Kouis Panayiotis, Psistaki Kyriaki, Yiallouros Panayiotis K, Paschalidou Anastasia Κ
Medical School, University of Cyprus, Nicosia, Cyprus.
Department of Forestry and Management of the Environment and Natural Resources, Democritus University of Thrace, Orestiada, Greece.
Environ Int. 2025 Jul;201:109563. doi: 10.1016/j.envint.2025.109563. Epub 2025 May 28.
Heatwaves constitute a major public health risk and climate change is projected to exacerbate this risk by increasing their intensity, duration, and frequency. This study focused on the Eastern Mediterranean and explored the impact of heatwave characteristics on cardiovascular (CVD) mortality in three typical sites (Athens, Thessaloniki and Cyprus). We demonstrated that the heatwave order and timing in the season, as well as the intensity and evolution, may determine the exposure-response relationship. Specifically, heatwave days occurring during the 1st heatwave were associated with a higher increase in CVD mortality risk compared to heatwave days of the 2nd and 3rd (or subsequent) event (e.g. for Athens: 28.3 %, 95%CI: 23.2 %, 33.6 % for 1st event; 17.0 %, 95% CI: 9.8 %, 24.7 % for 2nd event), while hotter heatwave days also amplified the health impact (increase in CVD risk per °C above the site-specific heatwave threshold for Athens: 11.79 %, 95%CI: 9.80 %, 13.79 %; for Thessaloniki: 18.44 %, 95 % 13.81 %, 23.13 %; for Cyprus: 36.14 %, 95% CI: 23.95 %, 49.14%). Heatwave days lagging from the onset of the event resulted in increased CVD mortality risk (e.g. for Athens: 7.96 %, 95%CI: 1.04 %, 15.02 % for the 1st heatwave day; 36.31 %, 95% CI; 27.59 %, 45.44 % for the 4th heatwave day and above) and the time-distance of heatwaves from the warm season onset was also found to be associated with increased CVD mortality. These findings suggest that tailored heatwave action plans and risk communication strategies could mitigate the higher risks associated with specific characteristics of more intense and prolonged heatwaves anticipated in the future.
热浪构成了重大的公共卫生风险，预计气候变化将通过增加热浪的强度、持续时间和频率来加剧这一风险。本研究聚焦于东地中海地区，探讨了热浪特征对三个典型地点（雅典、塞萨洛尼基和塞浦路斯）心血管疾病（CVD）死亡率的影响。我们证明了热浪的顺序、季节中的时间以及强度和演变，可能决定暴露-反应关系。具体而言，与第二次和第三次（或后续）热浪事件中的热浪日相比，第一次热浪期间出现的热浪日与心血管疾病死亡率风险的更高增加相关（例如，对于雅典：第一次事件为28.3%，95%置信区间：23.2%，33.6%；第二次事件为17.0%，95%置信区间：9.8%，24.7%），而更炎热的热浪日也会放大健康影响（雅典高于特定地点热浪阈值每摄氏度心血管疾病风险增加：11.79%，95%置信区间：9.80%，13.79%；对于塞萨洛尼基：18.44%，95%置信区间：13.81%，23.13%；对于塞浦路斯：36.14%，95%置信区间：23.95%，49.14%）。热浪事件开始后滞后的热浪日导致心血管疾病死亡率风险增加（例如，对于雅典：第一次热浪日为7.96%，95%置信区间：1.04%，15.02%；第四次及以上热浪日为36.31%，95%置信区间：27.59%，45.44%），并且还发现热浪与温暖季节开始的时间距离也与心血管疾病死亡率增加有关。这些发现表明，量身定制的热浪行动计划和风险沟通策略可以减轻与未来预期的更强烈和持久热浪的特定特征相关的更高风险。
