https://saludsindanio.org/sites/default/files/documents-files/151/Climate_Chg_Human_Health.pdf

Climate change and human health : present and future risks

This review examines recent evidence on mortality from elevated ambient temperature for studies published from January 2001 to December 2008. PubMed was used to search for the following keywords: temperature, apparent temperature, heat, heat index, and mortality. The search was limited to the English language and epidemiologic studies. Studies that reported mortality counts or excess deaths following heat waves were excluded so that the focus remained on general ambient temperature and mortality in a variety of locations. Studies focusing on cold temperature effects were also excluded. Thirty-six total studies were presented in three tables: 1) elevated ambient temperature and mortality; 2) air pollutants as confounders and/or effect modifiers of the elevated ambient temperature and mortality association; and 3) vulnerable subgroups of the elevated ambient temperature-mortality association. The evidence suggests that particulate matter with less than 10 um in aerodynamic diameter and ozone may confound the association, while ozone was an effect modifier in the warmer months in some locations. Nonetheless, the independent effect of temperature and mortality was withheld. Elevated temperature was associated with increased risk for those dying from cardiovascular, respiratory, cerebrovascular, and some specific cardiovascular diseases, such as ischemic heart disease, congestive heart failure, and myocardial infarction. Vulnerable subgroups also included: Black racial/ethnic group, women, those with lower socioeconomic status, and several age groups, particularly the elderly over 65 years of age as well as infants and young children. Many of these outcomes and vulnerable subgroups have only been identified in recent studies and varied by location and study population. Thus, region-specific policies, especially in urban areas, are vital to the mitigation of heat-related deaths.

/pdf/high-ambient-temperature-and-mortality-a-review-of-mlbi175jhf.pdf

High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008.

http://www.climateknowledge.org/heat_waves/Doc4002_Harlan_Microclimates_Vulnerabilty_Heat_SocSciMed_2006.pdf

Neighborhood microclimates and vulnerability to heat stress

With global warming forecast to continue into the foreseeable future, heat waves are very likely to increase in both frequency and intensity. In urban regions, these future heat waves will be exacerbated by the urban heat island effect, and will have the potential to negatively influence the health and welfare of urban residents. In order to investigate the health effects of the urban heat island (UHI) in Shanghai, China, 30 years of meteorological records (1975-2004) were examined for 11 first- and second-order weather stations in and around Shanghai. Additionally, automatic weather observation data recorded in recent years as well as daily all-cause summer mortality counts in 11 urban, suburban, and exurban regions (1998-2004) in Shanghai have been used. The results show that different sites (city center or surroundings) have experienced different degrees of warming as a result of increasing urbanization. In turn, this has resulted in a more extensive urban heat island effect, causing additional hot days and heat waves in urban regions compared to rural locales. An examination of summer mortality rates in and around Shanghai yields heightened heat-related mortality in urban regions, and we conclude that the UHI is directly responsible, acting to worsen the adverse health effects from exposure to extreme thermal conditions.

/pdf/the-urban-heat-island-and-its-impact-on-heat-waves-and-human-2c41w2hnr8.pdf

The urban heat island and its impact on heat waves and human health in Shanghai

Objectives: From August 1st to 20th, 2003, the mean maximum temperature in France exceeded the seasonal norm by 11–12°C on nine consecutive days. A major increase in mortality was then observed, which main epidemiological features are described herein. Methods: The number of deaths observed from August to November 2003 in France was compared to those expected on the basis of the mortality rates observed from 2000 to 2002 and the 2003 population estimates. Results: From August 1st to 20th, 2003, 15,000 excess deaths were observed. From 35 years age, the excess mortality was marked and increased with age. It was 15% higher in women than in men of comparable age as of age 45 years. Excess mortality at home and in retirement institutions was greater than that in hospitals. The mortality of widowed, single and divorced subjects was greater than that of married people. Deaths directly related to heat, heatstroke, hyperthermia and dehydration increased massively. Cardiovascular diseases, ill-defined morbid disorders, respiratory diseases and nervous system diseases also markedly contributed to the excess mortality. The geographic variations in mortality showed a clear age-dependent relationship with the number of very hot days. No harvesting effect was observed. Conclusions: Heat waves must be considered as a threat to European populations living in climates that are currently temperate. While the elderly and people living alone are particularly vulnerable to heat waves, no segment of the population may be considered protected from the risks associated with heat waves.

/pdf/excess-mortality-related-to-the-august-2003-heat-wave-in-3prjodfgo2.pdf

Excess mortality related to the August 2003 heat wave in France.

The Toronto-Windsor corridor of Southern Ontario, Canada, experiences hot and humid weather conditions in summer, thus exposing the population to heat stress and a greater risk of mortality. In the event of a climate change, heat-stress conditions may become more frequent and severe in Southern Ontario. To assess the impact of summer weather on health, we analyzed heat-related mortality in the elderly (older than 64 years) in the metropolitan areas of Windsor, London, Kitchener-Waterloo-Cambridge, Hamilton, and Toronto for a 17-year period. Demographic, socioeconomic, and housing factors were also evaluated to assess their effect on the potential of the population to adapt and their vulnerability to heat stress. Heat-stress days were defined as those with an apparent temperature (heat index) above 32 degrees C. Mortality among the elderly was significantly higher on heat-stress days than on non-heat-stress days in all cities except Windsor. The strongest relationships occurred in Toronto and London, followed by Hamilton. Cities with the greatest heat-related mortality have relatively high levels of urbanization and high costs of living. Even without the warming induced by a climate change, (1) vulnerability is likely to increase as the population ages, and (2) ongoing urban development and sprawl are expected to intensify heat-stress conditions in Southern Ontario. Actions should be taken to reduce vulnerability to heat stress conditions, and to develop a comprehensive hot weather watch/warning system for the region.

JN Hewko

Papers

Heat-stress-related mortality in five cities in Southern Ontario: 1980-1996.