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2025

• Batibeniz F, Seneviratne SI, Jha S, Ribeiro A, Suarez Gutierrez L, Raible CC, Malhotra A, Armstrong B, Bell ML, Lavigne E, Gasparrini A, Guo Y, Hashizume M, Masselot P, da Silva S, Royé D, Sera F, Tong S, Urban A, Vicedo-Cabrera AM (2025). Rapid climate action is needed: comparing heat vs. COVID-19-related mortality. Scientific Reports, vol. 15, art. no. 1002. 10.1038/s41598-024-82788-8.

  
  The impacts of climate change on human health are often underestimated or perceived to be in a distant future. Here, we present the projected impacts of climate change in the context of COVID-19, a recent human health catastrophe. We compared projected heat mortality with COVID-19 deaths in 38 cities worldwide and found that in half of these cities, heat-related deaths could exceed annual COVID-19 deaths in less than ten years (at + 3.0 °C increase in global warming relative to preindustrial). In seven of these cities, heat mortality could exceed COVID-19 deaths in less than five years. Our results underscore the crucial need for climate action and for the integration of climate change into public health discourse and policy.

  climate actionheat mortalitycovid-19public healthglobal warming

  
  

2024

• Xu R, Ye T, Huang W, Yue X, Morawska L, Abramson M, Chen G, Yu P, Liu Y, Yang Z, Zhang Y, Wu Y, Yu W, Wen B, Zhang Y, Hales S, Lavigne E, Saldiva P, Coelho M, Matus P, Royé D, Klompmaker J, Mistry M, Breitner S, Zeka A, Raz R, Tong S, Johnston F, Schwartz J, Gasparrini A, Guo Y, Li S (2024). Global, regional, and national mortality burden attributable to air pollution from landscape fires: a health impact assessment study. The Lancet, vol. 404(10470), pp. 2447-2459. 10.1016/S0140-6736(24)02251-7.

  
  Background: Landscape fire-sourced (LFS) air pollution is an increasing public health concern in the context of climate change. However, little is known about the attributable global, regional, and national mortality burden related to LFS air pollution. Methods: We calculated country-specific population-weighted average daily and annual LFS fine particulate matter (PM2·5) and surface ozone (O3) during 2000-19 from a validated dataset. We obtained the relative risks (RRs) for both short-term and long-term impact of LFS PM2·5 and O3 on all-cause, cardiovascular, and respiratory mortality. The short-term RRs were pooled from community-specific standard time-series regressions in 2267 communities across 59 countries or territories. The long-term RRs were obtained from published meta-analyses of cohort studies on all-source PM2·5 and O3. Annual mortality, population, and socio-demographic data for each country or territory were extracted from the Global Burden of Diseases Study 2019. These data were used to estimate country-specific annual deaths attributable to LFS air pollution using standard algorithms. Findings: Globally, 1·53 million all-cause deaths per year (95% empirical confidence interval [eCI] 1·24-1·82) were attributable to LFS air pollution during 2000-19, including 0·45 million (0·32-0·57) cardiovascular deaths and 0·22 million respiratory deaths (0·08-0·35). LFS PM2·5 and O3 contributed to 77·6% and 22·4% of the total attributable deaths, respectively. Over 90% of all attributable deaths were in low-income and middle-income countries, particularly in sub-Saharan Africa (606 769 deaths per year), southeast Asia (206 817 deaths), south Asia (170 762 deaths), and east Asia (147 291 deaths). The global cardiovascular attributable deaths saw an average 1·67% increase per year (ptrend <0·001), although the trends for all-cause and respiratory attributable deaths were not statistically significant. The five countries with the largest all-cause attributable deaths were China, the Democratic Republic of the Congo, India, Indonesia, and Nigeria, although the order changed in the second decade. The leading countries with the greatest attributable mortality rates (AMRs) were all in sub-Saharan Africa, despite decreasing trends from 2000 to 2019. North and central America, and countries surrounding the Mediterranean, showed increasing trends of all-cause, cardiovascular, and respiratory AMRs. Increasing cardiovascular AMR was also observed in southeast Asia, south Asia, and east Asia. In 2019, the AMRs in low-income countries remained four times those in high-income countries, though this had reduced from nine times in 2000. AMRs negatively correlated with a country-specific socio-demographic index (Spearman correlation coefficients r around -0·60). Interpretation: LFS air pollution induced a substantial global mortality burden, with notable geographical and socioeconomic disparities. Urgent actions are required to address such substantial health impact and the associated environmental injustice in a warming climate.

  air pollutionlandscape firesmortality burdenhealth impactglobal assessment

  
  
• Carbone J, Sanchez B, Román-Cascón C, Martilli A, Royé D, Yagüe C (2024). Effects of the urban development on the nearsurface air temperature and surface energy balance: The case study of Madrid from 1970 to 2020. Urban Climate, vol. 58, art. no. 102198. 10.1016/j.uclim.2024.102198.

  
  The aim of the present study is to examine the impact of Madrid’s urban growth over the last 50 years (1970–2020). We conduct a modelling study using WRF-ARW with the multilayer urban parameterization BEP-BEM, in which different urban parameters have been incorporated at each point within the model’s inner domain according to urban expansion from 1970 to 2020. Two scenarios of important societal interest with different meteorological conditions are selected for this study: a period of intense heatwave during the summer season and a short period of strongly stable atmospheric conditions in winter, both in 2020. The results show that in areas where the urban fraction becomes greater an increase in near-surface air temperature is found for both simulated periods, especially during the night. The urbanization modifies the surface energy balance and turbulent transport in Madrid and its surroundings. It leads to a decrease in latent heat flux due to the high impermeability and reduced vegetation in urban areas. Additionally, the urban areas with a higher density of buildings have a high heat capacity, increasing heat flux storage during the day through solar radiation absorption. This stored energy is released at night, exacerbating the increase in nighttime near-surface air temperature in both periods.

  urban climateurban growthnear-surface air temperaturessurface energy balanceturbulenceheatwavestable atmospheric conditionsmadrid

  
  
• Feurer D, Riffe T, Kniffka M, Acosta E, Armstrong B, Mistry M, Lowe R, Royé D, Hashizume M, Madaniyazi L, Ng C, Tobias A, Íñiguez C, Vicedo-Cabrera A, Ragettli M, Lavigne E, Correa P, Ortega N, Kyselý J, Urban A, Orru H, Indermitte E, Maasikmets M, Dallavalle M, Schneider A, Honda Y, Alahmad B, Zanobetti A, Schwartz J, Carrasco G, Holobâca I, Kim H, Lee W, Bell M, Scovronick N, Acquaotta F, Coélho M, Diaz M, Arellano E, Michelozzi P, Stafoggia M, de’Donato F, Rao S, Di Ruscio F, Seposo X, Guo Y, Tong S, Masselot P, Gasparrini A, Sera F (2024). Meteorological factors, population immunity, and COVID19 incidence: A global multicity analysis. Environmental Epidemiology, vol. 8(6), art. no. e338. 10.1097/ee9.0000000000000338.

  
  Objectives: While COVID-19 continues to challenge the world, meteorological variables are thought to impact COVID-19 transmission. Previous studies showed evidence of negative associations between high temperature and absolute humidity on COVID-19 transmission. Our research aims to fill the knowledge gap on the modifying effect of vaccination rates and strains on the weather-COVID-19 association. Methods: Our study included COVID-19 data from 439 cities in 22 countries spanning 3 February 2020 - 31 August 2022 and meteorological variables (temperature, relative humidity, absolute humidity, solar radiation, and precipitation). We used a two-stage time-series design to assess the association between meteorological factors and COVID-19 incidence. For the exposure modeling, we used distributed lag nonlinear models with a lag of up to 14 days. Finally, we pooled the estimates using a random effect meta-analytic model and tested vaccination rates and dominant strains as possible effect modifiers. Results: Our results showed an association between temperature and absolute humidity on COVID-19 transmission. At 5 °C, the relative risk of COVID-19 incidence is 1.22-fold higher compared to a reference level at 17 °C. Correlated with temperature, we observed an inverse association for absolute humidity. We observed a tendency of increased risk on days without precipitation, but no association for relative humidity and solar radiation. No interaction between vaccination rates or strains on the weather-COVID-19 association was observed. Conclusions: This study strengthens previous evidence of a relationship of temperature and absolute humidity with COVID-19 incidence. Furthermore, no evidence was found that vaccinations and strains significantly modify the relationship between environmental factors and COVID-19 transmission.

  covid-19distributed lag nonlinear modelshumiditymulti-country multi-city collaborative research networkprecipitationsolar radiationtemperaturetime-series design

  
  
• Lee W, Kang C, Park C, Bell M, Armstrong B, Royé D, Hashizume M, Gasparrini A, Tobias A, Sera F, Honda Y, Urban A, Kyselý J, Íñiguez C, Ryti N, Guo Y, Tong S, de Sousa Zanotti Stagliorio Coelho M, Lavigne E, de’Donato F, Guo Y, Schwartz J, Schneider A, Breitner S, Chung Y, Kim S, Ha E, Kim H, Kim Y (2024). Association of holidays and the day of the week with suicide risk: multicountry, two stage, time series study. BMJ, vol. 387, art. no. e077262. 10.1136/bmj-2024-077262.

  
  Objectives To assess the short term temporal variations in suicide risk related to the day of the week and national holidays in multiple countries. Design Multicountry, two stage, time series design. Setting Data from 740 locations in 26 countries and territories, with overlapping periods between 1971 and 2019, collected from the Multi-city Multi-country Collaborative Research Network database. Participants All suicides were registered in these locations during the study period (overall 1 701  286 cases). Main outcome measures Daily suicide mortality. Results Mondays had peak suicide risk during weekdays (Monday-Friday) across all countries, with relative risks (reference: Wednesday) ranging from 1.02 (95% confidence interval (CI) 0.95 to 1.10) in Costa Rica to 1.17 (1.09 to 1.25) in Chile. Suicide risks were lowest on Saturdays or Sundays in many countries in North America, Asia, and Europe. However, the risk increased during weekends in South and Central American countries, Finland, and South Africa. Additionally, evidence suggested strong increases in suicide risk on New Year’s day in most countries with relative risks ranging from 0.93 (95% CI 0.75 to 1.14) in Japan to 1.93 (1.31 to 2.85) in Chile, whereas the evidence on Christmas day was weak. Suicide risk was associated with a weak decrease on other national holidays, except for Central and South American countries, where the risk generally increased one or two days after these holidays. Conclusions Suicide risk was highest on Mondays and increased on New Year’s day in most countries. However, the risk of suicide on weekends and Christmas varied by country and territory. The results of this study can help to better understand the short term variations in suicide risks and define suicide prevention action plans and awareness campaigns.

  suicide riskholidaysday of the weektime series analysismulticountry study

  
  
• Orlov A, De Hertog S, Havermann F, Guo S, Manola I, Lejeune Q, Schleussner C, Thiery W, Pongratz J, Humpenöder F, Popp A, Aunan K, Armstrong B, Royé D, Cvijanovic I, Lavigne E, Achilleos S, Bell M, Masselot P, Sera F, Vicedo-Cabrera A, Gasparrini A, Mistry M (2024). Impacts of landuse and landcover changes on temperature related mortality. Environmental Epidemiology, vol. 8(6), art. no. e337. 10.1097/ee9.0000000000000337.

  
  Background: Land-use and land-cover change (LULCC) can substantially affect climate through biogeochemical and biogeophysical effects. Here, we examine the future temperature–mortality impact for two contrasting LULCC scenarios in a background climate of low greenhouse gas concentrations. The first LULCC scenario implies a globally sustainable land use and socioeconomic development (sustainability). In the second LULCC scenario, sustainability is implemented only in the Organisation for Economic Cooperation and Development countries (inequality). Methods: Using the Multi-Country Multi-City (MCC) dataset on mortality from 823 locations in 52 countries and territories, we estimated the temperature–mortality exposure–response functions (ERFs). The LULCC and noLULCC scenarios were implemented in three fully coupled Earth system models (ESMs): Community Earth System Model, Max Planck Institute Earth System Model, and European Consortium Earth System Model. Next, using temperature from the ESMs’ simulations and the estimated location-specific ERFs, we assessed the temperature-related impact on mortality for the LULCC and noLULCC scenarios around the mid and end century. Results: Under sustainability, the multimodel mean changes in excess mortality range from −1.1 to +0.6 percentage points by 2050–2059 across all locations and from −1.4 to +0.5 percentage points by 2090–2099. Under inequality, these vary from −0.7 to +0.9 percentage points by 2050–2059 and from −1.3 to +2 percentage points by 2090–2099. Conclusions: While an unequal socioeconomic development and unsustainable land use could increase the burden of heat-related mortality in most regions, globally sustainable land use has the potential to reduce it in some locations. However, the total (cold and heat) impact on mortality is very location specific and strongly depends on the underlying climate change scenario due to nonlinearity in the temperature–mortality relationship.

  land-use changetemperature-related mortalityclimate impactbiogeophysical effectshealth assessment

  
  
• Tobías A, Íñiguez C, Hurtado Díaz M, Riojas H, Cifuentes L, Royé D, Abrutzky R, Coelho M, Saldiva P, Valdés Ortega N, Matus Correa P, Osorio S, Carrasco G, Colistro V, Pascal M, Chanel O, Madaniyazi L, Gasparrini A (2024). Mortality burden and economic loss attributable to cold and heat in Central and South America. Environmental Epidemiology, vol. 8(6), art. no. e335. 10.1097/ee9.0000000000000335.

  
  Background: We quantify the mortality burden and economic loss attributable to nonoptimal temperatures for cold and heat in the Central and South American countries in the Multi-City Multi-Country (MCC) Collaborative Research Network. Methods: We collected data for 66 locations from 13 countries in Central and South America to estimate location-specific temperature–mortality associations using time-series regression with distributed lag nonlinear models. We calculated the attributable deaths for cold and heat as the 2.5th and 97.5th temperature percentiles, above and below the minimum mortality temperature, and used the value of a life year to estimate the economic loss of delayed deaths. Results: The mortality impact of cold varied widely by country, from 9.64% in Uruguay to 0.22% in Costa Rica. The heat-attributable fraction for mortality ranged from 1.41% in Paraguay to 0.01% in Ecuador. Locations in arid and temperate climatic zones showed higher cold-related mortality (5.10% and 5.29%, respectively) than those in tropical climates (1.71%). Arid and temperate climatic zones saw lower heat-attributable fractions (0.69% and 0.58%) than arid climatic zones (0.92%). Exposure to cold led to an annual economic loss of $0.6 million in Costa Rica to $472.2 million in Argentina. In comparison, heat resulted in economic losses of $0.05 million in Ecuador to $90.6 million in Brazil. Conclusion: Most of the mortality burden for Central and South American countries is caused by cold compared to heat, generating annual economic losses of $2.1 billion and \(290.7 million, respectively. Public health policies and adaptation measures in the region should account for the health effects associated with nonoptimal temperatures.

  mortality burdeneconomic losscold and heatcentral and south americanonoptimal temperatures

  
  
• He C, Breitner-Busch S, Huber V, Chen K, Zhang S, Gasparrini A, Bell M, Kan H, Royé D, Armstrong B, Schwartz J, Sera F, Vicedo-Cabrera A, Honda Y, Jaakkola J, Ryti N, Kyselý J, Guo Y, Tong S, de’Donato F, Michelozzi P, Coelho M, Saldiva P, Lavigne E, Orru H, Indermitte E, Pascal M, Goodman P, Zeka A, Kim Y, Diaz M, Arellano E, Overcenco A, Klompmaker J, Rao S, Palomares A, Carrasco G, Seposo X, Pereira da Silva S, Madureira J, Holobaca I, Scovronick N, Acquaotta F, Kim H, Lee W, Hashizume M, Tobias A, Íñiguez C, Forsberg B, Ragettli M, Guo Y, Pan S, Osorio S, Li S, Zanobetti A, Dang T, Van Dung D, Schneider A (2024). Rainfall events and daily mortality across 645 global locations: two stage time series analysis. BMJ, vol. 387, art. no. e080944. 10.1136/bmj2024080944.

  
  Objective To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. Design Two stage time series analysis.Setting 645 locations across 34 countries or regions. Population Daily mortality data, comprising a total of 109954744 all cause, 31164161 cardiovascular, and 11817278 respiratory deaths from 1980 to 2020. Main outcome measure Association between daily mortality and rainfall events with return periods (the expected average time between occurrences of an extreme event of a certain magnitude) of one year, two years, and five years, with a 14 day lag period. A continuous relative intensity index was used to generate intensity-response curves to estimate mortality risks at a global scale. Results During the study period, a total of 50 913 rainfall events with a one year return period, 8362 events with a two year return period, and 3301 events with a five year return period were identified. A day of extreme rainfall with a five year return period was significantly associated with increased daily all cause, cardiovascular, and respiratory mortality, with cumulative relative risks across 0-14 lag days of 1.08 (95% confidence interval 1.05 to 1.11), 1.05 (1.02 to 1.08), and 1.29 (1.19 to 1.39), respectively. Rainfall events with a two year return period were associated with respiratory mortality only, whereas no significant associations were found for events with a one year return period. Non-linear analysis revealed protective effects (relative risk <1) with moderate-heavy rainfall events, shifting to adverse effects (relative risk >1) with extreme intensities. Additionally, mortality risks from extreme rainfall events appeared to be modified by climate type, baseline variability in rainfall, and vegetation coverage, whereas the moderating effects of population density and income level were not significant. Locations with lower variability of baseline rainfall or scarce vegetation coverage showed higher risks. Conclusion Daily rainfall intensity is associated with varying health effects, with extreme events linked to an increasing relative risk for all cause, cardiovascular, and respiratory mortality. The observed associations varied with local climate and urban infrastructure.

  rainfall eventsdaily mortalitytime series analysisglobal studycardiovascular and respiratory mortality

  
  
• Alvarez I, Diaz-Poso A, Lorenzo MN, Royé D (2024). Heat index historical trends and projections due to climate change in the Mediterranean basin based on CMIP6. Atmospheric Research, vol. 308, art. no. 107512. 10.1016/j.atmosres.2024.107512.

  
  Air temperature and relative humidity can be considered as two essential meteorological parameters in the determination of heat stress. The heat index (HI) includes both of them and it is appropriate for determining the thermal conditions of different climates. We investigated potential changes in the HI for the Mediterranean basin using simulations from the Coupled Model Intercomparison Project Phase 6 (CMIP6) climate models under two future scenarios (Shared Socio-economic Pathways: SSP2-4.5 and SSP5-8.5) over the period 2020–2099. Results reveal an important increase of HI at the end of the 21st century for both scenarios, with greater changes for the SSP5-8.5 scenario all over the basin. Strong significant upwards trends (around 1 °C per decade; significance level computed at 5%) are expected in the entire area and for all months at the end of the century, with greatest values during the summer months (close to 1.5 °C per decade) along the coastal areas of the basin. Many areas of the Southern Mediterranean basin (Africa and Arabian Peninsula) will be strongly affected with dangerously high heat index values (higher than 41 °C) during summer months by the end of the 21st century. A northward extension of these dangerous conditions is also expected including several areas of southern Europe.

  heat indexheat riskmediterraneanarabian peninsulaafricacmip6

  
  
• Yang D, Hashizume M, Tobías A, Honda Y, Royé D, Oh J, Dang T, Kim Y, Abrutzky R, Guo Y, Tong S, Coelho M, Saldiva P, Lavigne E, Correa P, Ortega N, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola J, Ryti N, Pascal M, Huber V, Schneider A, Katsouyanni K, Analitis A, Entezari A, Mayvaneh F, Goodman P, Zeka A, Michelozzi P, de’Donato F, Alahmad B, Diaz M, la Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Nunes B, Madureira J, Holo-bâc I, Scovronick N, Acquaotta F, Kim H, Lee W, Íñiguez C, Forsberg B, Vicedo-Cabrera A, Ragettli M, Guo Y, Pan S, Li S, Sera F, Zanobetti A, Schwartz J, Armstrong B, Gasparrini A, Chung Y (2024). Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986–2015. Environmental Epidemiology, vol. 8(5), art. no. e334. 10.1097/ee9.0000000000000334.

  
  Background: The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries. Methods: Daily time-series data for mortality and ambient mean temperature for 699 communities in 34 countries spanning 1986–2015 were analyzed using a two-stage meta-analysis. First, a quasi-Poisson regression was employed to estimate MMT and MMTP for each community during the designated subperiods. Second, we pooled the community-specific temporally varying estimates using mixed-effects meta-regressions to examine temporal changes in MMT and MMTP in the entire study population, as well as by climate zone, geographical region, and country. Results: Temporal increases in MMT and MMTP from 19.5 °C (17.9, 21.1) to 20.3 °C (18.5, 22.0) and from the 74.5 (68.3, 80.6) to 75.0 (71.0, 78.9) percentiles in the entire population were found, respectively. Temporal change was significantly heterogeneous across geographical regions (P < 0.001). Temporal increases in MMT were observed in East Asia (linear slope [LS] = 0.91, P = 0.02) and South-East Asia (LS = 0.62, P = 0.05), whereas a temporal decrease in MMT was observed in South Europe (LS = −0.46, P = 0.05). MMTP decreased temporally in North Europe (LS = −3.45, P = 0.02) and South Europe (LS = −2.86, P = 0.05). Conclusions: The temporal change in MMT or MMTP was largely heterogeneous. Population susceptibility in terms of optimum temperature may have changed under a warming climate, albeit with large region-dependent variations.

  minimum mortality temperatureclimate changetemporal changemulticountry studyobservational analysis

  
  
• Scovronick N, Sera F, Vu B, Vicedo-Cabrera A, Royé D, Tobias A, Seposo X, Forsberg B, Guo Y, Li S, Honda Y, Abrutzky R, de Sousa Zanotti Stagliorio Coelho M, Nascimento Saldiva P, Lavigne E, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola J, Ryti N, Pascal M, Katsouyanni K, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Zanobetti A, Schwartz J, Hurtado Diaz M, De La Cruz Valencia C, Rao S, Madureira J, Acquaotta F, Kim H, Lee W, Iniguez C, Ragettli M, Guo Y, Dang T, Dung D, Armstrong B, Gasparrini A (2024). Temperaturemortality associations by age and cause: a multicountry multicity study. Environmental Epidemiology, vol. 8(5), art. no. e336. 10.1097/ee9.0000000000000336.

