Air temperature-related human health outcomes: Current impact and estimations of future risks in Central Italy

Abstract

The association between air temperature and human health is described in detail in a large amount of literature. However, scientific publications estimating how climate change will affect the population's health are much less extensive. In this study current evaluations and future predictions of the impact of temperature on human health in different geographical areas have been carried out. Non-accidental mortality and hospitalizations, and daily average air temperatures have been obtained for the 1999-2008 period for the ten main cities in Tuscany (Central Italy). High-resolution city-specific climatologic A1B scenarios centered on 2020 and 2040 have been assessed. Generalized additive and distributed lag models have been used to identify the relationships between temperature and health outcomes stratified by age: general adults (<65), elderly (aged 65-74) and very elderly (≥75). The cumulative impact (over a lag-period of 30 days) of the effects of cold and especially heat, was mainly significant for mortality in the very elderly, with a higher impact on coastal plain than inland cities: 1 °C decrease/increase in temperature below/above the threshold was associated with a 2.27% (95% CI: 0.17-4.93) and 15.97% (95% CI: 7.43-24.51) change in mortality respectively in the coastal plain cities. A slight unexpected increase in short-term cold-related mortality in the very elderly, with respect to the baseline period, is predicted for the following years in half of the cities considered. Most cities also showed an extensive predicted increase in short-term heat-related mortality and a general increase in the annual temperature-related elderly mortality rate. These findings should encourage efforts to implement adaptation actions conducive to policy-making decisions, especially for planning short- and long-term health intervention strategies and mitigation aimed at preventing and minimizing the consequences of climate change on human health.

The Health Effects of Climate Change in the WHO European Region

“…A study across 10 cities in central Italy projects increases in heat-related mortality. The greatest increases are predicted in coastal regions, with mortality expected to increase by up to 11.8% by 2031-2050, compared with the baseline for 1999-2008, for each 1 °C increase above the estimated temperature threshold [19]. Heat-related hospital admissions for respiratory conditions are predicted to increase as well.…”

“…In contrast, cities with cooler climates have a greater increase in mortality per 1 °C increase above a local temperature threshold, compared to warmer cities [18]. A study in Central Italy found that a 1 °C increase in temperature above a threshold was associated with an increase in mortality of up to 15.97% among people aged 75 years or more, over a lag period of 30 days [19]. A lag effect is evident for heat-and heatwave-related mortality and morbidity, with the maximum death rate and hospital emergency department presentations occurring two to three days after peak temperature [20][21][22].…”

“…Extreme temperatures are associated with increases in mortality [15][16][17]22,32] Mortality increases are associated with temperatures above a local comfort threshold [13,18] Observed morbidity Extreme temperature is associated with increases in morbidity [20,23,26] Morbidity indicators are associated with higher temperatures [24,25,33] Future projection Future expected extreme temperatures are expected to increase heat-related mortality [14] Future increases in temperature are estimated to increase health effects of temperatures above a comfort temperature [28,29,31,34] Projected effects of heatwaves and high temperature have economic costs [27,30] Other or multiple focus There is confounding by air pollution for heat and cold effects [35] Heat and cold, mortality and morbidity, observation and projection are relevant in Europe [19] Different population subgroups are at risk [36] 3.1.2. Low Temperature and Cold Spells Ten papers identified in this search addressed the health effects of low temperatures and cold spells.…”

“…Cold-related mortality shows a variable change, from −1.2% to 0.9% for each 1 °C below the estimated cold season temperature threshold. Conversely, in the same region, mortality rates are expected to increase by up to 11.8% for each 1 °C increase above the threshold during the warm season [19]. Table 3, [19,30,35,[38][39][40][41][42][43][44][45][46] lists the search results according to the focus of the research.…”

Exploring Winter Mortality Variability in Five Regions of England Using Back Trajectory Analysis

“…Added to this is the observation that for a number of regions, such as northern Europe, there has been a progressive reduction in temperature-related deaths from the beginning of the twentieth century until the present (Carson et al 2006;Astrom et al 2013). Nevertheless, although the relative risk of mortality during extreme temperature events appears to have fallen in northern Europe, such events still pose a threat to public health (Morabito et al 2012;Scarborough et al 2012;Astrom et al 2013), primarily for the most sensitive groups of people like the elderly (Hajat et al 2007;Xu et al 2013).…”