Impact of Short-Term Exposure to Extreme Temperatures on Mortality: A Multi-City Study in Belgium

Abstract

In light of climate change, health risks are expected to be exacerbated by more frequent high temperatures and reduced by less frequent cold extremes. To assess the impact of different climate change scenarios, it is necessary to describe the current effects of temperature on health. A time-stratified case-crossover design fitted with conditional quasi-Poisson regressions and distributed lag non-linear models was applied to estimate specific temperature-mortality associations in nine urban agglomerations in Belgium, and a random-effect meta-analysis was conducted to pool the estimates. Based on 307,859 all-cause natural deaths, the mortality risk associated to low temperature was 1.32 (95% CI: 1.21–1.44) and 1.21 (95% CI: 1.08–1.36) for high temperature relative to the minimum mortality temperature (23.1 °C). Both cold and heat were associated with an increased risk of cardiovascular and respiratory mortality. We observed differences in risk by age category, and women were more vulnerable to heat than men. People living in the most built-up municipalities were at higher risk for heat. Air pollutants did not have a confounding effect. Evidence from this study helps to identify specific populations at risk and is important for current and future public health interventions and prevention strategies.

Future Temperature‐Related Deaths in the U.S.: The Impact of Climate Change, Demographics, and Adaptation

“…Previous studies reported that the impact of a hot day can extend for up to 3 days, while the impact of a cold day could extend 21 days (Demoury et al., 2022 ; Dimitrova et al., 2021 ). Therefore, we include lags of up to 21 days in the DLNM model.…”

“…The relationship between temperature and human mortality has been the subject of many previous studies (Berko, 2014 ; Bobb et al., 2014 ; Demoury et al., 2022 ; Dimitrova et al., 2021 ; Gasparrini & Armstrong, 2011 ; Gasparrini et al., 2015b ; Guo et al., 2011 ; Kalkstein & Greene, 1997 ; Ma et al., 2015 ; Yi & Chan, 2015 ; Zhang et al., 2016 ). Previous studies have projected future temperature‐related mortality covering different regions, such as global major cities in the U.S. (Anderson et al., 2018 ; Barreca, 2012 ; Jackson et al., 2010 ; Knowlton et al., 2007 ; Lo et al., 2019 ; Petkova et al., 2017 ; Wang et al., 2016 ; Weinberger et al., 2017 ), Europe (Hajat et al., 2014 ; Martínez‐Solanas et al., 2021 ; Muthers et al., 2010 ), or Asia (Lee & Kim, 2016 ; Yang et al., 2021 ).…”

Where do you live and what do you do? Two questions that might impact your kidney health

“…A study from Belgium by Demoury et al. analyzed 307,859 natural deaths between 2010 and 2015 ( 44 ). They found out that, compared to the normal temperature of 23.1°C, being exposed to cold (-1.7°C 1st percentile and 2.3°C 5th percentile) or high (26.7°C 95th percentile and 31.3°C 99th percentile) temperature significantly increased the mortality risk by 1.32 and 1.21 respectively ( 44 ).…”

“…analyzed 307,859 natural deaths between 2010 and 2015 ( 44 ). They found out that, compared to the normal temperature of 23.1°C, being exposed to cold (-1.7°C 1st percentile and 2.3°C 5th percentile) or high (26.7°C 95th percentile and 31.3°C 99th percentile) temperature significantly increased the mortality risk by 1.32 and 1.21 respectively ( 44 ). In this study, despite adjusting to exposure to humidity and fine particulate matter (<2.5 micrometers in diameter, PM 2.5 ), the results remained significant.…”

“…In this study, despite adjusting to exposure to humidity and fine particulate matter (<2.5 micrometers in diameter, PM 2.5 ), the results remained significant. Moreover, women were more vulnerable to heat than men and stronger effects of cold were reported in highly-educated municipalities ( 44 ). Not only in Europe, but also in Taiwan/Asia, an analysis of emergency room visits between 2000 and 2014 revealed an association between extreme low temperature and hypertensive events whereas very high temperature increased the risk of visits for kidney disease and ischemic heart disease ( 45 ).…”