Antonio Gasparrini, London School of Hygiene and Tropical Medicine
Yurning Guo, Monash University, Australia
Francesa Sera, London School of Hygiene and Tropical Medicine
Ana Maria Vicedo-Cabrera, London School of Hygiene and Tropical Medicine
Veronika Huber, Potsdam Institute for Climate Impact Research
Shilu Tong, Anhui Medical
Micheline de Sousa Zanotti Stagliorio Coelho, University of Sao Paulo, Brazil
Paulo Saldiva, University of Sao Paulo, Brazil
Eric Lavigne, University of Ottawa
Patricia Correa, Universidad de Los Andes, Venezuela
Nicolas Valdes Ortega, Universidad de Los Andes, Venezuela
Haidong Kan, Fudang University
Samuel Osorio, University of Sao Paolo
Jan Kysely, Czech University of Life Sciences
Ales Urban, Academy of Sciences of the Czech Republic
Jauni Jaakkola, University of Oulu
Niilo Ryti, University of Oulu
Mathilde Pascal, French National Public Health Agency
Patrick J. Goodman, Technological University DublinFollow
Ariana Zeka, Brunel University
Paola Michelozzi, Lazio Regional Health Service
Matteo Scortichini, Lazio Regional Health Service
Masahiro Hashizume, Nagasaki University
Yasushi Honda, University of Tsukuba
Magali Hurtado-Diaz, National Institute of Public Health, Mexioc
Julio Cruz, National Institute of Public Health
Xerxes Seposo, Kyoto University
Ho Kim, Seoul National University
Aurelio Tobias, IDAEA, Spain
Carmen Iniguez
Bertil Forsberg
Daniel Astrom
Martina Ragettli
Yue Guo, National Taiwan University
Chang-fu Wu, Taipei University
Antonella Zaobetti, Harvard University
Joel Schwartz, Harvard University
Michelle Bell, Yale University
Tran Ngoc Dang, University of Medicine and Pharmacy of Ho Chi Minh City
Duong Do Van, Duy Tan University
Clare Heaviside, Public Health England
Sotiris Vardoulakis, London School of Hygiene and Tropical Medicine
Shakoor Hajat, Institute of Occupational Medicine Edinburgh
Andy Haines, London School of Hygiene and Tropical Medicine
Ben Armstrong, London School of Hygiene and Tropical Medicine

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Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence



Publication Details

Lancet Planetary Health


Summary 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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