The impact of heat waves on mortality in 9 European cities: Results from the EuroHEAT project

Department of Epidemiology, Regional Health Authority, Rome, Italy.
Environmental Health (Impact Factor: 3.37). 07/2010; 9(37):37. DOI: 10.1186/1476-069X-9-37
Source: PubMed


The present study aimed at developing a standardized heat wave definition to estimate and compare the impact on mortality by gender, age and death causes in Europe during summers 1990-2004 and 2003, separately, accounting for heat wave duration and intensity.
Heat waves were defined considering both maximum apparent temperature and minimum temperature and classified by intensity, duration and timing during summer. The effect was estimated as percent increase in daily mortality during heat wave days compared to non heat wave days in people over 65 years. City specific and pooled estimates by gender, age and cause of death were calculated.
The effect of heat waves showed great geographical heterogeneity among cities. Considering all years, except 2003, the increase in mortality during heat wave days ranged from + 7.6% in Munich to + 33.6% in Milan. The increase was up to 3-times greater during episodes of long duration and high intensity. Pooled results showed a greater impact in Mediterranean (+ 21.8% for total mortality) than in North Continental (+ 12.4%) cities. The highest effect was observed for respiratory diseases and among women aged 75-84 years. In 2003 the highest impact was observed in cities where heat wave episode was characterized by unusual meteorological conditions.
Climate change scenarios indicate that extreme events are expected to increase in the future even in regions where heat waves are not frequent. Considering our results prevention programs should specifically target the elderly, women and those suffering from chronic respiratory disorders, thus reducing the impact on mortality.

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    • "There are many risks related to heat stress in outdoor and indoor spaces. An increase in mortality rates has been identified and quantified by McMichael and Haines [6], Smoyer, Rainham [7], Michelozzi, Accetta [8], D'Ippoliti, Michelozzi [9], Gabriel and Endlicher [10], Ye, Wolff [11], Almeida, Casimiro [12], Scherer, Fehrenbach [13]. The impact of heat stress on morbidity is also evident, as shown by Scherber, Langner [14], Monteiro, Carvalho [15] and McGeehin and Mirabelli [16]. "
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    ABSTRACT: The mean radiant temperature (Tmrt) is the most complex variable regarding the input parameters for heat balance models of human being that are the background for the assessment of thermally unfavourable conditions and heat stress. This paper investigates the simplification of past studies that the Tmrt is equal to the air temperature (Ta) under indoor conditions. In a second step, the causes for deviations between the two parameters are examined and integrated into the context of indoor climate. Measurements were conducted in four rooms at the Geography Department of Humboldt University in Berlin during autochthonal weather conditions from the 16th of August to the 2nd of September 2013. Tmrt was derived using integral radiation measurements and three different types of globe thermometers. The study indicates that the deviations between the different methods of obtaining Tmrt are negligible for indoor environments. The results show that the differences between Ta and Tmrt are negligible during most periods, as stated in previous literature. As air temperatures increase, however, Tmrt exceeds Ta up to 1.3 K. The examination of the surface temperatures indicates that rooms with window walls facing southeast and southwest show the largest disparities between Ta and Tmrt. The correlation between Ta and Tmrt and the sum of the short and long wave radiation specifies the radiation intensity and duration as the main driver of Tmrt. Future studies on indoor heat stress should hence consider that Tmrt and Ta can differ depending on the characteristics of the room and on solar radiation.
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    • "Around 15,000 excess deaths were attributed to the European heat wave in 2003 (Hattis et al., 2012). A study of nine European cities observed larger heat effects in Mediterranean compared to North-continental cities (D'Ippoliti et al., 2010), while Sheridan and Dolney (2003) argued that the strongest heat mortality impact is in locations where heat waves occur irregularly but intensively and are beyond the acclimatized range of the local population. Accordingly, studies reported increasing heat vulnerability with increasing latitude for the USA (Medina-Ramon and Schwartz, 2007; Anderson and Bell, 2011). "
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    ABSTRACT: Heat stress increasingly affects urban populations in higher geographical latitudes. Related adverse health effects are expected to increase due to urbanization, population aging, and global warming. While many studies have examined the relationship between heat and mortality, only a few have examined the intra-urban spatial variability between them. This missing research is particularly evident for northern mid-latitude cities, where populations are not prepared for heat stress. The aim of this study is therefore to investigate heat-related excess mortality in its spatial variability at the neighborhood scale (397 planning areas) for Berlin, the capital of Germany. We analyzed age-standardized mortality rates by calculating the relative heat mortality risk ratio for months with and without severe heat waves. Local indicators of spatial association were used to locate spatial clusters. The results highlighted the intra-urban variability of heat-related excess mortality, and demonstrated clustering for the planning areas of Berlin. Temporal aggregation of mortality data enabled a neighborhood-scale analysis. Resulting heat-related excess mortality maps allow urban decision makers to identify hot spots for emergency and adaptation planning, and serve as a basis for further investigations of heat stress risk on an individual level.
    Full-text · Article · Nov 2014 · Urban Climate
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    • "Epidemiological studies have found consistent effect of heat waves on mortality across various countries (Anderson and Bell, 2011; Bi et al., 2011; Conti et al., 2005; D'Ippoliti et al., 2010; Huang et al., 2010; Son et al., 2012). Under a changing climate, higher mortality risks from heat waves are expected since the intensity, frequency, and duration of heat waves may increase in the future (Meehl and Tebaldi, 2004; Wu et al., 2014). "
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    ABSTRACT: Few studies have explored the added effect of heat waves, especially in China. Moreover, no prior studies have assessed whether the choice of heat wave definitions affected this added effect. This study compared the associations between heat waves defined by different heat wave definitions (HWs) and cause-specific mortality in warm season in Nanjing, China.MethodsA distributed lag model was applied to evaluate the differences in daily mortality during heat-wave days (defined using 15 HWs) compared with non-heat-wave days in Nanjing, during 2007 to 2013. For different HWs, model fits were examined by the Akaike Information Criterion for quasi-Poisson and effects were compared by stratified analysis and bootstrapping. In addition, we explored the effect modifications by individual characteristics under different HWs.ResultsDifferent HWs resulted in considerable differences in associations between heat waves and mortality. Heat waves defined as ≥ 4 consecutive days with daily average temperature > 98th percentile had the best model fit and were associated with an increase of 24.6% (95% CI: 15.6%, 34.3%) total mortality, 46.9% (95% CI: 33.0%, 62.3%) cardiovascular mortality, 32.0% (95% CI: 8.5%, 60.5%) respiratory mortality, 51.3% (95% CI: 23.4%, 85.6%) stroke mortality, 63.4% (95% CI: 41.5%, 88.8%) ischemic heart disease mortality, and 47.6% (95% CI: 14.5%, 90.3%) chronic obstructive pulmonary disease mortality at lag day 2. Under different HWs, added effects of heat waves on mortality were higher for females versus males, the elderly versus young residents, and people with low education versus those with high education. Results were less sensitive to the inclusion of air pollutants.Conclusions Heat wave definition plays a critical role in the relationship between heat waves and mortality. Selecting an appropriate definition of heat waves is therefore important to design local heat warning systems and to reduce the burden of disease during heat waves.
    Full-text · Article · Nov 2014 · Science of The Total Environment
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