change projections of temperature-related mortality.     

中国不适环境温度对人群死亡影响的疾病负担分析和健康经济学评价

气候变化对人群健康的影响不断加剧,亟待评价不适环境温度对健康的不良影响,量化与温度相关的死亡负担和对应的健康经济损失。本研究基于2013年1月1日至2015年12月31日中国272个主要城市的气温和人口死亡数据,采用时间序列方法建立温度与死亡的暴露-反应关系。同时,收集2020年中国大陆364个城市的气象、社会经济和人口数据,进一步估算31个省、自治区、直辖市低温和高温暴露的归因死亡人数和经济损失。结果表明,环境温度与死亡的暴露-反应关系近似呈反“J”型,环境低温和高温暴露均可引起死亡风险升高。2020年环境低温和高温暴露分别导致中国大陆84.24（95%置信区间（95%CI）:65.93—102.20）万例和23.58（95%CI:14.69—32.17）万例死亡;相应健康的经济损失分别为17011.08（95%CI:13353.51—20597.72）亿元和5097.35（95%CI:3179.66—6945.93）亿元,共占国内生产总值（GDP）的2.18%。不适环境温度暴露已对中国造成了较大的死亡负担和健康经济损失。未来还需加强行动应对气候变化和不适环境温度的健康威胁,因地制宜采取适应措施保护人群健康。      

不同气候变化情景下未来中国热相关死亡风险的预估

预估气候变化背景下中国未来近期、中期及远期温度热相关人群超额死亡风险,为未来热相关人群健康风险防范提供科学依据。基于中国网格化日均气温数据集与3种排放情景下未来日均气温数据、历史人口数据与3种生育率情景下未来人口数据以及死因数据资料计算的热效应暴露-反应关系,计算每日热相关死亡人数。结果表明:（1）未来中国平均气温将持续升高,且北方地区升温幅度较大。（2）1986—2005年中国热相关非意外总死亡人数约为7.1（95%置信区间:5.7—8.5）万。（3）RCP2.6、RCP4.5情景下未来中国热相关非意外总死亡人数均呈现先升后降的变化趋势。21世纪末,不同情景下的热相关非意外总死亡人数均高于基准年代。（4）未来不同情景下中国热相关非意外总死亡人数在黄淮海地区以及成渝地区均呈上升趋势,在RCP2.6、RCP4.5情景下北方地区热相关非意外总死亡人数呈下降趋势,东南沿海地区在21世纪30年代后开始呈下降趋势。总体而言在全球变暖的背景下未来中国热相关死亡风险将上升,而在RCP2.6情景下可以有效抑制其上升趋势。      

Causes for the recent changes in cold- and heat-related mortality in England and Wales

Cold related mortality among people aged over 50 in England and Wales has decreased at a rate of 85 deaths per million population per year over the period 1976–2005. This trend is two orders of magnitude higher than the increase in heat-related mortality observed after 1976. Long term changes in temperature-related mortality may be linked to human activity, natural climatic forcings, or to adaptation of the population to a wider range of temperatures. Here we employ optimal detection, a formal statistical methodology, to carry out an end to end attribution analysis. We find that adaptation is a major influence on changing mortality rates. We also find that adaptation has prevented a significant increase in heat-related mortality and considerably enhanced a significant decrease in cold-related mortality. Our analysis suggests that in the absence of adaptation, the human influence on climate would have been the main contributor to increases in heat-related mortality and decreases in cold-related mortality.     

Heat health planning: The importance of social and community factors

Extreme heat events frequently have adverse effects on population health. Within every population certain groups and individuals are at a greater risk of heat-related morbidity and mortality than others. While certain physiological characteristics (advanced age, chronic conditions, etc.) are known to increase the risk of illness and/or death during periods of extreme heat, the role of social and community level factors in aggravating or mitigating this risk is poorly understood. This paper reviews the literature on the social and community level factors that affect heat-related morbidity and mortality in order to identify shortfalls in current heat health response plans so that new approaches can be recommended. While social isolation, ethnicity, socioeconomic status, and neighborhood characteristics have all been identified as potential factors affecting the risk of heat-related illness and mortality, these are rarely, if ever, identified as heat health research priorities and are thus often neglected in heat emergency planning. Current research and programming practices are often prioritized from the top down where decisions are made at the federal level and research priorities are determined by national research bodies. This, unfortunately, may not allow enough flexibility to meet the needs of physically, socially and culturally diverse communities. A more socio-ecological approach to heat health research and planning would better allow for the identification of community level vulnerabilities and available resources and would encourage communities to work with regional or national partners to adapt response plans accordingly. The development of future plans should involve more partnerships at the community level so that social and community level factors that are currently overlooked may be included in heat health response strategies.     

