Abstract
In 2016, South Korea experienced extremely high temperatures and the Korea Centre for Disease Control and Prevention (KCDC) reported 17 heat-caused deaths during these heat waves, most due to heat stroke. Because the reported number of heat-caused deaths is only part of the total deaths associated with heat waves, we aimed to estimate attributable deaths during heat wave episodes. We linked mortality to meteorological data in 16 regions in South Korea and estimated relative risk at or above threshold of maximum temperature during summer using generalized linear regression models after controlling for confounders. We computed overall, age-, sex-, and cause-specific attributable deaths from 2006 to 2017. With a 1.5% increase in all-cause mortality per 1 °C increase in concurrent days’ maximum temperature during summer, this study estimates a total of 1440 all-cause deaths associated with heat waves during the 2006–2017 study period in South Korea. We estimate that 343 deaths in 2016 can be ascribed to heat waves, which is approximately 20 times more than the number reported by the KCDC (17 heat-caused deaths). This study addresses attributable heat wave deaths in South Korea and illustrates that the reports of medically classified heat-caused deaths seriously underestimate the number of deaths attributable to heat waves. Our findings may enable the implementation and reinforcement of government- and individual-level management strategies for heat waves.
This is a preview of subscription content, access via your institution.



Abbreviations
- AC:
-
attributable mortality counts
- aAC:
-
annual attributable mortality counts
- cAC:
-
cumulative attributable mortality counts
- CI:
-
confidence intervals
- ER:
-
emergency room
- ICD:
-
international classification of diseases
- KCDC:
-
Korea Centre for Disease Control and Prevention
- KMA:
-
Korea Meteorological Administration
- KOSIS:
-
Korean Statistical Information Service
- RR:
-
relative risk
References
Baccini M, Kosatsky T, Analitis A, Anderson HR, D’Ovidio M, Menne B, Michelozzi P, Biggeri A, Group PC (2011) Impact of heat on mortality in 15 European cities: attributable deaths under different weather scenarios. J Epidemiol Community Health 65(1):64–70. https://doi.org/10.1136/jech.2008.085639
Fouillet A, Rey G, Laurent F, Pavillon G, Bellec S, Guihenneuc-Jouyaux C, Clavel J, Jougla E, Hémon D (2006) Excess mortality related to the August 2003 heat wave in France. Int Arch Occup Environ Health 80(1):16–24. https://doi.org/10.1007/s00420-006-0089-4
Ha J, Kim H (2013) Changes in the association between summer temperature and mortality in Seoul, South Korea. Int J Biometeorol 57(4):535–544. https://doi.org/10.1007/s00484-012-0580-4
Ha J, Shin Y, Kim H (2011) Distributed lag effects in the relationship between temperature and mortality in three major cities in South Korea. Sci Total Environ 409(18):3274–3280. https://doi.org/10.1016/j.scitotenv.2011.05.034
Kim Y-H, Baik J-J (2002) Maximum urban heat island intensity in Seoul. J Appl Meteorol 41(6):651–659. https://doi.org/10.1175/1520-0450(2002)041<0651:MUHIII>2.0.CO;2
Kim Y, Joh S (2006) A vulnerability study of the low-income elderly in the context of high temperature and mortality in Seoul, Korea. Sci Total Environ 371(1–3):82–88. https://doi.org/10.1016/j.scitotenv.2006.08.014
Kim E-J, Kim H (2017) Effect modification of individual-and regional-scale characteristics on heat wave-related mortality rates between 2009 and 2012 in Seoul, South Korea. Sci Total Environ 595:141–148. https://doi.org/10.1016/j.scitotenv.2017.03.248
Kim H, Ha J-S, Park J (2006) High temperature, heat index, and mortality in 6 major cities in South Korea. Arch Environ Occup Health 61(6):265–270. https://doi.org/10.3200/AEOH.61.6.265-270
Kim Y, Kim H, Kim D-S (2011) Association between daily environmental temperature and suicide mortality in Korea (2001–2005). Psychiatry Res 186(2–3):390–396. https://doi.org/10.1016/j.psychres.2010.08.006
Kim S-H, Jo S-N, Myung H-N, Jang J-Y (2014) The effect of pre-existing medical conditions on heat stroke during hot weather in South Korea. Environ Res 133:246–252. https://doi.org/10.1016/j.envres.2014.06.003
Kim CT, Lim Y-H, Woodward A, Kim H (2015) Heat-attributable deaths between 1992 and 2009 in Seoul, South Korea. PLoS One 10(2):e0118577. https://doi.org/10.1371/journal.pone.0118577
Kim D-W, Deo RC, Park S-J, Lee J-S, Lee W-S (2018) Weekly heat wave death prediction model using zero-inflated regression approach. Theor Appl Climatol:1–16. https://doi.org/10.1007/s00704-018-2636-9
