Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014 Donostia-San Sebastián, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga 20700, Spain.
Civil Engineering Department, Jordan University of Science and Technology, Irbid 22110, Jordan.
Sci Total Environ. 2024 Nov 20;952:176010. doi: 10.1016/j.scitotenv.2024.176010. Epub 2024 Sep 2.
The Middle East is one of the most vulnerable regions to the impacts of climate change, yet evidence of the heat-related mortality remains limited in this area. Our present study investigated the heat-mortality association in Jordan and the potential modifying effect of greenness, population density and urbanization level on the association.
For each of the 42 included districts, daily meteorological and mortality data from 2000 to 2020 were obtained for the warmest months (May to September). First, a distributed lag non-linear model was applied to estimate the district level heat-mortality association, then the district specific estimates were pooled using multivariate meta-regression models to obtain an overall estimate. Last, the modifying effect of district level greenness, population density and urbanization level was examined through subgroup analysis.
When compared to the minimum mortality temperature (MMT, percentile 0th, 22.20 °C), the 99th temperature percentile exhibited a relative risk (RR) of 1.34 (95 % CI 1.23, 1.45). Districts with low greenness had a higher heat-mortality risk (RR 1.39, 95 % CI 1.22, 1.58) when compared to the high greenness (RR 1.28, 95 % CI 1.13, 1.45). While heat-mortality risk did not significantly differ between population density subgroups, highly urbanized districts had a greater heat-mortality risk (RR 1.41, 95 % CI 1.23, 1.62) as compared to ones with low levels of urbanization (RR 1.32, 95 % CI 1.13, 1.55). Districts with high urbanization level had the highest heat-mortality risk if they were further categorized as having low greenness (RR 1.63, 95 % CI 1.30, 2.04).
Exposure to heat was associated with increased mortality risk in Jordan. This risk was higher in districts with low greenness and high urbanization level. As climate change-related heat mortality will be on the rise, early warning systems in highly vulnerable communities in Jordan are required and greening initiatives should be pursued.
中东是受气候变化影响最脆弱的地区之一，但该地区与热有关的死亡率证据仍然有限。本研究调查了约旦的热死亡率关联以及绿化程度、人口密度和城市化水平对该关联的潜在调节作用。
对于纳入的 42 个区中的每一个，获取了 2000 年至 2020 年最热月份（5 月至 9 月）的逐日气象和死亡率数据。首先，应用分布式滞后非线性模型来估计区县级的热死亡率关联，然后使用多元荟萃回归模型对区县级特定估计值进行汇总，以获得总体估计值。最后，通过亚组分析检查区县级绿化程度、人口密度和城市化水平的调节作用。
与最低死亡率温度（MMT，第 0 百分位，22.20°C）相比，第 99 个温度百分位的相对风险（RR）为 1.34（95%置信区间 1.23，1.45）。与绿化程度高的地区相比，绿化程度低的地区的热死亡率风险更高（RR 1.39，95%置信区间 1.22，1.58）（RR 1.28，95%置信区间 1.13，1.45）。虽然人口密度亚组之间的热死亡率风险没有显著差异，但高度城市化地区的热死亡率风险更高（RR 1.41，95%置信区间 1.23，1.62），而城市化水平低的地区的热死亡率风险较低（RR 1.32，95%置信区间 1.13，1.55）。如果进一步将城市化水平高的地区分为绿化程度低的地区，则这些地区的热死亡率风险最高（RR 1.63，95%置信区间 1.30，2.04）。
在约旦，暴露于高温与死亡率风险增加有关。在绿化程度低和城市化水平高的地区，这种风险更高。随着与气候变化相关的热死亡率将上升，约旦高脆弱社区需要早期预警系统，并且应该推行绿化计划。
