University of Oulu

Wu, Y., Li, S., Zhao, Q., Wen, B., Gasparrini, A., Tong, S., Overcenco, A., Urban, A., Schneider, A., Entezari, A., Vicedo-Cabrera, A. M., Zanobetti, A., Analitis, A., Zeka, A., Tobias, A., Nunes, B., Alahmad, B., Armstrong, B., Forsberg, B., … Guo, Y. (2022). Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19: A three-stage modelling study. The Lancet Planetary Health, 6(5), e410–e421.

Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19 : a three-stage modelling study

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Author: Wu, Yao1,2; Li, Shanshan1,2; Zhao, Qi1,3;
Organizations: 1Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia.
2Monash Univ, Sch Publ Hlth & Prevent Med, Air Qual Res Unit, Climate, Melbourne, Vic 3004, Australia.
3Shandong Univ, Cheeloo Coll Med, Sch Publ Hlth, Dept Epidemiol, Jinan, Peoples R China.
4London Sch Hyg & Trop Med, Dept Publ Hlth Environm & Soc, London, England.
5London Sch Hyg & Trop Med, Ctr Stat Methodol, London, England.
6London Sch Hyg & Trop Med, Ctr Climate Change & Planetary Hlth, London, England.
7Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Shanghai, Peoples R China.
8Anhui Med Univ, Sch Publ Hlth, Inst Environm & Populat Hlth, Hefei, Peoples R China.
9Nanjing Med Univ, Ctr Global Hlth, Nanjing, Peoples R China.
10Queensland Univ Technol, Sch Publ Hlth & Social Work, Brisbane, Qld, Australia.
11Minist Hlth Labour & Social Protect Republ Moldov, Natl Agcy Publ Hlth, Kishinev, Moldova.
12Czech Acad Sci, Inst Atmospher Phys, Prague, Czech Republic.
13Czech Univ Life Sci, Fac Environm Sci, Prague, Czech Republic.
14Helmholtz Zentrum Munchen, Inst Epidemiol, German Res Ctr Environm Hlth, Neuherberg, Germany.
15Hakim Sabzevari Univ, Fac Geog & Environm Sci, Sabzevar, Iran.
16Univ Bern, Inst Social & Prevent Med, Bern, Switzerland.
17Univ Bern, Oeschger Ctr Climate Change Res, Bern, Switzerland.
18Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA.
19Natl & Kapodistrian Univ Athens, Dept Hyg Epidemiol & Med Stat, Athens, Greece.
20Brunel Univ London, Inst Environm Hlth & Soc, London, England.
21Spanish Council Sci Res, Inst Environm Assessment & Water Res, Barcelona, Spain.
22Nagasaki Univ, Sch Trop Med & Global Hlth, Nagasaki, Japan.
23Inst Nacl Saude Dr Ricardo Jorge, Dept Epidemiol, Porto, Portugal.
24Univ NOVA Lisboa, Ctr Invest Saude Publ, Escola Nacl Saude Publ, Lisbon, Portugal.
25Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden.
26Natl Inst Environm Hlth Sci, Natl Hlth Res Inst, Zhunan, Taiwan.
27Univ Valencia, Dept Stat & Computat Res, Valencia, Spain.
28CIBER Epidemiol & Publ Hlth, Madrid, Spain.
29Natl Inst Publ Hlth & Environm RIVM, Ctr Sustainabil & Environm Hlth, Bilthoven, Netherlands.
30Natl Inst Publ Hlth, Dept Environm Hlth, Cuernavaca, Morelos, Mexico.
31Univ Med & Pharm Ho Chi Minh City, Fac Publ Hlth, Dept Environm Hlth, Ho Chi Minh City, Vietnam.
32Univ Santiago de Compostela, Dept Geog, Santiago De Compostela, Spain.
33Univ Tartu, Inst Family Med & Publ Hlth, Tartu, Estonia.
34Univ Ottawa, Fac Med, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada.
35Hlth Canada, Air Hlth Sci Div, Ottawa, ON, Canada.
36Univ Torino, Dept Earth Sci, Turin, Italy.
37Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy.
38Norwegian Inst Publ Hlth, Oslo, Norway.
39Univ Florence, Dept Stat Comp Sci & Applicat G Parenti, Florence, Italy.
40Univ Peruana Cayetano Heredia, Inst Trop Med Alexander von Humboldt, Hlth Innovat Lab, Lima, Peru.
41Univ Calif San Diego, Scripps Inst Oceanog, La Jolla, CA 92093 USA.
42Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai, Peoples R China.
43Seoul Natl Univ, Grad Sch Publ Hlth, Seoul, South Korea.
44Babes Bolyai Univ, Fac Geog, Cluj Napoca, Romania.
45Inst Nacl Saude Dr Ricardo Jorge, Environm Hlth Dept, Porto, Portugal.
46Univ Porto, Inst Saude Publ, EPIUnit, Porto, Portugal.
47Lab Invest Integrat & Translat Saude Populat ITR, Porto, Portugal.
48Univ Oulu, Ctr Environm & Resp Hlth Res CERH, Oulu, Finland.
49Oulu Univ Hosp, Med Res Ctr Oulu MRC Oulu, Oulu, Finland.
50Univ Oulu, Oulu, Finland.
51Kings Coll London, Sch Populat Hlth & Environm Sci, London, England.
52Swiss Trop & Publ Hlth Inst, Basel, Switzerland.
53Univ Basel, Basel, Switzerland.
54Univ Tokyo, Grad Sch Med, Dept Global Hlth Policy, Tokyo, Japan.
55French Natl Publ Hlth Agcy, Dept Environm & Occupat Hlth, St Publ France, St Maurice, France.
56Univ Sao Paulo, Fac Med, Dept Pathol, Sao Paulo, Brazil.
57Univ Los Andes, Dept Publ Hlth, Santiago, Chile.
58Emory Univ, Rollins Sch Publ Hlth, Gangarosa Dept Environm Hlth, Atlanta, GA 30322 USA.
59Technol Univ Dublin, Sch Phys, Dublin, Ireland.
60INSPER, Sao Paulo, Brazil.
61Univ Buenos Aires, Fac Ciencias Sociales, Inst Invest Gino Germani, Buenos Aires, DF, Argentina.
62Univ Sao Paulo, Dept Environm Hlth, Sao Paulo, Brazil.
63Univ Republica, Sch Med, Dept Quantitat Methods, Montevideo, Uruguay.
64Ludwig Maximilians Univ Munchen, IBE Chair Epidemiol, Munich, Germany.
65Univ Pablo de Olavide, Dept Phys Chem & Nat Syst, Seville, Spain.
66Yale Univ, Sch Environm, New Haven, CT USA.
67Ewha Womans Univ, Sch Med, Dept Occupat & Environm Med, Seoul, South Korea.
68Natl Inst Environm Studies, Ctr Climate Change Adaptat, Tsukuba, Ibaraki, Japan.
69Natl Taiwan Univ, Coll Med, Environm & Occupat Med, Taipei, Taiwan.
70NTU Hosp, Taipei, Taiwan.
71Natl Taiwan Univ, Coll Publ Hlth, Grad Inst Environm & Occupat Hlth Sci, Taipei, Taiwan.
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 3.9 MB)
Persistent link:
Language: English
Published: Elsevier, 2022
Publish Date: 2022-10-21


