High Summer Temperatures and Mortality in Estonia

Abstract

BackgroundOn-going climate change is predicted to result in a growing number of extreme weather events—such as heat waves—throughout Europe. The effect of high temperatures and heat waves are already having an important impact on public health in terms of increased mortality, but studies from an Estonian setting are almost entirely missing. We investigated mortality in relation to high summer temperatures and the time course of mortality in a coastal and inland region of Estonia.MethodsWe collected daily mortality data and daily maximum temperature for a coastal and an inland region of Estonia. We applied a distributed lag non-linear model to investigate heat related mortality and the time course of mortality in Estonia.ResultsWe found an immediate increase in mortality associated with temperatures exceeding the 75th percentile of summer maximum temperatures, corresponding to approximately 23°C. This increase lasted for a couple of days in both regions. The total effect of elevated temperatures was not lessened by significant mortality displacement.DiscussionWe observed significantly increased mortality in Estonia, both on a country level as well as for a coastal region and an inland region with a more continental climate. Heat related mortality was higher in the inland region as compared to the coastal region, however, no statistically significant differences were observed. The lower risks in coastal areas could be due to lower maximum temperatures and cooling effects of the sea, but also better socioeconomic condition. Our results suggest that region specific estimates of the impacts of temperature extremes on mortality are needed.

Probability Risk of Heat- and Cold-Related Mortality to Temperature, Gender, and Age Using GAM Regression Analysis

“…The GAM model revealed significantly increased mortality on hot (no lag period) and cold days (with a lag of 3-4 days), agreeing with a similar study in Estonia [4,9]. The adverse effects of heat on health are usually more direct with increased mortality on the same day or a couple of days after a heatwave [2,10]. As proposed by Curriero et al [14], adaptation of populations to their local climate is evident by the increased health risk in relation to cold temperatures in warmer climates and on the contrary in relation to high temperature in colder climates.…”

“…Mortality risk with respect to temperature has been assessed by scientists in northeastern Europe [9][10][11][12], the USA [13,14], and China [4] by considering fixed variables such as gender and age, resulting in contrasting findings of the threshold temperature and minimum mortality temperature (MMT). MMT is defined as the temperature at which there is the lowest risk of mortality according to a probability risk assessment.…”

Regional Assessment of Temperature-Related Mortality in Finland

“…However, in recent years, more complex distributed lag non-linear models (DLNM) have been developed and applied in studies on the mortality–temperature relationship [ 2 , 18 , 19 , 20 , 21 ]. DLNM has been applied in several multi-country, (e.g., [ 6 , 22 ]), and multi-city studies including Helsinki, the capital of Finland [ 23 ], and at the country level, e.g., in Estonia, a neighbouring country of Finland [ 24 ].…”

Heat-related mortality during hot summers in Polish cities

“…For England and Wales,Hajat et al (2007) studied even lower values (17-18°C). The differences are also seen in the work of analyzing various country-specific thresholds of the maximum daily air temperature, like about 24°C for Estonia(Oudin Åström et al 2016), 26°C in the Czech Republic(Kysely and Huth 2004) and 31°C in Italy (Zauli…”