Human biometeorological evaluation of heat-related mortality in Vienna

The relationship between heat stress and mortality in the federal state of Vienna (Austria) was analyzed from 1970 to 2007. Long-term trends of mortality data and short-term adaptation to heat stress were considered by two complex approaches. The evaluation is based on the human biometeorological parameter, physiologically equivalent temperature. The results revealed a significant impact of heat stress on the human health, with a significantly higher sensitivity on women compared to men. Additionally, higher risks of deaths due to cardiovascular and respiratory diseases were found. During the long period of 38?years, some significant decreases of the sensitivity were found, especially in the medium heat stress levels. This could indicate active processes of long-term adaptation to the increasing heat stress.     

Public health impacts of climate change in Washington State: projected mortality risks due to heat events and air pollution

Illness and mortality related to heat and worsening air quality are core public health concerns associated with climate change projections. We examined the historical relationship between age- and cause-specific mortality rates from 1980 through 2006 and heat events at the 99th percentile of humidex values in the historic period from January 1, 1970 to December 31, 2006 in the greater Seattle area (King, Pierce and Snohomish counties), Spokane County, the Tri-Cities (Benton and Franklin counties) and Yakima County; the relative risks of mortality during heat events were applied to population and climate projections for Washington State to calculate number of deaths above the baseline (1980–2006) expected during projected heat events in 2025, 2045 and 2085. Three different warming scenarios were used in the analysis. Relative risks for the greater Seattle area showed a significant dose-response relationship between heat event duration and daily mortality rates for non-traumatic deaths for persons ages 45 and above, typically peaking at four days of exposure to humidex values above the 99th percentile. The largest number of projected excess deaths in all years and scenarios for the Seattle region was found for age 65 and above. Under the middle warming scenario, this age group is expected to have 96, 148 and 266 excess deaths from all non-traumatic causes in 2025, 2045 and 2085, respectively. We also examined projected excess deaths due to ground-level ozone concentrations at mid century (2045–2054) in King and Spokane counties. Current (1997–2006) ozone measurements and mid-twenty-first century ozone projections were coupled with dose-response data from the scientific literature to produce estimates overall and cardiopulmonary mortality. Daily maximum 8-h ozone concentrations are forecasted to be 16–28% higher in the mid twenty-first century compared to the recent decade of 1997–2006. By mid-century in King County the non-traumatic mortality rate related to ozone was projected to increase from baseline (0.026 per 100,000; 95% confidence interval 0.013–0.038) to 0.033 (95% CI 0.017–0.049). For the same health outcome in Spokane County, the baseline period rate of 0.058 (95% CI 0.030–0.085) was estimated increase to 0.068 (95% CI 0.035–0.100) by mid-century. The cardiopulmonary death rate per 100,000 due to ozone was estimated to increase from 0.011 (95% CI 0.005–0.017) to 0.015 (0.007–0.022) in King County, and from 0.027 (95% CI 0.013–0.042) to 0.032 (95% CI 0.015–0.049) in Spokane County. Public health interventions aimed at protecting Washington’s population from excessive heat and increased ozone concentrations will become increasingly important for preventing deaths, especially among older adults. Furthermore, heat and air quality related illnesses that do not result in death, but are serious nevertheless, may be reduced by the same measures.     

Probabilistic spatial risk assessment of heat impacts and adaptations for London

High temperatures and heatwaves can cause large societal impacts by increasing health risks, mortality rates, and personal discomfort. These impacts are exacerbated in cities because of the Urban Heat Island (UHI) effect, and the high and increasing concentrations of people, assets and economic activities. Risks from high temperatures are now widely recognised but motivation and implementation of proportionate policy responses is inhibited by inadequate quantification of the benefits of adaptation options, and associated uncertainties. This study utilises high spatial resolution probabilistic projections of urban temperatures along with projections of demographic change, to provide a probabilistic risk assessment of heat impacts on urban society. The study focuses on Greater London and the surrounding region, assessing mortality risk, thermal discomfort in residential buildings, and adaptation options within an integrated framework. Climate change is projected to increase future heat-related mortality and residential discomfort. However, adjusting the temperature response function by 1–2 °C, to simulate adaptation and acclimatisation, reduced annual heat related mortality by 32–69 % across the scenarios tested, relative to a no adaptation scenario. Similar benefits of adaptation were seen for residential discomfort. The study also highlights additional benefits in terms of reduced mortality and residential discomfort that mitigating the urban heat island, by reducing albedo and anthropogenic heat emissions, could have.     

上海热浪与健康监测预警系统

用1989～1998年上海逐日4次气象观测资料,应用美国特拉华大学的SSC天气分类方法确定逐日天气类型,形成了10年逐日天气类型日历。并通过天气类型与死亡率的对比分析,确定MT+类型是上海地区形成热浪的“侵人型”气团,是具有最高死亡率的天气类型。采用逐步回归方法建立了MT+类型下因受热浪侵袭而超正常死亡数的回归方程。在此基础上建立了上海热浪与健康监测预警系统。通过1999年气象和死亡实况资料检验,系统对热浪及因此引起的死亡具有较好的监测和预警效果。     

衡量上海夏季暑热程度的相对舒适度指数研究

为了改进目前被广泛应用的绝对舒适度指数的局限性，介绍了一种可以用来衡量夏季暑热程度的相对舒适度指数，该指数包含了有些指标没有考虑到的因子，如高温天气的连续天数、云量、有效累积温度等。相对舒适度指数可用于夏季暑热程度与热死亡的关系研究。     

Human mortality impacts of the 2015 summer heat spells in Slovakia

In 2015, Central Europe experienced an unusually warm summer season. For a great majority of climatic stations around Slovakia, it had been the warmest summer ever recorded over their entire instrumental observation period. In this study, we investigate the mortality effects of hot days’ sequences during that particular summer on the Slovak population. In consideration of the range of available mortality data, the position of 2015 is analysed within the years 1996–2015. Over the given 20-year period, the summer heat spells of 2015 were by far the most severe from a meteorological point of view, and clearly the deadliest with the total of almost 540 excess deaths. In terms of impacts, an extraordinary 10-day August heat spell was especially remarkable. The massive lethal effects of heat would have likely been even more serious under normal circumstances, since the number of premature deaths appeared to be partially reduced due to a non-standard mortality pattern in the first quarter of the year. The heat spells of the extremely warm summer of 2015 in Slovakia are notable not just for their short-term response in mortality. It appears that in a combination with the preceding strong influenza season, they subsequently affected mortality conditions in the country in the following months up until the end of the year. The impacts described above were rather different for selected population subgroups (men and women, the elderly). Both separately and as a part of the annual mortality cycle, the 2015 summer heat spells may represent a particularly valuable source of information for public health.     

沿海城市极端气温对脑卒中死亡的滞后定量影响

当夏季和冬季出现极端气温时,脑卒中死亡有明显增加,但不同地区极端气温对脑卒中死亡的影响不同。以宁波为沿海城市的代表,采用2013—2019年宁波市脑卒中死亡病例和同期的气温数据,利用分布滞后非线性模型（DLNM）,研究了极端气温对不同群组脑卒中死亡的滞后定量影响。结果表明：（1）极端高温对除低龄组外的其他人群脑卒中死亡效应趋势基本一致,即累积相对危险度（RR）及95%置信区间（95%CI）随时间延长增大,热累积促进效应随时间增强,对全部人群滞后3 d内的脑卒中死亡有促进效应。40℃滞后0—1 d、0—2 d和0—3 d累积相对危险度（95%CI）分别为1.29(1.17—1.43)、1.38(1.22—1.55)和1.41(1.25—1.60)。（2）极端低温对不同人群脑卒中死亡促进效应趋势不同,对于全部人群,当天没有明显的促进效应,滞后第3到4天开始有明显的促进效应,累积相对危险度（95%CI）随时间增大,低温累积促进效应随时间增强,滞后15 d后对脑卒中死亡无明显的促进效应。-4℃滞后0—5 d、0—10 d和0—15 d累积相对危险度（95%CI）分别为1.23(1.00—1.5...     

