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

Pyrgou, Andri; Santamouris, M.

doi:10.3390/cli8030040

Cited by 13 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As for assessing health impacts using WBGT on different sex groups, our analysis showed mixed results of either higher heat-health risks for males or females in morbidity or mortality, similar to those presented in the literature [ 40 , 45 , 46 , 47 ]. A review study has concluded that heat-related health impacts could be higher for males or females, in terms of different health outcomes [ 37 ].…”

Section: Discussionsupporting

confidence: 79%

Selecting Thresholds of Heat-Warning Systems with Substantial Enhancement of Essential Population Health Outcomes for Facilitating Implementation

Lung

Yeh

Hwang

2021

IJERPH

View full text Add to dashboard Cite

Most heat-health studies identified thresholds just outside human comfort zones, which are often too low to be used in heat-warning systems for reducing climate-related health risks. We refined a generalized additive model for selecting thresholds with substantial health risk enhancement, based on Taiwan population records of 2000–2017, considering lag effects and different spatial scales. Reference-adjusted risk ratio (RaRR) is proposed, defined as the ratio between the relative risk of an essential health outcome for a threshold candidate against that for a reference; the threshold with the highest RaRR is potentially the optimal one. It was found that the wet-bulb globe temperature (WBGT) is a more sensitive heat-health indicator than temperature. At lag 0, the highest RaRR (1.66) with WBGT occurred in emergency visits of children, while that in hospital visits occurred for the working-age group (1.19), presumably due to high exposure while engaging in outdoor activities. For most sex, age, and sub-region categories, the RaRRs of emergency visits were higher than those of hospital visits and all-cause mortality; thus, emergency visits should be employed (if available) to select heat-warning thresholds. This work demonstrates the applicability of this method to facilitate the establishment of heat-warning systems at city or country scales by authorities worldwide.

show abstract

Section: Discussionsupporting

confidence: 79%

Selecting Thresholds of Heat-Warning Systems with Substantial Enhancement of Essential Population Health Outcomes for Facilitating Implementation

Lung

Yeh

Hwang

2021

IJERPH

View full text Add to dashboard Cite

show abstract

“…As for health impacts with WBGT on different sex groups, our analysis showed mixed results of either higher heat-health risks for males or females in morbidity or mortality, similar to those presented in the literature (44,(46)(47)(48). For example, a study found that males were more affected than females in heat-related illness (29).…”

Section: Discussionsupporting

confidence: 78%

“…It was speculated that males may suffer more from heat partly due to their participation in more outdoor activities (29). However, other studies found higher heat-health impacts in either sex in different cities (44,(47)(48). A review study concluded that heat-related health impacts could be higher for males or females for different health outcomes (29).…”

Section: Discussionmentioning

confidence: 99%

Using GAM regression analysis to identify proper heat-warning thresholds: a population-based observational study

Lung¹,

Yeh²,

Hwang³

2021

Preprint

View full text Add to dashboard Cite

Background Climate change has augmented heat-related illnesses and deaths. Selecting proper thresholds in a heat-warning system is critical to reducing health risks. Methods This work evaluates the applicability of a modified generalized additive model (GAM) at different spatial scales, and identifies proper heat-warning thresholds using empirical morbidity and mortality records of 18 years from a population database and taking into account substantial health risk increases of the lag effects of 0–2 days. Reference-adjusted risk ratio (RaRR), i.e., risk ratio of threshold candidates against that of a reference, was respectively evaluated for heat-related emergency and hospital visits and all-cause mortality. The threshold with the highest RaRR among the candidates with infrequent occurrence is potentially the best one. Wet-bulb globe temperature (WBGT) and temperature were both used heat indicator in the model for comparison. Results It was found that WBGT is a more sensitive heat-health indicator than temperature. The highest RaRR with WBGT for the whole Taiwan island was observed to shift from lag 0 in emergency visits (1.44) to lags 0–1 in hospital visits (1.18) and also to lag 1 in all-cause mortality (1.04). For different age groups, children had the highest RaRR with WBGT of emergency visits on lag 0 (1.87) while the elderly had the highest RaRR for all-cause mortality on lag 0 (1.04), for hospital visits on lag 1 (1.23), and for emergency visits on lag 2 (1.38), respectively. Emergency visit is the most sensitive heat-related health record and should thus be employed, if available, to select heat-warning threshold. With the highest RaRR in emergency visits and the occurring frequency considered, the best area-specific thresholds can be chosen for various sizes of population at-risk. The novel RaRR allows comparison of health risks across different categories, providing a solid scientific basis for threshold selection. Conclusions This work demonstrated the feasibility and flexibility of the proposed approach which considers substantial enhancement of health risks on lags 0 to 2, removes the rare-event interference, and accommodates at-risk populations of different sizes. This methodology can be applied by authorities worldwide for selecting proper heat-health thresholds according to their own morbidity/mortality records.