  
  Background: Heterogeneity in temperature-mortality relationships across locations may partly result from differences in the demographic structure of populations and their cause-specific vulnerabilities. Here we conduct the largest epidemiological study to date on the association between ambient temperature and mortality by age and cause using data from 532 cities in 33 countries. Methods: We collected daily temperature and mortality data from each country. Mortality data was provided as daily death counts within age groups from all, cardiovascular, respiratory, or noncardiorespiratory causes. We first fit quasi-Poisson regression models to estimate location-specific associations for each age-by-cause group. For each cause, we then pooled location-specific results in a dose-response multivariate meta-regression model that enabled us to estimate overall temperature-mortality curves at any age. The age analysis was limited to adults. Results: We observed high temperature effects on mortality from both cardiovascular and respiratory causes compared to noncardiorespiratory causes, with the highest cold-related risks from cardiovascular causes and the highest heat-related risks from respiratory causes. Risks generally increased with age, a pattern most consistent for cold and for nonrespiratory causes. For every cause group, risks at both temperature extremes were strongest at the oldest age (age 85 years). Excess mortality fractions were highest for cold at the oldest ages. Conclusions: There is a differential pattern of risk associated with heat and cold by cause and age; cardiorespiratory causes show stronger effects than noncardiorespiratory causes, and older adults have higher risks than younger adults.

  temperature-mortality associationsage-specific mortalitycause-specific mortalitymulti-country studymulti-city analysis

  
  
• Guo Q, Mistry M, Zhou X, Zhao G, Kino K, Wen B, Yoshimura K, Satoh Y, Cvijanovic I, Kim Y, Ng C, Vicedo-Cabrera A, Armstrong B, Urban A, Katsouyanni K, Masselot P, Tong S, Sera F, Huber V, Bell M, Kyselý J, Gasparrini A, Hashizume M, Oki T, Abrutzky R, Guo Y, de Sousa Zanotti Stagliorio Coelho M, Nascimento Saldiva P, Lavigne E, Ortega N, Correa P, Kan H, Osorio S, Royé D, Indermitte E, Orru H, Jaakkola J, Ryti N, Pascal M, Schneider A, Analitis A, Entezari A, Mayvaneh F, Zeka A, Goodman P, de'Donato F, Michelozzi P, Alahmad B, De la Cruz Valencia C, Hurtado Diaz M, Overcenco A, Ameling C, Houthuijs D, Rao S, Carrasco G, Seposo X, Madureira J, das Neves Pereira da Silva S, Holobaca I, Acquaotta F, Scovronick N, Kim H, Lee W, Tobias A, Íñiguez C, Forsberg B, Ragettli M, Pan S, Guo Y, Li S, Schneider R, Colistro V, Zanobetti A, Schwartz J, Van Dung D, Ngoc Dang T, Honda Y (2024). Regional variation in the role of humidity on citylevel heatrelated mortality. PNAS Nexus, vol. 3(8), art. no. pgae290. 10.1093/pnasnexus/pgae290.

  
  The rising humid heat is regarded as a severe threat to human survivability, but the proper integration of humid heat into heat-health alerts is still being explored. Using state-of-the-art epidemiological and climatological datasets, we examined the association between multiple heat stress indicators (HSIs) and daily human mortality in 739 cities worldwide. Notable differences were observed in the long-term trends and timing of heat events detected by HSIs. Air temperature (Tair) predicts heat-related mortality well in cities with a robust negative Tair-relative humidity correlation (CT-RH). However, in cities with near-zero or weak positive CT-RH, HSIs considering humidity provide enhanced predictive power compared to Tair. Furthermore, the magnitude and timing of heat-related mortality measured by HSIs could differ largely from those associated with Tair in many cities. Our findings provide important insights into specific regions where humans are vulnerable to humid heat and can facilitate the further enhancement of heat-health alert systems.

  humidityheat-related mortalitycity-level analysisregional variationheat stress indicators

  
  
• Chua P, Tobias A, Madaniyazi L, Ng C, Phung V, Fu S, Rodriguez P, Brown P, Coelho M, Saldiva P, Scovronick N, Deshpande A, Salazar M, Dorotan M, Tantrakarnapa K, Kliengchuay W, Abrutzky R, Carrasco-Escobar G, Royé D, Hales S, Hashizume M (2024). Association between precipitation and mortality due to diarrheal diseases by climate zone: A multicountry modeling study. Environmental Epidemiology, vol. 8(4), art. no. e320. 10.1097/ee9.0000000000000320.

  
  Background: Precipitation could affect the transmission of diarrheal diseases. The diverse precipitation patterns across different climates might influence the degree of diarrheal risk from precipitation. This study determined the associations between precipitation and diarrheal mortality in tropical, temperate, and arid climate regions. Methods: Daily counts of diarrheal mortality and 28-day cumulative precipitation from 1997 to 2019 were analyzed across 29 locations in eight middle-income countries (Argentina, Brazil, Costa Rica, India, Peru, the Philippines, South Africa, and Thailand). A two-stage approach was employed: the first stage is conditional Poisson regression models for each location, and the second stage is meta-analysis for pooling location-specific coefficients by climate zone. Results: In tropical climates, higher precipitation increases the risk of diarrheal mortality. Under extremely wet conditions (95th percentile of 28-day cumulative precipitation), diarrheal mortality increased by 17.8% (95% confidence interval [CI] = 10.4%, 25.7%) compared with minimum-risk precipitation. For temperate and arid climates, diarrheal mortality increases in both dry and wet conditions. In extremely dry conditions (fifth percentile of 28-day cumulative precipitation), diarrheal mortality risk increases by 3.8% (95% CI = 1.2%, 6.5%) for temperate and 5.5% (95% CI = 1.0%, 10.2%) for arid climates. Similarly, under extremely wet conditions, diarrheal mortality risk increases by 2.5% (95% CI = −0.1%, 5.1%) for temperate and 4.1% (95% CI = 1.1%, 7.3%) for arid climates. Conclusions: Associations between precipitation and diarrheal mortality exhibit variations across different climate zones. It is crucial to consider climate-specific variations when generating global projections of future precipitation-related diarrheal mortality.

  precipitationdiarrheal diseasesclimate zonesmortalitymulti-country modeling

  
  
• Chen G, Guo Y, Yue X, Xu R, Yu W, Ye T, Tong S, Gasparrini A, Bell M, Armstrong B, Schwartz J, Jaakkola J, Lavigne E, Saldiva P, Kan H, Royé D, Urban A, Vicedo-Cabrera A, Tobias A, Forsberg B, Sera F, Lei Y, Abramson M, Li S, Abrutzky R, Alahmad B, Ameling C, Åström C, Breitner S, Carrasco-Escobar G, Coêlho M, Colistro V, Correa P, Dang T, de'Donato F, Dung D, Entezari A, Garcia S, Garland R, Goodman P, Guo Y, Hashizume M, Holobaca I, Honda Y, Houthuijs D, Hurtado-Díaz M, Íñiguez C, Katsouyanni K, Kim H, Kyselý J, Lee W, Maasikmets M, Madureira J, Mayvaneh F, Nunes B, Orru H, Ortega N, Overcenco A, Pan S, Pascal M, Ragettli M, Rao S, Ryti N, Samoli E, Schneider A, Scovronick N, Seposo X, Stafoggia M, Valencia C, Zanobetti A, Zeka A (2024). Allcause, cardiovascular, and respiratory mortality and wildfirerelated ozone: a multicountry twostage time series analysis. The Lancet Planetary Health, vol. 8(7), pp. e452-e462. 10.1016/S2542-5196(24)00117-7.

  
  Background. Wildfire activity is an important source of tropospheric ozone (O3) pollution. However, no study to date has systematically examined the associations of wildfire-related O3 exposure with mortality globally. Methods. We did a multicountry two-stage time series analysis. From the Multi-City Multi-Country (MCC) Collaborative Research Network, data on daily all-cause, cardiovascular, and respiratory deaths were obtained from 749 locations in 43 countries or areas, representing overlapping periods from Jan 1, 2000, to Dec 31, 2016. We estimated the daily concentration of wildfire-related O3 in study locations using a chemical transport model, and then calibrated and downscaled O3 estimates to a resolution of 0·25° × 0·25° (approximately 28 km2 at the equator). Using a random-effects meta-analysis, we examined the associations of short-term wildfire-related O3 exposure (lag period of 0–2 days) with daily mortality, first at the location level and then pooled at the country, regional, and global levels. Annual excess mortality fraction in each location attributable to wildfire-related O3 was calculated with pooled effect estimates and used to obtain excess mortality fractions at country, regional, and global levels. Findings. Between 2000 and 2016, the highest maximum daily wildfire-related O3 concentrations (≥30 μg/m3) were observed in locations in South America, central America, and southeastern Asia, and the country of South Africa. Across all locations, an increase of 1 μg/m3 in the mean daily concentration of wildfire-related O3 during lag 0–2 days was associated with increases of 0·55% (95% CI 0·29 to 0·80) in daily all-cause mortality, 0·44% (–0·10 to 0·99) in daily cardiovascular mortality, and 0·82% (0·18 to 1·47) in daily respiratory mortality. The associations of daily mortality rates with wildfire-related O3 exposure showed substantial geographical heterogeneity at the country and regional levels. Across all locations, estimated annual excess mortality fractions of 0·58% (95% CI 0·31 to 0·85; 31 606 deaths [95% CI 17 038 to 46 027]) for all-cause mortality, 0·41% (–0·10 to 0·91; 5249 [–1244 to 11 620]) for cardiovascular mortality, and 0·86% (0·18 to 1·51; 4657 [999 to 8206]) for respiratory mortality were attributable to short-term exposure to wildfire-related O3. Interpretation. In this study, we observed an increase in all-cause and respiratory mortality associated with short-term wildfire-related O3 exposure. Effective risk and smoke management strategies should be implemented to protect the public from the impacts of wildfires.

  wildfire-related ozoneall-cause mortalitycardiovascular mortalityrespiratory mortalitytwo-stage time series

  
  
• Lemus-Canovas M, Montesinos-Ciuró E, Cearreta-Innocenti T, Serrano-Notivoli R, Royé D (2024). Attribution of the unprecedented heat event of August 2023 in Barcelona (Spain) to observed and projected global warming. Urban Climate, vol. 56, art. no. 102019. 10.1016/j.uclim.2024.102019.

  
  The study analyses observed and numerical simulations of daily maximum and minimum temperature from 1920 onwards and to investigate the unprecedented heat event that occurred in 21–23 August 2023 in Barcelona. The historical changes in the intensity of such events, their expected future changes under scenarios of +1.5 °C, +2 °C, and + 3 °C, and the future exposure of populations to such kind of events are examined using the flow analogues approach. The findings indicate a significant increase in observed temperatures for similar heatwaves to those occurred in August 2023. The study also emphasises the impact of global warming on the intensification of heat events over the impact of urbanization. Additionally, after examining the role of natural variability in temperature changes, we concluded that global warming is the primary factor driving the increase in heatwave intensity. In terms of the frequency of such events, we found that extreme heat events, such as the August 2023 heatwave, will become 2 and 5 times more likely with a global summer warming of 2 °C and 3 °C, respectively. This will expose a large portion of the population to dangerous heat levels highlighting the importance of limiting global warming to 1.5 °C to mitigate the impacts on urban populations.

  extreme event attributionheatwaveurban climateglobal warmingbarcelona

  
  
• Alahmad B, Khraishah H, Kamineni M, Royé D, Papatheodorou S, Vicedo-Cabrera A, Guo Y, Lavigne E, Armstrong B, Sera F, Bernstein A, Zanobetti A, Garshick E, Schwartz J, Bell M, Al-Mulla F, Koutrakis P, Gasparrini A, Souzana A, Acquaotta F, Pan S, Sousa Zanotti Stagliorio Coelho M, Colistro V, Ngoc Dang T, Van Dung D, De’ Donato F, Entezari A, Leon Guo Y, Hashizume M, Honda Y, Indermitte E, Íñiguez C, Jaakkola J, Kim H, Lee W, Li S, Madureira J, Mayvaneh F, Orru H, Overcenco A, Ragettli M, Ryti N, Hilario Nascimento Saldiva P, Scovronick N, Seposo X, Pereira Silva S, Stafoggia M, Tobias A (2024). Extreme Temperatures and Stroke Mortality: Evidence From a MultiCountry Analysis. Stroke, vol. 55(7), pp. 1847-1856. 10.1161/strokeaha.123.045751.

  
  Background: Extreme temperatures contribute significantly to global mortality. While previous studies on temperature and stroke-specific outcomes presented conflicting results, these studies were predominantly limited to single-city or single-country analyses. Their findings are difficult to synthesize due to variations in methodologies and exposure definitions. Methods: Within the Multi-Country Multi-City Network, we built a new mortality database for ischemic and hemorrhagic stroke. Applying a unified analysis protocol, we conducted a multinational case-crossover study on the relationship between extreme temperatures and stroke. In the first stage, we fitted a conditional quasi-Poisson regression for daily mortality counts with distributed lag nonlinear models for temperature exposure separately for each city. In the second stage, the cumulative risk from each city was pooled using mixed-effect meta-analyses, accounting for clustering of cities with similar features. We compared temperature-stroke associations across country-level gross domestic product per capita. We computed excess deaths in each city that are attributable to the 2.5% hottest and coldest of days based on each city’s temperature distribution. Results: We collected data for a total of 3 443 969 ischemic strokes and 2 454 267 hemorrhagic stroke deaths from 522 cities in 25 countries. For every 1000 ischemic stroke deaths, we found that extreme cold and hot days contributed 9.1 (95% empirical CI, 8.6–9.4) and 2.2 (95% empirical CI, 1.9–2.4) excess deaths, respectively. For every 1000 hemorrhagic stroke deaths, extreme cold and hot days contributed 11.2 (95% empirical CI, 10.9–11.4) and 0.7 (95% empirical CI, 0.5–0.8) excess deaths, respectively. We found that countries with low gross domestic product per capita were at higher risk of heat-related hemorrhagic stroke mortality than countries with high gross domestic product per capita (P=0.02). Conclusions: Both extreme cold and hot temperatures are associated with an increased risk of dying from ischemic and hemorrhagic strokes. As climate change continues to exacerbate these extreme temperatures, interventional strategies are needed to mitigate impacts on stroke mortality, particularly in low-income countries.

  extreme temperaturesstroke mortalityischemic and hemorrhagic strokemulti-country analysis climate impact

  
  
• Hundessa S, Huang W, Zhao Q, Wu Y, Wen B, Alahmad B, Armstrong B, Gasparrini A, Sera F, Tong S, Madureira J, Kyselý J, Schwartz J, Vicedo-Cabrera A, Hales S, Johnson A, Li S, Guo Y, Jaakkola J, Ryti N, Urban A, Tobias A, Royé D, Lavigne E, Ragettli M, Åström C, Raz R, Pascal M, Kan H, Goodman P, Zeka A, Hashizume M, Diaz M, Seposo X, Nunes B, Kim H, Lee W, Íñiguez C, Guo Y, Pan S, Zanobetti A, Dang T, Van Dung D, Schneider A, Entezari A, Analitis A, Forsberg B, Ameling C, Houthuijs D, Indermitte E, Mayvaneh F, Acquaotta F, de'Donato F, Carrasco-Escobar G, Orru H, Katsouyanni K, de Sousa Zanotti Stagliorio Coelho M, Ortega N, Scovronick N, Michelozzi P, Correa P, Nascimento Saldiva P, Abrutzky R, Osorio S, Colistro V, Huber V, Honda Y, Kim Y, Bell M, Xu R, Yang Z, Roradeh H, Félix Arellano E, Rao S, Carlos Chua P, da Silva S, da Silva S, De la Cruz Valencia C (2024). Global and Regional Cardiovascular Mortality Attributable to Nonoptimal Temperatures Over Time. Journal of the American College of Cardiology, vol. 83(23), pp. 2276-2287. 10.1016/j.jacc.2024.03.425.

  
  Background. The association between nonoptimal temperatures and cardiovascular mortality risk is recognized. However, a comprehensive global assessment of this burden is lacking. Objectives. The goal of this study was to assess global cardiovascular mortality burden attributable to nonoptimal temperatures and investigate spatiotemporal trends. Methods. Using daily cardiovascular deaths and temperature data from 32 countries, a 3-stage analytical approach was applied. First, location-specific temperature–mortality associations were estimated, considering nonlinearity and delayed effects. Second, a multivariate meta-regression model was developed between location-specific effect estimates and 5 meta-predictors. Third, cardiovascular deaths associated with nonoptimal, cold, and hot temperatures for each global grid (55 km × 55 km resolution) were estimated, and temporal trends from 2000 to 2019 were explored. Results. Globally, 1,801,513 (95% empirical CI: 1,526,632-2,202,831) annual cardiovascular deaths were associated with nonoptimal temperatures, constituting 8.86% (95% empirical CI: 7.51%-12.32%) of total cardiovascular mortality corresponding to 26 deaths per 100,000 population. Cold-related deaths accounted for 8.20% (95% empirical CI: 6.74%-11.57%), whereas heat-related deaths accounted for 0.66% (95% empirical CI: 0.49%-0.98%). The mortality burden varied significantly across regions, with the highest excess mortality rates observed in Central Asia and Eastern Europe. From 2000 to 2019, cold-related excess death ratios decreased, while heat-related ratios increased, resulting in an overall decline in temperature-related deaths. Southeastern Asia, Sub-Saharan Africa, and Oceania observed the greatest reduction, while Southern Asia experienced an increase. The Americas and several regions in Asia and Europe displayed fluctuating temporal patterns. Conclusions. Nonoptimal temperatures substantially contribute to cardiovascular mortality, with heterogeneous spatiotemporal patterns. Effective mitigation and adaptation strategies are crucial, especially given the increasing heat-related cardiovascular deaths amid climate change.

  cardiovascular mortalitynonoptimal temperaturesglobal assessmentspatiotemporal trendsclimate impact

  
  
• Zhao Q, Li S, Ye T, Wu Y, Gasparrini A, Tong S, Urban A, Vicedo-Cabrera A, Tobias A, Armstrong B, Royé D, Lavigne E, de’Donato F, Sera F, Kan H, Schwartz J, Pascal M, Ryti N, Goodman P, Saldiva P, Bell M, Guo Y (2024). Global, regional, and national burden of heatwaverelated mortality from 1990 to 2019: A threestage modelling study. PLOS Medicine, vol. 21(5), art. no. e1004364. 10.1371/journal.pmed.1004364.

  
  Background. The regional disparity of heatwave-related mortality over a long period has not been sufficiently assessed across the globe, impeding the localisation of adaptation planning and risk management towards climate change. We quantified the global mortality burden associated with heatwaves at a spatial resolution of 0.5°×0.5° and the temporal change from 1990 to 2019. Methods and findings. We collected data on daily deaths and temperature from 750 locations of 43 countries or regions, and 5 meta-predictors in 0.5°×0.5° resolution across the world. Heatwaves were defined as location-specific daily mean temperature ≥95th percentiles of year-round temperature range with duration ≥2 days. We first estimated the location-specific heatwave-mortality association. Secondly, a multivariate meta-regression was fitted between location-specific associations and 5 meta-predictors, which was in the third stage used with grid cell-specific meta-predictors to predict grid cell-specific association. Heatwave-related excess deaths were calculated for each grid and aggregated. During 1990 to 2019, 0.94% (95% CI: 0.68–1.19) of deaths [i.e., 153,078 cases (95% eCI: 109,950–194,227)] per warm season were estimated to be from heatwaves, accounting for 236 (95% eCI: 170–300) deaths per 10 million residents. The ratio between heatwave-related excess deaths and all premature deaths per warm season remained relatively unchanged over the 30 years, while the number of heatwave-related excess deaths per 10 million residents per warm season declined by 7.2% per decade in comparison to the 30-year average. Locations with the highest heatwave-related death ratio and rate were in Southern and Eastern Europe or areas had polar and alpine climates, and/or their residents had high incomes. The temporal change of heatwave-related mortality burden showed geographic disparities, such that locations with tropical climate or low incomes were observed with the greatest decline. The main limitation of this study was the lack of data from certain regions, e.g., Arabian Peninsula and South Asia. Conclusions. Heatwaves were associated with substantial mortality burden that varied spatiotemporally over the globe in the past 30 years. The findings indicate the potential benefit of governmental actions to enhance health sector adaptation and resilience, accounting for inequalities across communities.

  heatwave-related mortalityglobal burdentemporal changespatiotemporal analysis

  
  
• Wu Y, Wen B, Gasparrini A, Armstrong B, Sera F, Lavigne E, Li S, Guo Y, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera A, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Forsberg B, Íñiguez C, Ameling C, la Cruz Valencia C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Mayvaneh F, Acquaotta F, de'Donato F, Carrasco-Escobar G, Kan H, Carlsen H, Orru H, Kim H, Holobaca I, Kyselý J, Madureira J, Schwartz J, Jaakkola J, Katsouyanni K, Diaz M, Ragettli M, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coelho M, Ortega N, Ryti N, Scovronick N, Michelozzi P, Correa P, Goodman P, Nascimento Saldiva P, Raz R, Abrutzky R, Osorio S, Pan S, Rao S, Tong S, Achilleos S, Dang T, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Kim Y, Guo Y, Li S, Guo Y (2024). Temperature frequency and mortality: Assessing adaptation to local temperature. Environment International, vol. 187, art. no. 108691. 10.1016/j.envint.2024.108691.

