Global variation in the effects of ambient temperature on mortality: A systematic evaluation

Yuming Guo, Antonio Gasparrini, Ben Armstrong, Shanshan Li, Benjawan Tawatsupa, Aurelio Tobias, Eric Lavigne, Micheline de Sousa Zanotti Stagliorio Coelho, Michela Leone, Xiaochuan Pan, Shilu Tong, Linwei Tian, Ho Hyun Kim, Masahiro Hashizume, Yasushi Honda, Yue Liang Leon Guo, Chang Fu Wu, Kornwipa Punnasiri, Seung Muk Yi, Paola MichelozziPaulo Hilario Nascimento Saldiva, Gail Williams

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Abstract

BACKGROUND: Studies have examined the effects of temperature on mortality in a single city, country, or region. However, less evidence is available on the variation in the associations between temperature and mortality in multiple countries, analyzed simultaneously. METHODS: We obtained daily data on temperature and mortality in 306 communities from 12 countries/regions (Australia, Brazil, Thailand, China, Taiwan, Korea, Japan, Italy, Spain, United Kingdom, United States, and Canada). Two-stage analyses were used to assess the nonlinear and delayed relation between temperature and mortality. In the first stage, a Poisson regression allowing overdispersion with distributed lag nonlinear model was used to estimate the community-specific temperature-mortality relation. In the second stage, a multivariate meta-analysis was used to pool the nonlinear and delayed effects of ambient temperature at the national level, in each country. RESULTS: The temperatures associated with the lowest mortality were around the 75th percentile of temperature in all the countries/regions, ranging from 66th (Taiwan) to 80th (UK) percentiles. The estimated effects of cold and hot temperatures on mortality varied by community and country. Meta-analysis results show that both cold and hot temperatures increased the risk of mortality in all the countries/regions. Cold effects were delayed and lasted for many days, whereas heat effects appeared quickly and did not last long. CONCLUSIONS: People have some ability to adapt to their local climate type, but both cold and hot temperatures are still associated with increased risk of mortality. Public health strategies to alleviate the impact of ambient temperatures are important, in particular in the context of climate change.This is an open access article distributed under the Creative Commons Attribution- Non Commercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially.

Original languageEnglish
Pages (from-to)781-789
Number of pages9
JournalEpidemiology
Volume25
Issue number6
DOIs
Publication statusPublished - 2014
Externally publishedYes

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