Exceptional heatwaves and mortality in Europe: Greater impacts since the coronavirus disease 2019 outbreak

Zhiwei Li; Yinguang Fan; Zhiwei Xu; Hung Chak Ho; Shilu Tong; Cunrui Huang; Zhongliang Bai; Yiming Gai; Wenjun Cheng; Jihong Hu; Yufan Feng; Hao Zheng; Ning Wang; Jing Ni; Guixia Pan; Mohammad Zahid Hossain; Hong Su; Jian Cheng

doi:10.1016/j.envpol.2024.125058

Exceptional heatwaves and mortality in Europe: Greater impacts since the coronavirus disease 2019 outbreak

Environ Pollut. 2024 Oct 5;363(Pt 1):125058. doi: 10.1016/j.envpol.2024.125058. Online ahead of print.

Authors

Zhiwei Li¹, Yinguang Fan¹, Zhiwei Xu², Hung Chak Ho³, Shilu Tong⁴, Cunrui Huang⁵, Zhongliang Bai⁶, Yiming Gai¹, Wenjun Cheng¹, Jihong Hu¹, Yufan Feng¹, Hao Zheng⁷, Ning Wang⁸, Jing Ni¹, Guixia Pan¹, Mohammad Zahid Hossain⁹, Hong Su¹, Jian Cheng¹⁰

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, 230000, China.
² School of Medicine and Dentistry, Griffith University, Gold Coast, 9726, Australia.
³ Department of Public and International Affairs, City University of Hong Kong, 999077, Hong Kong, China.
⁴ National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100000, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4702, Australia.
⁵ Vanke School of Public Health, Tsinghua University, Beijing, 100000, China.
⁶ School of Health Services Management, Anhui Medical University, Hefei, 230000, China.
⁷ Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210000, China.
⁸ The National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, Beijing, 100000, China.
⁹ International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1360, Bangladesh.
¹⁰ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230000, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, 230000, China; First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China; Anhui Public Health Clinical Center, Hefei, 230000, China. Electronic address: [email protected].

PMID: 39369868
DOI: 10.1016/j.envpol.2024.125058

Abstract

Record-breaking hot weather (exceptional heatwaves) has been increasingly common worldwide, posing a significant threat to human health. However, little is known about the effect of these exceptional heatwaves on mortality in Europe, especially since the coronavirus disease 2019 (COVID-19) outbreak, which converges with climate change to affect healthcare systems and human lives. We collected mortality data of 967 regions in 30 European countries over the last decade (2014-2023) from the Eurostat. A standard time-series analysis was used to estimate the effect of exceptional heatwaves by quasi-Poisson regression model, including the main effect (effect from heatwave intensity) and the added effect (effect from heatwave duration), on mortality for each region during two periods (before and since the COVID-19 outbreak). We used random effects meta-analysis to pool the mortality risk (i.e., relative risk [RR]) and burden (i.e., attributable fraction [AF]) associated with exceptional heatwaves, at the country level and for Europe as a whole. In Europe, the mortality burden attributable to main and added effects increased from 0.492% (95% CI: 0.488%-0.496%) to 1.276% (95% CI: 1.266%-1.285%) and from 0.307% (95% CI: 0.294%-0.318%) to 0.428% (95% CI: 0.407%-0.448%), respectively. Furthermore, substantial variations across countries were observed, with some countries such as France and Spain experiencing a large increase in the mortality burden attributable to exceptional heatwaves since the COVID-19 outbreak. Our findings underscore the urgent need for heat-health actions to consider the multi-effects of exceptional heatwaves amidst a warming climate.

Keywords: Coronavirus disease 2019; Heatwaves; Mortality.