Short-Term Effects of Apparent Temperature on Cause-Specific Mortality in the Urban Area of Thessaloniki, Greece

Abstract

Although there is a growing interest in the association between ambient temperatures and mortality, little evidence is available for Thessaloniki, the second largest city of Greece. In this study, we present an assessment of the effects of temperature on daily mortality from 2006 to 2016 in the urban area of Thessaloniki, by describing the exposure-lag-response association between temperature and cause-specific mortality with the use of a distributed lag non-linear model (DLNM). A J-shaped relationship was found between temperature and mortality. The highest values of risk were evident for respiratory (RR > 10) and cardiovascular causes (RR > 3), probably due to the fact that health status of individuals with chronic respiratory and cardiovascular diseases rapidly deteriorates during hot periods. Cold effects had longer lags of up to 15 days, whereas heat effects were short-lived, up to 4 days. Percentage change in all- and cause-specific mortality per 1 °C change above and below Minimum Mortality Temperature showed a larger increase for all-cause mortality in heat (1.95%, 95% CI: 1.07–2.84), in contrast to a smaller increase in cold (0.54%, 95% CI: 0, 1.09). Overall, 3.51% of all-cause deaths were attributable to temperature, whereas deaths attributed to heat (2.34%) were more than deaths attributed to cold (1.34%). The findings of this study present important evidence for planning public-health interventions, to reduce the health impact of extreme temperatures.

Short-Term Effects of Air Pollution on Mortality in the Urban Area of Thessaloniki, Greece

“…Thessaloniki, Greece, is particularly impaired with respect to the air pollution, especially due to PM 10 and O 3 levels [28,39]. Although some recent studies have quantified the impact of temperature on mortality [84,85], there is insufficient evidence concerning air quality, thus pointing a gap in relevant knowledge.…”

Projections of Heat-Related Mortality under the Impact of Climate Change in Thessaloniki, Greece

“…The observational dataset includes the daily number of cause-specific deaths stratified by age group in Thessaloniki between 2006 and 2016 [22]. The climate simulations were conducted through the regional WRF-ARW numerical weather prediction model for historical (2006)(2007)(2008)(2009)(2010) and future (2096-2100) periods as presented in [17], providing results of high spatial resolution (2 km) and temporal resolution of 3 hours.…”

“…Recently, [21] demonstrated noteworthy impacts of heat above the temperature threshold of 33 • C and a respective increase of 4.4% and 5.9% in the risk of cardiovascular and respiratory mortality above this threshold. The authors in [22] report a 1.95% increase in all-cause mortality due to heat, whereas deaths attributed to heat were higher than deaths attributed to cold for 2006-2016. In [23], the highest relative risks of cardiovascular mortality are associated with extreme temperatures and the population in Thessaloniki is found to be more susceptible to low temperatures.…”

The need for location-specific biometeorological indexes in Taiwan

“…The Central Weather Bureau of Taiwan has already included a biometeorological index in their weather forecast service; the index that they are using is AT ( 30 ). Following the above argument, it may not be a good idea to make direct use of the equation of AT, which was developed in the US nearly 40 years ago ( 13 ). In fact, the Hong Kong Observatory has already taken further steps to develop the Hong Kong Heat Index for enhancing the heat stress information service at the Hong Kong Observatory ( 31 ).…”

“…As its application was limited to the hotter months, the factor of wind speed was further incorporated into the index so that it could also be applied during the colder months ( 12 ). AT, meanwhile, was developed to describe the temperature and humidity perceived by humans ( 13 ). These biometeorological indexes are able to compact the information from multiple traditional weather factors into a single index.…”