Climate change affects human health, however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-5 induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of heat-related deaths can be attributed to anthropogenic climate change, and that increased mortality is evident on every continent. Burdens varied geographically, but were on the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public 10 health impacts of climate change.

Background Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. MethodsIn this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0•5° × 0•5° across the globe. A three-stage analysis strategy was used. First, the temperature-mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature-mortality association between 2000 and 2019 was predicted by use of the fitted metaregression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. FindingsGlobally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967-5 965 520) were associated with non-optimal temperatures per year, accounting for 9•43% (95% eCI 7•58-11•07) of all deaths (8•52% [6•19-10•47] were coldrelated and 0•91% [0•56-1•36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60-87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51•49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000-03 to 2016-19, the global cold-related excess death ratio changed by -0•51 percentage points (95% eCI -0•61 to -0•42) and the global heat-related excess death ratio increased by 0•21 percentage points (0•13-0•31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe.Interpretation Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios.

Abstract-We introduce a family of box splines for efficient, accurate, and smooth reconstruction of volumetric data sampled on the body-centered cubic (BCC) lattice, which is the favorable volumetric sampling pattern due to its optimal spectral sphere packing property. First, we construct a box spline based on the four principal directions of the BCC lattice that allows for a linear C 0 reconstruction. Then, the design is extended for higher degrees of continuity. We derive the explicit piecewise polynomial representations of the C 0 and C 2 box splines that are useful for practical reconstruction applications. We further demonstrate that approximation in the shift-invariant space-generated by BCC-lattice shifts of these box splines-is twice as efficient as using the tensor-product B-spline solutions on the Cartesian lattice (with comparable smoothness and approximation order and with the same sampling density). Practical evidence is provided demonstrating that the BCC lattice not only is generally a more accurate sampling pattern, but also allows for extremely efficient reconstructions that outperform tensor-product Cartesian reconstructions.

Background Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM 2•5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM 2•5 and mortality across various regions of the world.Methods For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000-16. Daily concentrations of wildfirerelated PM 2•5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0•25° × 0•25° resolution. The association between wildfire-related PM 2•5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM 2•5 exposure was calculated.Findings 65•6 million all-cause deaths, 15•1 million cardiovascular deaths, and 6•8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 µg/m³ increase in the 3-day moving average (lag 0-2 days) of wildfire-related PM 2•5 exposure were 1•019 (95% CI 1•016-1•022) for all-cause mortality, 1•017 (1•012-1•021) for cardiovascular mortality, and 1•019 (1•013-1•025) for respiratory mortality. Overall, 0•62% (95% CI 0•48-0•75) of all-cause deaths, 0•55% (0•43-0•67) of cardiovascular deaths, and 0•64% (0•50-0•78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM 2•5 exposure during the study period.Interpretation Short-term exposure to wildfire-related PM 2•5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.

Background: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods: We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. Results: The analyses included deaths from any cardiovascular cause (32 154 935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1–2.3) and 9.1 (95% eCI, 8.9–9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4–2.8) and 12.8 (95% eCI, 12.2–13.1) for every 1000 heart failure deaths, respectively. Conclusions: Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day—and especially under a changing climate.