Temporal variation in heat–mortality associations

A multicountry study

Antonio Gasparrini, Yuming Guo, Masahiro Hashizume, Patrick L. Kinney, Elisaveta P. Petkova, Eric Lavigne, Antonella Zanobetti, Joel D. Schwartz, Aurelio Tobias, Michela Leone, Shilu Tong, Yasushi Honda, Ho Kim, Ben G. Armstrong

Research output: Contribution to journalArticleResearchpeer-review

123 Citations (Scopus)

Abstract

Background: Recent investigations have reported a decline in the heat-related mortality risk during the last decades. However, these studies are frequently based on modeling approaches that do not fully characterize the complex temperature–mortality relationship, and are limited to single cities or countries. Objectives: We assessed the temporal variation in heat–mortality associations in a multi-country data set using flexible modelling techniques. Methods: We collected data for 272 locations in Australia, Canada, Japan, South Korea, Spain, the United Kingdom, and the United States, with a total 20,203,690 deaths occurring in summer months between 1985 and 2012. The analysis was based on two-stage time-series models. The temporal variation in heat–mortality relationships was estimated in each location with time-varying distributed lag nonlinear models, expressed through an interaction between the transformed temperature variables and time. The estimates were pooled by country through multivariate meta-analysis. Results: Mortality risk due to heat appeared to decrease over time in several countries, with relative risks associated to high temperatures significantly lower in 2006 compared with 1993 in the United States, Japan, and Spain, and a nonsignificant decrease in Canada. Temporal changes are difficult to assess in Australia and South Korea due to low statistical power, and we found little evidence of variation in the United Kingdom. In the United States, the risk seems to be completely abated in 2006 for summer temperatures below their 99th percentile, but some significant excess persists for higher temperatures in all the countries. conclusions: We estimated a statistically significant decrease in the relative risk for heat-related mortality in 2006 compared with 1993 in the majority of countries included in the analysis.

Original languageEnglish
Pages (from-to)1200-1207
Number of pages8
JournalEnvironmental Health Perspectives
Volume123
Issue number11
DOIs
Publication statusPublished - 1 Nov 2015
Externally publishedYes

Cite this

Gasparrini, A., Guo, Y., Hashizume, M., Kinney, P. L., Petkova, E. P., Lavigne, E., ... Armstrong, B. G. (2015). Temporal variation in heat–mortality associations: A multicountry study. Environmental Health Perspectives, 123(11), 1200-1207. https://doi.org/10.1289/ehp.1409070
Gasparrini, Antonio ; Guo, Yuming ; Hashizume, Masahiro ; Kinney, Patrick L. ; Petkova, Elisaveta P. ; Lavigne, Eric ; Zanobetti, Antonella ; Schwartz, Joel D. ; Tobias, Aurelio ; Leone, Michela ; Tong, Shilu ; Honda, Yasushi ; Kim, Ho ; Armstrong, Ben G. / Temporal variation in heat–mortality associations : A multicountry study. In: Environmental Health Perspectives. 2015 ; Vol. 123, No. 11. pp. 1200-1207.
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Gasparrini, A, Guo, Y, Hashizume, M, Kinney, PL, Petkova, EP, Lavigne, E, Zanobetti, A, Schwartz, JD, Tobias, A, Leone, M, Tong, S, Honda, Y, Kim, H & Armstrong, BG 2015, 'Temporal variation in heat–mortality associations: A multicountry study', Environmental Health Perspectives, vol. 123, no. 11, pp. 1200-1207. https://doi.org/10.1289/ehp.1409070

Temporal variation in heat–mortality associations : A multicountry study. / Gasparrini, Antonio; Guo, Yuming; Hashizume, Masahiro; Kinney, Patrick L.; Petkova, Elisaveta P.; Lavigne, Eric; Zanobetti, Antonella; Schwartz, Joel D.; Tobias, Aurelio; Leone, Michela; Tong, Shilu; Honda, Yasushi; Kim, Ho; Armstrong, Ben G.