KMA (2019) Number of heatwave days. Korea Meteorological Administration. https://data.kma.go.kr/climate/heatWave/selectHeatWaveChart.do?pgmNo=106. Accessed June 25 2019
KOSIS (2019) Statistical database. Statistics Korea. http://kosis.kr/eng/. Accessed April 30 2019
Kysely J, Kim J (2009) Mortality during heat waves in South Korea, 1991 to 2005: how exceptional was the 1994 heat wave? Clim Res 38(2):105–116. https://doi.org/10.3354/cr00775
Lee S-J (2018) Heat wave victims to be eligible for natural disaster subsidies of up to W10m. The Korea Herald, Dec 3, 2018, p 1
Lee W-H, Lim Y-H, Dang TN, Seposo X, Honda Y, Guo Y-LL, Jang H-M, Kim H (2017) An investigation on attributes of ambient temperature and diurnal temperature range on mortality in five east-Asian countries. Sci Rep 7:10207. https://doi.org/10.1038/s41598-017-10433-8
Lim YH, Ohn IS, Kim H (2013) HEAT: health effects of air pollution and temperature. The Comprehensive R Archive Network. https://CRAN.R-project.org/package=HEAT. Accessed 28 Jan 2019
Lim Y-H, So R, Lee C, Hong Y-C, Park M, Kim L, Yoon H-J (2018) Ambient temperature and hospital admissions for acute kidney injury: a time-series analysis. Sci Total Environ 616:1134–1138. https://doi.org/10.1016/j.scitotenv.2017.10.207
Madrigano J, McCormick S, Kinney PL (2015) The two ways of assessing heat-related mortality and vulnerability. Am J Public Health 105(11):2212–2213. https://doi.org/10.2105/AJPH.2015.302848
Mitchell D, Heaviside C, Vardoulakis S, Huntingford C, Masato G, Guillod BP, Frumhoff P, Bowery A, Wallom D, Allen M (2016) Attributing human mortality during extreme heat waves to anthropogenic climate change. Environ Res Lett 11(7):074006. https://doi.org/10.1088/1748-9326/11/7/074006
Na W, Jang J-Y, Lee KE, Kim H, Jun B, Kwon J-W, Jo S-N (2013) The effects of temperature on heat-related illness according to the characteristics of patients during the summer of 2012 in the Republic of Korea. J Prev Med Public Health 46(1):19–27. https://doi.org/10.3961/jpmph.2013.46.1.19
Park S-W, Park S, Lee H-I, Lee S-W (2016) Results of heat-related illnesses surveillance, 2016 Korea Centers for Disease Control and Prevention, Osong, Korea
Patz JA, Campbell-Lendrum D, Holloway T, Foley JA (2005) Impact of regional climate change on human health. Nature 438(7066):310–317. https://doi.org/10.1038/nature04188
Pirard P, Vandentorren S, Pascal M, Laaidi K, Le Tertre A, Cassadou S, Ledrans M (2005) Summary of the mortality impact assessment of the 2003 heat wave in France. Euro Surveill 10(7):153–156. https://doi.org/10.2807/esm.10.07.00554-en
Schwartz JD, Wang Y, Kloog I, Ma Y-S, Dominici F, AJEhp Z (2018) Estimating the effects of PM 2.5 on life expectancy using causal modeling methods. Environ Health Perspect 126(12):127002. https://doi.org/10.1289/EHP3130
Son J-Y, Lee J-T, Anderson GB, Bell ML (2011) Vulnerability to temperature-related mortality in Seoul, Korea. Environ Res Lett 6(3):034027. https://doi.org/10.1088/1748-9326/6/3/034027
Son J-Y, Lane KJ, Lee J-T, Bell ML (2016) Urban vegetation and heat-related mortality in Seoul, Korea. Environ Res 151:728–733. https://doi.org/10.1016/j.envres.2016.09.001
Whitman S, Good G, Donoghue ER, Benbow N, Shou W, Mou S (1997) Mortality in Chicago attributed to the July 1995 heat wave. Am J Public Health 87(9):1515–1518. https://doi.org/10.2105/AJPH.87.9.1515
Wood SN (2001) mgcv: GAMs and generalized ridge regression for R. R News 1:20–25
Yeh S-W, Won Y-J, Hong J-S, Lee K-J, Kwon M, Seo K-H, Ham Y-G (2018) The record-breaking heat wave in 2016 over South Korea and its physical mechanism. Mon Weather Rev 146(5):1463–1474. https://doi.org/10.1175/MWR-D-17-0205.1
Funding
This research was supported by the Women Scientist Research Program through the National Research Foundation of Korea (NRF) and funded by the Ministry of Science, ICT, and Future Planning (#2015R1A1A3A04001325); the Korea Centre for Disease Control and Prevention (#20180202D8A-00); National Disaster Management Research Institute (#21183078700); and the Centre for Environmental Health through the Ministry of Environment.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare that they have no competing interests.
Electronic supplementary material
ESM 1
(DOCX 300 kb).
Rights and permissions
About this article
Cite this article
Lim, YH., Lee, KS., Bae, HJ. et al. Estimation of heat-related deaths during heat wave episodes in South Korea (2006–2017). Int J Biometeorol 63, 1621–1629 (2019). https://doi.org/10.1007/s00484-019-01774-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00484-019-01774-2
Keywords
- Attributable mortality
- Health impact
- Heat waves
- Temperature