Learning to Take the Heat: Declines in U.S. Heat-Related Mortality
2014; National Institute of Environmental Health Sciences; Volume: 122; Issue: 8 Linguagem: Inglês
10.1289/ehp.122-a220
ISSN1552-9924
Autores Tópico(s)Thermoregulation and physiological responses
ResumoVol. 122, No. 8 News | Science SelectionsOpen AccessLearning to Take the Heat: Declines in U.S. Heat-Related Mortalityis accompanied byHeat-Related Mortality and Adaptation to Heat in the United States Lindsey Konkel Lindsey Konkel Search for more papers by this author Published:1 August 2014https://doi.org/10.1289/ehp.122-A220Cited by:9View Article in:中文版AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit Americans are learning to take the heat, literally, according to new research in this issue of EHP. Overall, the authors of the new study estimate that the risk of heat-related mortality on hotter-than-usual days was 63% lower in 2005 than it was in 1987.1 This may indicate the U.S. population, over time, has become more resilient to temperature changes, although some cities showed greater decreases in risk than others.However, climate change could contribute to additional deaths in the future, according to lead author Jennifer Bobb of the Harvard School of Public Health. “Heat-related mortality is down, but more extreme heat exposures will lead to higher risk,” she says. “I think it is likely that we will continue to adapt, but the rate of adaptation might change moving forward from what we observed in our data from 1987 to 2005.”A Philadelphia resident carries a fan distributed by a local senior center. Cities across the United States are implementing public health initiatives to help the elderly and other vulnerable populations cope with hotter-than-usual temperatures in summer months.© AP Photo/Matt RourkeBobb and colleagues projected that a 5°F increase in average daily temperatures across the United States would lead to 1,907 additional deaths each summer.1 (The National Climate Assessments projects average U.S. temperatures could increase by 3–15°F by 2099, depending on future emissions of greenhouse gases.2) The researchers did not account for continued adaptation beyond 2005 in this estimate.To assess how day-to-day changes in temperature related to changes in daily numbers of deaths, the researchers compared daily summertime weather data for the years 1987 through 2005 with daily deaths reported in 105 U.S. cities (excluding deaths due to external causes, such as accidents and homicides). Their analysis covered about 106 million people.When they compared mortality on average-temperature days and days with higher-than-average temperatures, the researchers found that the number of excess deaths declined from 51 per 1,000 in 1987 to 19 per 1,000 in 2005. In a sensitivity analysis, they accounted for air pollution levels, which have been linked to increases in same-day mortality risks.3 Adults over age 75 and those living in northern cities and cooler climates saw the greatest decrease in estimated heat-related mortality.1Previous studies on heat-related mortality have largely assumed that mortality risk stayed constant over several years.4,5 Fewer studies have investigated how heat-related mortality risk may be changing.6 “This study shows that the effect of temperature on deaths isn’t constant over time,” says Patrick Kinney, director of Columbia University’s Climate and Health Program. Kinney was not involved in the study.A number of factors may account for the decline, according to Bobb. Heat can exacerbate respiratory and cardiovascular diseases,7 and cardiovascular deaths make up a large proportion of heat-related deaths.5 A decline in heat-related mortality could reflect the overall drop in cardiovascular deaths reported in recent years,8 the researchers suggest.Public health initiatives to increase awareness of the health effects of severe heat also may be working, Bobb says. Several cities have implemented hot-weather warning systems, which include media announcements encouraging people to minimize their own heat exposure and to check on sick and elderly neighbors throughout the day. Cities have also provided “cooling centers” for residents who lack access to air conditioning.9Earlier research suggested that an increase in the use of central air conditioning over the past few decades may be a major contributor to declines in heat-related deaths.6,10 But Bobb and colleagues found that air conditioning may not play as big a role as previously thought.Although the prevalence of central air conditioning in homes increased by an average of about 1% each year over the study period (from a low of 48% in 1987), the researchers found no evidence of larger declines in heat-related mortality for cities with larger increases in air-conditioning prevalence.1 However, their analysis was limited by the unavailability of data on air conditioning usage among different groups.