  
  Assessing the association between temperature frequency and mortality can provide insights into human adaptation to local ambient temperatures. We collected daily time-series data on mortality and temperature from 757 locations in 47 countries/regions during 1979–2020. We used a two-stage time series design to assess the association between temperature frequency and all-cause mortality. The results were pooled at the national, regional, and global levels. We observed a consistent decrease in the risk of mortality as the normalized frequency of temperature increases across the globe. The average increase in mortality risk comparing the 10th to 100th percentile of normalized frequency was 13.03% (95% CI: 12.17–13.91), with substantial regional differences (from 4.56% in Australia and New Zealand to 33.06% in South Europe). The highest increase in mortality was observed for high-income countries (13.58%, 95% CI: 12.56–14.61), followed by lower-middle-income countries (12.34%, 95% CI: 9.27–15.51). This study observed a declining risk of mortality associated with higher temperature frequency. Our findings suggest that populations can adapt to their local climate with frequent exposure, with the adapting ability varying geographically due to differences in climatic and socioeconomic characteristics.

  temperatureadaptationfrequencymortalityclimate change

  
  
• Madaniyazi L, Alpízar J, Cifuentes L, Riojas-Rodríguez H, Hurtado Díaz M, de Sousa Zanotti Stagliorio Coelho M, Abrutzky R, Osorio S, Carrasco Escobar G, Valdés Ortega N, Colistro V, Royé D, Tobías A (2024). Health and Economic Benefits of Complying With the World Health Organization Air Quality Guidelines for Particulate Matter in Nine Major Latin American Cities. International Journal of Public Health, vol. 69, art. no. 1606909. 10.3389/ijph.2024.1606909.

  
  Objectives: This study aims to estimate the short-term preventable mortality and associated economic costs of complying with the World Health Organization (WHO) air quality guidelines (AQGs) limit values for PM10 and PM2.5 in nine major Latin American cities. Methods: We estimated city-specific PM-mortality associations using time-series regression models and calculated the attributable mortality fraction. Next, we used the value of statistical life to calculate the economic benefits of complying with the WHO AQGs limit values. Results: In most cities, PM concentrations exceeded the WHO AQGs limit values more than 90% of the days. PM10 was found to be associated with an average excess mortality of 1.88% with concentrations above WHO AQGs limit values, while for PM2.5 it was 1.05%. The associated annual economic costs varied widely, between US\) 19.5 million to 3,386.9 million for PM10, and US$ 196.3 million to 2,209.6 million for PM2.5.

  Conclusion: Our findings suggest that there is an urgent need for policymakers to develop interventions to achieve sustainable air quality improvements in Latin America. Complying with the WHO AQGs limit values for PM10 and PM2.5 in Latin American cities would substantially benefits for urban populations.

  air quality guidelinesparticulate matterhealth benefitseconomic benefitslatin american cities

  
  
• Wen B, Wu Y, Guo Y, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera A, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan S, Íñiguez C, Ameling C, Valencia C, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de’Donato F, Rao S, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca I, Kyselý J, Madureira J, Schwartz J, Jaakkola J, Katsouyanni K, Diaz M, Ragettli M, Hashizume M, Pascal M, Coélho M, Ortega N, Ryti N, Scovronick N, Michelozzi P, Matus Correa P, Goodman P, Saldiva P, Raz R, Abrutzky R, Osorio S, Dang T, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Kim Y, Guo Y, Bell M, Li S (2024). Comparison for the effects of different components of temperature variability on mortality: A multicountry timeseries study. Environment International, vol. 187, art. no. 108712. 10.1016/j.envint.2024.108712.

  
  Background. Temperature variability (TV) is associated with increased mortality risk. However, it is still unknown whether intra-day or inter-day TV has different effects. Objectives. We aimed to assess the association of intra-day TV and inter-day TV with all-cause, cardiovascular, and respiratory mortality. Methods. We collected data on total, cardiovascular, and respiratory mortality and meteorology from 758 locations in 47 countries or regions from 1972 to 2020. We defined inter-day TV as the standard deviation (SD) of daily mean temperatures across the lag interval, and intra-day TV as the average SD of minimum and maximum temperatures on each day. In the first stage, inter-day and intra-day TVs were modelled simultaneously in the quasi-Poisson time-series model for each location. In the second stage, a multi-level analysis was used to pool the location-specific estimates. Results. Overall, the mortality risk due to each interquartile range [IQR] increase was higher for intra-day TV than for inter-day TV. The risk increased by 0.59% (95% confidence interval [CI]: 0.53, 0.65) for all-cause mortality, 0.64% (95% CI: 0.56, 0.73) for cardiovascular mortality, and 0.65% (95% CI: 0.49, 0.80) for respiratory mortality per IQR increase in intra-day TV0–7 (0.9 °C). An IQR increase in inter-day TV0–7 (1.6 °C) was associated with 0.22% (95% CI: 0.18, 0.26) increase in all-cause mortality, 0.44% (95% CI: 0.37, 0.50) increase in cardiovascular mortality, and 0.31% (95% CI: 0.21, 0.41) increase in respiratory mortality. The proportion of all-cause deaths attributable to intra-day TV0–7 and inter-day TV0–7 was 1.45% and 0.35%, respectively. The mortality risks varied by lag interval, climate area, season, and climate type. Conclusions. Our results indicated that intra-day TV may explain the main part of the mortality risk related to TV and suggested that comprehensive evaluations should be proposed in more countries to help protect human health.

  temperature variabilitymortalityinter-dayintra-day

  
  
• Gincheva A, Pausas J, Edwards A, Provenzale A, Cerdà A, Hanes C, Royé D, Chuvieco E, Mouillot F, Vissio G, Rodrigo J, Bedía J, Abatzoglou J, Senciales González J, Short K, Baudena M, Llasat M, Magnani M, Boer M, González M, Torres-Vázquez M, Fiorucci P, Jacklyn P, Libonati R, Trigo R, Herrera S, Jerez S, Wang X, Turco M (2024). A monthly gridded burned area database of national wildland fire data. Scientific Data, vol. 11(352). 10.1038/s41597-024-03141-2.

  
  We assembled the first gridded burned area (BA) database of national wildfire data (ONFIRE), a comprehensive and integrated resource for researchers, non-government organisations, and government agencies analysing wildfires in various regions of the Earth. We extracted and harmonised records from different regions and sources using open and reproducible methods, providing data in a common framework for the whole period available (starting from 1950 in Australia, 1959 in Canada, 1985 in Chile, 1980 in Europe, and 1984 in the United States) up to 2021 on a common 1° × 1° grid. The data originate from national agencies (often, ground mapping), thus representing the best local expert knowledge. Key opportunities and limits in using this dataset are discussed as well as possible future expansions of this open-source approach that should be explored. This dataset complements existing gridded BA data based on remote sensing and offers a valuable opportunity to better understand and assess fire regime changes, and their drivers, in these regions. The ONFIRE database can be freely accessed at https://zenodo.org/record/8289245.

  urned area databasewildland firegridded datanational fire dataonfire database

  
  
• Chen K, de Schrijver E, Sivaraj S, Sera F, Scovronick N, Jiang L, Royé D, Lavigne E, Kyselý J, Urban A, Schneider A, Huber V, Madureira J, Mistry M, Cvijanovic I, Armstrong B, Schneider R, Tobias A, Astrom C, Guo Y, Honda Y, Abrutzky R, Tong S, de Sousa Zanotti Stagliorio Coelho M, Saldiva P, Correa P, Ortega N, Kan H, Osorio S, Orru H, Indermitte E, Jaakkola J, Ryti N, Pascal M, Katsouyanni K, Analitis A, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Diaz M, De la Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Carrasco-Escobar G, Seposo X, da Silva S, Holobaca I, Acquaotta F, Kim H, Lee W, Íñiguez C, Forsberg B, Ragettli M, Guo Y, Pan S, Li S, Colistro V, Zanobetti A, Schwartz J, Dang T, Van Dung D, Carlsen H, Cauchi J, Achilleos S, Raz R, Gasparrini A, Vicedo-Cabrera A (2024). Impact of population aging on future temperaturerelated mortality at different global warming levels. Nature Communications, vol. 15, art. no. 1796. 10.1038/s41467-024-45901-z.

  
  Older adults are generally amongst the most vulnerable to heat and cold. While temperature-related health impacts are projected to increase with global warming, the influence of population aging on these trends remains unclear. Here we show that at 1.5 °C, 2 °C, and 3 °C of global warming, heat-related mortality in 800 locations across 50 countries/areas will increase by 0.5%, 1.0%, and 2.5%, respectively; among which 1 in 5 to 1 in 4 heat-related deaths can be attributed to population aging. Despite a projected decrease in cold-related mortality due to progressive warming alone, population aging will mostly counteract this trend, leading to a net increase in cold-related mortality by 0.1%–0.4% at 1.5–3 °C global warming. Our findings indicate that population aging constitutes a crucial driver for future heat- and cold-related deaths, with increasing mortality burden for both heat and cold due to the aging population.

  population agingtemperature-related mortalityglobal warming levelsheat and cold mortalityfuture projections

  
  
• Gao Y, Huang W, Zhao Q, Ryti N, Armstrong B, Gasparrini A, Tong S, Pascal M, Urban A, Zeka A, Lavigne E, Madureira J, Goodman P, Huber V, Forsberg B, Kyselý J, Sera F, Guo Y, Li S, Gao Y, Huang W, Zhao Q, Ryti N, Armstrong B, Gasparrini A, Tong S, Pascal M, Urban A, Zeka A, Lavigne E, Madureira J, Goodman P, Huber V, Forsberg B, Kyselý J, Sera F, Bell M, Hales S, Honda Y, Jaakkola J, Tobias A, Vicedo-Cabrera A, Abrutzky R, Coelho M, Saldiva P, Correa P, Ortega N, Kan H, Osorio S, Royé D, Orru H, Indermitte E, Schneider A, Katsouyanni K, Analitis A, Carlsen H, Mayvaneh F, Roradeh H, Raz R, Michelozzi P, de’Donato F, Hashizume M, Kim Y, Alahmad B, Cauchy J, Diaz M, Arellano E, Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Carrasco G, Seposo X, Chua P, Silva S, Nunes B, Holobaca I, Cvijanovic I, Mistry M, Scovronick N, Acquaotta F, Kim H, Lee W, Íñiguez C, Åström C, Ragettli M, Guo Y, Pan S, Colistro V, Zanobetti A, Schwartz J, Dang T, Dung D, Guo Y, Li S (2024). Global, regional, and national burden of mortality associated with cold spells during 2000–19: a threestage modelling study. The Lancet Planetary Health, vol. 8(2), pp. e108-e116. 10.1016/S2542-5196(23)00277-2.

  
  Background. Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells. Methods. A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions). First, we fitted the location-specific, cold spell-related mortality associations using a quasi-Poisson regression with a distributed lag non-linear model with a lag period of up to 21 days. Second, we built a multivariate meta-regression model between location-specific associations and seven predictors. Finally, we predicted the global grid-specific cold spell-related mortality associations during 2000–19 using the fitted meta-regression model and the yearly grid-specific meta-predictors. We calculated the annual excess deaths, excess death ratio (excess deaths per 1000 deaths), and excess death rate (excess deaths per 100 000 population) due to cold spells for each grid across the world. Findings.Globally, 205 932 (95% empirical CI [eCI] 162 692–250 337) excess deaths, representing 3·81 (95% eCI 2·93–4·71) excess deaths per 1000 deaths (excess death ratio), and 3·03 (2·33–3·75) excess deaths per 100 000 population (excess death rate) were associated with cold spells per year between 2000 and 2019. The annual average global excess death ratio in 2016–19 increased by 0·12 percentage points and the excess death rate in 2016–19 increased by 0·18 percentage points, compared with those in 2000–03. The mortality burden varied geographically. The excess death ratio and rate were highest in Europe, whereas these indicators were lowest in Africa. Temperate climates had higher excess death ratio and rate associated with cold spells than other climate zones. Interpretation. Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells. Funding.Australian Research Council, Australian National Health and Medical Research Council, EU’s Horizon 2020 Project Exhaustion.

  cold spellsmortality burdenthree-stage modellingglobal assessmentclimate impact

  
  
• Madaniyazi L, Armstrong B, Tobias A, Mistry M, Bell M, Urban A, Kyselý J, Ryti N, Cvijanovic I, Ng C, Royé D, Vicedo-Cabrera A, Tong S, Lavigne E, Íñiguez C, da Silva S, Madureira J, Jaakkola J, Sera F, Honda Y, Gasparrini A, Hashizume M, Abrutzky R, Acquaotta F, Alahmad B, Analitis A, Carlsen H, Carrasco-Escobar G, de Sousa Zanotti Stagliorio Coelho M, Colistro V, Matus Correa P, Dang T, de’Donato F, Hurtado Diaz M, Dung D, Entezari A, Forsberg B, Goodman P, Guo Y, Guo Y, Holobaca I, Houthuijs D, Huber V, Indermitte E, Kan H, Katsouyanni K, Kim Y, Kim H, Lee W, Li S, Mayvaneh F, Michelozzi P, Orru H, Valdés Ortega N, Osorio S, Overcenco A, Pan S, Pascal M, Ragettli M, Rao S, Raz R, Saldiva P, Schneider A, Schwartz J, Scovronick N, Seposo X, De la Cruz Valencia C, Zanobetti A, Zeka A (2024). Seasonality of mortality under climate change: a multicountry projection study. The Lancet Planetary Health, vol. 8(2), pp. e86-e94. 10.1016/s25425196(23)00269-3.

  
  Background. Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones. Methods. In this modelling study, we collected daily time series of mean temperature and mortality (all causes or non-external causes only) via the Multi-Country Multi-City Collaborative (MCC) Research Network. These data were collected during overlapping periods, spanning from Jan 1, 1969 to Dec 31, 2020. We projected daily mortality from Jan 1, 2000 to Dec 31, 2099, under four climate change scenarios corresponding to increasing emissions (Shared Socioeconomic Pathways [SSP] scenarios SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). We compared the seasonality in projected mortality between decades by its shape, timings (the day-of-year) of minimum (trough) and maximum (peak) mortality, and sizes (peak-to-trough ratio and attributable fraction). Attributable fraction was used to measure the burden of seasonality of mortality. The results were summarised by climate zones. Findings. The MCC dataset included 126 809 537 deaths from 707 locations within 43 countries or areas. After excluding the only two polar locations (both high-altitude locations in Peru) from climatic zone assessments, we analysed 126 766 164 deaths in 705 locations aggregated in four climate zones (tropical, arid, temperate, and continental). From the 2000s to the 2090s, our projections showed an increase in mortality during the warm seasons and a decrease in mortality during the cold seasons, albeit with mortality remaining high during the cold seasons, under all four SSP scenarios in the arid, temperate, and continental zones. The magnitude of this changing pattern was more pronounced under the high-emission scenarios (SSP3-7.0 and SSP5-8.5), substantially altering the shape of seasonality of mortality and, under the highest emission scenario (SSP5-8.5), shifting the mortality peak from cold seasons to warm seasons in arid, temperate, and continental zones, and increasing the size of seasonality in all zones except the arid zone by the end of the century. In the 2090s compared with the 2000s, the change in peak-to-trough ratio (relative scale) ranged from 0·96 to 1·11, and the change in attributable fraction ranged from 0·002% to 0·06% under the SSP5-8.5 (highest emission) scenario. Interpretation. A warming climate can substantially change the seasonality of mortality in the future. Our projections suggest that health-care systems should consider preparing for a potentially increased demand during warm seasons and sustained high demand during cold seasons, particularly in regions characterised by arid, temperate, and continental climates.

  seasonality of mortalityclimate changemulticountry projectiontemperature-related deathsfuture climate scenarios

  
  
• Royé D, Íñiguez C, Tobías A (2024). Comparison of Air Pollution–Mortality Associations Using Observed Particulate Matter Concentrations and Reanalysis Data in 33 Spanish Cities. Environment & Health, vol. 2(3), pp. 161-169. 10.1021/envhealth.3c00128.

  
  Air pollution poses a health hazard in all countries. However, complete data on ambient particulate matter (PM) concentrations are not available in all world regions. Reanalysis data is already a valuable source of exposure data in epidemiological studies examining the relationship between temperature and health. Nevertheless, the performance of reanalysis data in assessing the short-term health effects of particulate air pollution remains unclear. We assessed the performance of CAMS reanalysis (EAC4) data from the European Centre for Medium-Range Weather Forecasts, compared with daily PM concentrations from field monitoring stations, to estimate short-term exposure to PM with an aerodynamic diameter less than 10 μm (PM10) on daily mortality in 33 Spanish provincial capital cities using a two-stage time series regression design. The shape of the PM10 distribution varied substantially between PM observations and CAMS global reanalysis of atmospheric composition (EAC4) reanalysis data, with correlation ranging from 0.21 to 0.58. The pooled mortality risk for a 10 μg/m3 increase in PM10 showed similar estimates using PM concentrations {relative risks (RR) = 1.007, 95% confidence intervals (95% CI) = [1.002, 1.011]} and EAC4 reanalysis data (RR = 1.011, 95% CI = [1.006, 1.015]). However, the city-specific PM10 beta coefficients estimated using PM concentrations and EAC4 reanalysis data showed a low correlation (r = 0.22). The use of reanalysis data should be approached with caution when assessing the association between particulate matter air pollution and health outcomes, particularly in cities with small populations.

  air pollutionparticulate matterpm10reanalysiseac4mortalityspaintime series regression

  
  

2023

• Stafoggia M, Michelozzi P, Schneider A, Armstrong B, Scortichini M, Rai M, Achilleos S, Alahmad B, Analitis A, Åström C, Bell M, Calleja N, Krage Carlsen H, Carrasco G, Paul Cauchi J, DSZS Coelho M, Correa P, Diaz M, Entezari A, Forsberg B, Garland R, Leon Guo Y, Guo Y, Hashizume M, Holobaca I, Íñiguez C, Jaakkola J, Kan H, Katsouyanni K, Kim H, Kyselý J, Lavigne E, Lee W, Li S, Maasikmets M, Madureira J, Mayvaneh F, Fook Sheng Ng C, Nunes B, Orru H, V Ortega N, Osorio S, Palomares A, Pan S, Pascal M, Ragettli M, Rao S, Raz R, Royé D, Ryti N, HN Saldiva P, Samoli E, Schwartz J, Scovronick N, Sera F, Tobias A, Tong S, DLC Valencia C, Maria Vicedo-Cabrera A, Urban A, Gasparrini A, Breitner S, de’ Donato F (2023). Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. Environment International, vol. 181, art. no. 108258. 10.1016/j.envint.2023.108258.

  
  Background. The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. Objectives. To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. Methods. We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995–2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. Results. We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. Conclusions. Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.

  air temperatureair pollutioneffect modificationepidemiologymortality

  
  
• Díaz-Poso A, Lorenzo N, Martí A, Royé D (2023). Cold wave intensity on the Iberian Peninsula: Future climate projections. Atmospheric Research, vol. 295, art. no. 107011. 10.1016/j.atmosres.2023.107011.

  
  In the context of global warming, cold waves have generated less interest in the scientific community than heat waves, despite their impacts on public health, transport infrastructures and energy consumption. The present study analyses climate change scenarios with simulations of the EURO-CORDEX project, using the Excess Cold Factor (ECF) index for the Iberian Peninsula and Balearic Islands (IPB). The dimensions of intensity, frequency, duration and spatial extent are evaluated for the near future (2021–2050) with respect to the historical period of reference (1971–2000). The projections show a significant overall decrease in all dimensions. The mean change in maximum cold wave intensity is −50% over most of the IPB as a whole in the near future (2021–2050). The largest changes occur in the interior of the Peninsula, where the decrease is around −100%. The annual mean number of cold wave days decreases for the IPB as a whole by −50% compared to 1971–2000, with the maximum extent decreasing by more than the mean, with decreases of between −2.4%/decade and − 5.5%/decade. Although a smaller number of cold waves suggests less human exposure, the acclimatisation of the population to higher temperatures will imply that cold waves will continue to pose a serious local threat.

  ecfcold waveintensityspatial extentclimate changefuture projections

  
  
• Uhl J, Royé D, Burghardt K, Aldrey Vázquez J, Borobio Sanchiz M, Leyk S (2023). HISDACES: historical settlement data compilation for Spain (1900–2020). Earth System Science Data, vol. 15(10), pp. 4713-4747. 10.5194/essd-15-4713-2023.

