Journal
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Volume 18, Issue 18, Pages -Publisher
MDPI
DOI: 10.3390/ijerph18189506
Keywords
health adaptation; Sustainable Development Goal 3; heat-health threshold identification; extreme events and health
Funding
- Research Center for Environmental Changes of Academia Sinica
- Academia Sinica thematic project [AS-104-SS-A02, AS-SS-107-03]
- Ministry of Science and Technology project [108-2621-M-001-004]
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This study improved a generalized additive model to identify thresholds with significant health risk enhancements based on Taiwan population data from 2000-2017. It proposed the use of reference-adjusted risk ratio (RaRR) to determine the optimal threshold, highlighting the importance of wet-bulb globe temperature (WBGT) as a more sensitive heat-health indicator. Results showed higher RaRRs for emergency visits compared to hospital visits and all-cause mortality across various demographics, suggesting the prioritization of emergency visits in selecting heat-warning thresholds.
Most heat-health studies identified thresholds just outside human comfort zones, which are often too low to be used in heat-warning systems for reducing climate-related health risks. We refined a generalized additive model for selecting thresholds with substantial health risk enhancement, based on Taiwan population records of 2000-2017, considering lag effects and different spatial scales. Reference-adjusted risk ratio (RaRR) is proposed, defined as the ratio between the relative risk of an essential health outcome for a threshold candidate against that for a reference; the threshold with the highest RaRR is potentially the optimal one. It was found that the wet-bulb globe temperature (WBGT) is a more sensitive heat-health indicator than temperature. At lag 0, the highest RaRR (1.66) with WBGT occurred in emergency visits of children, while that in hospital visits occurred for the working-age group (1.19), presumably due to high exposure while engaging in outdoor activities. For most sex, age, and sub-region categories, the RaRRs of emergency visits were higher than those of hospital visits and all-cause mortality; thus, emergency visits should be employed (if available) to select heat-warning thresholds. This work demonstrates the applicability of this method to facilitate the establishment of heat-warning systems at city or country scales by authorities worldwide.
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