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The main and added effects of heat on mortality in 33 Chinese cities from 2007 to 2013

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Abstract

Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health. However, evidence on their effects on public health is limited and inconclusive in China. In this study, data on daily deaths recorded in 33 Chinese cities from 2007 to 2013 was used to evaluate the effect of heat on mortality in China. In addition to the definition of a heatwave established by the China Meteorological Administration, we combined four city-specific relative thresholds (90th, 92.5th, 95th, and 97.5th percentiles) of the daily mean temperature during the study period and three durations of ≽ 2, ≽ 3, and ≽ 4 days, from which 13 heatwave definitions were developed. Then, we estimated the main and added effects of heat at the city level using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model. Next, the estimates for the effects were pooled at the national level using a multivariable meta-analysis. Subgroup analysis was performed according to sex, age, educational attainment, and spatially stratified heterogeneity. The results showed that the mortality risk increased from 22.3% to 37.1% due to the effects of the different heatwave definitions. The added effects were much lower, with the highest increase of 3.9% (95% CI: 1.7%–6.1%) in mortality risk. Females, the elderly, populations with low educational levels, and populations living inland in China were found to be the most vulnerable to the detrimental effects of heat. These findings have important implications for the improvement of early warning systems for heatwaves.

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Acknowledgements

This research was funded in part by the Wellcome Trust (No. 209387/Z/17/Z). Funding was also provided by the Cultivation Fund of Beijing Center for Disease Prevention and Control, the Beijing Research Center for Preventive Medicine (No. 2020-BJYJ-10), the National Natural Science Foundation of China (No. 82003552), and the Guangdong Basic and Applied Basic Research Foundation (No. 2020A1515011161). We thank Prof. Paul Wilkinson and Ai Milojevic from London School of Hygiene and Tropical Medicine, and Prof. Mike Davies from Institute for Environmental Design and Engineering, University College London for their contributions in designing and revising of the review. The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Beijing Center for Disease Prevention and Control, Institute for Nutrition and Food Hygiene, Beijing, 100013, China

    Yanlin Niu

  2. State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China

    Yanlin Niu & Qiyong Liu

  3. University College London, London, WC1H 0NN, UK

    Yanlin Niu

  4. School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China

    Jun Yang

  5. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China

    Qi Zhao

  6. Shandong University Climate Change and Health Center, Shandong University, Jinan, 250100, China

    Qi Zhao & Qiyong Liu

  7. Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, 40225, Germany

    Qi Zhao

  8. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia

    Yuan Gao

  9. Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China

    Tao Xue

  10. State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing, 100101, China

    Qian Yin & Jinfeng Wang

  11. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China

    Peng Yin & Maigeng Zhou

  12. University of Chinese Academy of Sciences, Beijing, 100049, China

    Jinfeng Wang

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  1. Yanlin Niu
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  2. Jun Yang
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  3. Qi Zhao
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  4. Yuan Gao
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  5. Tao Xue
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  7. Peng Yin
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  9. Maigeng Zhou
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  10. Qiyong Liu
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Correspondence to Qiyong Liu.

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Highlights

• The main and added effect from heat co-existed in China.

• Both of the main and added effect could increase the mortality risk of population.

• Females, the elderly, the less educated and inland residents were more vulnerable.

Special Issue—Climate Change and Public Health: emerging impacts and responses (Responsible Editors: Can Wang, Shihui Zhang, Derrick Ho & Miriam Marlier)

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Niu, Y., Yang, J., Zhao, Q. et al. The main and added effects of heat on mortality in 33 Chinese cities from 2007 to 2013. Front. Environ. Sci. Eng. 17, 81 (2023). https://doi.org/10.1007/s11783-023-1681-5

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