  
  Multi-temporal measurements quantifying the changes to the Earth’s surface are critical for understanding many natural, anthropogenic, and social processes. Researchers typically use remotely sensed Earth observation data to quantify and characterize such changes in land use and land cover (LULC). However, such data sources are limited in their availability prior to the 1980s. While an observational window of 40 to 50 years is sufficient to study most recent LULC changes, processes such as urbanization, land development, and the evolution of urban and coupled nature–human systems often operate over longer time periods covering several decades or even centuries. Thus, to quantify and better understand such processes, alternative historical–geospatial data sources are required that extend farther back in time. However, such data are rare, and processing is labor-intensive, often involving manual work. To overcome the resulting lack in quantitative knowledge of urban systems and the built environment prior to the 1980s, we leverage cadastral data with rich thematic property attribution, such as building usage and construction year. We scraped, harmonized, and processed over 12 000 000 building footprints including construction years to create a multi-faceted series of gridded surfaces, describing the evolution of human settlements in Spain from 1900 to 2020, at 100 m spatial and 5-year temporal resolution. These surfaces include measures of building density, built-up intensity, and built-up land use. We evaluated our data against a variety of data sources including remotely sensed human settlement data and land cover data, model-based historical land use depictions, and historical maps and historical aerial imagery and find high levels of agreement. This new data product, the Historical Settlement Data Compilation for Spain (HISDAC-ES), is publicly available (https://doi.org/10.6084/m9.figshare.22009643, Uhl et al., 2023a) and represents a rich source for quantitative, long-term analyses of the built environment and related processes over large spatial and temporal extents and at fine resolutions.

  historical settlement dataspainland use and land coverurbanizationgeospatial analysis

  
  
• Tobías A, Íñiguez C, Royé D (2023). From Research to the Development of an Innovative Application for Monitoring HeatRelated Mortality in Spain. Environment & Health, vol. 1(6). 10.1021/envhealth.3c00134.

  
  Exposure to heat poses a major threat to high-risk populations by substantially contributing to increased mortality and morbidity. Heat-related mortality has been a significant concern since the summer of 2003, when Europe experienced a heatwave, leading to an excess of more than 70,000 deaths during the summer months, with 3,166 of those occurring in Spain. Heat-health early warning systems can reduce the burden of high ambient temperatures. However, the evidence of their effectiveness is limited. Therefore, developing innovative tools for real-time monitoring and forecast of health impacts from heat becomes essential for effective public health interventions and resource allocation strategies. We developed a user-friendly and accessible tool for monitoring heat-attributable mortality in Spain during the summer season between June and August. https://ficlima.shinyapps.io/mace/

  heat-related mortalityinnovative applicationreal-time monitoringpublic healthspain

  
  
• Liu C, Chen R, Sera F, Vicedo-Cabrera A, Guo Y, Tong S, Lavigne E, Correa P, Ortega N, Achilleos S, Royé D, Jaakkola J, Ryti N, Pascal M, Schneider A, Breitner S, Entezari A, Mayvaneh F, Raz R, Honda Y, Hashizume M, Ng C, Gaio V, Madureira J, Holobaca I, Tobias A, Íñiguez C, Guo Y, Pan S, Masselot P, Bell M, Zanobetti A, Schwartz J, Gasparrini A, Kan H (2023). Interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities: two stage time series analysis. BMJ, vol. 383, art. no. e075203. 10.1136/bmj-2023-075203.

  
  Objective: To investigate potential interactive effects of fine particulate matter (PM2.5) and ozone (O3) on daily mortality at global level. Design: Two stage time series analysis. Setting: 372 cities across 19 countries and regions. Population: Daily counts of deaths from all causes, cardiovascular disease, and respiratory disease. Main outcome measure: Daily mortality data during 1994-2020. Stratified analyses by co-pollutant exposures and synergy index (>1 denotes the combined effect of pollutants is greater than individual effects) were applied to explore the interaction between PM2.5 and O3 in association with mortality. Results: During the study period across the 372 cities, 19.3 million deaths were attributable to all causes, 5.3 million to cardiovascular disease, and 1.9 million to respiratory disease. The risk of total mortality for a 10 μg/m3 increment in PM2.5 (lag 0-1 days) ranged from 0.47% (95% confidence interval 0.26% to 0.67%) to 1.25% (1.02% to 1.48%) from the lowest to highest fourths of O3 concentration; and for a 10 μg/m3 increase in O3 ranged from 0.04% (-0.09% to 0.16%) to 0.29% (0.18% to 0.39%) from the lowest to highest fourths of PM2.5 concentration, with significant differences between strata (P for interaction <0.001). A significant synergistic interaction was also identified between PM2.5 and O3 for total mortality, with a synergy index of 1.93 (95% confidence interval 1.47 to 3.34). Subgroup analyses showed that interactions between PM2.5 and O3 on all three mortality endpoints were more prominent in high latitude regions and during cold seasons. Conclusion: The findings of this study suggest a synergistic effect of PM2.5 and O3 on total, cardiovascular, and respiratory mortality, indicating the benefit of coordinated control strategies for both pollutants.

  fine particulate matter (pm2.5)ozone (o3)daily mortalitytwo-stage time seriessynergistic effects

  
  
• Lüthi S, Fairless C, Fischer EM, Scovronick N, Armstrong B, De Sousa Zanotti Stagliorio Coelho M, Guo YL, Guo Y, Honda Y, Huber V, Kyselý J, Lavigne E, Royé D, Ryti N, Silva S, Urban A, Gasparrini A, Bresch DN, Vicedo-Cabrera AM (2023). Rapid increase in the risk of heatrelated mortality. Nature Communications, vol. 14, art. no. 4894. 10.1038/s41467-023-40599-x.

  
  Heat-related mortality has been identified as one of the key climate extremes posing a risk to human health. Current research focuses largely on how heat mortality increases with mean global temperature rise, but it is unclear how much climate change will increase the frequency and severity of extreme summer seasons with high impact on human health. In this probabilistic analysis, we combined empirical heat-mortality relationships for 748 locations from 47 countries with climate model large ensemble data to identify probable past and future highly impactful summer seasons. Across most locations, heat mortality counts of a 1-in-100 year season in the climate of 2000 would be expected once every ten to twenty years in the climate of 2020. These return periods are projected to further shorten under warming levels of 1.5 °C and 2 °C, where heat-mortality extremes of the past climate will eventually become commonplace if no adaptation occurs. Our findings highlight the urgent need for strong mitigation and adaptation to reduce impacts on human lives.

  extreme heatclimate changeheatwavespublic healthrisk assessment

  
  
• Huang W, Li S, Vogt T, Xu R, Tong S, Molina T, Masselot P, Gasparrini A, Armstrong B, Pascal M, Royé D, Sheng Ng C, Vicedo-Cabrera A, Schwartz J, Lavigne E, Kan H, Goodman P, Zeka A, Hashizume M, Diaz M, De la Cruz Valencia C, Seposo X, Nunes B, Madureira J, Kim H, Lee W, Tobias A, Íñiguez C, Guo Y, Pan S, Zanobetti A, Dang T, Van Dung D, Geiger T, Otto C, Johnson A, Hales S, Yu P, Yang Z, Ritchie E, Guo Y (2023). Global shortterm mortality risk and burden associated with tropical cyclones from 1980 to 2019: a multicountry timeseries study. The Lancet Planetary Health, vol. 7(8), pp. e694-e705. 10.1016/S2542-5196(23)00143-2.

  
  Background. The global spatiotemporal pattern of mortality risk and burden attributable to tropical cyclones is unclear. We aimed to evaluate the global short-term mortality risk and burden associated with tropical cyclones from 1980 to 2019. Methods. The wind speed associated with cyclones from 1980 to 2019 was estimated globally through a parametric wind field model at a grid resolution of 0·5° × 0·5°. A total of 341 locations with daily mortality and temperature data from 14 countries that experienced at least one tropical cyclone day (a day with maximum sustained wind speed associated with cyclones ≥17·5 m/s) during the study period were included. A conditional quasi-Poisson regression with distributed lag non-linear model was applied to assess the tropical cyclone–mortality association. A meta-regression model was fitted to evaluate potential contributing factors and estimate grid cell-specific tropical cyclone effects. Findings. Tropical cyclone exposure was associated with an overall 6% (95% CI 4–8) increase in mortality in the first 2 weeks following exposure. Globally, an estimate of 97 430 excess deaths (95% empirical CI [eCI] 71 651–126 438) per decade were observed over the 2 weeks following exposure to tropical cyclones, accounting for 20·7 (95% eCI 15·2–26·9) excess deaths per 100 000 residents (excess death rate) and 3·3 (95% eCI 2·4–4·3) excess deaths per 1000 deaths (excess death ratio) over 1980–2019. The mortality burden exhibited substantial temporal and spatial variation. East Asia and south Asia had the highest number of excess deaths during 1980–2019: 28 744 (95% eCI 16 863–42 188) and 27 267 (21 157–34 058) excess deaths per decade, respectively. In contrast, the regions with the highest excess death ratios and rates were southeast Asia and Latin America and the Caribbean. From 1980–99 to 2000–19, marked increases in tropical cyclone-related excess death numbers were observed globally, especially for Latin America and the Caribbean and south Asia. Grid cell-level and country-level results revealed further heterogeneous spatiotemporal patterns such as the high and increasing tropical cyclone-related mortality burden in Caribbean countries or regions. Interpretation. Globally, short-term exposure to tropical cyclones was associated with a significant mortality burden, with highly heterogeneous spatiotemporal patterns. In-depth exploration of tropical cyclone epidemiology for those countries and regions estimated to have the highest and increasing tropical cyclone-related mortality burdens is urgently needed to help inform the development of targeted actions against the increasing adverse health impacts of tropical cyclones under a changing climate.

  tropical cyclonesshort-term mortalityglobal burden,time-series analysisspatiotemporal patterns

  
  
• Díaz-Poso A, Royé D, Martínez-Ibarra E (2023). Turismo y Cambio Climático: Aplicación del Holiday Climate Index (HCI:Urban) en España en los meses de verano para mediados y finales de siglo. Investigaciones Turísticas, vol. 26. 10.14198/inturi.23493.

  
  En las últimas décadas el turismo ha adquirido una importancia cada vez mayor en la economía española. Con 83,5 millones de turistas en 2019, el 11.7% del PIB nacional proviene del sector turístico. El clima es uno de los principales aspectos a tener en cuenta por las personas para elegir un destino turístico. El índice Holiday Climate Index (HCI) es un indicador bioclimático que tiene en cuenta diferentes variables climáticas (temperatura, precipitación, humedad, viento y nubosidad), con el fin de determinar si las condiciones climáticas son adecuadas para las actividades turísticas de carácter urbano. Utilizando el HCI:Urban, se ha analizado la evolución de los niveles de confortabilidad climática para la Península y Baleares (PB) en verano (junio, julio y agosto) para mediados (2041-2060) y finales de siglo (2081-2100) bajo los escenarios climáticos RCP 4.5 y 8.5. Tomando como referencia el periodo 1986-2005, los resultados indican un aumento considerable del confort climático especialmente a finales de siglo en las comunidades autónomas del norte y noroeste del país, donde los valores, alcanzan la calificación de “excelente” (HCI 80-90). Paralelamente, la progresiva pérdida de confort a consecuencia del cambio climático en comunidades autónomas meridionales como Extremadura, Murcia, Andalucía e Islas Baleares, dará lugar a cambios en la distribución espacio-temporal de los flujos turísticos. Pese a que su formulación es susceptible de mejora, los datos proporcionados por el índice HCI:Urban pueden ser útiles en el desarrollo de instrumentos de planificación urbana, facilitando a las autoridades la toma de decisiones en un nuevo contexto turístico.

  hci (holiday climate index)cambio climáticoconfort climáticoturismoespaña.

  
  
• Lo Y, Mitchell D, Buzan J, Zscheischler J, Schneider R, Mistry M, Kyselý J, Lavigne É, da Silva S, Royé D, Urban A, Armstrong B, Gasparrini A, Vicedo‐Cabrera A (2023). Optimal heat stress metric for modelling heat‐related mortality varies from country to country. International Journal of Climatology, vol. 43(12), pp. 5553-5568. 10.1002/joc.8160.

  
  Combined heat and humidity is frequently described as the main driver of human heat-related mortality, more so than dry-bulb temperature alone. While based on physiological thinking, this assumption has not been robustly supported by epidemiological evidence. By performing the first systematic comparison of eight heat stress metrics (i.e., temperature combined with humidity and other climate variables) with warm-season mortality, in 604 locations over 39 countries, we find that the optimal metric for modelling mortality varies from country to country. Temperature metrics with no or little humidity modification associates best with mortality in ~40% of the studied countries. Apparent temperature (combined temperature, humidity and wind speed) dominates in another 40% of countries. There is no obvious climate grouping in these results. We recommend, where possible, that researchers use the optimal metric for each country. However, dry-bulb temperature performs similarly to humidity-based heat stress metrics in estimating heat-related mortality in present-day climate.

  heat stress metricsheat-related mortalitycountry-specific analysisclimate variablesepidemiological evidence

  
  
• Gestal Romaní S, Figueiras A, Royé D (2023). Effect of Temperature on Emergency Ambulance CallOuts for Cardiovascular Causes: A Scoping Review. Environment & Health, vol. 1(1). 10.1021/envhealth.3c00003.

  
  Climate change has increased interest in the effects of the thermal environment on cardiovascular health. Most studies have focused on mortality data. However, pre-hospital care data are better able to evaluate these effects, as they can register the full spectrum of the disease in real time. This scoping review aims to synthesize the epidemiological evidence regarding the effects of the thermal environment on cardiovascular morbidity in the pre-hospital setting, evaluated through ambulance calls. A staged literature search was performed using the PubMed database for the period between 1st January 2000 and 30th March 2023, using the MeSH terms “Weather” AND “Emergency Medical Services”. A total of 987 publications were identified that examined the correlation between the thermal environment and ambulance call-outs for cardiovascular causes. The studies were mostly ecological time series, with significant variability in the methodological aspects employed. An increase in the number of ambulance call-outs has been observed in association with low temperatures, both for overall cardiovascular pathologies and for certain pathological subtypes. For high temperatures, no effect has been observed in overall call-outs, although an increase has been observed during heat waves. The demand for ambulances for cardiac arrests is increased by both low and high temperatures and during heat waves. Ambulance call-outs for cardiovascular causes increase with low temperatures and heat waves, with no significant increase in the overall demand associated with high temperatures. Ambulance call-outs for cardiac arrests are the only subtype that is increased by high temperatures.

  cardiovascular diseasesweathercold exposureheat exposure ambulance call-outemergency medical services

  
  
• O’Brien E, Masselot P, Sera F, Royé D, Breitner S, Ng C, de Sousa Zanotti Stagliorio Coelho M, Madureira J, Tobias A, Vicedo-Cabrera A, Bell M, Lavigne E, Kan H, Gasparrini (2023). ShortTerm Association between Sulfur Dioxide and Mortality: A Multicountry Analysis in 399 Cities. Environmental Health Perspectives, vol. 131(3). 10.1289/ehp11112.

  
  Background: Epidemiological evidence on the health risks of sulfur dioxide (SO2) is more limited compared with other pollutants, and doubts remain on several aspects, such as the form of the exposure–response relationship, the potential role of copollutants, as well as the actual risk at low concentrations and possible temporal variation in risks. Objectives: Our aim was to assess the short-term association between exposure to SO2 and daily mortality in a large multilocation data set, using advanced study designs and statistical techniques. Methods: The analysis included 43,729,018 deaths that occurred in 399 cities within 23 countries between 1980 and 2018. A two-stage design was applied to assess the association between the daily concentration of SO2 and mortality counts, including first-stage time-series regressions and second-stage multilevel random-effect meta-analyses. Secondary analyses assessed the exposure–response shape and the lag structure using spline terms and distributed lag models, respectively, and temporal variations in risk using a longitudinal meta-regression. Bi-pollutant models were applied to examine confounding effects of particulate matter with an aerodynamic diameter of ≤10μ⁢m (PM10) and 2.5μ⁢m (PM2.5), ozone, nitrogen dioxide, and carbon monoxide. Associations were reported as relative risks (RRs) and fractions of excess deaths. Results: The average daily concentration of SO2 across the 399 cities was 11⁢.7⁢ μ⁢g/m3, with 4.7% of days above the World Health Organization (WHO) guideline limit (40⁢ μ⁢g/m3, 24-h average), although the exceedances occurred predominantly in specific locations. Exposure levels decreased considerably during the study period, from an average concentration of 19.0 μ⁢g/m3 in 1980–1989 to 6.3⁢ μ⁢g/m3 in 2010–2018. For all locations combined, a 10-μ⁢g/m3 increase in daily SO2 was associated with an RR of mortality of 1.0045 [95% confidence interval (CI): 1.0019, 1.0070], with the risk being stable over time but with substantial between-country heterogeneity. Short-term exposure to SO2 was associated with an excess mortality fraction of 0.50% [95% empirical CI (eCI): 0.42%, 0.57%] in the 399 cities, although decreasing from 0.74% (0.61%, 0.85%) in 1980–1989 to 0.37% (0.27%, 0.47%) in 2010–2018. There was some evidence of nonlinearity, with a steep exposure–response relationship at low concentrations and the risk attenuating at higher levels. The relevant lag window was 0–3 d. Significant positive associations remained after controlling for other pollutants. Discussion: The analysis revealed independent mortality risks associated with short-term exposure to SO2, with no evidence of a threshold. Levels below the current WHO guidelines for 24-h averages were still associated with substantial excess mortality, indicating the potential benefits of stricter air quality standards. https://doi.org/10.1289/EHP11112

  sulfur dioxide (so2)daily mortalitymulticountry analysisair pollutiontime-series study

  
  
• de Schrijver E, Royé D, Gasparrini A, Franco O, Vicedo-Cabrera A (2023). Exploring vulnerability to heat and cold across urban and rural populations in Switzerland. Environmental Research: Health, vol. 1(2), art. no. 25003. 10.1088/2752-5309/acab78.

  
  Heat- and cold-related mortality risks are highly variable across different geographies, suggesting a differential distribution of vulnerability factors between and within countries, which could partly be driven by urban-to-rural disparities. Identifying these drivers of risk is crucial to characterize local vulnerability and design tailored public health interventions to improve adaptation of populations to climate change. We aimed to assess how heat- and cold-mortality risks change across urban, peri-urban and rural areas in Switzerland and to identify and compare the factors associated with increased vulnerability within and between different area typologies. We estimated the heat- and cold-related mortality association using the case time-series design and distributed lag non-linear models over daily mean temperature and all-cause mortality series between 1990-2017 in each municipality in Switzerland. Then, through multivariate meta-regression, we derived pooled heat and cold-mortality associations by typology (i.e. urban/rural/peri-urban) and assessed potential vulnerability factors among a wealth of demographic, socioeconomic, topographic, climatic, land use and other environmental data. Urban clusters reported larger pooled heat-related mortality risk (at 99th percentile, vs. temperature of minimum mortality (MMT)) (relative risk=1.17(95%CI:1.10;1.24, vs peri-urban 1.03(1.00;1.06), and rural 1.03 (0.99;1.08)), but similar cold-mortality risk (at 1st percentile, vs. MMT) (1.35(1.28;1.43), vs rural 1.28(1.14;1.44) and peri-urban 1.39 (1.27-1.53)) clusters. We found different sets of vulnerability factors explaining the differential risk patterns across typologies. In urban clusters, mainly environmental factors (i.e. PM2.5) drove differences in heat-mortality association, while for peri-urban/rural clusters socio-economic variables were also important. For cold, socio-economic variables drove changes in vulnerability across all typologies, while environmental factors and ageing were other important drivers of larger vulnerability in peri-urban/rural clusters, with heterogeneity in the direction of the association. Our findings suggest that urban populations in Switzerland may be more vulnerable to heat, compared to rural locations, and different sets of vulnerability factors may drive these associations in each typology. Thus, future public health adaptation strategies should consider local and more tailored interventions rather than a one-size fits all approach. size fits all approach.

  vulnerabilityheatcoldurban-rural differencesswitzerland

  
  
• Díaz-Poso A, Lorenzo N, Royé D (2023). Spatiotemporal evolution of heat waves severity and expansion across the Iberian Peninsula and Balearic islands. Environmental Research, vol. 217, art. no. 114864. 10.1016/j.envres.2022.114864.

