Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015

Daewon Yang¹, Masahiro Hashizume^{2

3}, Aurelio Tobías^{3

4}, Yasushi Honda⁵, Dominic Roye^{6

7}, Jaemin Oh⁸, Tran Ngoc Dang⁹, Yoonhee Kim¹⁰, Rosana Abrutzky¹¹, Yuming Guo^{12

13}, Shilu Tong^{14

15

16

17}, Micheline de Sousa Zanotti Stagliorio Coelho¹⁸, Paulo Hilario Nascimento Saldiva¹⁹, Eric Lavigne^{20

21}, Patricia Matus Correa²², Nicolás Valdés Ortega²², Samuel Osorio²³, Jan Kyselý^{24

25}, Aleš Urban^{24

25}, Hans Orru²⁶, Ene Indermitte²⁶, Jouni Jaakkola^{27

28}, Niilo Ryti^{27

28}, Mathilde Pascal²⁹, Veronika Huber^{30

31}, Alexandra Schneider³¹, Klea Katsouyanni^{32

33}, Antonis Analitis³², Alireza Entezari³⁴, Fatemeh Mayvaneh³⁴, Patrick Goodman³⁵, Ariana Zeka³⁶, Paola Michelozzi³⁷, Francesca de'Donato³⁷, Barrak Alahmad³⁸, Magali Hurtado Diaz³⁹, César De la Cruz Valencia³⁹, Ala Overcenco⁴⁰, Danny Houthuijs⁴¹, Caroline Ameling⁴¹, Shilpa Rao⁴², Baltazar Nunes^{43

44}, Joana Madureira^{45

46

47}, Iulian Horia Holo-Bâc⁴⁸, Noah Scovronick⁴⁹, Fiorella Acquaotta⁵⁰, Ho Kim⁵¹, Whanhee Lee⁵², Carmen Íñiguez^{53

54}, Bertil Forsberg⁵⁵, Ana Maria Vicedo-Cabrera^{56

57}, Martina S Ragettli^{58

59}, Yue-Liang Leon Guo^{60

61

62}, Shih Chun Pan⁶², Shanshan Li^{12

13}, Francesco Sera⁶³, Antonella Zanobetti³⁸, Joel Schwartz³⁸, Ben Armstrong⁶⁴, Antonio Gasparrini⁶⁴, Yeonseung Chung⁸

Affiliations

¹ Department of Information and Statistics, Chungnam National University, Daejeon, South Korea.
² Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁴ Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Re-search (CSIC), Barcelona, Spain.
⁵ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
⁶ Climate Research Foundation (FIC), Madrid, Spain.
⁷ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
⁸ Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
⁹ Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
¹⁰ Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹¹ Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina.
¹² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹³ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁴ School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
¹⁵ School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China.
¹⁶ National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
¹⁷ Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
¹⁸ Department of Pathology, University of Sao Paulo School of Medicine, São Paulo, Brazil.
¹⁹ Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.
²⁰ School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
²¹ Air Health Science Division, Health Canada, Ottawa, Canada.
²² Department of Public Health, Universidad de los Andes, Santiago, Chile.
²³ Department of Environmental Health, University of São Paulo, São Paulo, Brazil.
²⁴ Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic.
²⁵ Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.
²⁶ Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
²⁷ Center for Environmental and Respiratory Health Research (CERH), Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.
²⁸ Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
²⁹ Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France.
³⁰ IBE-Chair of Epidemiology, LMU Munich, Munich, Germany.
³¹ Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
³² Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
³³ Environmental Research Group, School of Public Health, Imperial College London, London, UK.
³⁴ Climatology Research Group, Institute of Landscape Ecology, University of Münster, Münster, Germany.
³⁵ School of Physics, Technological University Dublin, Dublin, Ireland.
³⁶ Institute of Environment, Health and Societies, Brunel University London, London, United Kingdom.
³⁷ Department of Epidemiology, Lazio Regional Health Service, ASL Roma1, Rome, Italy.
³⁸ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
³⁹ Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
⁴⁰ Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Republic of Moldova.
⁴¹ National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands.
⁴² Norwegian Institute of Public Health, Oslo, Norway.
⁴³ Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.
⁴⁴ Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
⁴⁵ Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.
⁴⁶ EPIUnit - Instituto de Saude Publica, Universidade do Porto, Porto, Portugal.
⁴⁷ Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
⁴⁸ Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania.
⁴⁹ Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, Georgia.
⁵⁰ Department of Earth Sciences, University of Torino, Torino, Italy.
⁵¹ Graduate School of Public Health, Seoul National University, Seoul, South Korea.
⁵² School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea.
⁵³ Department of Statistics and Computational Research, Universitat de València, València, Spain.
⁵⁴ CIBER of Epidemiology and Public Health, Madrid, Spain.
⁵⁵ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
⁵⁶ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
⁵⁷ Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
⁵⁸ University of Basel, Basel, Switzerland.
⁵⁹ Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
⁶⁰ Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan.
⁶¹ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.
⁶² Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.
⁶³ Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy.
⁶⁴ Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.

PMID: 39555185
PMCID: PMC11567688
DOI: 10.1097/EE9.0000000000000334

Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015

Daewon Yang et al. Environ Epidemiol. 2024.

. 2024 Sep 30;8(5):e334.

doi: 10.1097/EE9.0000000000000334. eCollection 2024 Oct.

