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...
| Authors: | ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2021 |
| Country: | España |
| Institution: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repository: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:10230/52963 |
| Online Access: | http://hdl.handle.net/10230/52963 http://dx.doi.org/10.1016/j.envint.2020.106170 |
| Access Level: | Open access |
| Keyword: | Cold Heat Heat waves Meta-analysis Mortality South Asia Systematic review Temperature |
| _version_ | 1878732058677739520 |
|---|---|
| author | Dimitrova, Asya, 1988- |
| author2 | Ingole, Vijendra Basagaña Flores, Xavier Ranzani, Otavio Milà, Carles Ballester, Joan Tonne, Cathryn |
| author2_role | author author author author author author |
| author_browse | Ballester, Joan Basagaña Flores, Xavier Dimitrova, Asya, 1988- Ingole, Vijendra Milà, Carles Ranzani, Otavio Tonne, Cathryn |
| author_facet | Dimitrova, Asya, 1988- Ingole, Vijendra Basagaña Flores, Xavier Ranzani, Otavio Milà, Carles Ballester, Joan Tonne, Cathryn |
| author_role | author |
| collection | Recercat. Dipósit de la Recerca de Catalunya |
| 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_3bfbcfb55a8ffbd5eb3eb5c26bf4acde |
| institution | 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) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:recercat.cat:10230/52963 |
| publishDate | 2021 |
| publishDateSort | 2021 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| reponame_str | Recercat. Dipósit de la Recerca de Catalunya |
| spelling | Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis Dimitrova, Asya, 1988- Ingole, Vijendra Basagaña Flores, Xavier Ranzani, Otavio Milà, Carles Ballester, Joan Tonne, Cathryn Cold Heat Heat waves Meta-analysis Mortality South Asia Systematic review Temperature 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. 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. Elsevier http://hdl.handle.net/10230/52963 http://dx.doi.org/10.1016/j.envint.2020.106170 |
| 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 |
| status_str | publishedVersion |
| title | 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_short | 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 |
| topic | Cold Heat Heat waves Meta-analysis Mortality South Asia Systematic review Temperature |
| topic_facet | Cold Heat Heat waves Meta-analysis Mortality South Asia Systematic review Temperature |
| url | http://hdl.handle.net/10230/52963 http://dx.doi.org/10.1016/j.envint.2020.106170 |