“What we’d really like to see is how much air conditioning is used by people who are the most vulnerable to the health effects of heat, and that sort of information isn’t readily available,” Kinney says. “My intuition is still that air conditioning may be a key factor.”Although this report focused solely on heat-related mortality during the months of June, July, and August, the health effects of heat are sometimes most striking early in the season, before people have acclimated to the shift in the seasons, says Kinney. With climate change projected to increase year-round temperatures across months,2 he says that including additional months may provide a more comprehensive picture of heat-related mortality risk throughout the year.References1 Bobb JFet al.Heat-related mortality and adaptation to heat in the United States.Environ Health Perspect 122(8):811-8162014.; doi:10.1289/ehp.1307392. Link, Google Scholar2 USGCRP. National Climate Assessment. Washington, DC:U.S. Global Change Research Program (2014). Available: http://nca2014.globalchange.gov/highlights/report-findings/future-climate [accessed 26 June 2014]. Google Scholar3 Samet JMet al.Fine particulate air pollution and mortality in 20 U.S. cities, 1987–1994.N Engl J Med 343(24):1742-17492000.; doi:10.1056/NEJM20001214343240111114312. Crossref, Medline, Google Scholar4 Anderson B, Bell MLWeather-related mortality: how heat, cold, and heat waves affect mortality in the United States.Epidemiology 20(2):205-2132009.; doi:10.1097/EDE.0b013e318190ee0819194300. Crossref, Medline, Google Scholar5 Basu RHigh ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008.Environ Health 8(1):402009.; doi:10.1186/1476-069X-8-4019758453. Crossref, Medline, Google Scholar6 Barnett AGTemperature and cardiovascular deaths in the US elderly: changes over time.Epidemiology 18(3):369-3722007.; doi:10.1097/01.ede.0000257515.34445.a017435447. Crossref, Medline, Google Scholar7 NIEHS. Heat and Climate Change [website]. Research Triangle Park, NC:National Institute of Environmental Health Sciences, National Institutes of Health (updated 28 March 2013). Available: http://www.niehs.nih.gov/research/programs/geh/climatechange/health_impacts/heat_related_morbidity/index.cfm [accessed 26 June 2014]. Google Scholar8 Ford ES, Capewell SProportion of the decline in cardiovascular mortality disease due to prevention versus treatment: public health versus clinical care.Annu Rev Public Health 32:5-222011.; doi:10.1146/annurev-publhealth-031210-10121121417752. Crossref, Medline, Google Scholar9 EPA. Excessive Heat Events Guidebook. Washington, DC:U.S. Environmental Protection Agency (2006). Available: http://www.epa.gov/heatisland/about/heatguidebook.html [accessed 26 June 2014]. Google Scholar10 O’Neill MSet al.Disparities by race in heat-related mortality in four US cities: the role of air conditioning prevalence.J Urban Health 82(2):191-1972005.; doi:10.1093/jurban/jti04315888640. Crossref, Medline, Google ScholarFiguresReferencesRelatedDetailsCited by Díaz J, Sáez M, Carmona R, Mirón I, Barceló M, Luna M and Linares C (2019) Mortality attributable to high temperatures over the 2021–2050 and 2051–2100 time horizons in Spain: Adaptation and economic estimate, Environmental Research, 10.1016/j.envres.2019.02.041, 172, (475-485), Online publication date: 1-May-2019. Martinez G, Diaz J, Hooyberghs H, Lauwaet D, De Ridder K, Linares C, Carmona R, Ortiz C, Kendrovski V, Aerts R, Van Nieuwenhuyse A and Dunbar M (2018) Heat and health in Antwerp under climate change: Projected impacts and implications for prevention, Environment International, 10.1016/j.envint.2017.11.012, 111, (135-143), Online publication date: 1-Feb-2018. Díaz J, Carmona R, Mirón I, Luna M and Linares C (2018) Time trend in the impact of heat waves on daily mortality in Spain for a period of over thirty years (1983–2013), Environment International, 10.1016/j.envint.2018.04.001, 116, (10-17), Online publication date: 1-Jul-2018. Martinez G, Diaz J, Hooyberghs H, Lauwaet D, De Ridder K, Linares C, Carmona R, Ortiz C, Kendrovski V and Adamonyte D (2018) Cold-related mortality vs heat-related mortality in a changing climate: A case study in Vilnius (Lithuania), Environmental Research, 10.1016/j.envres.2018.06.001, 166, (384-393), Online publication date: 1-Oct-2018. Díaz J, López I, Carmona R, Mirón I, Luna M and Linares C (2018) Short-term effect of heat waves on hospital admissions in Madrid: Analysis by gender and comparision with previous findings, Environmental Pollution, 10.1016/j.envpol.2018.09.098, 243, (1648-1656), Online publication date: 1-Dec-2018. Hepler C, Foy C, Higgins M and Renquist B (2016) The hypophagic response to heat stress is not mediated by GPR109A or peripheral β-OH butyrate, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 10.1152/ajpregu.00513.2015, 310:10, (R992-R998), Online publication date: 15-May-2016. Carmona R, Díaz J, Mirón I, Ortiz C, Luna M and Linares C (2016) Mortality attributable to extreme temperatures in Spain: A comparative analysis by city, Environment International, 10.1016/j.envint.2016.02.018, 91, (22-28), Online publication date: 1-May-2016. Díaz J, Carmona R, Mirón I, Ortiz C, León I and Linares C (2015) Geographical variation in relative risks associated with heat: Update of Spain's Heat Wave Prevention Plan, Environment International, 10.1016/j.envint.2015.09.022, 85, (273-283), Online publication date: 1-Dec-2015. Díaz J, Carmona R, Mirón I, Ortiz C and Linares C (2015) Comparison of the effects of extreme temperatures on daily mortality in Madrid (Spain), by age group: The need for a cold wave prevention plan, Environmental Research, 10.1016/j.envres.2015.10.018, 143, (186-191), Online publication date: 1-Nov-2015. Related articlesHeat-Related Mortality and Adaptation to Heat in the United States29 April 2014Environmental Health Perspectives Vol. 122, No. 8 August 2014Metrics About Article Metrics Publication History Originally published1 August 2014Published in print1 August 2014 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.
Referência(s)