  
  In the current climate change scenario, heat waves have become one of the most concerning extreme climatic events, both because of their implications for human health and the economy, and because of their increase in intensity and frequency in recent decades. This work presents for the first time a climatological analysis of heat waves in the Iberian Peninsula and Balearic Archipelago (IPB) using the Excess Heat Factor index (EHF). This index considers the factor of intensity and the acclimatization process of human body in the study of heat waves. We focused on the intensity (also called severity), duration, frequency and spatial extension of heat waves in the IPB in the 1950–2020 period. The exceptional heat wave of August 2018 was approached in a similar way to further explore the usefulness of the EHF index. We found that the EHF index identified heat wave conditions 2 days earlier than indices that used only maximum temperatures. Results showed a significant increase in intensity, duration, frequency and spatial extension of heat waves for the whole IPB for 1950–2020 period. The average extent of heat waves increased by 4.0% per decade and the maximum extent by 4.1% per decade. This trend suggested a significant increase in human exposure, droughts, fire risk and energy demand in this region in the last decades.

  ehfintensityseverityheat waveextentduration

  
  
• Alahmad B, Khraishah H, Royé D, Vicedo-Cabrera A, Guo Y, Papatheodorou S, Achilleos S, Acquaotta F, Armstrong B, Bell M, Pan S, de Sousa Zanotti Stagliorio Coelho M, Colistro V, Dang T, Van Dung D, De’ Donato F, Entezari A, Guo Y, Hashizume M, Honda Y, Indermitte E, Íñiguez C, Jaakkola J, Kim H, Lavigne E, Lee W, Li S, Madureira J, Mayvaneh F, Orru H, Overcenco A, Ragettli M, Ryti N, Saldiva P, Scovronick N, Seposo X, Sera F, Silva S, Stafoggia M, Tobias A, Garshick E, Bernstein A, Zanobetti A, Schwartz J, Gasparrini A, Koutrakis P (2023). Associations Between Extreme Temperatures and Cardiovascular CauseSpecific Mortality: Results From 27 Countries. Circulation, vol. 147(1). 10.1161/circulationaha.122.061832.

  
  Background: Cardiovascular disease is the leading cause of death worldwide. Existing studies on the association between temperatures and cardiovascular deaths have been limited in geographic zones and have generally considered associations with total cardiovascular deaths rather than cause-specific cardiovascular deaths. Methods: We used unified data collection protocols within the Multi-Country Multi-City Collaborative Network to assemble a database of daily counts of specific cardiovascular causes of death from 567 cities in 27 countries across 5 continents in overlapping periods ranging from 1979 to 2019. City-specific daily ambient temperatures were obtained from weather stations and climate reanalysis models. To investigate cardiovascular mortality associations with extreme hot and cold temperatures, we fit case-crossover models in each city and then used a mixed-effects meta-analytic framework to pool individual city estimates. Extreme temperature percentiles were compared with the minimum mortality temperature in each location. Excess deaths were calculated for a range of extreme temperature days. Results: The analyses included deaths from any cardiovascular cause (32 154  935), ischemic heart disease (11 745 880), stroke (9 351 312), heart failure (3 673 723), and arrhythmia (670 859). At extreme temperature percentiles, heat (99th percentile) and cold (1st percentile) were associated with higher risk of dying from any cardiovascular cause, ischemic heart disease, stroke, and heart failure as compared to the minimum mortality temperature, which is the temperature associated with least mortality. Across a range of extreme temperatures, hot days (above 97.5th percentile) and cold days (below 2.5th percentile) accounted for 2.2 (95% empirical CI [eCI], 2.1–2.3) and 9.1 (95% eCI, 8.9–9.2) excess deaths for every 1000 cardiovascular deaths, respectively. Heart failure was associated with the highest excess deaths proportion from extreme hot and cold days with 2.6 (95% eCI, 2.4–2.8) and 12.8 (95% eCI, 12.2–13.1) for every 1000 heart failure deaths, respectively. Conclusions: Across a large, multinational sample, exposure to extreme hot and cold temperatures was associated with a greater risk of mortality from multiple common cardiovascular conditions. The intersections between extreme temperatures and cardiovascular health need to be thoroughly characterized in the present day—and especially under a changing climate.

  cardiovascular mortalityextreme temperaturesheatcoldmulti-country analysis

  
  
• Nottmeyer L, Armstrong B, Lowe R, Abbott S, Meakin S, O’Reilly K, von Borries R, Schneider R, Royé D, Hashizume M, Pascal M, Tobias A, Vicedo-Cabrera A, Lavigne E, Correa P, Ortega N, Kynčl J, Urban A, Orru H, Ryti N, Jaakkola J, Dallavalle M, Schneider A, Honda Y, Ng C, Alahmad B, Carrasco-Escobar G, Holobâc I, Kim H, Lee W, Íñiguez C, Bell M, Zanobetti A, Schwartz J, Scovronick N, Coélho M, Saldiva P, Diaz M, Gasparrini A, Sera F (2023). The association of COVID19 incidence with temperature, humidity, and UV radiation – A global multicity analysis. Science of The Total Environment, vol. 854, art. no. 158636. 10.1016/j.scitotenv.2022.158636.

  
  Background and aim. The associations between COVID-19 transmission and meteorological factors are scientifically debated. Several studies have been conducted worldwide, with inconsistent findings. However, often these studies had methodological issues, e.g., did not exclude important confounding factors, or had limited geographic or temporal resolution. Our aim was to quantify associations between temporal variations in COVID-19 incidence and meteorological variables globally. Methods. We analysed data from 455 cities across 20 countries from 3 February to 31 October 2020. We used a time-series analysis that assumes a quasi-Poisson distribution of the cases and incorporates distributed lag non-linear modelling for the exposure associations at the city-level while considering effects of autocorrelation, long-term trends, and day of the week. The confounding by governmental measures was accounted for by incorporating the Oxford Governmental Stringency Index. The effects of daily mean air temperature, relative and absolute humidity, and UV radiation were estimated by applying a meta-regression of local estimates with multi-level random effects for location, country, and climatic zone. Results. We found that air temperature and absolute humidity influenced the spread of COVID-19 over a lag period of 15 days. Pooling the estimates globally showed that overall low temperatures (7.5 °C compared to 17.0 °C) and low absolute humidity (6.0 g/m3 compared to 11.0 g/m3) were associated with higher COVID-19 incidence (RR temp =1.33 with 95%CI: 1.08; 1.64 and RR AH =1.33 with 95%CI: 1.12; 1.57). RH revealed no significant trend and for UV some evidence of a positive association was found. These results were robust to sensitivity analysis. However, the study results also emphasise the heterogeneity of these associations in different countries. Conclusion. Globally, our results suggest that comparatively low temperatures and low absolute humidity were associated with increased risks of COVID-19 incidence. However, this study underlines regional heterogeneity of weather-related effects on COVID-19 transmission.

  temperaturehumidityuv radiationcovid-19distributed lag non-linear modellingglobal analysis

  
  

2022

• Tobías A, Royé D, Iñiguez C (2022). Heatattributable Mortality in the Summer of 2022 in Spain. Epidemiology, vol. 34(2), pp. e5-e6. 10.1097/ede.0000000000001583.

  
  The article examines heat-attributable mortality during the summer of 2022 in Spain, a period marked by exceptionally high temperatures. Using Poisson regression models with non-linear distributions, deaths attributable to moderate and extreme heat were estimated. In June, July, and August, temperatures exceeded extreme heat thresholds multiple times, resulting in a significant increase in mortality. The study highlights the importance of clearly defining reference scenarios to assess the impact of heat on health and underscores the need for adaptation measures to mitigate the effects of climate change.

  mortalityextreme heatsummer 2022spaintemperature

  
  
• Choi H, Lee W, Royé D, Heo S, Urban A, Entezari A, Vicedo-Cabrera A, Zanobetti A, Gasparrini A, Analitis A, Tobias A, Armstrong B, Forsberg B, Íñiguez C, Åström C, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, Sera F, Orru H, Kim H, Kyselý J, Madueira J, Schwartz J, Jaakkola J, Katsouyanni K, Diaz M, Ragettli M, Pascal M, Ryti N, Scovronick N, Osorio S, Tong S, Seposo X, Guo Y, Guo Y, Bell M (2022). Effect modification of greenness on the association between heat and mortality: A multicity multicountry study. eBioMedicine, vol. 84, art. no. 104251. 10.1016/j.ebiom.2022.104251.

  
  Background. Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. Methods. We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. Findings. Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. Interpretation. Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change.

  green spacesheat mortalityurbanizationclimate changepublic health

  
  
• Wu Y, Li S, Zhao Q, Wen B, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera A, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan S, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de’Donato F, Rao S, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca I, Kyselý J, Madureira J, Schwartz J, Jaakkola J, Katsouyanni K, Hurtado Diaz M, Ragettli M, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Ortega N, Ryti N, Scovronick N, Michelozzi P, Correa P, Goodman P, Nascimento Saldiva P, Abrutzky R, Osorio S, Dang T, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo Y, Bell M, Guo Y (2022). Global, regional, and national burden of mortality associated with shortterm temperature variability from 2000–19: a threestage modelling study. The Lancet Planetary Health, vol. 6(5), pp. e410-e421. 10.1016/S2542-5196(22)00073-0.

  
  Background. Increased mortality risk is associated with short-term temperature variability. However, to our knowledge, there has been no comprehensive assessment of the temperature variability-related mortality burden worldwide. In this study, using data from the MCC Collaborative Research Network, we first explored the association between temperature variability and mortality across 43 countries or regions. Then, to provide a more comprehensive picture of the global burden of mortality associated with temperature variability, global gridded temperature data with a resolution of 0·5° × 0·5° were used to assess the temperature variability-related mortality burden at the global, regional, and national levels. Furthermore, temporal trends in temperature variability-related mortality burden were also explored from 2000–19. Methods. In this modelling study, we applied a three-stage meta-analytical approach to assess the global temperature variability-related mortality burden at a spatial resolution of 0·5° × 0·5° from 2000–19. Temperature variability was calculated as the SD of the average of the same and previous days’ minimum and maximum temperatures. We first obtained location-specific temperature variability related-mortality associations based on a daily time series of 750 locations from the Multi-country Multi-city Collaborative Research Network. We subsequently constructed a multivariable meta-regression model with five predictors to estimate grid-specific temperature variability related-mortality associations across the globe. Finally, percentage excess in mortality and excess mortality rate were calculated to quantify the temperature variability-related mortality burden and to further explore its temporal trend over two decades. Findings. An increasing trend in temperature variability was identified at the global level from 2000 to 2019. Globally, 1 753 392 deaths (95% CI 1 159 901–2 357 718) were associated with temperature variability per year, accounting for 3·4% (2·2–4·6) of all deaths. Most of Asia, Australia, and New Zealand were observed to have a higher percentage excess in mortality than the global mean. Globally, the percentage excess in mortality increased by about 4·6% (3·7–5·3) per decade. The largest increase occurred in Australia and New Zealand (7·3%, 95% CI 4·3–10·4), followed by Europe (4·4%, 2·2–5·6) and Africa (3·3, 1·9–4·6). Interpretation. Globally, a substantial mortality burden was associated with temperature variability, showing geographical heterogeneity and a slightly increasing temporal trend. Our findings could assist in raising public awareness and improving the understanding of the health impacts of temperature variability.

  mortality burdentemperature variabilityclimate changeglobal analysispublic health

  
  
• Tedim F, Leone V, Lovreglio R, Xanthopoulos G, Chas-Amil M, Ganteaume A, Efe R, Royé D, Fuerst-Bjeliš B, Nikolov N, Musa S, Milenković M, Correia F, Conedera M, Boris Pezzatti G (2022). Forest Fire Causes and Motivations in the Southern and SouthEastern Europe through Experts’ Perception and Applications to Current Policies. Forests, vol. 13(4), art. no. 562. 10.3390/f13040562.

  
  Forest fires causes and motivations are poorly understood in southern and south-eastern Europe. This research aims to identify how experts perceive the different causes of forest fires as defined in the classification proposed by the European Commission in 2013. A panel of experts (N = 271) was gathered from the EU Southern Member States (France, Greece, Italy, Portugal, and Spain) and from Central (Switzerland) and south-eastern Europe (Croatia, Serbia, Bosnia and Herzegovina, Republic of North Macedonia, and Turkey). Experts were asked to answer a questionnaire to score the importance of the 29 fire causes using a five point (1–5) Likert Scale. Agricultural burnings received the highest score, followed by Deliberate fire for profit, and Vegetation management. Most of the events stem from Negligence, whereas malicious fire setting is arguably overestimated although there are differences among the countries. This research demonstrates the importance of different techniques to enhance the knowledge of the causes of the complex anthropogenic phenomenon of forest fire occurrence.

  delphi methodeffisforest fire causesforest fire motivationslikert scaleanthropogenic causes

  
  
• Mistry M, Schneider R, Masselot P, Royé D, Armstrong B, Kyselý J, Orru H, Sera F, Tong S, Lavigne É, Urban A, Madureira J, García-León D, Ibarreta D, Ciscar J, Feyen L, de Schrijver E, de Sousa Zanotti Stagliorio Coelho M, Pascal M, Tobias A, Alahmad B, Abrutzky R, Saldiva P, Correa P, Orteg N, Kan H, Osorio S, Indermitte E, Jaakkola J, Ryti N, Schneider A, Huber V, Katsouyanni K, Analitis A, Entezari A, Mayvaneh F, Michelozzi P, de’Donato F, Hashizume M, Kim Y, Diaz M, De la Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Seposo X, Nunes B, Holobaca I, Kim H, Lee W, Íñiguez C, Forsberg B, Åström C, Ragettli M, Guo Y, Chen B, Colistro V, Zanobetti A, Schwartz J, Dang T, Van Dung D, Guo Y, Vicedo-Cabrera A, Gasparrini A (2022). Comparison of weather station and climate reanalysis data for modelling temperaturerelated mortality. Scientific Reports, vol. 12, art. no. 5178. 10.1038/s41598-022-09049-4.

  
  Epidemiological analyses of health risks associated with non-optimal temperature are traditionally based on ground observations from weather stations that offer limited spatial and temporal coverage. Climate reanalysis represents an alternative option that provide complete spatio-temporal exposure coverage, and yet are to be systematically explored for their suitability in assessing temperature-related health risks at a global scale. Here we provide the first comprehensive analysis over multiple regions to assess the suitability of the most recent generation of reanalysis datasets for health impact assessments and evaluate their comparative performance against traditional station-based data. Our findings show that reanalysis temperature from the last ERA5 products generally compare well to station observations, with similar non-optimal temperature-related risk estimates. However, the analysis offers some indication of lower performance in tropical regions, with a likely underestimation of heat-related excess mortality. Reanalysis data represent a valid alternative source of exposure variables in epidemiological analyses of temperature-related risk.

  temperature-related mortalityweather stationsclimate reanalysishealth impact assessmentdata comparison

  
  
• Wu Y, Wen B, Li S, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera A, Zanobetti A, Analitis A, Zeka A, Tobias A, Alahmad B, Armstrong B, Forsberg B, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de’Donato F, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca I, Kyselý J, Madureira J, Schwartz J, Katsouyanni K, Hurtado-Diaz M, Ragettli M, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Scovronick N, Michelozzi P, Goodman P, Nascimento Saldiva P, Abrutzky R, Osorio S, Dang T, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Bell M, Guo Y (2022). Fluctuating temperature modifies heatmortality association around the globe. The Innovation, vol. 3(2), art. no. 100225. 10.1016/j.xinn.2022.100225.

  
  Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: −0.33 to 1.69), 1.34% (95% CI: −0.14 to 2.73), 1.99% (95% CI: 0.29–3.57), and 2.73% (95% CI: 0.76–4.50) of total deaths for Q1–Q4 (first quartile–fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25–9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: −0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.

  temperature variabilityheatmodification effectmortality

  
  

2021

• Royé D, Tobías A, Figueiras A, Gestal S, Taracido M, Santurtun A, Iñiguez C (2021). Temperaturerelated effects on respiratory medical prescriptions in Spain. Environmental Research, vol. 202, art. no. 111695. 10.1016/j.envres.2021.111695.

  
  Background. The increased risk of mortality during periods of high and low temperatures has been well established. However, most of the studies used daily counts of deaths or hospitalisations as health outcomes, although they are the ones at the top of the health impact pyramid reflecting only a limited proportion of patients with the most severe cases. Objectives. This study evaluates the relationship between short-term exposure to the daily mean temperature and medication prescribed for the respiratory system in five Spanish cities. Methods. We fitted time series regression models to cause-specific medical prescriptions, including different respiratory subgroups and age groups. We included a distributed lag non-linear model with lags up to 14 days for daily mean temperature. City-specific associations were summarised as overall-cumulative exposure-response curves. Results. We found a positive association between cause-specific medical prescriptions and daily mean temperature with a non-linear inverted J- or V-shaped relationship in most cities. Between 0.3% and 0.6% of all respiratory prescriptions were attributed to cold for Madrid, Zaragoza and Pamplona, while in cities with only cold effects the attributable fractions were estimated as 19.2% for Murcia and 13.5% for Santander. Heat effects in Madrid, Zaragoza and Pamplona showed higher fractions between 8.7% and 17.2%. The estimated costs are in general higher for heat effects, showing annual values ranging between €191,905 and €311,076 for heat per 100,000 persons. Conclusions. This study provides novel evidence of the effects of the thermal environment on the prescription of medication for respiratory disorders in Spain, showing that low and high temperatures lead to an increase in the number of such prescriptions. The consumption of medication can reflect exposure to the environment with a lesser degree of severity in terms of morbidity.

  medical prescriptionstemperaturerespiratoryexposurespaindrugs

  
  
• Sera F, Armstrong B, Abbott S, Meakin S, O’Reilly K, von Borries R, Schneider R, Royé D, Hashizume M, Pascal M, Tobias A, Vicedo-Cabrera A, Hu W, Tong S, Lavigne E, Correa P, Meng X, Kan H, Kynčl J, Urban A, Orru H, Ryti N, Jaakkola J, Cauchemez S, Dallavalle M, Schneider A, Zeka A, Honda Y, Ng C, Alahmad B, Rao S, Di Ruscio F, Carrasco-Escobar G, Seposo X, Holobâcă I, Kim H, Lee W, Íñiguez C, Ragettli M, Aleman A, Colistro V, Bell M, Zanobetti A, Schwartz J, Dang T, Scovronick N, de Sousa Zanotti Stagliorio Coélho M, Diaz M, Zhang Y, Russell T, Koltai M, Kucharski A, Barnard R, Quaife M, Jarvis C, Lei J, Munday J, Chan Y, Quilty B, Eggo R, Flasche S, Foss A, Clifford S, Tully D, Edmunds W, Klepac P, Brady O, Krauer F, Procter S, Jombart T, Rosello A, Showering A, Funk S, Hellewell J, Sun F, Endo A, Williams J, Gimma A, Waterlow N, Prem K, Bosse N, Gibbs H, Atkins K, Pearson C, Jafari Y, Villabona-Arenas C, Jit M, Nightingale E, Davies N, van Zandvoort K, Liu Y, Sandmann F, Waites W, Abbas K, Medley G, Knight G, Gasparrini A, Lowe R (2021). A crosssectional analysis of meteorological factors and SARSCoV2 transmission in 409 cities across 26 countries. Nature Communications, vol. 12, art. no. 5968. 10.1038/s41467-021-25914-8.

  
  There is conflicting evidence on the influence of weather on COVID-19 transmission. Our aim is to estimate weather-dependent signatures in the early phase of the pandemic, while controlling for socio-economic factors and non-pharmaceutical interventions. We identify a modest non-linear association between mean temperature and the effective reproduction number (Re) in 409 cities in 26 countries, with a decrease of 0.087 (95% CI: 0.025; 0.148) for a 10 °C increase. Early interventions have a greater effect on Re with a decrease of 0.285 (95% CI 0.223; 0.347) for a 5th - 95th percentile increase in the government response index. The variation in the effective reproduction number explained by government interventions is 6 times greater than for mean temperature. We find little evidence of meteorological conditions having influenced the early stages of local epidemics and conclude that population behaviour and government interventions are more important drivers of transmission.

  sars-cov-2 transmissionmeteorological factorstemperaturenon-pharmaceutical interventionsglobal analysis

  
  
• Tobías A, Hashizume M, Honda Y, Sera F, Ng C, Kim Y, Royé D, Chung Y, Dang T, Kim H, Lee W, Íñiguez C, Vicedo-Cabrera A, Abrutzky R, Guo Y, Tong S, Coelho M, Saldiva P, Lavigne E, Correa P, Ortega N, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola J, Ryti N, Pascal M, Huber V, Schneider A, Katsouyanni K, Analitis A, Entezari A, Mayvaneh F, Goodman P, Zeka A, Michelozzi P, de’Donato F, Alahmad B, Diaz M, De la Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Di Ruscio F, Carrasco G, Seposo X, Nunes B, Madureira J, Holobaca I, Scovronick N, Acquaotta F, Forsberg B, Åström C, Ragettli M, Guo Y, Chen B, Li S, Colistro V, Zanobetti A, Schwartz J, Dung D, Armstrong B, Gasparrini A (2021). Geographical Variations of the Minimum Mortality Temperature at a Global Scale. Environmental Epidemiology, vol. 5(5), art. no. e169. 10.1097/EE9.0000000000000169.

