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Added effect of heat wave on mortality in Seoul, Korea

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Abstract

A heat wave could increase mortality owing to high temperature. However, little is known about the added (duration) effect of heat wave from the prolonged period of high temperature on mortality and different effect sizes depending on the definition of heat waves and models. A distributed lag non-linear model with a quasi-Poisson distribution was used to evaluate the added effect of heat wave on mortality after adjusting for long-term and intra-seasonal trends and apparent temperature. We evaluated the cumulative relative risk of the added wave effect on mortality on lag days 0–30. The models were constructed using nine definitions of heat wave and two relationships (cubic spline and linear threshold model) between temperature and mortality to leave out the high temperature effect. Further, we performed sensitivity analysis to evaluate the changes in the effect of heat wave on mortality according to the different degrees of freedom for time trend and cubic spline of temperature. We found that heat wave had the added effect from the prolonged period of high temperature on mortality and it was considerable in the aspect of cumulative risk because of the lagged influence. When heat wave was defined with a threshold of 98th percentile temperature and ≥2, 3, and 4 consecutive days, mortality increased by 14.8 % (7.5–22.6, 95 % confidence interval (CI)), 18.1 % (10.8–26.0, 95 % CI), 18.1 % (10.7–25.9, 95 % CI), respectively, in cubic spline model. When it came to the definitions of 90th and 95th percentile, the risk increase in mortality declined to 3.7–5.8 % and 8.6–11.3 %, respectively. This effect was robust to the flexibility of the model for temperature and time trend, while the definitions of a heat wave were critical in estimating its relationship with mortality. This finding could help deepen our understanding and quantifying of the relationship between heat wave and mortality and select an appropriate definition of heat wave and temperature model in the future studies.

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Acknowledgments

This study was supported by a grant provided by the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI13C0729) and INHA UNIVERSITY RESITY Research Grant (INHA-50727-01), and the Women Scientist Research Program, Ministry of Science, ICT, and Future Planning (#2015R1A1A3A04001325).

Role of funding sources

The granting agency was not involved in the design and procedure of the study and played no role in the collection, management, analysis, and interpretation of the data or in the preparation, review, or approval of the manuscript.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Social and Preventive Medicine, Inha University School of Medicine, 27 Inhang-Ro, Jung Gu, Incheon, Republic of Korea

    Won Kyung Lee

  2. Department of Preventive Medicine, School of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-ku, Seoul, 158-710, Republic of Korea

    Hye Ah Lee & Hyesook Park

  3. Institute of Environmental Medicine, Seoul National University of Medical Research Center, Seoul National University, Seoul, Republic of Korea

    Youn Hee Lim

  4. Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea

    Youn Hee Lim

Authors
  1. Won Kyung Lee
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  2. Hye Ah Lee
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Corresponding author

Correspondence to Hyesook Park.

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Fig. S1

Plot for generalized additive model of the daily mortality rate according to daily apparent temperature (JPEG 79 kb)

High resolution image (TIFF 922 kb)

Fig. S2

Plot for change in the influence of daily apparent temperature on mortality depending on the lag days (JPEG 68 kb)

High resolution image (TIFF 922 kb)

Fig. S3

Percent changes in daily mortality on heat wave days for different degrees of freedoms per warm season (May–September) compared to non-heat wave days. NS and PL stand for natural cubic spline and piecewise linear regression for apparent temperature which was adjusted for in the model. (JPEG 135 kb)

High resolution image (TIFF 1172 kb)

Fig. S4

Percent changes in daily mortality on heat wave days for different degrees of freedoms for cubic spline of apparent temperature compared to non-heat wave days (JPEG 112 kb)

High resolution image (TIFF 879 kb)

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Lee, W.K., Lee, H.A., Lim, Y.H. et al. Added effect of heat wave on mortality in Seoul, Korea. Int J Biometeorol 60, 719–726 (2016). https://doi.org/10.1007/s00484-015-1067-x

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  • DOI: https://doi.org/10.1007/s00484-015-1067-x

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