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. 2018 Aug 8;17(1):66.
doi: 10.1186/s12940-018-0411-0.

The inter-annual variability of heat-related mortality in nine European cities (1990-2010)

Matteo Scortichini  1 , Francesca de'Donato  2 , Manuela De Sario  2 , Michela Leone  2 , Christofer Åström  3 , Ferran Ballester  4   5 , Xavier Basagaña  5   6   7 , Janos Bobvos  8 , Antonio Gasparrini  9 , Klea Katsouyanni  10   11 , Timo Lanki  12   13 , Bettina Menne  14 , Mathilde Pascal  15 , Paola Michelozzi  2
Affiliations

The inter-annual variability of heat-related mortality in nine European cities (1990-2010)

Matteo Scortichini et al. Environ Health. .

Abstract

Background: The association between heat and daily mortality and its temporal variation are well known. However, few studies have analyzed the inter-annual variations in both the risk estimates and impacts of heat. The aim is to estimate inter-annual variations in the effect of heat for a fixed temperature range, on mortality in 9 European cities included in the PHASE (Public Health Adaptation Strategies to Extreme weather events) project for the period 1990-2010. The second aim is to evaluate overall summer effects and heat-attributable deaths for each year included in the study period, considering the entire air temperature range (both mild and extreme temperatures).

Methods: A city-specific daily time-series analysis was performed, using a generalized additive Poisson regression model, restricted to the warm season (April-September). To study the temporal variation for a fixed air temperature range, a Bayesian Change Point analysis was applied to the relative risks of mortality for a 2 °C increase over the 90th percentile of the city-specific distribution. The number of heat attributable deaths in each summer were also calculated for mild (reference to 95th percentile) and extreme heat (95th percentile to maximum value).

Results: A decline in the effects of heat over time was observed in Athens and Rome when considering a fixed interval, while an increase in effects was observed in Helsinki. The greatest impact of heat in terms of attributable deaths was observed in the Mediterranean cities (Athens, Barcelona and Rome) for extreme air temperatures. In the other cities the impact was mostly related to extreme years with 2003 as a record breaking year in Paris (+ 1900 deaths) and London (+ 1200 deaths).

Conclusions: Monitoring the impact of heat over time is important to identify changes in population vulnerability and evaluate adaptation measures.

Keywords: Attributable risk; Bayesian models; Heat; Mortality; Temporal trends; Time factors.

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Conflict of interest statement

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Warm season mean temperatures by year, in the nine European cities over the period 1990–2010
Fig. 2
Fig. 2
Heat-related mortality effects in nine European cities for each summer (period 1990–2010). top panel: Effects expressed as percent change in mortality for a 2 °C increase in mean temperature over the threshold; bottom panel: posterior probability of being a change point of each estimated observation from Bayesian Change Point analysis. The red dotted lines represent the statistical significance
Fig. 3
Fig. 3
Overall heat-related mortality effects and impacts in nine European cities for each summer (period 1990–2010). Right hand-side: risk estimates attributable to heat (from Tref to maximum); left hand-side: heat-attributable deaths to mild heat (from Tref to 95th percentile, light blue) and to extreme heat (from 95th percentile to maximum, dark blue)
See this image and copyright information in PMC

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