show abstract

“…The observed absence of any sex differences in the cold is in line with a previous study done in the USA (O'Neill et al 2003 ). However, other studies have reported a higher mortality in males or females in the cold (Donaldson et al 2019 ; Liu et al 2020 ; Pyrgou and Santamouris 2020 ; Rocklöv et al 2014 ). Sex differences in the cold seem to be less prominent than in the heat, as there is no consensus in outcome of different studies.…”

Section: Discussionmentioning

confidence: 92%

“…In Madrid, a higher mortality amongst males in the age group between 65–75 years, and higher mortality in females in the age group older than 75 years, were reported (Díaz et al 2002 ). In Hong Kong (China), Stockholm County (Sweden) and Cyprus, higher mortality in males was reported in the cold (Liu et al 2020 ; Pyrgou and Santamouris 2020 ; Rocklöv et al 2014 ), while in South East England a higher mortality in females was reported (Donaldson et al 2019 ). In seven USA cities (Denver, Detroit, Minneapolis, New Haven, Pittsburgh and Chicago, and Seattle) no difference between males and females was found in the cold (O'Neill et al 2003 ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in temperature-related all-cause mortality in the Netherlands

Folkerts

Bröde

Botzen

et al. 2021

Int Arch Occup Environ Health

View full text Add to dashboard Cite

Purpose Over the last few decades, a global increase in both cold and heat extremes has been observed with significant impacts on human mortality. Although it is well-identified that older individuals (> 65 years) are most prone to temperature-related mortality, there is no consensus on the effect of sex. The current study investigated if sex differences in temperature-related mortality exist in the Netherlands. Methods Twenty-three-year ambient temperature data of the Netherlands were combined with daily mortality data which were subdivided into sex and three age classes (< 65 years, 65–80 years, ≥ 80 years). Distributed lag non-linear models were used to analyze the effect of ambient temperature on mortality and determine sex differences in mortality attributable to the cold and heat, which is defined as mean daily temperatures below and above the Minimum Mortality Temperature, respectively. Results Attributable fractions in the heat were higher in females, especially in the oldest group under extreme heat (≥ 97.5th percentile), whilst no sex differences were found in the cold. Cold- and heat-related mortality was most prominent in the oldest age group (≥ 80 years) and to a smaller extent in the age group between 65–80 years. In the age group < 65 years temperature-related mortality was only significant for males in the heat. Conclusion Mortality in the Netherlands represents the typical V- or hockey-stick shaped curve with a higher daily mortality in the cold and heat than at milder temperatures in both males and females, especially in the age group ≥ 80 years. Heat-related mortality was higher in females than in males, especially in the oldest age group (≥ 80 years) under extreme heat, whilst in the cold no sex differences were found. The underlying cause may be of physiological or behavioral nature, but more research is necessary.

show abstract

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

Cited by 13 publications

References 24 publications

Selecting Thresholds of Heat-Warning Systems with Substantial Enhancement of Essential Population Health Outcomes for Facilitating Implementation

Selecting Thresholds of Heat-Warning Systems with Substantial Enhancement of Essential Population Health Outcomes for Facilitating Implementation

Using GAM regression analysis to identify proper heat-warning thresholds: a population-based observational study

Sex differences in temperature-related all-cause mortality in the Netherlands

Contact Info

Product

Resources

About