University of Oulu

Gasparrini, A., Guo, Y., Sera, F., Vicedo-Cabrera, A., Huber, V., Tong, S., de Sousa Zanotti Stagliorio Coelho, M., Nascimento Saldiva, P., Lavigne, E., Matus Correa, P., Valdes Ortega, N., Kan, H., Osorio, S., Kyselý, J., Urban, A., Jaakkola, J., Ryti, N., Pascal, M., Goodman, P., Zeka, A., Michelozzi, P., Scortichini, M., Hashizume, M., Honda, Y., Hurtado-Diaz, M., Cesar Cruz, J., Seposo, X., Kim, H., Tobias, A., Iñiguez, C., Forsberg, B., Åström, D., Ragettli, M., Guo, Y., Wu, C., Zanobetti, A., Schwartz, J., Bell, M., Dang, T., Van, D., Heaviside, C., Vardoulakis, S., Hajat, S., Haines, A., Armstrong, B. (2017) Projections of temperature-related excess mortality under climate change scenarios. Lancet Planetary Health, 1 (9), e360-e367. doi:10.1016/S2542-5196(17)30156-0

Projections of temperature-related excess mortality under climate change scenarios

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Author: Gasparrini, Antonio1; Guo, Yuming2,3; Sera, Francesco1;
Organizations: 1Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine
2Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University
3Division of Epidemiology and Biostatistics, School of Population Health, University of Queensland
4Potsdam Institute for Climate Impact Research
5School of Public Health and Institute of Environment and Human Health, Anhui Medical University
6Shanghai Children's Medical Centre, Shanghai Jiao-Tong University
7School of Public Health and Social Work, Queensland University of Technology
8Institute of Advanced Studies, University of São Paulo
9Department of Epidemiology, Public Health and Preventive Medicine, University of Ottawa
10Department of Public Health, Universidad de los Andes
11Department of Environmental Health, School of Public Health, Fudan University
12Department of Environmental Health, University of São Paulo
13Institute of Atmospheric Physics, Academy of Sciences of the Czech Republic
14Faculty of Environmental Sciences, Czech University of Life Sciences
15Center for Environmental and Respiratory Health Research, University of Oulu
16Medical Research Center Oulu, Oulu University Hospital and University of Oulu
17Santé Publique France, French National Public Health Agency
18School of Physics, Dublin Institute of Technology
19Institute of Environment, Health and Societies, Brunel University London
20Department of Epidemiology, Lazio Regional Health Service
21Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University
22Faculty of Health and Sport Sciences, University of Tsukuba
23Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
24Department of Environmental Engineering, Kyoto University
25Graduate School of Public Health, Seoul National University
26Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC)
27Epidemiology and Environmental Health Joint Research Unit, CIBERESP, University of Valencia
28Department of Public Health and Clinical Medicine, Umeå University
29Department of Clinical Science, Malmö, Lund University
30Swiss Tropical and Public Health Institute
31University of Basel
32Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital
33Department of Public Health, National Taiwan University
34Department of Environmental Health, Harvard TH Chan School of Public Health
35School of Forestry and Environmental Studies, Yale University
36Faculty of Public Health, University of Medicine and Pharmacy of Ho Chi Minh City
37Institute of Research and Development, Duy Tan University
38Environmental Change Department, Centre for Radiation, Chemical & Environmental Hazards, Public Health England
39Institute of Occupational Medicine, Edinburgh
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Elsevier, 2017
Publish Date: 2018-03-02


Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates.

Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature–mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990–2099 under each scenario of climate change, assuming no adaptation or population changes.

Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090–99 compared with 2010–19 ranging from −1·2% (empirical 95% CI −3·6 to 1·4) in Australia to −0·1% (−2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (−3·0 to 9·3) in Central America to 12·7% (−4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet.

Interpretation: This study shows the negative health impacts of climate change that, under high-emission scenarios, would disproportionately affect warmer and poorer regions of the world. Comparison with lower emission scenarios emphasises the importance of mitigation policies for limiting global warming and reducing the associated health risks.

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Series: The Lancet. Planetary health
ISSN: 2542-5196
ISSN-E: 2542-5196
ISSN-L: 2542-5196
Volume: 1
Issue: 9
Pages: e360 - e367
DOI: 10.1016/S2542-5196(17)30156-0
Type of Publication: A1 Journal article – refereed
Field of Science: 3141 Health care science
Funding: This work was primarily supported by the Medical Research Council-UK (grant MR/M022625/1). The following individual grants also supported this work: YG was supported by the Career Development Fellowship of Australian National Health and Medical Research Council (grant APP1107107); AT was supported by the Ministry of Education of Spain (grant PRX17/00705); VH was supported by the German Federal Ministry of Education and Research (grant 01LS1201A2); JK was supported by the Czech Science Foundation (grant 16-22000S); JJKJ and NRIR were supported by the Research Council for Health, Academy of Finland (grant 266314); MH, YLG, C-fW, YH, and HKi were supported by the Global Research Laboratory (grant K21004000001-10A0500-00710) through the National Research Foundation of Korea; YH was supported by the Environment Research and Technology Development Fund (S-14) of the Ministry of the Environment, Japan; YLG was supported by the National Health Research Institutes of Taiwan (grant NHRI-EM-106-SP03); and MLB was supported by a US Environmental Protection Agency Assistance Agreement awarded to Yale University (grant 83587101).
Academy of Finland Grant Number: 266314
Detailed Information: 266314 (Academy of Finland Funding decision)
Copyright information: © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.