The impact of extreme heat on morbidity in Milwaukee, Wisconsin

Given predictions of increased intensity and frequency of heat waves, it is important to study the effect of high temperatures on human mortality and morbidity. Many studies focus on heat wave-related mortality; however, heat-related morbidity is often overlooked. The goals of this study are to examine the historical observed relationship between temperature and morbidity (illness), and explore the extent to which observed historical relationships could be used to generate future projections of morbidity under climate change. We collected meteorological, air pollution, and hospital admissions data in Milwaukee, Wisconsin, for the years 1989–2005, and employed a generalized additive model (GAM) to quantify the relationship between morbidity (as measured by hospital admissions) and high temperatures with adjustment for the effects of potential confounders. We also estimated temperature threshold values for different causes of hospital admissions and then quantified the associated percent increase of admissions per degree above the threshold. Finally, the future impact of higher temperatures on admissions for the years 2059–2075 was examined. Our results show that five causes of admission (endocrine, genitourinary, renal, accidental, and self-harm) and three age groups (15–64, 75–84, >85 years) were affected by high temperatures. Future projections indicate a larger number of days above the current temperature threshold leading to an increase in admissions. Our results indicate that climate change may increase heat-related hospital admissions in the US urban mid-West and that health systems should include heat wave planning.     

Relevance of thermal environment to human health: a case study of Ondo State, Nigeria

The interconnection between weather and climate and the performance, well-being, and human health cannot be overemphasized. The relationship between them is of both local and global significance. Information about weather, climate, and thermal environment is very important to human health and medical practitioners. The most crucial environmental information needed by medical practitioners and for maintaining human health, performance, and well-being are thermal conditions. The study used meteorological variables: air temperature, relative humidity, wind speed, solar radiation, and RayMan model as an analytical tool to compute physiologically equivalent temperature (PET) in order to assess thermo-physiological thresholds in Ondo State. The study revealed that there are marked spatial and seasonal variations in the environmental thermal conditions in the study area. The results of physiologically equivalent temperature for different grades of thermal sensation and physiological stress on human beings indicate that about 60 % of the total study period (1998–2008) fall under physiological stress level of moderate heat stress (PET 31–36 °C). In derived savannah, 32.6 % out of the total study period was under strong heat stress. In view of this, the study concluded that Ondo State may likely be prone to heat-related ailments and that some of the death recorded in the State, in recent times, may be heat-related mortality, but this is difficult to ascertain because there is no postmortem records in Nigeria where it could be confirmed. This type of study is relevant to help government to improve health care interventions and achieve Millennium Development Goals in health sector.     

Future heat vulnerability in California, Part II: projecting future heat-related mortality

Through the 21^st century, a significant increase in heat events is likely across California (USA). Beyond any climate change, the state will become more vulnerable through demographic changes resulting in a rapidly aging population. To assess these impacts, future heat-related mortality estimates are derived for nine metropolitan areas in the state for the remainder of the century. Heat-related mortality is first assessed by initially determining historical weather-type mortality relationships for each metropolitan area. These are then projected into the future based on predicted weather types created in Part I. Estimates account for several levels of uncertainty: for each metropolitan area, mortality values are produced for five different climate model-scenarios, three different population projections (along with a constant-population model), and with and without partial acclimatization. Major urban centers could have a greater than tenfold increase in short-term increases in heat-related mortality in the over 65 age group by the 2090s.     

石家庄高温、热浪和闷热天气对心脑血管疾病死亡人数的影响

评价高温、热浪、闷热不同热感天气暴露对心脑血管疾病死亡人数的影响。采用广义相加模型（GAM）、平滑曲线阈值效应方法,在控制了时间序列长期趋势、季节效应、节假日效应的混杂影响后,分析了2010—2016年的6—8月石家庄高温、热浪、闷热不同热感天气暴露对心脑血管疾病死亡人数的影响,并分析了男女性别的分人群效应。研究期间收集到心脑血管疾病死亡总计6552人,日均死亡10.2人,日死亡最多为40.0人。对应期间出现高温日98 d,热浪日58 d,闷热日79 d。相对于非高温、热浪、闷热日,高温、热浪、闷热天气对心脑血管疾病死亡人数影响的相对危险度分别为1.086（95%置信区间（95%CI）:1.013—1.164）、1.252（95%CI:1.101—1.442）、1.100（95%CI:1.020—1.185）,其最大滞后效应分别为3 d、1 d、0 d,对应死亡人数增加的风险分别为12.2%、31.8%、10.0%,且对女性的影响风险均大于男性。高温、热浪、闷热天气均可导致心脑血管疾病死亡风险的增加,归因滞后1 d热浪死亡的风险最大,归因闷热天气死亡的风险未发现滞后效应,建议依据不同热感天气有针对性地建立健康风险管理和应对机制。      

