Changes in Susceptibility to Heat during the Summer

A Multicountry Analysis

Antonio Gasparrini, Yuming Guo, Masahiro Hashizume, Eric Lavigne, Aurelio Tobias, Antonella Zanobetti, Joel D. Schwartz, Michela Leone, Paola Michelozzi, Haidong Kan, Shilu Tong, Yasushi Honda, Ho Kim, Ben G. Armstrong

Research output: Contribution to journalArticleResearchpeer-review

42 Citations (Scopus)

Abstract

Few studies have examined the variation in mortality risk associated with heat during the summer. Here, we apply flexible statistical models to investigate the issue by using a large multicountry data set. We collected daily time-series data of temperature and mortality from 305 locations in 9 countries, in the period 1985-2012. We first estimated the heat-mortality relationship in each location with time-varying distributed lag non-linear models, using a bivariate spline to model the exposure-lag-response over lag 0-10. Estimates were then pooled by country through multivariate meta-analysis. Results provide strong evidence of a reduction in risk over the season. Relative risks for the 99th percentile versus the minimum mortality temperature were in the range of 1.15-2.03 in early summer. In late summer, the excess was substantially reduced or abated, with relative risks in the range of 0.97-1.41 and indications of wider comfort ranges and higher minimum mortality temperatures. The attenuation is mainly due to shorter lag periods in late summer. In conclusion, this multicountry analysis suggests a reduction of heat-related mortality risk over the summer, which can be attributed to several factors, such as true acclimatization, adaptive behaviors, or harvesting effects. These findings may have implications on public health policies and climate change health impact projections.

Original languageEnglish
Pages (from-to)1027-1036
Number of pages10
JournalAmerican Journal of Epidemiology
Volume183
Issue number11
DOIs
Publication statusPublished - 1 Jun 2016
Externally publishedYes

Keywords

  • adaptation
  • climate change
  • distributed lag models
  • heat
  • mortality
  • temperature

Cite this

Gasparrini, A., Guo, Y., Hashizume, M., Lavigne, E., Tobias, A., Zanobetti, A., ... Armstrong, B. G. (2016). Changes in Susceptibility to Heat during the Summer: A Multicountry Analysis. American Journal of Epidemiology, 183(11), 1027-1036. https://doi.org/10.1093/aje/kwv260
Gasparrini, Antonio ; Guo, Yuming ; Hashizume, Masahiro ; Lavigne, Eric ; Tobias, Aurelio ; Zanobetti, Antonella ; Schwartz, Joel D. ; Leone, Michela ; Michelozzi, Paola ; Kan, Haidong ; Tong, Shilu ; Honda, Yasushi ; Kim, Ho ; Armstrong, Ben G. / Changes in Susceptibility to Heat during the Summer : A Multicountry Analysis. In: American Journal of Epidemiology. 2016 ; Vol. 183, No. 11. pp. 1027-1036.
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Gasparrini, A, Guo, Y, Hashizume, M, Lavigne, E, Tobias, A, Zanobetti, A, Schwartz, JD, Leone, M, Michelozzi, P, Kan, H, Tong, S, Honda, Y, Kim, H & Armstrong, BG 2016, 'Changes in Susceptibility to Heat during the Summer: A Multicountry Analysis', American Journal of Epidemiology, vol. 183, no. 11, pp. 1027-1036. https://doi.org/10.1093/aje/kwv260

Changes in Susceptibility to Heat during the Summer : A Multicountry Analysis. / Gasparrini, Antonio; Guo, Yuming; Hashizume, Masahiro; Lavigne, Eric; Tobias, Aurelio; Zanobetti, Antonella; Schwartz, Joel D.; Leone, Michela; Michelozzi, Paola; Kan, Haidong; Tong, Shilu; Honda, Yasushi; Kim, Ho; Armstrong, Ben G.

In: American Journal of Epidemiology, Vol. 183, No. 11, 01.06.2016, p. 1027-1036.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Changes in Susceptibility to Heat during the Summer

T2 - A Multicountry Analysis

AU - Gasparrini, Antonio

AU - Guo, Yuming

AU - Hashizume, Masahiro

AU - Lavigne, Eric

AU - Tobias, Aurelio

AU - Zanobetti, Antonella

AU - Schwartz, Joel D.

AU - Leone, Michela

AU - Michelozzi, Paola

AU - Kan, Haidong

AU - Tong, Shilu

AU - Honda, Yasushi

AU - Kim, Ho

AU - Armstrong, Ben G.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Few studies have examined the variation in mortality risk associated with heat during the summer. Here, we apply flexible statistical models to investigate the issue by using a large multicountry data set. We collected daily time-series data of temperature and mortality from 305 locations in 9 countries, in the period 1985-2012. We first estimated the heat-mortality relationship in each location with time-varying distributed lag non-linear models, using a bivariate spline to model the exposure-lag-response over lag 0-10. Estimates were then pooled by country through multivariate meta-analysis. Results provide strong evidence of a reduction in risk over the season. Relative risks for the 99th percentile versus the minimum mortality temperature were in the range of 1.15-2.03 in early summer. In late summer, the excess was substantially reduced or abated, with relative risks in the range of 0.97-1.41 and indications of wider comfort ranges and higher minimum mortality temperatures. The attenuation is mainly due to shorter lag periods in late summer. In conclusion, this multicountry analysis suggests a reduction of heat-related mortality risk over the summer, which can be attributed to several factors, such as true acclimatization, adaptive behaviors, or harvesting effects. These findings may have implications on public health policies and climate change health impact projections.

AB - Few studies have examined the variation in mortality risk associated with heat during the summer. Here, we apply flexible statistical models to investigate the issue by using a large multicountry data set. We collected daily time-series data of temperature and mortality from 305 locations in 9 countries, in the period 1985-2012. We first estimated the heat-mortality relationship in each location with time-varying distributed lag non-linear models, using a bivariate spline to model the exposure-lag-response over lag 0-10. Estimates were then pooled by country through multivariate meta-analysis. Results provide strong evidence of a reduction in risk over the season. Relative risks for the 99th percentile versus the minimum mortality temperature were in the range of 1.15-2.03 in early summer. In late summer, the excess was substantially reduced or abated, with relative risks in the range of 0.97-1.41 and indications of wider comfort ranges and higher minimum mortality temperatures. The attenuation is mainly due to shorter lag periods in late summer. In conclusion, this multicountry analysis suggests a reduction of heat-related mortality risk over the summer, which can be attributed to several factors, such as true acclimatization, adaptive behaviors, or harvesting effects. These findings may have implications on public health policies and climate change health impact projections.

KW - adaptation

KW - climate change

KW - distributed lag models

KW - heat

KW - mortality

KW - temperature

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U2 - 10.1093/aje/kwv260

DO - 10.1093/aje/kwv260

M3 - Article

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JO - American Journal of Epidemiology

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Gasparrini A, Guo Y, Hashizume M, Lavigne E, Tobias A, Zanobetti A et al. Changes in Susceptibility to Heat during the Summer: A Multicountry Analysis. American Journal of Epidemiology. 2016 Jun 1;183(11):1027-1036. https://doi.org/10.1093/aje/kwv260