Abstract：
BACKGROUND: Heat-related mortality has become a growing public health concern in light of climate change. However, few studies have quantified the climate-attributable health burden in Cyprus, a recognized climate change hotspot. This study aims to estimate the heat-related mortality in Cyprus for all future decades in the 21st century under moderate (SSP2-4.5) and extreme (SSP5-8.5) climate scenarios.
METHODS: We applied distributed lag non-linear models to estimate the baseline associations between temperature and mortality from 2004 to 2019 (data obtained from Department of Meteorology of the Ministry of Agriculture, Rural Development and Environment and the Health Monitoring Unit of the Cyprus Ministry of Health). The relationships were then extrapolated to future daily mean temperatures derived from downscaled global climate projections from General Circulation Models. Attributable number of deaths were calculated to determine the excess heat-related health burden compared to the baseline decade of 2000-2009 in the additive scale. The analysis process was repeated for all-cause, cardiovascular, and respiratory mortality and mortality among males, females, and adults younger or older than 65. We assumed a static population and demographic structure, no adaptation to hot temperatures over time, and did not evaluate potential interaction between temperature and humidity.
RESULTS: Compared to 2000-2009, heat-related total mortality is projected to increase by 2.7% (95% empirical confidence interval: 0.6, 4.0) and 4.75% (2.2, 7.1) by the end of the century in the moderate and extreme climate scenarios, respectively. Cardiovascular disease is expected to be an important cause of heat-related death with projected increases of 3.4% (0.7, 5.1) and 6% (2.6, 9.0) by the end of the century. Reducing carbon emission to the moderate scenario can help avoid 75% of the predicted increase in all-cause heat-related mortality by the end of the century relative to the extreme scenario.
CONCLUSIONS: Our findings suggest that climate change mitigation and sustainable adaptation strategies are crucial to reduce the anticipated heat-attributable health burden, particularly in Cyprus, where adaptation strategies such as air conditioning is nearing capacity.
METHODS: We applied distributed lag non-linear models to estimate the baseline associations between temperature and mortality from 2004 to 2019 (data obtained from Department of Meteorology of the Ministry of Agriculture, Rural Development and Environment and the Health Monitoring Unit of the Cyprus Ministry of Health). The relationships were then extrapolated to future daily mean temperatures derived from downscaled global climate projections from General Circulation Models. Attributable number of deaths were calculated to determine the excess heat-related health burden compared to the baseline decade of 2000-2009 in the additive scale. The analysis process was repeated for all-cause, cardiovascular, and respiratory mortality and mortality among males, females, and adults younger or older than 65. We assumed a static population and demographic structure, no adaptation to hot temperatures over time, and did not evaluate potential interaction between temperature and humidity.
RESULTS: Compared to 2000-2009, heat-related total mortality is projected to increase by 2.7% (95% empirical confidence interval: 0.6, 4.0) and 4.75% (2.2, 7.1) by the end of the century in the moderate and extreme climate scenarios, respectively. Cardiovascular disease is expected to be an important cause of heat-related death with projected increases of 3.4% (0.7, 5.1) and 6% (2.6, 9.0) by the end of the century. Reducing carbon emission to the moderate scenario can help avoid 75% of the predicted increase in all-cause heat-related mortality by the end of the century relative to the extreme scenario.
CONCLUSIONS: Our findings suggest that climate change mitigation and sustainable adaptation strategies are crucial to reduce the anticipated heat-attributable health burden, particularly in Cyprus, where adaptation strategies such as air conditioning is nearing capacity.
摘要：
背景：鉴于气候变化，与热相关的死亡率已成为越来越多的公共卫生问题。然而,很少有研究量化塞浦路斯的气候可归因于健康的负担，公认的气候变化热点。这项研究旨在估算21世纪在中度（SSP2-4.5）和极端（SSP5-8.5）气候情景下塞浦路斯未来几十年与热有关的死亡率。
方法：我们应用了分布式滞后非线性模型来估计2004年至2019年温度与死亡率之间的基线关联（从农业部气象司获得的数据，农村发展与环境以及塞浦路斯卫生部健康监测股）。然后将这些关系外推至未来的每日平均温度，该温度来自通用循环模型的缩减全球气候预测。计算了可归因的死亡人数，以确定与2000-2009年基线十年相比的过量热量相关的健康负担。对所有原因重复分析过程，心血管,以及男性的呼吸道死亡率和死亡率，女性,以及年龄小于或超过65岁的成年人。我们假设一个静态的人口和人口结构，随着时间的推移不适应高温，并且没有评估温度和湿度之间的潜在相互作用。
结果：与2000-2009年相比，预计与热有关的总死亡率将增加2.7％（95％经验置信区间：0.6，4.0）和4.75％（2.2，7.1）在温和和极端气候情景下，到本世纪末，分别。心血管疾病预计将是热相关死亡的重要原因，预计到本世纪末将增加3.4％（0.7，5.1）和6％（2.6，9.0）。将碳排放减少到适度的情景可以帮助避免在本世纪末相对于极端情景的所有原因与热相关的死亡率的预测增加的75％。
结论：我们的研究结果表明，减缓气候变化和可持续适应战略对于减少预期的热引起的健康负担至关重要。特别是在塞浦路斯，空调等适应策略已经接近容量。
方法：我们应用了分布式滞后非线性模型来估计2004年至2019年温度与死亡率之间的基线关联（从农业部气象司获得的数据，农村发展与环境以及塞浦路斯卫生部健康监测股）。然后将这些关系外推至未来的每日平均温度，该温度来自通用循环模型的缩减全球气候预测。计算了可归因的死亡人数，以确定与2000-2009年基线十年相比的过量热量相关的健康负担。对所有原因重复分析过程，心血管,以及男性的呼吸道死亡率和死亡率，女性,以及年龄小于或超过65岁的成年人。我们假设一个静态的人口和人口结构，随着时间的推移不适应高温，并且没有评估温度和湿度之间的潜在相互作用。
结果：与2000-2009年相比，预计与热有关的总死亡率将增加2.7％（95％经验置信区间：0.6，4.0）和4.75％（2.2，7.1）在温和和极端气候情景下，到本世纪末，分别。心血管疾病预计将是热相关死亡的重要原因，预计到本世纪末将增加3.4％（0.7，5.1）和6％（2.6，9.0）。将碳排放减少到适度的情景可以帮助避免在本世纪末相对于极端情景的所有原因与热相关的死亡率的预测增加的75％。
结论：我们的研究结果表明，减缓气候变化和可持续适应战略对于减少预期的热引起的健康负担至关重要。特别是在塞浦路斯，空调等适应策略已经接近容量。
