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      Biometeorological Assessment of Mortality Related to Extreme Temperatures in Helsinki Region, Finland, 1972–2014

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          Abstract

          Climate change is expected to increase heat-related and decrease cold-related mortality. The extent of acclimatization of the population to gradually-changing thermal conditions is not well understood. We aimed to define the relationship between mortality and temperature extremes in different age groups in the Helsinki-Uusimaa hospital district in Southern Finland, and changes in sensitivity of the population to temperature extremes over the period of 1972–2014. Time series of mortality were made stationary with a method that utilizes 365-day Gaussian smoothing, removes trends and seasonality, and gives relative mortality as the result. We used generalized additive models to examine the association of relative mortality to physiologically equivalent temperature (PET) and to air temperature in the 43-year study period and in two 21-year long sub-periods (1972–1992 and 1994–2014). We calculated the mean values of relative mortality in percentile-based categories of thermal indices. Relative mortality increases more in the hot than in the cold tail of the thermal distribution. The increase is strongest among those aged 75 years and older, but is somewhat elevated even among those younger than 65 years. Above the 99th percentile of the PET distribution, the all-aged relative mortality decreased in time from 18.3 to 8.6%. Among those ≥75 years old, the decrease in relative mortality between the sub-periods were found to be above the 90th percentile. The dependence of relative mortality on cold extremes was negligible, except among those ≥75 years old, in the latter period. Thus, heat-related mortality is also remarkable in Finland, but the sensitivity to heat stress has decreased over the decades.

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          Most cited references47

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          Climate change and human health: present and future risks.

          There is near unanimous scientific consensus that greenhouse gas emissions generated by human activity will change Earth's climate. The recent (globally averaged) warming by 0.5 degrees C is partly attributable to such anthropogenic emissions. Climate change will affect human health in many ways-mostly adversely. Here, we summarise the epidemiological evidence of how climate variations and trends affect various health outcomes. We assess the little evidence there is that recent global warming has already affected some health outcomes. We review the published estimates of future health effects of climate change over coming decades. Research so far has mostly focused on thermal stress, extreme weather events, and infectious diseases, with some attention to estimates of future regional food yields and hunger prevalence. An emerging broader approach addresses a wider spectrum of health risks due to the social, demographic, and economic disruptions of climate change. Evidence and anticipation of adverse health effects will strengthen the case for pre-emptive policies, and will also guide priorities for planned adaptive strategies.
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            Heat stress and public health: a critical review.

            Heat is an environmental and occupational hazard. The prevention of deaths in the community caused by extreme high temperatures (heat waves) is now an issue of public health concern. The risk of heat-related mortality increases with natural aging, but persons with particular social and/or physical vulnerability are also at risk. Important differences in vulnerability exist between populations, depending on climate, culture, infrastructure (housing), and other factors. Public health measures include health promotion and heat wave warning systems, but the effectiveness of acute measures in response to heat waves has not yet been formally evaluated. Climate change will increase the frequency and the intensity of heat waves, and a range of measures, including improvements to housing, management of chronic diseases, and institutional care of the elderly and the vulnerable, will need to be developed to reduce health impacts.
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              The physiological equivalent temperature - a universal index for the biometeorological assessment of the thermal environment.

              P Hoppe (1999)
              With considerably increased coverage of weather information in the news media in recent years in many countries, there is also more demand for data that are applicable and useful for everyday life. Both the perception of the thermal component of weather as well as the appropriate clothing for thermal comfort result from the integral effects of all meteorological parameters relevant for heat exchange between the body and its environment. Regulatory physiological processes can affect the relative importance of meteorological parameters, e.g. wind velocity becomes more important when the body is sweating. In order to take into account all these factors, it is necessary to use a heat-balance model of the human body. The physiological equivalent temperature (PET) is based on the Munich Energy-balance Model for Individuals (MEMI), which models the thermal conditions of the human body in a physiologically relevant way. PET is defined as the air temperature at which, in a typical indoor setting (without wind and solar radiation), the heat budget of the human body is balanced with the same core and skin temperature as under the complex outdoor conditions to be assessed. This way PET enables a layperson to compare the integral effects of complex thermal conditions outside with his or her own experience indoors. On hot summer days, for example, with direct solar irradiation the PET value may be more than 20 K higher than the air temperature, on a windy day in winter up to 15 K lower.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                22 August 2017
                August 2017
                : 14
                : 8
                : 944
                Affiliations
                [1 ]Finnish Meteorological Institute, P.O. Box 503, FI-00101 Helsinki, Finland; kirsti.jylha@ 123456fmi.fi
                [2 ]National Institute for Health and Welfare, P.O. Box 95, FI-70701 Kuopio, Finland; timo.lanki@ 123456thl.fi (T.L.); pekka.tiittanen@ 123456thl.fi (P.T.)
                [3 ]Research Center Human Biometeorology, German Meteorological Service, Stefan-Meier-Str. 4, D-79104 Freiburg, Germany; Andreas.Matzarakis@ 123456dwd.de
                Author notes
                [* ]Correspondence: reija.ruuhela@ 123456fmi.fi ; Tel.: +358-500-424533
                Author information
                https://orcid.org/0000-0003-3076-555X
                Article
                ijerph-14-00944
                10.3390/ijerph14080944
                5580646
                28829351
                1bb92cb8-9112-4025-af62-631f57445989
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 June 2017
                : 18 August 2017
                Categories
                Article

                Public health
                mortality,thermal comfort index,heat stress,cold stress,climate,acclimatization
                Public health
                mortality, thermal comfort index, heat stress, cold stress, climate, acclimatization

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