In: Environmental Health Perspectives, Vol. 123, No. 11, 01.11.2015, p. 1200-1207.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Temporal variation in heat–mortality associations

T2 - A multicountry study

AU - Gasparrini, Antonio

AU - Guo, Yuming

AU - Hashizume, Masahiro

AU - Kinney, Patrick L.

AU - Petkova, Elisaveta P.

AU - Lavigne, Eric

AU - Zanobetti, Antonella

AU - Schwartz, Joel D.

AU - Tobias, Aurelio

AU - Leone, Michela

AU - Tong, Shilu

AU - Honda, Yasushi

AU - Kim, Ho

AU - Armstrong, Ben G.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background: Recent investigations have reported a decline in the heat-related mortality risk during the last decades. However, these studies are frequently based on modeling approaches that do not fully characterize the complex temperature–mortality relationship, and are limited to single cities or countries. Objectives: We assessed the temporal variation in heat–mortality associations in a multi-country data set using flexible modelling techniques. Methods: We collected data for 272 locations in Australia, Canada, Japan, South Korea, Spain, the United Kingdom, and the United States, with a total 20,203,690 deaths occurring in summer months between 1985 and 2012. The analysis was based on two-stage time-series models. The temporal variation in heat–mortality relationships was estimated in each location with time-varying distributed lag nonlinear models, expressed through an interaction between the transformed temperature variables and time. The estimates were pooled by country through multivariate meta-analysis. Results: Mortality risk due to heat appeared to decrease over time in several countries, with relative risks associated to high temperatures significantly lower in 2006 compared with 1993 in the United States, Japan, and Spain, and a nonsignificant decrease in Canada. Temporal changes are difficult to assess in Australia and South Korea due to low statistical power, and we found little evidence of variation in the United Kingdom. In the United States, the risk seems to be completely abated in 2006 for summer temperatures below their 99th percentile, but some significant excess persists for higher temperatures in all the countries. conclusions: We estimated a statistically significant decrease in the relative risk for heat-related mortality in 2006 compared with 1993 in the majority of countries included in the analysis.

AB - Background: Recent investigations have reported a decline in the heat-related mortality risk during the last decades. However, these studies are frequently based on modeling approaches that do not fully characterize the complex temperature–mortality relationship, and are limited to single cities or countries. Objectives: We assessed the temporal variation in heat–mortality associations in a multi-country data set using flexible modelling techniques. Methods: We collected data for 272 locations in Australia, Canada, Japan, South Korea, Spain, the United Kingdom, and the United States, with a total 20,203,690 deaths occurring in summer months between 1985 and 2012. The analysis was based on two-stage time-series models. The temporal variation in heat–mortality relationships was estimated in each location with time-varying distributed lag nonlinear models, expressed through an interaction between the transformed temperature variables and time. The estimates were pooled by country through multivariate meta-analysis. Results: Mortality risk due to heat appeared to decrease over time in several countries, with relative risks associated to high temperatures significantly lower in 2006 compared with 1993 in the United States, Japan, and Spain, and a nonsignificant decrease in Canada. Temporal changes are difficult to assess in Australia and South Korea due to low statistical power, and we found little evidence of variation in the United Kingdom. In the United States, the risk seems to be completely abated in 2006 for summer temperatures below their 99th percentile, but some significant excess persists for higher temperatures in all the countries. conclusions: We estimated a statistically significant decrease in the relative risk for heat-related mortality in 2006 compared with 1993 in the majority of countries included in the analysis.

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Gasparrini A, Guo Y, Hashizume M, Kinney PL, Petkova EP, Lavigne E et al. Temporal variation in heat–mortality associations: A multicountry study. Environmental Health Perspectives. 2015 Nov 1;123(11):1200-1207. https://doi.org/10.1289/ehp.1409070