Abstract：
BACKGROUND: A large body of scientific evidence has established the impact of increased temperatures on human health. There is a relationship between extreme heat (either incremental temperature increase or heatwaves), and heat-related illnesses. This study aimed to collate the research findings on the effects of extreme heat on heat-related illness in a systematic review and meta-analysis, and to provide robust evidence for needed public health intervention.
METHODS: We conducted a search of peer-reviewed articles in three electronic databases (PubMed, EMBASE, and SCOPUS), from database inception until January 2022. A random-effects meta-analysis model was used to calculate the pooled relative risks (RRs) of the association between high temperature and heat-related illness outcomes. A narrative synthesis was also performed for studies analysing heatwave effects. Assessment of evidence was performed in three parts: individual study risk of bias; quality of evidence across studies; and overall strength of evidence.
RESULTS: A total of 62 studies meeting the eligibility criteria were included in the review, of which 30 were qualified to be included in the meta-analysis. The pooled results showed that for every 1 °C increase in temperature, when measured from study-specific baseline temperatures, direct heat illness morbidity and mortality increased by 18 % (RR 1.18, 95%CI: 1.16-1.19) and 35 % (RR 1.35, 95%CI: 1.29-1.41), respectively. For morbidity, the greatest increase was for direct heat illness (RR 1.45, 95%CI: 1.38-1.53), compared to dehydration (RR 1.02, 95%CI: 1.02-1.03). There was higher risk for people aged >65 years (RR 1.25; 95 % CI: 1.20-1.30), and those living in subtropical climates (RR 1.25; 95 % CI: 1.21-1.29).
CONCLUSIONS: Increased temperature leads to higher burden of disease from heat-related illness. Preventative efforts should be made to reduce heat-related illness during hot weather, targeting on the most vulnerable populations. This is especially important in the context of climate change.
METHODS: We conducted a search of peer-reviewed articles in three electronic databases (PubMed, EMBASE, and SCOPUS), from database inception until January 2022. A random-effects meta-analysis model was used to calculate the pooled relative risks (RRs) of the association between high temperature and heat-related illness outcomes. A narrative synthesis was also performed for studies analysing heatwave effects. Assessment of evidence was performed in three parts: individual study risk of bias; quality of evidence across studies; and overall strength of evidence.
RESULTS: A total of 62 studies meeting the eligibility criteria were included in the review, of which 30 were qualified to be included in the meta-analysis. The pooled results showed that for every 1 °C increase in temperature, when measured from study-specific baseline temperatures, direct heat illness morbidity and mortality increased by 18 % (RR 1.18, 95%CI: 1.16-1.19) and 35 % (RR 1.35, 95%CI: 1.29-1.41), respectively. For morbidity, the greatest increase was for direct heat illness (RR 1.45, 95%CI: 1.38-1.53), compared to dehydration (RR 1.02, 95%CI: 1.02-1.03). There was higher risk for people aged >65 years (RR 1.25; 95 % CI: 1.20-1.30), and those living in subtropical climates (RR 1.25; 95 % CI: 1.21-1.29).
CONCLUSIONS: Increased temperature leads to higher burden of disease from heat-related illness. Preventative efforts should be made to reduce heat-related illness during hot weather, targeting on the most vulnerable populations. This is especially important in the context of climate change.
摘要：
背景：大量科学证据已经确定了温度升高对人类健康的影响。有极端的热量（无论是增量温度增加或热浪）之间的关系，和热相关的疾病。本研究旨在通过系统评价和荟萃分析来整理有关极端高温对与热有关的疾病的影响的研究结果。并为所需的公共卫生干预提供有力的证据。
方法：我们在三个电子数据库（PubMed，EMBASE,和SCOPUS),从数据库开始到2022年1月。使用随机效应荟萃分析模型来计算高温与热相关疾病结局之间关联的合并相对风险（RR）。还进行了叙事综合，以分析热浪效应。证据评估分为三个部分：个体研究偏倚风险；跨研究的证据质量；和总体证据强度。
结果：共有62项符合资格标准的研究被纳入审查，其中30人符合纳入荟萃分析的条件.汇总结果显示，温度每升高1°C，当从研究特定的基线温度测量时，直接热病发病率和死亡率增加了18%(RR1.18,95CI:1.16-1.19)和35%(RR1.35,95CI:1.29-1.41)，分别。对于发病率，增幅最大的是直接热病(RR1.45，95CI：1.38-1.53)，与脱水相比（RR1.02，95CI：1.02-1.03）。年龄>65岁的人群风险较高（RR1.25；95%CI：1.20-1.30），和生活在亚热带气候中的人(RR1.25；95%CI：1.21-1.29)。
结论：温度升高会导致与热有关的疾病负担增加。在炎热天气期间，应采取预防性措施减少与热有关的疾病，针对最脆弱的人群。这在气候变化的背景下尤为重要。
方法：我们在三个电子数据库（PubMed，EMBASE,和SCOPUS),从数据库开始到2022年1月。使用随机效应荟萃分析模型来计算高温与热相关疾病结局之间关联的合并相对风险（RR）。还进行了叙事综合，以分析热浪效应。证据评估分为三个部分：个体研究偏倚风险；跨研究的证据质量；和总体证据强度。
结果：共有62项符合资格标准的研究被纳入审查，其中30人符合纳入荟萃分析的条件.汇总结果显示，温度每升高1°C，当从研究特定的基线温度测量时，直接热病发病率和死亡率增加了18%(RR1.18,95CI:1.16-1.19)和35%(RR1.35,95CI:1.29-1.41)，分别。对于发病率，增幅最大的是直接热病(RR1.45，95CI：1.38-1.53)，与脱水相比（RR1.02，95CI：1.02-1.03）。年龄>65岁的人群风险较高（RR1.25；95%CI：1.20-1.30），和生活在亚热带气候中的人(RR1.25；95%CI：1.21-1.29)。
结论：温度升高会导致与热有关的疾病负担增加。在炎热天气期间，应采取预防性措施减少与热有关的疾病，针对最脆弱的人群。这在气候变化的背景下尤为重要。
