Excess Mortality in Istanbul during Extreme Heat Waves between 2013 and 2017

Abstract

Heat waves are one of the most common direct impacts of anthropogenic climate change and excess mortality their most apparent impact. While Turkey has experienced an increase in heat wave episodes between 1971 and 2016, no epidemiological studies have examined their potential impacts on public health so far. In this study excess mortality in Istanbul attributable to extreme heat wave episodes between 2013 and 2017 is presented. Total excess deaths were calculated using mortality rates across different categories, including age, sex, and cause of death. The analysis shows that three extreme heat waves in the summer months of 2015, 2016, and 2017, which covered 14 days in total, significantly increased the mortality rate and caused 419 excess deaths in 23 days of exposure. As climate simulations show that Turkey is one of the most vulnerable countries in the Europe region to the increased intensity of heat waves until the end of the 21st century, further studies about increased mortality and morbidity risks due to heat waves in Istanbul and other cities, as well as intervention studies, are necessary.

The effect of air-pollution and weather exposure on mortality and hospital admission and implications for further research: A systematic scoping review

“…In India, cold temperatures below 13.8°C were associated with increased risk of 6.3% for all-cause mortality, 27.2% for stroke mortality, 9.7% for ischemic heart disease mortality, and 6.5% for respiratory diseases mortality [ 92 ]. In Istanbul-Turkey, 23 days of exposure to hot temperature above 22.8°C was associated with a total of 419 excess deaths [ 90 ]. In Korea, hot temperature days of 25°C compared to 15°C were significantly associated with a 4.5% increase in cardiovascular hospitalizations [ 98 ].…”

A novel cross-validation strategy for artificial neural networks using distributed-lag environmental factors

“…Numerous studies from different countries have found environmental aspects that are key factors attributable to human mortality [1][2][3][4]. Extreme climates occur more frequently than ever due to global warming, encouraging more research on the impact of temperature variations on health outcomes [5,6].…”

Does Ethnic Diversity Impact on Risk Perceptions, Preparedness, and Management of Heat Waves?

“…Unless prepared for and mitigated, extreme temperatures can have detrimental health impacts, including excess mortality, even among communities that are accustomed to recurring heat waves ( 7 , 8 ). In the past two decades, heat waves caused excess mortality in many countries, ranging from an increase of 38% ( 7 , 9 , 10 ) to more than 135% ( 11 , 12 ).…”

“…Sustained heat waves pose a substantial risk for vulnerable populations, including the elderly, young children, individuals that suffer from respiratory or cardiovascular diseases, as well as tourists or migrants that are not accustomed to similar weather conditions or cannot understand heat wave warnings due to language barriers ( 1 , 13 ). When exposed to extreme temperature environments to which they are not physically accustomed, vulnerable populations become more susceptible to morbidity and even death ( 8 , 14 ). Beyond physical morbidity and mortality, heat waves are also reported for their potentially severe impact on “mental health and societal wellbeing” ( 15 ).…”

“…It has been recommended that research of heat waves be conducted not only on national scales, but rather by comparing varied spatial, local and regional levels and by comparing different sectors of the population ( 5 ). This is vital as the impacts of heat waves are not derived solely from the extreme temperature but are also determined by socio-economic status, levels of emergency preparedness, and access to protective measures such as air conditioning or cooling systems ( 8 , 17 , 18 ).…”