Authors

Affiliations

¹ Department of Information and Statistics, Chungnam National University, Daejeon, South Korea.
² Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
⁴ Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Re-search (CSIC), Barcelona, Spain.
⁵ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
⁶ Climate Research Foundation (FIC), Madrid, Spain.
⁷ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
⁸ Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
⁹ Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
¹⁰ Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹¹ Universidad de Buenos Aires, Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Buenos Aires, Argentina.
¹² Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹³ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁴ School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
¹⁵ School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China.
¹⁶ National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
¹⁷ Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
¹⁸ Department of Pathology, University of Sao Paulo School of Medicine, São Paulo, Brazil.
¹⁹ Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.
²⁰ School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
²¹ Air Health Science Division, Health Canada, Ottawa, Canada.
²² Department of Public Health, Universidad de los Andes, Santiago, Chile.
²³ Department of Environmental Health, University of São Paulo, São Paulo, Brazil.
²⁴ Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic.
²⁵ Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic.
²⁶ Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
²⁷ Center for Environmental and Respiratory Health Research (CERH), Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.
²⁸ Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
²⁹ Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France.
³⁰ IBE-Chair of Epidemiology, LMU Munich, Munich, Germany.
³¹ Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
³² Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
³³ Environmental Research Group, School of Public Health, Imperial College London, London, UK.
³⁴ Climatology Research Group, Institute of Landscape Ecology, University of Münster, Münster, Germany.
³⁵ School of Physics, Technological University Dublin, Dublin, Ireland.
³⁶ Institute of Environment, Health and Societies, Brunel University London, London, United Kingdom.
³⁷ Department of Epidemiology, Lazio Regional Health Service, ASL Roma1, Rome, Italy.
³⁸ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
³⁹ Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
⁴⁰ Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Republic of Moldova.
⁴¹ National Institute for Public Health and the Environment (RIVM), Centre for Sustainability and Environmental Health, Bilthoven, Netherlands.
⁴² Norwegian Institute of Public Health, Oslo, Norway.
⁴³ Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.
⁴⁴ Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
⁴⁵ Department of Environmental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal.
⁴⁶ EPIUnit - Instituto de Saude Publica, Universidade do Porto, Porto, Portugal.
⁴⁷ Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
⁴⁸ Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania.
⁴⁹ Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, Georgia.
⁵⁰ Department of Earth Sciences, University of Torino, Torino, Italy.
⁵¹ Graduate School of Public Health, Seoul National University, Seoul, South Korea.
⁵² School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea.
⁵³ Department of Statistics and Computational Research, Universitat de València, València, Spain.
⁵⁴ CIBER of Epidemiology and Public Health, Madrid, Spain.
⁵⁵ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
⁵⁶ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
⁵⁷ Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
⁵⁸ University of Basel, Basel, Switzerland.
⁵⁹ Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
⁶⁰ Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan.
⁶¹ National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan.
⁶² Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.
⁶³ Department of Statistics, Informatics, Applications, University of Florence, Florence, Italy.
⁶⁴ Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.

PMID: 39555185
PMCID: PMC11567688
DOI: 10.1097/EE9.0000000000000334

Abstract

Background: The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries.

Methods: Daily time-series data for mortality and ambient mean temperature for 699 communities in 34 countries spanning 1986-2015 were analyzed using a two-stage meta-analysis. First, a quasi-Poisson regression was employed to estimate MMT and MMTP for each community during the designated subperiods. Second, we pooled the community-specific temporally varying estimates using mixed-effects meta-regressions to examine temporal changes in MMT and MMTP in the entire study population, as well as by climate zone, geographical region, and country.

Results: Temporal increases in MMT and MMTP from 19.5 °C (17.9, 21.1) to 20.3 °C (18.5, 22.0) and from the 74.5 (68.3, 80.6) to 75.0 (71.0, 78.9) percentiles in the entire population were found, respectively. Temporal change was significantly heterogeneous across geographical regions (P < 0.001). Temporal increases in MMT were observed in East Asia (linear slope [LS] = 0.91, P = 0.02) and South-East Asia (LS = 0.62, P = 0.05), whereas a temporal decrease in MMT was observed in South Europe (LS = -0.46, P = 0.05). MMTP decreased temporally in North Europe (LS = -3.45, P = 0.02) and South Europe (LS = -2.86, P = 0.05).

Conclusions: The temporal change in MMT or MMTP was largely heterogeneous. Population susceptibility in terms of optimum temperature may have changed under a warming climate, albeit with large region-dependent variations.

Keywords: Climate change; Heterogeneity; Human adaptation; Minimum mortality temperature; Temporal change.

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Conflict of interest statement

The authors declare that they have no conflicts of interest with regard to the content of this report.

Figures

**Figure 1.**
Temporal change in (A) MMT and (B) MMTP in the entire study population (top left) and each of the 11 geographical regions. The linear slope (LS) is presented with the corresponding P value.

**Figure 2.**
Temporal change in MMT (A) and MMTP (B) in each of the four climate zones. The linear slope (LS) is presented with the corresponding P value.

**Figure 3.**
Distribution of the community-specific (A) MMT and (B) MMTP in the first (1986–1990) and last (2011–2015) subperiods in the entire population (top left) and each of the 11 geographical regions.

**Figure 4.**
Change in the community-specific (A) MMT and (B) MMTP between the first (1986–1990) and last (2011–2015) subperiods for each of the 677 communities.

See this image and copyright information in PMC

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Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015

Affiliations

Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources