Yi Weizhuo, Bach Aaron, Tong Shilu, Cheng Jian, Yang Jun, Zheng Hao, Ho Hung Chak, Song Jian, Pan Rubing, Su Hong, Xu Zhiwei
School of Public Health, Anhui Medical University, Hefei, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China; School of Medicine and Dentistry, Griffith University, Gold Coast, Australia.
School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia; Cities Research Institute, Griffith University, Gold Coast, Australia.
Environ Res. 2024 Dec 1;262(Pt 1):119869. doi: 10.1016/j.envres.2024.119869. Epub 2024 Aug 30.
China published its inaugural national heat-health action plan (HHAP) in 2023, but the mortality burden associated with temperatures exceeding the heat alert thresholds specified by this HHAP (maximum temperatures >35, 37, or 40 °C) remains unknown. We aimed to estimate the historical and future mortality burden associated with temperatures above the heat alert thresholds of the Chinese national HHAP.
We conducted time-series analyses to estimate the mortality burden associated with temperatures exceeding the three heat alert thresholds from 2016 to 2019 in Jiangsu Province (including 13 cities, population ∼80.7 million), China. A quasi-Poisson regression in conjunction with a distributed lag non-linear model was used to estimate the dose-response association between maximum temperature and mortality risk from 2016 to 2019, adjusting for potential covariates. We then projected the future mortality burden associated with temperatures exceeding these thresholds under three distinct levels of greenhouse gas (GHG) emission scenarios via scenario shared socioeconomic pathways [SSP] 1-2.6 (low), SSP2-4.5 (intermediate), and SSP5-8.5 (high), respectively, by assuming that there will be no adaptation to heat. Climate scenarios derived from the General Circulation Model (GCM) under the Coupled Model Intercomparison Project Phase 6 (CMIP6) were used.
From 2016 to 2019, temperatures above 35 °C were associated with 0.51% of mortality, including 0.40% associated with 35 °C-37 °C and 0.11% associated with >37 °C. Heat-related mortality risk was most prominent in those who were single/divorced/widowed and had <10 years of education. Under SSP2-4.5, compared with the 2020s, the excess mortality associated with >37 °C would increase by 1.4 times in the 2050s and 1.7 times in the 2090s. Under SSP5-8.5, the annual number of days with maximum temperature >37 °C would approximately double every 20 years (67 days annually in the 2090s). Consequently, compared with the 2020s, the excess mortality associated with >37 °C would increase by 2.8 times in the 2050s and 18.4 times in the 2090s.
Significant mortality risk is associated with temperatures above the lowest heat alert threshold of the Chinese national HHAP (35 °C). If the high GHG emission scenario occurred, the annual number of days and excess mortality associated with maximum temperatures >37 °C would largely increase in the coming decades.
中国于2023年发布了首个国家热健康行动计划（HHAP），但与超过该HHAP规定的高温预警阈值（最高温度>35、37或40°C）相关的死亡负担仍不明确。我们旨在估计与中国国家HHAP高温预警阈值以上温度相关的历史和未来死亡负担。
我们进行了时间序列分析，以估计2016年至2019年中国江苏省（包括13个城市，人口约8070万）超过三个高温预警阈值的温度相关的死亡负担。使用准泊松回归结合分布滞后非线性模型来估计2016年至2019年最高温度与死亡风险之间的剂量反应关联，并对潜在协变量进行调整。然后，我们通过情景共享社会经济路径[SSP]1-2.6（低）、SSP2-4.5（中）和SSP5-8.5（高），分别在三种不同水平的温室气体（GHG）排放情景下，假设不存在对高温的适应措施，预测与超过这些阈值的温度相关的未来死亡负担。使用耦合模式比较计划第6阶段（CMIP6）下通用环流模型（GCM）得出的气候情景。
2016年至2019年，高于35°C的温度与0.51%的死亡率相关，其中0.40%与35°C - 37°C相关，0.11%与>37°C相关。与高温相关的死亡风险在单身/离异/丧偶且受教育年限<10年的人群中最为突出。在SSP2-4.5情景下，与2020年代相比，>37°C相关的超额死亡率在2050年代将增加1.4倍，在2090年代将增加1.7倍。在SSP5-8.5情景下，最高温度>37°C的年天数每20年将大约翻倍（2090年代每年67天）。因此，与2020年代相比，>37°C相关的超额死亡率在2050年代将增加2.8倍，在2090年代将增加18.4倍。
与中国国家HHAP最低高温预警阈值（35°C）以上温度相关的死亡风险显著。如果出现高温室气体排放情景，未来几十年与最高温度>37°C相关的年天数和超额死亡率将大幅增加。
