Physiological Equivalent Temperature Index and mortality in Tabriz (The northwest of Iran)

Rahim Sharafkhani, Narges Khanjani, Bahram Bakhtiari, Yunes Jahani, Jafar Sadegh Tabrizi

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There are few epidemiological studies about climate change and the effect of temperature variation on health using human thermal indices such as the Physiological Equivalent Temperature (PET) Index in Iran. This study was conducted in Tabriz, the northwest of Iran and Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression models were used to assess the impacts of PET on mortality by using the DLNM Package in R Software. The effect of air pollutants, time trend, day of the week and holidays were controlled as confounders. There was a significant relation between high (30 °C, 27 °C) and low (−0.8 °C, −9.2 °C and −14.2 °C) PET and total (non-accidental) mortality; and a significant increase in respiratory and cardiovascular deaths in high PET values. Heat stress increased Cumulative Relative Risk (CRR) for total (non-accidental), respiratory and cardiovascular mortality significantly (CRR Non Accidental Death, PET=30 °C, lag 0–30=1.67, 95%CI: 1.31–2.13; CRR Respiratory Death, PET=30 °C, lag 0–13=1.88, 95%CI: 1.30–2.72; CRR Cardiovascular Death, PET=30 °C, lag0-30=1.67 95%CI: 1.16–2.40). Heat stress increases the risk of total (non-accidental), respiratory mortality, but cold stress decreases the risk of total (non-accidental) mortality in Tabriz which is one of the cold cities of Iran.

Original languageEnglish
Pages (from-to)195-201
Number of pages7
JournalJournal of Thermal Biology
Publication statusPublished - 1 Jan 2018


  • Mortality
  • Physiological Equivalent Temperature
  • Temperature
  • Thermal indices
  • Thermal stress

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