The role of humidity in associations of high temperature with mortality: A multicountry, multicity study

BACKGROUND: There is strong experimental evidence that physiologic stress from high temperatures is greater if humidity is higher. However, heat indices developed to allow for this have not consistently predicted mortality better than dry-bulb temperature. OBJECTIVES: We aimed to clarify the potenti...

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Autores: Armstrong, Ben G., Sera, Francesco, Vicedo-Cabrera, Ana Maria, Diaz, Magali Hurtado, Tobías, Aurelio, Gasparrini, Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/199797
Acceso en línea:http://hdl.handle.net/10261/199797
Access Level:acceso abierto
Palabra clave:Hot temperature
Temperatures
Heat-related mortality
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network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
title The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
spellingShingle The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
Armstrong, Ben G.
Hot temperature
Temperatures
Heat-related mortality
title_short The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
title_full The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
title_fullStr The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
title_full_unstemmed The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
title_sort The role of humidity in associations of high temperature with mortality: A multicountry, multicity study
dc.creator.none.fl_str_mv Armstrong, Ben G.
Sera, Francesco
Vicedo-Cabrera, Ana Maria
Diaz, Magali Hurtado
Tobías, Aurelio
Gasparrini, Antonio
author Armstrong, Ben G.
author_facet Armstrong, Ben G.
Sera, Francesco
Vicedo-Cabrera, Ana Maria
Diaz, Magali Hurtado
Tobías, Aurelio
Gasparrini, Antonio
author_role author
author2 Sera, Francesco
Vicedo-Cabrera, Ana Maria
Diaz, Magali Hurtado
Tobías, Aurelio
Gasparrini, Antonio
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Tobías, Aurelio [0000-0001-6428-6755]
Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Hot temperature
Temperatures
Heat-related mortality
topic Hot temperature
Temperatures
Heat-related mortality
description BACKGROUND: There is strong experimental evidence that physiologic stress from high temperatures is greater if humidity is higher. However, heat indices developed to allow for this have not consistently predicted mortality better than dry-bulb temperature. OBJECTIVES: We aimed to clarify the potential contribution of humidity an addition to temperature in predicting daily mortality in summer by using a large multicountry dataset. METHODS: In 445 cities in 24 countries, we fit a time-series regression model for summer mortality with a distributed lag nonlinear model (DLNM) for temperature (up to lag 3) and supplemented this with a range of terms for relative humidity (RH) and its interaction with temperature. Cityspecific associations were summarized using meta-analytic techniques. RESULTS: Adding a linear term for RH to the temperature term improved fit slightly, with an increase of 23% in RH (the 99th percentile anomaly) associated with a 1.1% [95% confidence interval (CI): 0.8, 1.3] decrease in mortality. Allowing curvature in the RH term or adding terms for interaction of RH with temperature did not improve the model fit. The humidity-related decreased risk was made up of a positive coefficient at lag 0 outweighed by negative coefficients at lags of 1–3 d. Key results were broadly robust to small model changes and replacing RH with absolute measures of humidity. Replacing temperature with apparent temperature, a metric combining humidity and temperature, reduced goodness of fit slightly. DISCUSSION: The absence of a positive association of humidity with mortality in summer in this large multinational study is counter to expectations from physiologic studies, though consistent with previous epidemiologic studies finding little evidence for improved prediction by heat indices. The result that there was a small negative average association of humidity with mortality should be interpreted cautiously; the lag structure has unclear interpretation and suggests the need for future work to clarify. https://doi.org/10.1289/EHP5430. © 2019, Public Health Services, US Dept of Health and Human Services. All rights reserved.
publishDate 2019
dc.date.none.fl_str_mv 2019
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/199797
url http://hdl.handle.net/10261/199797
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://doi.org/10.1289/EHP5430
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Department of Health and Human Services (U.S.)
publisher.none.fl_str_mv Department of Health and Human Services (U.S.)
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
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spelling The role of humidity in associations of high temperature with mortality: A multicountry, multicity studyArmstrong, Ben G.Sera, FrancescoVicedo-Cabrera, Ana MariaDiaz, Magali HurtadoTobías, AurelioGasparrini, AntonioHot temperatureTemperaturesHeat-related mortalityBACKGROUND: There is strong experimental evidence that physiologic stress from high temperatures is greater if humidity is higher. However, heat indices developed to allow for this have not consistently predicted mortality better than dry-bulb temperature. OBJECTIVES: We aimed to clarify the potential contribution of humidity an addition to temperature in predicting daily mortality in summer by using a large multicountry dataset. METHODS: In 445 cities in 24 countries, we fit a time-series regression model for summer mortality with a distributed lag nonlinear model (DLNM) for temperature (up to lag 3) and supplemented this with a range of terms for relative humidity (RH) and its interaction with temperature. Cityspecific associations were summarized using meta-analytic techniques. RESULTS: Adding a linear term for RH to the temperature term improved fit slightly, with an increase of 23% in RH (the 99th percentile anomaly) associated with a 1.1% [95% confidence interval (CI): 0.8, 1.3] decrease in mortality. Allowing curvature in the RH term or adding terms for interaction of RH with temperature did not improve the model fit. The humidity-related decreased risk was made up of a positive coefficient at lag 0 outweighed by negative coefficients at lags of 1–3 d. Key results were broadly robust to small model changes and replacing RH with absolute measures of humidity. Replacing temperature with apparent temperature, a metric combining humidity and temperature, reduced goodness of fit slightly. DISCUSSION: The absence of a positive association of humidity with mortality in summer in this large multinational study is counter to expectations from physiologic studies, though consistent with previous epidemiologic studies finding little evidence for improved prediction by heat indices. The result that there was a small negative average association of humidity with mortality should be interpreted cautiously; the lag structure has unclear interpretation and suggests the need for future work to clarify. https://doi.org/10.1289/EHP5430. © 2019, Public Health Services, US Dept of Health and Human Services. All rights reserved.B.A. was supported by the UK National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Change and Health; A.G., F.S., and A.V.C. were supported by grants from the UK Medical Research Council (grant IDs: MR/M022625/1, MR/R013349/1) and from the UK Natural Environment Research Council (grant ID: NE/R009384/1); and M.L.B. was supported by Assistance Agreement No. 83587101 awarded by the U.S. Environmental Protection Agency and R01 MD012769 awarded by the U.S. National Institutes of Health. Y.G. was supported by the Career Development Fellowship of Australian National Health and Medical Research Council (APP1107107). A.T. was supported by the Japanese Society for the Promotion of Science (JSPS) Invitational Fellowships for Research in Japan (S18149). Y.L.G. was supported by NHRI-105-EMSP09 from National Health Research Institutes, Taiwan. H.O. and E.I. were supported by Ministry of Education and Research (Estonia) grant IUT34-17. J.K. and A.U. were supported by the Czech Science Foundation, grant 18-22125S. H.K., M.H., and Y.H. were supported by the Global Research Lab (#K21004000001-10A0500-00710) through the National Research Foundation of Korea. M.H. and Y.H. were supported by the Environment Research and Technology Development Fund (S-14) of the Environmental Restoration and Conservation Agency.Peer reviewedDepartment of Health and Human Services (U.S.)Tobías, Aurelio [0000-0001-6428-6755]Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]202020202019info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10261/199797reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Ingléshttps://doi.org/10.1289/EHP5430Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/1997972026-05-22T06:33:51Z
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