한빛사논문
Satbyul Estella Kim
Satbyul Estella Kim 1, Masahiro Hashizume 2,3, Ben Armstrong 4, Antonio Gasparrini 4,5,6, Kazutaka Oka 7, Yasuaki Hijioka 7, Ana M Vicedo-Cabrera 8,9, Yasushi Honda 1,7
1Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
2Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
3School of Tropical Medicine and Global Health, Nagasaki University, Japan.
4Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
5Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK.
6Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
7Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan.
8Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
9Oeschger Center for Climate Change Research, University of Bern, Switzerland.
Address correspondence to Yasushi Honda
Abstract
Objectives:
We estimated the effects of hot nights on the cause- and location-specific mortality in a nationwide assessment over 43 y (1973–2015) using a unified analytical framework in the 47 prefectures of Japan.
Methods:
Hot nights were defined as days with a) minimum temperature greater than or equal to 25 degrees Celsius≥25°C(hot nights begin subscript twenty-five end subscriptHN25) and b) minimum temperature greater than or equal to ninety-fifth≥95th percentile (hot nights begin subscript ninety-fifth end subscriptHN95th) for the prefecture. We conducted a time-series analysis using a two-stage approach during the hot night occurrence season (April–November). For each prefecture, we estimated associations between hot nights and mortality controlling for potential confounders including daily mean temperature. We then used a random-effects meta-analytic model to estimate the pooled cumulative association.
Results:
Overall, 24,721,226 deaths were included in this study. Nationally, all-cause mortality increased by 9%–10% [hot nights begin subscript twenty-five end subscriptHN25
relative risk open parenthesis relative risk close parenthesis equals 1.09(RR)=1.09
, 95% confidence interval (CI): 1.08, 1.10; hot nights begin subscript ninety-fifth end subscriptHN95th relative risk equals 1.10RR=1.10, 95% CI: 1.09, 1.11] during hot nights in comparison with nonhot nights. All 11 cause-specific mortalities were strongly associated with hot nights, and the corresponding associations appeared to be acute and lasted a few weeks, depending on the cause of death. The strength of the association between hot nights and mortality varied among prefectures. We found a higher mortality risk from hot nights in early summer in comparison with the late summer in all regions.
Conclusions:
Our findings support the evidence of mortality impacts from hot nights in excess of that explicable by daily mean temperature and have implications useful for establishing public health policy and research efforts estimating the health effects of climate change.
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