  
  Background: Minimum mortality temperature (MMT) is an important indicator to assess the temperature-mortality association, indicating long-term adaptation to local climate. Limited evidence about the geographical variability of the MMT is available at a global scale. Methods: We collected data from 658 communities in 43 countries under different climates. We estimated temperature-mortality associations to derive the MMT for each community using Poisson regression with distributed lag nonlinear models. We investigated the variation in MMT by climatic zone using a mixed-effects meta-analysis and explored the association with climatic and socioeconomic indicators. Results: The geographical distribution of MMTs varied considerably by country between 14.2 and 31.1 °C decreasing by latitude. For climatic zones, the MMTs increased from alpine (13.0 °C) to continental (19.3 °C), temperate (21.7 °C), arid (24.5 °C), and tropical (26.5 °C). The MMT percentiles (MMTPs) corresponding to the MMTs decreased from temperate (79.5th) to continental (75.4th), arid (68.0th), tropical (58.5th), and alpine (41.4th). The MMTs indreased by 0.8 °C for a 1 °C rise in a community’s annual mean temperature, and by 1 °C for a 1 °C rise in its SD. While the MMTP decreased by 0.3 centile points for a 1 °C rise in a community’s annual mean temperature and by 1.3 for a 1 °C rise in its SD. Conclusions: The geographical distribution of the MMTs and MMTPs is driven mainly by the mean annual temperature, which seems to be a valuable indicator of overall adaptation across populations. Our results suggest that populations have adapted to the average temperature, although there is still more room for adaptation.

  adaptationclimatedistributed lag nonlinear modelsminimum mortality temperaturemulti-citymulti-countrytime-series

  
  
• Chen G, Guo Y, Yue X, Tong S, Gasparrini A, Bell M, Armstrong B, Schwartz J, Jaakkola J, Zanobetti A, Lavigne E, Nascimento Saldiva P, Kan H, Royé D, Milojevic A, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera A, Zeka A, Tobias A, Nunes B, Alahmad B, Forsberg B, Pan S, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Van Dung D, Samoli E, Mayvaneh F, Sera F, Carrasco-Escobar G, Lei Y, Orru H, Kim H, Holobaca I, Kyselý J, Teixeira J, Madureira J, Katsouyanni K, Hurtado-Díaz M, Maasikmets M, Ragettli M, Hashizume M, Stafoggia M, Pascal M, Scortichini M, de Sousa Zanotti Stagliorio Coêlho M, Valdés Ortega N, Ryti N, Scovronick N, Matus P, Goodman P, Garland R, Abrutzky R, Garcia S, Rao S, Fratianni S, Dang T, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo Y, Ye T, Yu W, Abramson M, Samet J, Li S (2021). Mortality risk attributable to wildfire related PM2·5 pollution: a global time series study in 749 locations. The Lancet Planetary Health, vol. 5(9), pp. e579-e587. 10.1016/S2542-5196(21)00200-X.

  
  ackground. Many regions of the world are now facing more frequent and unprecedentedly large wildfires. However, the association between wildfire-related PM2·5 and mortality has not been well characterised. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2·5 and mortality across various regions of the world. Methods. For this time series study, data on daily counts of deaths for all causes, cardiovascular causes, and respiratory causes were collected from 749 cities in 43 countries and regions during 2000–16. Daily concentrations of wildfire-related PM2·5 were estimated using the three-dimensional chemical transport model GEOS-Chem at a 0·25° × 0·25° resolution. The association between wildfire-related PM2·5 exposure and mortality was examined using a quasi-Poisson time series model in each city considering both the current-day and lag effects, and the effect estimates were then pooled using a random-effects meta-analysis. Based on these pooled effect estimates, the population attributable fraction and relative risk (RR) of annual mortality due to acute wildfire-related PM2·5 exposure was calculated. Findings. 65·6 million all-cause deaths, 15·1 million cardiovascular deaths, and 6·8 million respiratory deaths were included in our analyses. The pooled RRs of mortality associated with each 10 μg/m3 increase in the 3-day moving average (lag 0–2 days) of wildfire-related PM2·5 exposure were 1·019 (95% CI 1·016–1·022) for all-cause mortality, 1·017 (1·012–1·021) for cardiovascular mortality, and 1·019 (1·013–1·025) for respiratory mortality. Overall, 0·62% (95% CI 0·48–0·75) of all-cause deaths, 0·55% (0·43–0·67) of cardiovascular deaths, and 0·64% (0·50–0·78) of respiratory deaths were annually attributable to the acute impacts of wildfire-related PM2·5 exposure during the study period. Interpretation. Short-term exposure to wildfire-related PM2·5 was associated with increased risk of mortality. Urgent action is needed to reduce health risks from the increasing wildfires.

  wildfire-related pm2.5mortality riskglobal analysiscardiovascular mortality respiratory mortality

  
  
• Lorenzo N, Díaz-Poso A, Royé D (2021). Heatwave intensity on the Iberian Peninsula: Future climate projections. Atmospheric Research, vol. 258(15), art. no. 105655. 10.1016/j.atmosres.2021.105655.

  
  Heatwaves are the most relevant extreme climatic events, particularly in the context of global warming and the related increasing impacts on society and the natural environment. This work presents an analysis of climate change scenarios with simulations from the EURO-CORDEX project using the excess heat factor over the Iberian Peninsula. We focus on climate change projections of the heatwave intensity and spatial distribution, which are evaluated for the near future (2021–2050) relative to a reference past climate (1971–2000). Heatwave projections show a general significant increase in intensity, frequency, duration and spatial extent for the whole region. The average change in heatwave intensity is 104% for the whole Iberian Peninsula for the near future 2021–2050. The largest changes occur in the eastern-central region, rising to 150% for the Mediterranean coast and the Pyrenees. The greater spatial extent of heatwaves strongly suggests increased human exposure, increased energy demand, and implications for fire risk. This spatial trend is predicted to continue in the near future with increases in the maximum spatial heatwave extent ranging from 6% to 8% per decade.

  heatwavesclimate changeiberian peninsulatemperature projectionsextreme weather

  
  
• Mathbout S, Lopez-Bustins J, Royé D, Martin-Vide J (2021). MediterraneanScale Drought: Regional Datasets for Exceptional Meteorological Drought Events during 1975–2019. Atmosphere, vol. 12(8), art. no. 941. 10.3390/atmos12080941.

  
  Drought is one of the most complex climate-related phenomena and is expected to progressively affect our lives by causing very serious environmental and socioeconomic damage by the end of the 21st century. In this study, we have extracted a dataset of exceptional meteorological drought events between 1975 and 2019 at the country and subregional scales. Each drought event was described by its start and end date, intensity, severity, duration, areal extent, peak month and peak area. To define such drought events and their characteristics, separate analyses based on three drought indices were performed at 12-month timescale: the Standardized Precipitation Index (SPI), the Standardized Precipitation Evapotranspiration Index (SPEI), and the Reconnaissance Drought Index (RDI). A multivariate combined drought index (DXI) was developed by merging the previous three indices for more understanding of droughts’ features at the country and subregional levels. Principal component analysis (PCA) was used to identify five different drought subregions based on DXI-12 values for 312 Mediterranean stations and a new special score was defined to classify the multi-subregional exceptional drought events across the Mediterranean Basin (MED). The results indicated that extensive drought events occurred more frequently since the late 1990s, showing several drought hotspots in the last decades in the southeastern Mediterranean and northwest Africa. In addition, the results showed that the most severe events were more detected when more than single drought index was used. The highest percentage area under drought was also observed through combining the variations of three drought indices. Furthermore, the drought area in both dry and humid areas in the MED has also experienced a remarkable increase since the late 1990s. Based on a comparison of the drought events during the two periods—1975–1996 and 1997–2019—we find that the current dry conditions in the MED are more severe, intense, and frequent than the earlier period; moreover, the strongest dry conditions occurred in last two decades. The SPEI-12 and RDI-12 have a higher capacity in providing a more comprehensive description of the dry conditions because of the inclusion of temperature or atmospheric evaporative demand in their scheme. A complex range of atmospheric circulation patterns, particularly the Western Mediterranean Oscillation (WeMO) and East Atlantic/West Russia (EATL/WRUS), appear to play an important role in severe, intense and region-wide droughts, including the two most severe droughts, 1999–2001 and 2007–2012, with lesser influence of the NAO, ULMO and SCAND.

  climate changedrought eventmediterranean basinmeteorological droughtspeispirdidxi

  
  
• Martí Ezpeleta A, Royé D (2021). Intensidad y duración del estrés térmico en verano en el área urbana de Madrid. Geographicalia, vol. 73. 10.26754/ojs_geoph/geoph.2021735202.

  
  En este trabajo se aplica una metodología nueva al estudio de las noches calurosas, también denominadas “tropicales”, en el área metropolitana de Madrid, de cara a evaluar desde una perspectiva temporal y espacial aquellas noches en las que la población pueda verse afectada por estrés térmico. La utilización de dos indicadores obtenidos a través de datos horarios, junto a la información climática suministrada por el modelo UrbClim, ha permitido conocer a una escala de detalle las características térmicas de las noches del mes de julio entre 2008 y 2017, pudiendo así evaluar con más precisión el riesgo para el bienestar y la salud de la población. Los resultados muestran una gran variabilidad interurbana en cuanto a intensidad y duración del estrés térmico, así como una correlación significativa entre las intensidades de la isla de calor y los índices de exceso de calor. Asimismo se ha comprobado la existencia de una estrecha relación entre las tipologías de usos del suelo y estructuras urbanas definidas en el Urban Atlas, y los índices de exceso de calor nocturno.

  noche calurosaestrés térmicoisla de calorurbclimmadrid

  
  
• Zhao Q, Guo Y, Ye T, Gasparrini A, Tong S, Overcenco A, Urban A, Schneider A, Entezari A, Vicedo-Cabrera A, Zanobetti A, Analitis A, Zeka A, Tobias A, Nunes B, Alahmad B, Armstrong B, Forsberg B, Pan S, Íñiguez C, Ameling C, De la Cruz Valencia C, Åström C, Houthuijs D, Dung D, Royé D, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, de’Donato F, Di Ruscio F, Sera F, Carrasco-Escobar G, Kan H, Orru H, Kim H, Holobaca I, Kyselý J, Madureira J, Schwartz J, Jaakkola J, Katsouyanni K, Hurtado Diaz M, Ragettli M, Hashizume M, Pascal M, de Sousa Zanotti Stagliorio Coélho M, Valdés Ortega N, Ryti N, Scovronick N, Michelozzi P, Matus Correa P, Goodman P, Nascimento Saldiva P, Abrutzky R, Osorio S, Rao S, Fratianni S, Dang T, Colistro V, Huber V, Lee W, Seposo X, Honda Y, Guo Y, Bell M, Li S (2021). Global, regional, and national burden of mortality associated with nonoptimal ambient temperatures from 2000 to 2019: a threestage modelling study. The Lancet Planetary Health, vol. 5(7), pp. e415-e425. 10.1016/S2542-5196(21)00081-4.

  
  Background. Exposure to cold or hot temperatures is associated with premature deaths. We aimed to evaluate the global, regional, and national mortality burden associated with non-optimal ambient temperatures. Methods. In this modelling study, we collected time-series data on mortality and ambient temperatures from 750 locations in 43 countries and five meta-predictors at a grid size of 0·5° × 0·5° across the globe. A three-stage analysis strategy was used. First, the temperature–mortality association was fitted for each location by use of a time-series regression. Second, a multivariate meta-regression model was built between location-specific estimates and meta-predictors. Finally, the grid-specific temperature–mortality association between 2000 and 2019 was predicted by use of the fitted meta-regression and the grid-specific meta-predictors. Excess deaths due to non-optimal temperatures, the ratio between annual excess deaths and all deaths of a year (the excess death ratio), and the death rate per 100 000 residents were then calculated for each grid across the world. Grids were divided according to regional groupings of the UN Statistics Division. Findings. Globally, 5 083 173 deaths (95% empirical CI [eCI] 4 087 967–5 965 520) were associated with non-optimal temperatures per year, accounting for 9·43% (95% eCI 7·58–11·07) of all deaths (8·52% [6·19–10·47] were cold-related and 0·91% [0·56–1·36] were heat-related). There were 74 temperature-related excess deaths per 100 000 residents (95% eCI 60–87). The mortality burden varied geographically. Of all excess deaths, 2 617 322 (51·49%) occurred in Asia. Eastern Europe had the highest heat-related excess death rate and Sub-Saharan Africa had the highest cold-related excess death rate. From 2000–03 to 2016–19, the global cold-related excess death ratio changed by −0·51 percentage points (95% eCI −0·61 to −0·42) and the global heat-related excess death ratio increased by 0·21 percentage points (0·13–0·31), leading to a net reduction in the overall ratio. The largest decline in overall excess death ratio occurred in South-eastern Asia, whereas excess death ratio fluctuated in Southern Asia and Europe. Interpretation. Non-optimal temperatures are associated with a substantial mortality burden, which varies spatiotemporally. Our findings will benefit international, national, and local communities in developing preparedness and prevention strategies to reduce weather-related impacts immediately and under climate change scenarios.

  mortality burdennon-optimal temperaturesclimate changeglobal analysis public health

  
  
• Wright B, Laffineur B, Royé D, Armstrong G, Fensham R (2021). RainfallLinked Megafires as Innate Fire Regime Elements in Arid Australian Spinifex (Triodia spp.) Grasslands. Frontiers in Ecology and Evolution, vol. 9. 10.3389/fevo.2021.666241.

  
  Large, high-severity wildfires, or “megafires,” occur periodically in arid Australian spinifex (Triodia spp.) grasslands after high rainfall periods that trigger fuel accumulation. Proponents of the patch-burn mosaic (PBM) hypothesis suggest that these fires are unprecedented in the modern era and were formerly constrained by Aboriginal patch burning that kept landscape fuel levels low. This assumption deserves scrutiny, as evidence from fire-prone systems globally indicates that weather factors are the primary determinant behind megafire incidence, and that fuel management does not mitigate such fires during periods of climatic extreme. We reviewed explorer’s diaries, anthropologist’s reports, and remotely sensed data from the Australian Western Desert for evidence of large rainfall-linked fires during the pre-contact period when traditional Aboriginal patch burning was still being practiced. We used only observations that contained empiric estimates of fire sizes. Concurrently, we employed remote rainfall data and the Oceanic Niño Index to relate fire size to likely seasonal conditions at the time the observations were made. Numerous records were found of small fires during periods of average and below-average rainfall conditions, but no evidence of large-scale fires during these times. By contrast, there was strong evidence of large-scale wildfires during a high-rainfall period in the early 1870s, some of which are estimated to have burnt areas up to 700,000 ha. Our literature review also identified several Western Desert Aboriginal mythologies that refer to large-scale conflagrations. As oral traditions sometimes corroborate historic events, these myths may add further evidence that large fires are an inherent feature of spinifex grassland fire regimes. Overall, the results suggest that, contrary to predictions of the PBM hypothesis, traditional Aboriginal burning did not modulate spinifex fire size during periods of extreme-high arid zone rainfall. The mechanism behind this is that plant assemblages in seral spinifex vegetation comprise highly flammable non-spinifex tussock grasses that rapidly accumulate high fuel loads under favorable precipitation conditions. Our finding that fuel management does not prevent megafires under extreme conditions in arid Australia has parallels with the primacy of climatic factors as drivers of megafires in the forests of temperate Australia.

  megafiresrainfallspinifex grasslandsfire regimesaboriginal burning

  
  
• Vicedo-Cabrera A M, Scovronick N, Sera F, Royé D, Schneider R, Tobias A, Astrom C, Guo Y, Honda Y, Hondula D M, Abrutzky R, Tong S, Coelho M de Sousa Zanotti Stagliorio, Saldiva P H Nascimento, Lavigne E, Correa P Matus, Ortega N Valdes, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola J J K, Ryti N, Pascal M, Schneider A, Katsouyanni K, Samoli E, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Diaz M Hurtado, Valencia C De La Cruz, Overcenco A, Houthuijs D, Ameling C, Rao S, Di Ruscio F, Carrasco-Escobar G, Seposo X, Silva S, Madureira J, Holobaca I H, Fratianni S, Acquaotta F, Kim H, Lee W, Iniguez C, Forsberg B, Ragettli M S, Guo Y L L, Chen B Y, Li S, Armstrong B, Aleman A, Zanobetti A, Schwartz J, Dang T N, Dung D V, Gillett N, Haines A, Mengel M, Huber V, Gasparrini A (2021). The burden of heatrelated mortality attributable to recent humaninduced climate change. Nature Climate Change, vol. 11, pp. 492-500. 10.1038/s41558-021-01058-x.

  
  Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991–2018. Across all study countries, we find that 37.0% (range 20.5–76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.

  heat-related mortalityclimate changeanthropogenic warmingglobal analysispublic health

  
  
• de Schrijver E, Folly C, Schneider R, Royé D, Franco O, Gasparrini A, Vicedo‐Cabrera A (2021). A Comparative Analysis of the Temperature‐Mortality Risks Using Different Weather Datasets Across Heterogeneous Regions. GeoHealth, vol. 5(5). 10.1029/2020GH000363.

  
  New gridded climate datasets (GCDs) on spatially resolved modeled weather data have recently been released to explore the impacts of climate change. GCDs have been suggested as potential alternatives to weather station data in epidemiological assessments on health impacts of temperature and climate change. These can be particularly useful for assessment in regions that have remained understudied due to limited or low quality weather station data. However to date, no study has critically evaluated the application of GCDs of variable spatial resolution in temperature-mortality assessments across regions of different orography, climate, and size. Here we explored the performance of population-weighted daily mean temperature data from the global ERA5 reanalysis dataset in the 10 regions in the United Kingdom and the 26 cantons in Switzerland, combined with two local high-resolution GCDs (HadUK-grid UKPOC-9 and MeteoSwiss-grid-product, respectively) and compared these to weather station data and unweighted homologous series. We applied quasi-Poisson time series regression with distributed lag nonlinear models to obtain the GCD- and region-specific temperature-mortality associations and calculated the corresponding cold- and heat-related excess mortality. Although the five exposure datasets yielded different average area-level temperature estimates, these deviations did not result in substantial variations in the temperature-mortality association or impacts. Moreover, local population-weighted GCDs showed better overall performance, suggesting that they could be excellent alternatives to help advance knowledge on climate change impacts in remote regions with large climate and population distribution variability, which has remained largely unexplored in present literature due to the lack of reliable exposure data.

  temperature-related mortalityweather datasetsheterogeneous regionsclimate datahealth impact assessment

  
  
• Royé D, Sera F, Tobías A, Lowe R, Gasparrini A, Pascal M, de’Donato F, Nunes B, Teixeira J (2021). Effects of Hot Nights on Mortality in Southern Europe. Epidemiology, vol. 32(4), pp. 487-498. 10.1097/ede.0000000000001359.

  
  Background: There is strong evidence concerning the impact of heat stress on mortality, particularly from high temperatures. However, few studies to our knowledge emphasize the importance of hot nights, which may prevent necessary nocturnal rest. Objectives: In this study, we use hot-night duration and excess to predict daily cause-specific mortality in summer, using multiple cities across Southern Europe. Methods: We fitted time series regression models to summer cause-specific mortality, including natural, respiratory, and cardiovascular causes, in 11 cities across four countries. We included a distributed lag nonlinear model with lags up to 7 days for hot night duration and excess adjusted by daily mean temperature. We summarized city-specific associations as overall-cumulative exposure–response curves at the country level using meta-analysis. Results: We found positive but generally nonlinear associations between relative risk (RR) of cause-specific mortality and duration and excess of hot nights. RR of duration associated with nonaccidental mortality in Portugal was 1.29 (95% confidence interval [CI] = 1.07, 1.54); other associations were imprecise, but we also found positive city-specific estimates for Rome and Madrid. Risk of hot-night excess ranged from 1.12 (95% CI = 1.05, 1.20) for France to 1.37 (95% CI = 1.26, 1.48) for Portugal. Risk estimates for excess were consistently higher than for duration. Conclusions: This study provides new evidence that, over a wider range of locations, hot night indices are strongly associated with cause-specific deaths. Modeling the impact of thermal characteristics during summer nights on mortality could improve decisionmaking for preventive public health strategies.

  hot nightsmortalitysouthern europeheat stresspublic health

  
  
• Fdez-Arróyabe P, Marti-Ezpeleta A, Royé D, Zarrabeitia A (2021). Effects of circulation weather types on influenza hospital admissions in Spain. International Journal of Biometeorology, vol. 65. 10.1007/s00484-021-02107-y.

  
  In this study, we use a statistical approach based on generalized additive models, linking atmospheric circulation and the number of influenza-related hospital admissions in the Spanish Iberian Peninsula during 2003–2013. The relative risks are estimated for administrative units in the Spanish territory, which is politically structured into 15 regions called autonomous communities. A catalog of atmospheric circulation types is defined for this purpose. The relationship between the exposure and response variables is modeled using a distributed lag nonlinear model (DLNM). Types from southwest and anticyclonic are significant in terms of the probability of having more influenza-related hospital admissions for all of Spain. The heterogeneity of the results is very high. The relative risk is also estimated for each autonomous community and weather type, with the maximum number of influenza-related hospital admissions associated with circulation types from the southwest and the south. We identify six specific situations where relative risk is considered extreme and twelve with a high risk of increasing influenza-related hospital admissions. The rest of the situations present a moderate risk. Atmospheric local conditions become a key factor for understanding influenza spread in each spatial unit of the Peninsula. Further research is needed to understand how different weather variables (temperature, humidity, and sun radiation) interact and promote the spread of influenza.

  influenzaatmospheric circulationhospital admissionsspainweather types

  
  
• Iñiguez C, Royé D, Tobías A (2021). Contrasting patterns of temperature related mortality and hospitalization by cardiovascular and respiratory diseases in 52 Spanish cities. Environmental Research, vol. 192, art. no. 110191. 10.1016/j.envres.2020.110191.