Background: Increased mortality risk is associated with short-term temperature variability: However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000–19.

Methods: In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° degrees from 2000–19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades.

Findings: An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1753392 deaths (95% CI 1159 901–2357 718) were associated with temperature variability per year, accounting for 3·4% (2·2–4·6) of all deaths. Most of Asia, Australia, and New Zealand were observed to have a higher percentage excess in mortality than the global mean. Globally, the percentage excess in mortality increased by about 4·6% (3·7–5·3) per decade. The largest increase occurred in Australia and New Zealand (7·3%, 95% CI 4·3–10·4), followed by Europe (4·4%, 2·2–5·6) and Africa (3·3, 1·9–4·6).

Interpretation: Globally, a substantial mortality burden was associated with temperature variability, showing geographical heterogeneity and a slightly increasing temporal trend. Our findings could assist in raising public awareness and improving the understanding of the health impacts of temperature variability.

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Series: The Lancet. Planetary health
ISSN: 2542-5196
ISSN-E: 2542-5196
ISSN-L: 2542-5196
Volume: 6
Issue: 5
Pages: e410 - e421
DOI: 10.1016/s2542-5196(22)00073-0
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This study was supported by the Australian Research Council (DP210102076) and the Australian National Health and Medical Research Council (APP2000581). YW was supported by the China Scholarship Council (number 202006010044). SL was supported by an Emerging Leader Fellowship of the Australian National Health and Medical Research Council (number APP2009866). QZ was supported by the Program of Qilu Young Scholars of Shandong University, Jinan, China. BW was supported by the China Scholarship Council (number 202006010043). JK and AU were supported by the Czech Science Foundation (project number 20–28560S). NS was supported by the National Institute of Environmental Health Sciences-funded HERCULES Center (P30ES019776). S-CP and YLG were supported by the Ministry of Science and Technology (Taiwan; MOST 109–2621-M-002–021). YH was supported by the Environment Research and Technology Development Fund (JPMEERF15S11412) of the Environmental Restoration and Conservation Agency. MdSZSC and PHNS were supported by the São Paulo Research Foundation (FAPESP). ST was supported by the Science and Technology Commission of Shanghai Municipality (grant number 18411951600). HO and EI were supported by the Estonian Ministry of Education and Research (IUT34–17). JM was supported by a fellowship of Fundação para a Ciência e a Tecnlogia (SFRH/BPD/115112/2016). AG and FS were supported by the Medical Research Council UK (grant ID MR/R013349/1), the Natural Environment Research Council UK (grant ID NE/R009384/1), and the EU's Horizon 2020 project, Exhaustion (grant ID 820655). AS, SR, and FdD were supported by the EU's Horizon 2020 project, Exhaustion (grant ID 820655). VH was supported by the Spanish Ministry of Economy, Industry and Competitiveness (grant ID PCIN-2017–046). AT was supported by MCIN/AEI/10.13039/501100011033 (grant CEX2018-000794-S). YG was supported by the Career Development Fellowship (number APP1163693) and Leader Fellowship (number APP2008813) of the Australian National Health and Medical Research Council. Statistics South Africa kindly provided the mortality data, but had no other role in the study. This Article is published in memory of Simona Fratianni, who helped to contribute the data for Romania.
Copyright information: © 2022 The Author(s). This is an Open Access article under the CC BY 4.0 license.