Huber Veronika, Breitner-Busch Susanne, He Cheng, Matthies-Wiesler Franziska, Peters Annette, Schneider Alexandra
Institute of Epidemiology, The Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Medical Faculty, Ludwig-Maximilians-Universität (LMU), München, Germany; Institute of Epidemiology, Helmholtz Center Munich - German Research Center for Environmental Health, Neuherberg, Germany; German Alliance on Climate Change and Health (KLUG e.V.), Berlin, Germany; Munich Heart Alliance, German Center for Cardiovascular Health (DZHK e.V., partner-site Munich), München, Germany.
Dtsch Arztebl Int. 2024 Feb 9;121(3):79-85. doi: 10.3238/arztebl.m2023.0254.
Estimating the excess mortality attributable to heat is a central element of the documentation of the consequences of climate change for human health. Until now, estimates of heatrelated deaths in Germany by the Robert Koch Institute (RKI) have been based on weekly mortality records.
Our study is the first to use higher resolution data-i.e. daily all-cause mortality linked to daily mean temperatures-from each of the German federal states to assess the heat-related mortality from 2000 to 2023 in Germany, employing quasi-Poisson models and multivariate meta-regression analyses. We focus our analysis on the extreme summer of 2022.
Our analysis yielded an estimate of 9100 (95% CI: [7300; 10 700]) heat-related deaths in Germany for the summer of 2022, whereas previous studies of the RKI estimated the number of heatrelated deaths at 4500 [2100; 7000]. When we set a higher temperature threshold in the definition of the heat risk, we arrived at a figure of 6900 [5500; 8100] heat-related deaths in 2022. In other summers that-similarly to 2022-were characterized by large fluctuations in daily mean temperatures, we also robustly estimated higher numbers of heat-related deaths than the RKI did. The exclusion of reported deaths due to COVID-19 had only a minor effect on our estimates.
Our findings suggest that previous studies based on weekly mortality data have underestimated the full extent of heat-related mortality in Germany, particularly in the extreme summer of 2022. The monitoring of heat-related mortality should be systematic and as comprehensive as possible if it is to enable the development of effective heat-health action plans.
估算因高温导致的超额死亡率是记录气候变化对人类健康影响的核心内容。到目前为止,德国罗伯特·科赫研究所(RKI)对与高温相关死亡人数的估计一直基于每周的死亡率记录。
我们的研究首次使用了更高分辨率的数据,即德国每个联邦州的每日全因死亡率与日平均气温相关联的数据,采用准泊松模型和多元meta回归分析来评估2000年至2023年德国与高温相关的死亡率。我们将分析重点放在2022年的极端夏季。
我们的分析得出,2022年德国与高温相关的死亡人数估计为9100人(95%置信区间:[7300;10700]),而RKI之前的研究估计与高温相关的死亡人数为4500人[2100;7000]。当我们在高温风险定义中设定更高的温度阈值时,得出2022年与高温相关的死亡人数为6900人[5500;8100]。在其他与2022年类似、日平均气温波动较大的夏季,我们同样有力地估计出与高温相关的死亡人数比RKI的估计要高。排除报告的因COVID-19导致的死亡对我们的估计影响较小。
我们的研究结果表明,以前基于每周死亡率数据的研究低估了德国与高温相关死亡率的全部程度,特别是在2022年的极端夏季。如果要制定有效的高温-健康行动计划,对与高温相关死亡率的监测应该是系统且尽可能全面的。