Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis

Background: South Asia is highly vulnerable to climate change and is projected to experience some of the highest increases in average annual temperatures throughout the century. Although the adverse impacts of ambient temperature on human health have been extensively documented in the literature, on...

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Autores: Dimitrova, Asya, 1988-, Ingole, Vijendra, Basagaña Flores, Xavier, Ranzani, Otavio, Milà, Carles, Ballester, Joan, Tonne, Cathryn
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/52963
Acceso en línea:http://hdl.handle.net/10230/52963
http://dx.doi.org/10.1016/j.envint.2020.106170
Access Level:acceso abierto
Palabra clave:Cold
Heat
Heat waves
Meta-analysis
Mortality
South Asia
Systematic review
Temperature
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dc.title.none.fl_str_mv Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
title Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
spellingShingle Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
Dimitrova, Asya, 1988-
Cold
Heat
Heat waves
Meta-analysis
Mortality
South Asia
Systematic review
Temperature
title_short Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
title_full Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
title_fullStr Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
title_full_unstemmed Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
title_sort Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis
dc.creator.none.fl_str_mv Dimitrova, Asya, 1988-
Ingole, Vijendra
Basagaña Flores, Xavier
Ranzani, Otavio
Milà, Carles
Ballester, Joan
Tonne, Cathryn
author Dimitrova, Asya, 1988-
author_facet Dimitrova, Asya, 1988-
Ingole, Vijendra
Basagaña Flores, Xavier
Ranzani, Otavio
Milà, Carles
Ballester, Joan
Tonne, Cathryn
author_role author
author2 Ingole, Vijendra
Basagaña Flores, Xavier
Ranzani, Otavio
Milà, Carles
Ballester, Joan
Tonne, Cathryn
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Cold
Heat
Heat waves
Meta-analysis
Mortality
South Asia
Systematic review
Temperature
topic Cold
Heat
Heat waves
Meta-analysis
Mortality
South Asia
Systematic review
Temperature
description Background: South Asia is highly vulnerable to climate change and is projected to experience some of the highest increases in average annual temperatures throughout the century. Although the adverse impacts of ambient temperature on human health have been extensively documented in the literature, only a limited number of studies have focused on populations in this region. Objectives: Our aim was to systematically review the current state and quality of available evidence on the direct relationship between ambient temperature and heat waves and all-cause mortality in South Asia. Methods: The databases Pubmed, Web of Science, Scopus and Embase were searched from 1990 to 2020 for relevant observational quantitative studies. We applied the Navigation Guide methodology to assess the strength of the evidence and performed a meta-analysis based on a novel approach that allows for combining nonlinear exposure-response associations without access to data from individual studies. Results: From the 6,759 screened papers, 27 were included in the qualitative synthesis and five in a meta-analysis. Studies reported an association of all-cause mortality with heat wave episodes and both high and low daily temperatures. The meta-analysis showed a U-shaped pattern, with increasing mortality for both high and low temperatures, but a statistically significant association was found only at higher temperatures - above 31° C for lag 0-1 days and above 34° C for lag 0-13 days. Effects were found to vary with cause of death, age, sex, location (urban vs. rural), level of education and socio-economic status, but the profile of vulnerabilities was somewhat inconsistent and based on a limited number of studies. Overall, the strength of the evidence for ambient temperature as a risk factor for all-cause mortality was judged as limited and for heat wave episodes as inadequate. Conclusions: The evidence base on temperature impacts on mortality in South Asia is limited due to the small number of studies, their skewed geographical distribution and methodological weaknesses. Understanding the main determinants of the temperature-mortality association as well as how these may evolve in the future in a dynamic region such as South Asia will be an important area for future research. Studies on viable adaptation options to high temperatures for a region that is a hotspot for climate vulnerability, urbanisation and population growth are also needed.
publishDate 2021
dc.date.none.fl_str_mv 2021
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/52963
http://dx.doi.org/10.1016/j.envint.2020.106170
url http://hdl.handle.net/10230/52963
http://dx.doi.org/10.1016/j.envint.2020.106170
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Environ Int. 2021 Jan;146:106170
info:eu-repo/grantAgreement/EC/H2020/730004
info:eu-repo/grantAgreement/EC/H2020/865564
info:eu-repo/grantAgreement/EC/H2020/727852
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
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spelling Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysisDimitrova, Asya, 1988-Ingole, VijendraBasagaña Flores, XavierRanzani, OtavioMilà, CarlesBallester, JoanTonne, CathrynColdHeatHeat wavesMeta-analysisMortalitySouth AsiaSystematic reviewTemperatureBackground: South Asia is highly vulnerable to climate change and is projected to experience some of the highest increases in average annual temperatures throughout the century. Although the adverse impacts of ambient temperature on human health have been extensively documented in the literature, only a limited number of studies have focused on populations in this region. Objectives: Our aim was to systematically review the current state and quality of available evidence on the direct relationship between ambient temperature and heat waves and all-cause mortality in South Asia. Methods: The databases Pubmed, Web of Science, Scopus and Embase were searched from 1990 to 2020 for relevant observational quantitative studies. We applied the Navigation Guide methodology to assess the strength of the evidence and performed a meta-analysis based on a novel approach that allows for combining nonlinear exposure-response associations without access to data from individual studies. Results: From the 6,759 screened papers, 27 were included in the qualitative synthesis and five in a meta-analysis. Studies reported an association of all-cause mortality with heat wave episodes and both high and low daily temperatures. The meta-analysis showed a U-shaped pattern, with increasing mortality for both high and low temperatures, but a statistically significant association was found only at higher temperatures - above 31° C for lag 0-1 days and above 34° C for lag 0-13 days. Effects were found to vary with cause of death, age, sex, location (urban vs. rural), level of education and socio-economic status, but the profile of vulnerabilities was somewhat inconsistent and based on a limited number of studies. Overall, the strength of the evidence for ambient temperature as a risk factor for all-cause mortality was judged as limited and for heat wave episodes as inadequate. Conclusions: The evidence base on temperature impacts on mortality in South Asia is limited due to the small number of studies, their skewed geographical distribution and methodological weaknesses. Understanding the main determinants of the temperature-mortality association as well as how these may evolve in the future in a dynamic region such as South Asia will be an important area for future research. Studies on viable adaptation options to high temperatures for a region that is a hotspot for climate vulnerability, urbanisation and population growth are also needed.VI gratefully acknowledges funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 730,004 (project PUCS). JB gratefully acknowledges funding from the European Union’s Horizon 2020 research and innovation programme under grant agreements No 865,564 (European Research Council Consolidator Grant EARLY-ADAPT), 727,852 (project Blue-Action) and 730,004 (project PUCS). CT was funded through a Ramón y Cajal fellowship (RYC-2015–17402) awarded by the Spanish Ministry of Economy and Competitiveness.Elsevier202220222021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/52963http://dx.doi.org/10.1016/j.envint.2020.106170reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésEnviron Int. 2021 Jan;146:106170info:eu-repo/grantAgreement/EC/H2020/730004info:eu-repo/grantAgreement/EC/H2020/865564info:eu-repo/grantAgreement/EC/H2020/727852© 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/529632026-05-29T05:05:01Z
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