  
  Background. Climate change is a severe public health challenge. Understanding to what extent fatal and non-fatal consequences of specific diseases are associated with temperature may help to improve the effectiveness of preventive public health efforts. This study examines the effects of temperature on deaths and hospital admissions by cardiovascular and respiratory diseases, empathizing the difference between mortality and morbidity. Methods. Daily counts for mortality and hospital admissions by cardiovascular and respiratory diseases were collected for the 52 provincial capital cities in Spain, between 1990 and 2014. The association with temperature in each city was investigated by means of distributed lag non-linear models using quasi-Poisson regression. City-specific exposure-response curves were pooled by multivariate random-effects meta-analysis to obtain countrywide risk estimates of mortality and hospitalizations due to heat and cold, and attributable fractions were computed. Results. Heat and cold exposure were identified to be associated with increased risk of cardiovascular and respiratory mortality. Heat was not found to have an impact on hospital admissions. The estimated fraction of mortality attributable to cold was of greater magnitude in hospitalizations (17.5% for cardiovascular and 12.5% for respiratory diseases) compared to deaths (9% and 2.7%, respectively). Conclusions. There were noteworthy differences between temperature-related mortality and hospital admissions regarding cardiovascular and respiratory diseases, hence reinforcing the convenience of cause-specific measures to prevent temperature-related deaths.

  temperature-related mortalityhospital admissionscardiovascular diseases, respiratory diseasesspain

  
  

2020

• Romani S, Royé D, Sánchez Santos L, Figueiras A (2020). Impact of Extreme Temperatures on Ambulance Dispatches Due to Cardiovascular Causes in NorthWest Spain. International Journal of Environmental Research and Public Health, vol. 17(23), art. no. 9001. 10.3390/ijerph17239001.

  
  Introduction and objectives. The increase in mortality and hospital admissions associated with high and low temperatures is well established. However, less is known about the influence of extreme ambient temperature conditions on cardiovascular ambulance dispatches. This study seeks to evaluate the effects of minimum and maximum daily temperatures on cardiovascular morbidity in the cities of Vigo and A Coruña in North-West Spain, using emergency medical calls during the period 2005–2017. Methods. For the purposes of analysis, we employed a quasi-Poisson time series regression model, within a distributed non-linear lag model by exposure variable and city. The relative risks of cold- and heat-related calls were estimated for each city and temperature model. Results. A total of 70,537 calls were evaluated, most of which were associated with low maximum and minimum temperatures on cold days in both cities. At maximum temperatures, significant cold-related effects were observed at lags of 3–6 days in Vigo and 5–11 days in A Coruña. At minimum temperatures, cold-related effects registered a similar pattern in both cities, with significant relative risks at lags of 4 to 12 days in A Coruña. Heat-related effects did not display a clearly significant pattern. Conclusions. An increase in cardiovascular morbidity is observed with moderately low temperatures without extremes being required to establish an effect. Public health prevention plans and warning systems should consider including moderate temperature range in the prevention of cardiovascular morbidity.

  ambulance dispatchesextreme temperaturegaliciacardiovascular diseasesquasi-poisson regression model

  
  
• Fdez-Arroyabe P, Kourtidis K, Haldoupis C, Savoska S, Matthews J, Mir L, Kassomenos P, Cifra M, Barbosa S, Chen X, Dragovic S, Consoulas C, Hunting E, Robert D, van der Velde O, Apollonio F, Odzimek A, Chilingarian A, Royé D, Mkrtchyan H, Price C, Bór J, Oikonomou C, Birsan M, Crespo-Facorro B, Djordjevic M, Salcines C, López-Jiménez A, Donner R, Vana M, Pedersen J, Vorenhout M, Rycroft M (2020). Glossary on atmospheric electricity and its effects on biology. International Journal of Biometeorology, vol. 65, pp. 5-29. 10.1007/s00484-020-02013-9.

  
  There is an increasing interest to study the interactions between atmospheric electrical parameters and living organisms at multiple scales. So far, relatively few studies have been published that focus on possible biological effects of atmospheric electric and magnetic fields. To foster future work in this area of multidisciplinary research, here we present a glossary of relevant terms. Its main purpose is to facilitate the process of learning and communication among the different scientific disciplines working on this topic. While some definitions come from existing sources, other concepts have been re-defined to better reflect the existing and emerging scientific needs of this multidisciplinary and transdisciplinary area of research.

  atmospheric electric field (aef)schumann resonancesbiological processeselectromagnetic interferencemultidisciplinary research

  
  
• Santurtún A, Almendra R, Fdez-Arroyabe P, Sanchez-Lorenzo A, Royé D, Zarrabeitia M, Santana P (2020). Predictive value of three thermal comfort indices in low temperatures on cardiovascular morbidity in the Iberian peninsula. Science of The Total Environment, vol. 729, art. no. 138969. 10.1016/j.scitotenv.2020.138969.

  
  The natural environment has been considered an important determinant of cardiovascular morbidity. This work seeks to assess the impact of the winter thermal environment on hospital admissions from diseases of the circulatory system by using three biometeorological indices in five regions of the Iberian Peninsula. A theoretical index based on a thermophysiological model (Universal Thermal Climate Index [UTCI]) and two experimental biometeorological ones (Net Effective Temperature [NET] and Apparent Temperature [AT]) were estimated in two metropolitan areas of Portugal (Porto and Lisbon) and in three provinces of Spain (Madrid, Barcelona and Valencia). Subsequently, their relationship with hospital admissions, adjusted by NO2 concentration, time, and day of the week, was analyzed using a Generalized Additive Model. As the estimation method, a semi-parametric quasi-Poisson regression was used. Around 53% of the hospitalizations occurred during the cold periods. The admissions rate followed an upward trend over the 9-year period in both capitals (Madrid and Lisbon) as well as in Barcelona. An inverse and statistically significant relationship was found between thermal comfort and hospital admissions in the five regions (p < 0.001). The highest relative risk (RR) was found after a cumulative 7-day exposure in Lisbon, where there was a 1.4% increase in hospital admissions for each NET and AT degree Celsius, and 1.0% for each UTCI degree Celsius. In conclusion, low air temperatures are a significant risk factor for hospital admissions from diseases of the circulatory system in the Iberian Peninsula, regardless of the index calculated.

  thermal comfort indiceslow temperaturescardiovascular morbidityiberian peninsulahealth impacts

  
  
• Royé D, Íñiguez C, Tobías A (2020). Comparison of temperature–mortality associations using observed weather station and reanalysis data in 52 Spanish cities. Environmental Research, vol. 183, art. no. 109237. 10.1016/j.envres.2020.109237.

  
  Background. Most studies use temperature observation data from weather stations near the analyzed region or city as the reference point for the exposure-response association. Climatic reanalysis data sets have already been used for climate studies, but are not yet used routinely in environmental epidemiology. Methods. We compared the mortality-temperature association using weather station temperature and ERA-5 reanalysis data for the 52 provincial capital cities in Spain, using time-series regression with distributed lag non-linear models. Results. The shape of temperature distribution is very close between the weather station and ERA-5 reanalysis data (correlation from 0.90 to 0.99). The overall cumulative exposure-response curves are very similar in their shape and risks estimates for cold and heat effects, although risk estimates for ERA-5 were slightly lower than for weather station temperature. Conclusions. Reanalysis data allow the estimation of the health effects of temperature, even in areas located far from weather stations or without any available.

  temperature-mortalityweather stationsreanalysis datatime-seriesregression distributed lag non-linear models

  
  
• Royé D, Codesido R, Tobías A, Taracido M (2020). Heat wave intensity and daily mortality in four of the largest cities of Spain. Environmental Research, vol. 182, art. no. 109027. 10.1016/j.envres.2019.109027.

  
  In the current context of climate change, heat waves have become a significant problem for human health. This study assesses the effects of heat wave intensity on mortality (natural, respiratory and cardiovascular causes) in four of the largest cities of Spain (Barcelona, Bilbao, Madrid and Seville) during the period between 1990 and 2014. To model the heat wave severity the Excess Heat Factor (EHF) was used. The EHF is a two-component index. The first is the comparison of the three-day average daily mean temperature with the 95th percentile. The second component is a measure of the temperatures reached during the three-day period compared with the recent past (the previous 30 days). The city-specific exposure-response curves showed a non-linear J-shaped relationship between mortality and the EHF. Overall city-specific mortality risk estimates in natural causes for 1st vs. 99th percentile increases range from the highest mortality risk with 2.73 (95% CI: 2.34-3.18) in Seville to a risk of 1.78 (95% CI: 1.62-1.97) and 1.78 (95% CI: 1.45-2.19) in Barcelona and Bilbao, respectively. When we compare our results with risk estimates for the analyzed Spanish cities in other studies, the heat wave related mortality risks seem to be clearly higher. Furthermore, it has been demonstrated that different heat wave days of the same event do not present the same degree of severity/intensity. Thus, the intensity of a heat wave is an important mortality risk indicator during heat wave days. Due to the low number of studies on the EHF as a heat wave intensity indicator and heat-related mortality and morbidity, further research is required to validate its application in other geographic areas and focus populations.

  apparent temperatureexcess heat factorheat effectsintensitymortalityspain

  
  
• Monjo R, Royé D, Martin-Vide J (2020). Meteorological drought lacunarity around the world and its classification. Earth System Science Data, vol. 12(1), pp. 741-752. 10.5194/essd-12-741-2020.

  
  The measure of drought duration strongly depends on the definition considered. In meteorology, dryness is habitually measured by means of fixed thresholds (e.g. 0.1 or 1 mm usually define dry spells) or climatic mean values (as is the case of the standardised precipitation index), but this also depends on the aggregation time interval considered. However, robust measurements of drought duration are required for analysing the statistical significance of possible changes. Herein we climatically classified the drought duration around the world according to its similarity to the voids of the Cantor set. Dryness time structure can be concisely measured by the n index (from the regular or irregular alternation of dry or wet spells), which is closely related to the Gini index and to a Cantor-based exponent. This enables the world’s climates to be classified into six large types based on a new measure of drought duration. To conclude, outcomes provide the ability to determine when droughts start and finish. We performed the dry-spell analysis using the full global gridded daily Multi-Source Weighted-Ensemble Precipitation (MSWEP) dataset. The MSWEP combines gauge-, satellite-, and reanalysis-based data to provide reliable precipitation estimates. The study period comprises the years 1979–2016 (total of 45 165 d), and a spatial resolution of 0.5∘, with a total of 259 197 grid points. The dataset is publicly available at https://doi.org/10.5281/zenodo.3247041 (Monjo et al., 2019).

  lacunaritydrought durationcantor setdry spellsglobal classification

  
  
• Mori-Gamarra F, Moure-Rodríguez L, Sureda X, Carbia C, Royé D, Montes-Martínez A, Cadaveira F, Caamaño-Isorna F (2020). Alcohol outlet density and alcohol consumption in Galician youth. Gaceta Sanitaria, vol. 34(1), pp. 15-20. 10.1016/j.gaceta.2018.09.005.

  
  Objective. To assess the influence that alcohol outlet density, off- and on-alcohol premises, and alcohol consumption wield on the consumption patterns of young pre-university students in Galicia (Spain). Method. A cross-sectional analysis of a cohort of students of the University of Santiago de Compostela (Compostela Cohort 2016) was carried out. Consumption prevalence were calculated for each of the municipalities from the first-cycle students’ home residence during the year prior to admission. The association with risky alcohol consumption (RC) and binge-drinking (BD) was assessed with a logistic model considering as independent variables the municipality population, alcohol outlet density of off- premises, density of off- and on- premises and total density of both types of premises in the municipality. Results. The prevalence of RC was 60.5% (95% confidence interval [95%CI]: 58.4-62.5) and the BD was 28.5% (95%CI: 26.7-30.2). A great variability was observed according to the municipality of provenance. The multivariate logistic model showed municipalities with a density of 8.42-9.34 of both types of premises per thousand inhabitants presented a higher risk of RC (odds ratio [OR]: 1,39; 95%CI: 1.09-1.78) and BD (OR: 1.29; 95%CI: 1.01-1.66). Conclusion. These data suggest the importance of including environmental information when studying alcohol consumption. Knowing our environment better could help plan policies that encourage healthier behaviour in the population.

  alcohol outlet densityalcoholunderage drinkingadolescents

  
  

2019

• Royé D, Tedim F, Martin‐Vide J, Salis M, Vendrell J, Lovreglio R, Bouillon C, Leone V (2019). Wildfire burnt area patterns and trends in Western Mediterranean Europe via the application of a concentration index. Land Degradation & Development, vol. 31(3), pp. 311-324. 10.1002/ldr.3450.

  
  The most widely used metrics to characterize wildfire regime and estimate the impact of wildfires are total burnt area (BA) and the number of fire events (FE). However, these are insufficient to analyse the threat to society of a new fire regime characterized by a higher occurrence of very large events. To overcome this weakness, we propose the use of a Concentration Index (CIB) which makes it possible to identify spatio-temporal patterns. The frequency distribution of BA follows a negative exponential distribution almost everywhere, in which a small minority of FE is responsible of the majority of BA. In this article, the spatio-temporal behaviour of BA is analysed in Western Mediterranean Europe, with particular focus on Portugal, Spain, France and Italy, using data from the European Forest Fire Information System and national wildfire databases. This is the first time that the CI has been applied to wildfire events. This research shows that, in most Mediterranean European countries, the amount of BA is increasingly related with a lower number of fires. The spatio-temporal distribution of CIB shows high variability in all of the countries analysed in Europe. Portugal and Spain show increasing significant trends of CIB + 7.6% (p-value = 0.001) and + 1.3% per decade (p-value = 0.003). Statistically significant correlations for Portugal, Spain and Italy are also found between the annual CIB and several teleconnection indices. The application of the CIB demonstrates its discriminatory ability, which is a key point in detecting vulnerable areas and temporal trends under climate change.

  burnt areaconcentration indexspatial patternstemporal trendsfire regimes

  
  
• Mathbout S, Lopez‐Bustins J, Royé D, Martin‐Vide J, Benhamrouche A (2019). Spatiotemporal variability of daily precipitation concentration and its relationship to teleconnection patterns over the Mediterranean during 1975–2015. International Journal of Climatology, vol. 40(3), pp. 1435-1455. 10.1002/joc.6278.

  
  This study has addressed the spatiotemporal distribution of the daily rainfall concentration and its relation to the teleconnection patterns across the Mediterranean (MR). Daily concentration index (CI) and the ordered n index ( nor) are used at annual time scale to reveal the statistical structure of precipitation across the MR based on 233 daily rainfall series for the period 1975–2015. Eight teleconnection patterns, North Atlantic Oscillation (NAO), Mediterranean Oscillation (MO), Western Mediterranean Oscillation (WeMO), Upper-Level Mediterranean Oscillation index (ULMO), East Atlantic (EA) pattern, East Atlantic/West Russia (EATL/WRUS) pattern, Scandinavia (SCAND) pattern and Southern Oscillation (SO) at annual time scale are selected. The spatiotemporal patterns in precipitation concentration indices, annual precipitation and their teleconnections with previous large-scale circulations are investigated. Results show a strong connection between the CI and the nor (r = 0.70, p < .05) which present the same relative areas of high and low concentration. The annual values range from 0.57 to 0.70 for CI and 0.49 to 0.71 for nor index which show a high daily precipitation concentration across the MR. Trend analysis demonstrated mostly significant increasing trends for both indices. This increase is mainly found in south France, northern coastlands of the Iberian Peninsula (IP), Greece and Tunisia. An inverse relationship between the number of rainy days and concentration indices is evident. Both of WeMO and MO can play an important role in modulating rainfall in the northwest Mediterranean. The positive EATL/WRUS phase is mainly connected with positive precipitation mean anomalies in the eastern Mediterranean and vice versa in the west. The high daily precipitation concentration values over south France, northeast Spain, Croatia and Tunisia are linked to the low values of WeMO and high values of EA. These results could pave the way for new possibilities regarding the projection of precipitation concentration and precipitation irregularity in downscaling techniques.

  precipitation concentrationteleconnection patternsspatiotemporal variabilitymediterraneanclimate indices

  
  
• Lemus-Canovas M, Lopez-Bustins J, Martin-Vide J, Royé D (2019). synoptReg: An R package for computing a synoptic climate classification and a spatial regionalization of environmental data. Environmental Modelling & Software, vol. 118, pp. 114-119. 10.1016/j.envsoft.2019.04.006.

  
  Spatial knowledge of the climatic or environmental variables associated with the most frequent circulation types is essential with regard to developing strategies to address the risk of avalanches, floods, soil erosion, air pollution or other natural hazards. In order to derive an environmental regionalization, we present an Open Source R package known as synoptReg, which combines the spatialization of environmental variables based on the atmospheric circulation types. The synoptReg package contains a set of functions which we will employ (1) to perform a PCA-based synoptic classification using an atmospheric variable; (2) to map the spatial distribution of the selected environmental variable based upon the circulation types; (3) to develop a spatial environmental regionalization based on the previous results. We illustrate the usefulness of the package for a case study in the Alps area.

  synoptic classificationclusteringenvironmental dataregionalizationcirculation types

  
  
• Royé D, Zarrabeitia M, Fdez-Arroyabe P, Álvarez Gutiérrez A, Santurtún A (2019). Role of Apparent Temperature and Air Pollutants in Hospital Admissions for Acute Myocardial Infarction in the North of Spain. Revista Española de Cardiología, vol. 72(8), pp. 634-640. 10.1016/j.recesp.2018.05.032.

  
  Introduction and objectives. The role of the environment on cardiovascular health is becoming more prominent in the context of global change. The aim of this study was to analyze the relationship between apparent temperature (AT) and air pollutants and acute myocardial infarction (AMI) and to study the temporal pattern of this disease and its associated mortality. Methods. We performed a time-series study of admissions for AMI in Cantabria between 2001 and 2015. The association between environmental variables (including a biometeorological index, AT) and AMI was analyzed using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of these variables on AMI, a lag non-linear model was fitted in a generalized additive model. Results. The incidence rate and the mortality followed a downward trend during the study period (CC = –0.714; P = .0002). An annual pattern was found in hospital admissions (P = .005), with the highest values being registered in winter; a weekly trend was also identified, reaching a minimum during the weekends (P = .000005). There was an inverse association between AT and the number of hospital admissions due to AMI and a direct association with particulate matter with a diameter smaller than 10 μm. Conclusions. Hospital admissions for AMI followed a downward trend between 2007 and 2015. Mortality associated with admissions due to this diagnosis has decreased. Predictive factors for this disease were AT and particulate matter with a diameter smaller than 10 μm.

  apparent temperatureair pollutantsacute myocardial infarctionhospital admissionsparticulate matter

  
  
• Royé D, Zarrabeitia M, Riancho J, Santurtún A (2019). A time series analysis of the relationship between apparent temperature, air pollutants and ischemic stroke in Madrid, Spain. Environmental Research, vol. 173, pp. 349-358. 10.1016/j.envres.2019.03.065.

  
  The understanding of the role of environment on the pathogenesis of stroke is gaining importance in the context of climate change. This study analyzes the temporal pattern of ischemic stroke (IS) in Madrid, Spain, during a 13-year period (2001-2013), and the relationship between ischemic stroke (admissions and deaths) incidence and environmental factors on a daily scale by using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of air pollutants and Apparent Temperature (AT), a biometeorological index which represents human thermal comfort on IS, a lag non-linear model was fitted in a generalized additive model. The mortality rate followed a downward trend over the studied period, however admission rates progressively increased. Our results show that both increases and decreases in AT had a marked relationship with IS deaths, while hospital admissions were only associated with low AT. When analyzing the cumulative effects (for lag 0-14 days), with an AT of 1.7 °C (percentile 5%) a RR of 1.20 (95% CI, 1.05-1.37) for IS mortality and a RR of 1.09 (95% CI, 0.91-1.29) for morbidity is estimated. Concerning gender differences, men show higher risks of mortality in low temperatures and women in high temperatures. No significant relationship was found between air pollutant concentrations and IS morbi-mortality, but this result must be interpreted with caution, since there are strong spatial fluctuations of the former between nearby geographical areas that make it difficult to perform correlation analyses.

  admissionsair pollutantsapparent temperatureischemic strokemortality

  
  

2018

• Royé D, Lorenzo N, Rasilla D, Martí A (2018). Spatio‐temporal variations of cloud fraction based on circulation types in the Iberian Peninsula. International Journal of Climatology, vol. 39(3), pp. 1716-1732. 10.1002/joc.5914.

  
  This paper presents the first systematic study of the relationships between atmospheric circulation types (CT) and cloud fraction (CF) over the whole Iberian Peninsula, using satellite data from the MODIS (MOD09GA and MYD09GA) cloud mask for the period 2001–2017. The high level of detail, in combination with a classification for circulation patterns, provides us with relevant information about the spatio-temporal variability of cloudiness and the main mechanisms affecting the genesis of clouds. The results show that westerly CTs are the most influential, followed by cyclonic types, in cloudiness in the west of the Iberian Peninsula. Westerly flows, however, do not affect the Mediterranean coastline, which is dominated by easterly CTs, suggesting that local factors such as convective processes, orography and proximity to a body of warm water could play a major role in cloudiness processes. The Cantabrian Coast also has a particularly characteristic cloudiness dominated by northerly CTs. In general, the results found in this study are in line with the few studies that exist on cloudiness in the Iberian Peninsula. Furthermore, the results are geographically consistent, showing links to synoptic forcing in terms of atmospheric circulation patterns and the impact of the Iberian Peninsula’s complex orography upon this element of the climate system.

  cloudinesscirculation typesvariabilityorographysynoptic forcing

  
  
• Vélez A, Martin-Vide J, Royé D, Santaella O (2018). Spatial analysis of daily precipitation concentration in Puerto Rico. Theoretical and Applied Climatology, vol. 136, pp. 1347-1355. 10.1007/s0070401825501.