Heat vulnerability and adaptation of low-income households in Germany

Heat waves associated with global warming are a significant hazard to human health, and they particularly endanger low-income households. In this study, we systematically analyze how the different components of heat vulnerability are related to household income, and present empirical evidence on the determinants of heat adaptation, focusing on the role of income. We contribute the first empirical analysis of heat vulnerability using household-level data at the national level, based on a longitudinal survey, including data points for 10,226 households in Germany in the period 2012–2020. Our results indicate that low income households are significantly more heat sensitive and have lower adaptive capacity than high income households, measured inter alia by health status, household composition, and economic and psychological resources to implement adaptation measures. However, heat hazard and exposure levels are comparable between income groups, hence there is no sorting of richer households into less hazardous or exposed locations on a national scale. We also contribute robust empirical evidence on the factors influencing household decisions to implement technical adaptation measures (e.g. installation of air conditioning), ultimately showing that the adaptation behavior of the most vulnerable households (e.g. people with poor health conditions or the elderly) is not limited by financial constraints.     

Difference in the Interdecadal Variability of Spring and Summer Sensible Heat Flux over Northwest China

The present study investigates the difference in interdecadal variability of the spring and summer sensible heat fluxes over Northwest China by using station observations from 1960 to 2000. It was found that the spring sensible heat flux over Northwest China was greater during the period from the late 1970s to the 1990s than during the period from the 1960s to the mid-1970s. The summer sensible heat flux was smaller in the late 1980s through the 1990s than it was in the 1970s through the early 1980s. Both the spring and summer land-air temperature differences over Northwest China displayed an obvious interdecadal increase in the late 1970s. Both the spring and summer surface wind speeds experienced an obvious interdecadal weakening in the late 1970s. The change in the surface wind speed played a more important role in the interdecadal variations in sensible heat flux during the summer, whereas the change in the land-air temperature difference was more important for the interdecadal variations in sensible heat flux in the spring. This difference was related to seasonal changes in the mean land-air temperature difference and the surface wind speed. Further analysis indicated that the increase in the spring land surface temperature in Northwest China was related to an increase in surface net radiation.     

高温热浪致死风险的人群和城市分异及保险费率厘定的研究

在全球变暖背景下,高温热浪事件在世界各地频繁发生且大大加剧了人群致死的风险。基于3个研究地区（南京、广州和重庆）1951—2015年的逐日气象数据和2007—2013年逐日死亡数据,首先设计了热浪强度指数来量化热浪特征;其次采用分布滞后非线性模型构建高温热浪灾害下人群的脆弱性模型;最后采用蒙特卡洛仿真方法模拟随机高温热浪事件,并在此基础上开展概率风险评估与高温热浪生命保险费率的厘定。研究发现：老年人的高温热浪死亡风险与对应的费率水平是年轻人的9~28倍;其中,高温热浪费率水平与社会经济发展水平呈反比,即经济发展水平较高的地区费率水平较低。该研究成果为指数生命/健康保险产品的研发,为政府采取综合性的风险管理措施以减少公众健康风险等提供了一定的借鉴和参考。     

青藏高原中东部地区地表感热通量的时空变化特征

基于1970—2015年青藏高原地区78个站点的观测资料,应用物理方法计算了高原中东部地区的感热通量。利用小波分析、相关性分析等研究了高原中东部感热通量的时空特征和影响因子。结果表明,高原年平均和春夏季节,感热通量周期为3~4 a,而秋冬季节为2~3 a;感热通量的变化趋势为,1970—1980年和2001—2015年感热通量呈增加趋势,而1981—2000年呈减小趋势;高原年平均和各季节的最强感热加热中心均位于高原南坡E区（除冬季外),最弱加热区域位于高原西北部A区（夏季除外);高原春秋季节感热通量的空间分布均匀,冬夏季节有明显的梯度分布且梯度相反,夏季呈现自东到西的梯度;春季、夏季及秋季,高原感热通量和降水呈负相关;高原10 m风速的极值中心随季节北上南撤变化与地气温差的强弱变化共同决定了感热通量的季节变化。