  
  The present study analyzes spatial patterns of precipitation Concentration Index (CI) in Puerto Rico considering the daily precipitation data of 20 precipitation-gauging stations during 1971–2010. The South and East interior parts of Puerto Rico are characterized by higher CI and the West and North-West parts show lower CI. The annual CI and the rainy season CI show a gradient from South-East to North-West and the dry season CI shows a gradient from South to North. Another difference between the rainy season CI and dry season CI is that the former shows the lowest values of CI while the latter shows the highest values of CI. The different types of seasonal precipitation seem to play a major role on the spatial CI distribution. However, the local relief plays a major role in the spatial patterns due to the effect of the air circulation by the mountains. These findings can contribute to basin-scale water resource management (flooding, soil erosion, etc.) and conservation of the ecological environment.

  precipitation concentrationspatial patternsconcentration index (ci)seasonal variabilityclimate change

  
  
• Riancho-Zarrabeitia L, Rasilla D, Royé D, Fdez-Arroyabe P, Santurtún A (2018). Kawasaki disease in Spanish paediatric population and synoptic weather types: an observational study. Rheumatology International, vol. 38(7), pp. 1259-1266. 10.1007/s00296-018-4066-5.

  
  Kawasaki disease (KD) is a vasculitis of unelucidated pathogenesis that usually occurs in paediatric patients. In this study we analyse the temporal pattern and geographical distribution of the disease in Spain, and its relationship with atmospheric circulation patterns. We performed a retrospective study in which we collected all hospital admissions due to KD in the country between 2005 and 2015 and explored their relationship with demographic and geographical characteristics. Moreover, we calculated daily surface atmospheric patterns over Spain to study the relationship between weather types (WT) and KD Admissions. The average admission rate for KD in the paediatric population was 3.90 per 100,000, with a male to female ratio of 1.56:1. The highest rate of admissions was found in the 0-4-year-old group, with an incidence of 11.7 cases per 100,000. Admissions followed an annual cyclic pattern with a peak of incidence in January (p = 0.022) and a nadir in September. There was an upwards trend in the number of KD admissions in male sex during the study period (p = 0.004). However, there were marked geographical differences in the incidence rate. Finally, the analysis of the relationship between the WT and the number of admissions by KD revealed no statistically significant association. KD admissions follow a peculiar seasonal and spatial distribution, that suggest the involvement of environmental factors in the disease; however, the absence of an association with WT should be interpreted with caution and regional studies should be done to explore this relationship.

  kawasaki diseaseseasontrendweather types

  
  
• Royé D, Figueiras A, Taracido M (2018). Short‐term effects of heat and cold on respiratory drug use. A time‐series epidemiological study in A Coruña, Spain. Pharmacoepidemiology and Drug Safety, vol. 27(6), pp. 638-644. 10.1002/pds.4427.

  
  The consumption of medication, especially over-the-counter drugs, can reflect environmental exposure with a lesser degree of severity in terms of morbidity. The non-linear effects of maximum and minimum apparent temperature on respiratory drug sales in A Coruña from 2006 to 2010 were examined using a distributed lag nonlinear model. In particular, low apparent temperatures proved to be associated with increased sales of respiratory drugs. The strongest consistent risk estimates were found for minimum apparent temperatures in respiratory drug sales with an increase of 33.4% (95% CI, 12.5%-58.0%) when the temperature changed from 2.8°C to −1.4 °C. These findings may serve to guide the planning of public health interventions to predict and manage the health effects of exposure to the thermal environment for lower degrees of morbidity. More precisely, significant increases in the use of measured over-the-counter medication could be used to identify and anticipate influenza outbreaks due to a more sensitive degree of the data source.

  respiratory drug useheatcoldtime-series analysisa coruña

  
  
• Royé D, Lorenzo N, Martin-Vide J (2018). Spatial–temporal patterns of cloudtoground lightning over the northwest Iberian Peninsula during the period 2010–2015. Natural Hazards, vol. 92, pp. 857-884. 10.1007/s11069-018-3228-9.

  
  The spatial–temporal patterns of cloud-to-ground (CG) lightning covering the period 2010–2015 over the northwest Iberian Peninsula were investigated. The analysis conducted employed three main methods: the circulation weather types developed by Jenkinson and Collison, the fit of a generalized additive model (GAM) for geographic variables, and the use of a concentration index for the ratio of lightning strikes and thunderstorm days. The main activity in the summer months can be attributed to situations with eastern or anticyclonic flow due to convection by insolation. In winter, lightning proves to have a frontal origin and is mainly associated with western or cyclonic flow situations which occur with advections of air masses of maritime origin. The largest number of CG discharges occurs under eastern flow and their hybrids with anticyclonic situations. Thunderstorms with greater CG lightning activity, highlighted by a higher concentration index, are located in areas with a higher density of lightning strikes, above all in mountainous areas away from the sea. The modeling of lightning density with geographic variables shows the positive influence of altitude and, particularly, distance to the sea, with nonlinear relationships due to the complex orography of the region. Likewise, areas with convex topography receive more lightning strikes than concave ones, a relation which has been demonstrated for the first time from a GAM.

  cloud-to-ground lightningspatial-temporal patternsnorthwest iberian peninsulacirculation weather typesgeneralized additive model (gam)

  
  

2017

• Royé D, Martin-Vide J (2017). Concentration of daily precipitation in the contiguous United States. Atmospheric Research, vol. 196(1), pp. 237-247. 10.1016/j.atmosres.2017.06.011.

  
  The contiguous US exhibits a wide variety of precipitation regimes, first, because of the wide range of latitudes and altitudes. The physiographic units with a basic meridional configuration contribute to the differentiation between east and west in the country while generating some large interior continental spaces. The frequency distribution of daily precipitation amounts almost anywhere conforms to a negative exponential distribution, reflecting the fact that there are many small daily totals and few large ones. Positive exponential curves, which plot the cumulative percentages of days with precipitation against the cumulative percentage of the rainfall amounts that they contribute, can be evaluated through the Concentration Index. The Concentration Index has been applied to the contiguous United States using a gridded climate dataset of daily precipitation data, at a resolution of 0.25°, provided by CPC/NOAA/OAR/Earth System Research Laboratory, for the period between 1956 and 2006. At the same time, other rainfall indices and variables such as the annual coefficient of variation, seasonal rainfall regimes and the probabilities of a day with precipitation have been presented with a view to explaining spatial CI patterns. The spatial distribution of the CI in the contiguous United States is geographically consistent, reflecting the principal physiographic and climatic units of the country. Likewise, linear correlations have been established between the CI and geographical factors such as latitude, longitude and altitude. In the latter case the Pearson correlation coefficient (r) between this factor and the CI is −0.51 (p-value < 0.001). For annual probability of days with precipitation and the CI there is also a significant and negative correlation, r = −0.25 (p-value < 0.001).

  daily precipitationclimate variabilitycontiguous united statesrainfall patternshydrology

  
  
• Mathbout S, Lopez-Bustins J A, Royé D, Martin-Vide J, Bech J, Rodrigo F S (2017). Observed Changes in Daily Precipitation Extremes at Annual Timescale Over the Eastern Mediterranean During 1961–2012. Pure and Applied Geophysics, vol. 175, pp. 3875-3890. 10.1007/s00024-017-1695-7.

  
  The Eastern Mediterranean is one of the most prominent hot spots of climate change in the world and extreme climatic phenomena in this region such as drought or extreme rainfall events are expected to become more frequent and intense. In this study climate extreme indices recommended by the joint World Meteorological Organization Expert Team on Climate Change Detection and Indices are calculated for daily precipitation data in 70 weather stations during 1961–2012. Observed trends and changes in daily precipitation extremes over the EM basin were analysed using the RClimDex package, which was developed by the Climate Research Branch of the Meteorological Service of Canada. Extreme and heavy precipitation events showed globally a statistically significant decrease in the Eastern Mediterranean and, in the southern parts, a significant decrease in total precipitation. The overall analysis of extreme precipitation indices reveals that decreasing trends are generally more frequent than increasing trends. We found statistically significant decreasing trends (reaching 74% of stations for extremely wet days) and increasing trends (reaching 36% of stations for number of very heavy precipitation days). Finally, most of the extreme precipitation indices have a statistically significant positive correlation with annual precipitation, particularly the number of heavy and very heavy precipitation days.

  precipitation extremeseastern mediterraneanclimate changehydrological cycletrend analysis

  
  
• Royé D (2017). The effects of hot nights on mortality in Barcelona, Spain. International Journal of Biometeorology, vol. 61, pp. 2127-2140. 10.1007/s00484-017-1416-z.

  
  Heat-related effects on mortality have been widely analyzed using maximum and minimum temperatures as exposure variables. Nevertheless, the main focus is usually on the former with the minimum temperature being limited in use as far as human health effects are concerned. Therefore, new thermal indices were used in this research to describe the duration of night hours with air temperatures higher than the 95% percentile of the minimum temperature (hot night hours) and intensity as the summation of these air temperatures in degrees (hot night degrees). An exposure-response relationship between mortality due to natural, respiratory, and cardiovascular causes and summer night temperatures was assessed using data from the Barcelona region between 2003 and 2013. The non-linear relationship between the exposure and response variables was modeled using a distributed lag non-linear model. The estimated associations for both exposure variables and mortality shows a relationship with high and medium values that persist significantly up to a lag of 1–2 days. In mortality due to natural causes, an increase of 1.1% per 10% (CI95% 0.6–1.5) for hot night hours and 5.8% per each 10° (CI95% 3.5–8.2%) for hot night degrees is observed. The effects of hot night hours reach their maximum with 100% and lead to an increase by 9.2% (CI95% 5.3–13.1%). The hourly description of night heat effects reduced to a single indicator in duration and intensity is a new approach and shows a different perspective and significant heat-related effects on human health.

  hot nightsmortalitybarcelonaheat stresspublic health

  
  

2015

• Royé D (2015). The use of climate databases netCDF with array structure in the environment of R. Sémata: Ciencias Sociais e Humanidades, vol. 27, pp. 11-37. https://revistas.usc.gal/index.php/semata/article/view/2690.

  
  A practical introduction in the use of netCDF in the environment of R Spatio-temporal data is currently key to many disciplines, especially to climatology and meteorology. A widespread format is netCDF allowing a multidimensional structure and an exchange of data machine independently. In this article, we introduce the use of these databases with the free software environment R. To do this, we will work with a grid of the maximum temperature of the Iberian Peninsula for the period 1971-2007. The goal is to read and visualize the netCDF format, and make some fist overall and specifi calculations. Finally the applicability is shown in a case study: the diurnal temperature variation in the Iberian Peninsula for January and August 2006. (Spanish)

  ncdfdata cubeclimateprogrammingarray

  
  
• Royé D, Martí­ Ezpeleta A (2015). Analysis of tropical nights on the atlantic coast of the Iberian Peninsula. A proposed methodology. Boletín de la Asociación de Geógrafos Españoles, vol. 69, pp. 351-368. 10.21138/bage.1900.

  
  Analysis of tropical nights on the Atlantic coast of the Iberian peninsula. A proposed methodology. This paper presents a new methodology for the study of warm nights, also called «tropical», in Galicia and Portugal in order to identify those nights where people can be affected by heat stress. The use of two indicators obtained through half-hourly data has allowed us to define in more detail the thermal characteristics of the nights between May and October, thereby being able to more accurately assess the risk to the health and well-being of the population. There is a significant increase in the frequency of tropical nights and warm nights on the Atlantic coast, from the north of Galicia to the south of Portugal. The lower latitude and proximity to the coastline are associated with greater persistence of heat and thermal stress during these nights. In inland areas the persistence is less. The warmest nights are more frequent and intense in centres of the cities, due to the effect of the urban heat island.

  tropical nightsatlantic coastiberian peninsulaheat stressclimate change

  
  
• Royé D, Taboada J J, Martí A, Lorenzo M N (2015). Winter circulation weather types and hospital admissions for respiratory diseases in Galicia, Spain. International Journal of Biometeorology, vol. 60. 10.1007/s00484-015-1047-1.

  
  The link between various pathologies and atmospheric conditions has been a constant topic of study over recent decades in many places across the world; knowing more about it enables us to pre-empt the worsening of certain diseases, thereby optimizing medical resources. This study looked specifically at the connections in winter between respiratory diseases and types of atmospheric weather conditions (Circulation Weather Types, CWT) in Galicia, a region in the north-western corner of the Iberian Peninsula. To do this, the study used hospital admission data associated with these pathologies as well as an automatic classification of weather types. The main result obtained was that weather types giving rise to an increase in admissions due to these diseases are those associated with cold, dry weather, such as those in the east and south-east, or anticyclonic types. A second peak was associated with humid, hotter weather, generally linked to south-west weather types. In the future, this result may help to forecast the increase in respiratory pathologies in the region some days in advance.

  circulation weather types (cwt)respiratory diseaseshospital admissionsgaliciawinter

  
  

Book chapters

2024

• Royé D, Tobías A (2024). Cambio climático: un riesgo para nuestro bienestar y salud. Cambio climático en España Tirant Lo Blanch. https://editorial.tirant.com/es/libro/cambio-climatico-en-espana-luis-efren-rios-vega-9788411837279?busqueda=Cambio+clim%3Ftico+&.

  
  El ambiente influye de forma directa e indirecta en nuestra salud, por tanto, una relación directa con el dinamismo antropogenético de las sociedades, en el sentido social, cultural, económico y político. El organismo humano y la atmósfera se encuentran en un equilibrio físico y químico en constante intercambio. Todos los seres humanos se ven forzados a reaccionar ante los elementos atmosféricos para poder garantizar su correcto y óptimo funcionamiento orgánico. En este contexto, el cambio climático es uno de los mayores desafíos que enfrenta la humanidad en el siglo XXI, porque implica consecuencias muy graves para la salud y el bienestar de las personas en todo el planeta. Se ha convertido en una inaplazable emergencia climática afectando especialmente a nuestro bienestar con hasta 3,6 millones de personas en áreas altamente susceptibles y vulnerables (IPCC, 2022). El cambio climático es un multiplicador de riesgos existentes, aumentando la frecuencia, intensidad y la duración de eventos extremos, así como de olas de calor o redistribuyendo enfermedades transmitidas por vectores. Dado que no es posible separar los impactos actuales del clima de aquellos provocados por el cambio climático antropogénico, aquí se resumen en dos los principales impactos del calentamiento global sobre la salud en España: las temperaturas extremas y la contaminación del aire, y se analizan las posibles medidas de adaptación y mitigación.

  
  
• Royé D (2024). Geoprocesamiento en nube. Fundamentos de ciencia de datos con R Publisher: Mc Graw Hill Editors: G Fernández-Avilés, JM Montero. https://cdr-book.github.io/geoproces.html.

  
  El planteamiento de un problema basado en datos de diversos proveedores habitualmente implica la descarga de grandes volúmenes de datos. La actual proliferación de servicios de Open Data, despliegues de sensores y diversas fuentes, incluyendo los satélites, dificulta su procesamiento en equipos personales. El gran crecimiento en grandes volúmenes de datos espaciotemporales de tipo vectorial o raster lleva a la necesidad en trabajar con servicios en nube para ahorrar tiempo computacional y espacio de almacenamiento. En la actualidad existen diferentes servicios de geoprocesamiento en nube que ayudan a hacer análisis online sin necesidad de descargar los datos ni preocuparse por el rendimiento computacional. Uno de estos servicios es Google Earth Engine (GEE), donde se combina un catálogo de varios petabytes de imágenes satelitales y conjuntos de datos geoespaciales multidimensionales (vectorial y raster) de alta resolución con capacidades de análisis a escala planetaria. Este servicio gratuito para uso no comercial incluye incluso la posibilidad de crear aplicaciones.

  
  
• Royé D (2024). Una nota sobre el cambio climático. Fundamentos de ciencia de datos con R Publisher: Mc Graw Hill Editors: G Fernández-Avilés, JM Montero. https://cdr-book.github.io/cambioclimatico.html.

  
  La temperatura media global en la superficie terrestre ha aumentado en 1,1 ºC desde la era preindustrial (1880-1900). A pesar de parecer un leve incremento en la temperatura, implica un aumento significativo en el calor acumulado del sistema Tierra. Cuando se combina el aumento de la temperatura en la superficie terrestre y en la superficie oceánica, la tasa de incremento promedio es de 0,08 ºC por década desde 1880. Sin embargo, la tasa promedio de aumento desde 1981 ha sido más del doble: 0,18 ºC por año. Los océanos se caracterizan por una menor tasa de calentamiento debido a su capacidad calorífica. No obstante, son los océanos los que absorben la mayoría del calor adicional del planeta debido al cambio climático…

  
  

2020

• Tedim F, Leone V, Coughlan M, Bouillon C, Xanthopoulos G, Royé D, Correia FJM, Ferreira C (2020). Extreme wildfire events: the definition. 10.1016/B978-0-12-815721-3.00001-1.

  
  Extreme wildfires events (EWEs) represent a minority among all wildfires but are a true challenge for societies as they exceed the current control capacity even in the best prepared regions of the world and they create destruction and a disproportionately number of fatalities. Recent events in Portugal, Chile, Greece, Australia, Canada, and the USA provide evidence that EWEs are an escalating worldwide problem, exceeding all previous records. Despite the challenges put by climate change, the occurrence of EWEs and disasters is not an ecological inevitability. In this chapter the rationale of the definition of EWEs and the integration of potential consequences on people and assets in a novel wildfire classification scheme are proposed and discussed. They are excellent instruments to enhance wildfire risk and crisis communication programs and to define appropriate prevention, mitigation, and response measures which are crucial to build up citizens’ safety.

  extreme wildfire events (ewes)climate changerisk communicationmitigation measureswildfire classification

  
  

2017

• Fdez-Arroyabe P, Royé D (2017). Co-creation and Participatory Design of Big Data Infrastructures on the Field of Human Health Related Climate Services. Internet of Things and Big Data Technologies for Next Generation HealthcareEdition: Studies in Big Data, Vol. 23 Publisher: Springer International PublishingEditors: C. Bhatt, N. Dey, A.S. Ashour. 10.1007/978-3-319-49736-5_9.

  
  Co-creation of scientific knowledge based on new technologies and big data sources is one of the main challenges for the digital society in the XXI century. Data management and the analysis of patterns among datasets based on machine learning and artificial intelligence has become essential for many sectors nowadays. The development of real time health-related climate services represents an example where abundant structured and unstructured information and transdisciplinary research are needed. The study of the interactions between atmospheric processes and human health through a big data approach can reveal the hidden value of data. The Oxyalert technological platform is presented as an example of a digital biometeorological infrastructure able to forecast, at an individual level, oxygen changes impacts on human health.

  co-creationinterdisciplinaritytransdisciplinaritymorbidityclimate servicesdigital dividebig datahealth

  
  

Books

2019

• Royé D, Serrano-Notivoli R (2019). Introducción a los SIG con R. Publicaciones de la Universidad de Zaragoza . https://puz.unizar.es/2133-introduccion-a-los-sig-con-r.html.

  
  R tiene, como lenguaje de programación enfocado al análisis estadístico, todos los ingredientes para ser usado como herramienta de análisis espacial y representación cartográfica: es gratuito, permite personalizar, replicar y compartir los análisis de cualquier nivel de dificultad y no tiene ninguna limitación en cuanto a cantidad de información a procesar o tipos de formato diferentes para gestionar. Esto le sitúa en una situación de ventaja que mejora día a día, gracias a su amplia comunidad de usuarios, respecto a un SIG (Sistema de Información Geográfica) convencional. Este manual explica, sin necesidad de conocimientos previos, cómo desarrollar con R todos los análisis disponibles en un SIG, con ejemplos sencillos y multitud de casos prácticos. Además, se muestran las enormes posibilidades de representación cartográfica, que van mucho más allá de la simple creación de mapas. R permite, desde exportar a cualquier formato de archivo, hasta crear mapas dinámicos para supublicación en Internet.

  
  
• Martí A, Taboada J, Royé D, Fonseca X (2019). Os tempos e o clima de Galicia. Vigo: Xerais. https://www.xerais.gal/libro/basicos-ciencia/os-tempos-e-o-clima-de-galicia-alberto-marti-ezpeleta-9788491215066/.

  
  Que récords climáticos se alcanzaron en Galicia? Cales son os lugares máis calorosos? E os máis fríos? Onde chove máis? Onde se rexistran máis días de precipitación? Que zonas gozan dun maior número de horas de sol? Cales teñen maior nebulosidade? Que lugares son os máis ventosos? Como está a afectar o cambio climático a Galicia? Neste libro atoparás as respostas a estas e a outras preguntas relacionadas co clima de Galicia e os diversos tipos de tempo que o caracterizan. Nas súas páxinas explícase como se producen os fenómenos meteorolóxicos máis habituais no noso territorio: as inversións térmicas, as néboas costeiras e orográficas, as illas de calor urbanas, os tipos de precipitación, o efecto foehn, as brisas mariñas, o arco da vella etc. A través de exemplos concretos, analízanse tamén os riscos climáticos que afectan regularmente a Galicia, como vagas de calor, temporais de neve, cicloxéneses explosivas e temporais de choiva e vento, tormentas, secas, tornados… Tamén poderás coñecer como está a cambiar o clima da nosa comunidade debido ao quecemento global e cales son os escenarios de futuro.