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Projecting Future Heat-Related Mortality under Climate Change Scenarios: A Systematic Review

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      Background: Heat-related mortality is a matter of great public health concern, especially in the light of climate change. Although many studies have found associations between high temperatures and mortality, more research is needed to project the future impacts of climate change on heat-related mortality.

      Objectives: We conducted a systematic review of research and methods for projecting future heat-related mortality under climate change scenarios.

      Data sources and extraction: A literature search was conducted in August 2010, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 through July 2010.

      Data synthesis: Fourteen studies fulfilled the inclusion criteria. Most projections showed that climate change would result in a substantial increase in heat-related mortality. Projecting heat-related mortality requires understanding historical temperature–mortality relationships and considering the future changes in climate, population, and acclimatization. Further research is needed to provide a stronger theoretical framework for projections, including a better understanding of socioeconomic development, adaptation strategies, land-use patterns, air pollution, and mortality displacement.

      Conclusions: Scenario-based projection research will meaningfully contribute to assessing and managing the potential impacts of climate change on heat-related mortality.

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      Most cited references 101

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      Advances in the science and observation of climate change are providing a clearer understanding of the inherent variability of Earth's climate system and its likely response to human and natural influences. The implications of climate change for the environment and society will depend not only on the response of the Earth system to changes in radiative forcings, but also on how humankind responds through changes in technology, economies, lifestyle and policy. Extensive uncertainties exist in future forcings of and responses to climate change, necessitating the use of scenarios of the future to explore the potential consequences of different response options. To date, such scenarios have not adequately examined crucial possibilities, such as climate change mitigation and adaptation, and have relied on research processes that slowed the exchange of information among physical, biological and social scientists. Here we describe a new process for creating plausible scenarios to investigate some of the most challenging and important questions about climate change confronting the global community.
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        A global coupled climate model shows that there is a distinct geographic pattern to future changes in heat waves. Model results for areas of Europe and North America, associated with the severe heat waves in Chicago in 1995 and Paris in 2003, show that future heat waves in these areas will become more intense, more frequent, and longer lasting in the second half of the 21st century. Observations and the model show that present-day heat waves over Europe and North America coincide with a specific atmospheric circulation pattern that is intensified by ongoing increases in greenhouse gases, indicating that it will produce more severe heat waves in those regions in the future.
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          The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Niño/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.

            Author and article information

            [1 ]School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
            [2 ]CSIRO Climate Adaptation Flagship and CSIRO Ecosystem Sciences, Commonwealth Scientific and Industrial Research Organisation, Melbourne, Australia
            Author notes
            Address correspondence to C. Huang, School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Rd., Kelvin Grove, Brisbane, QLD 4059, Australia. Telephone: 61 731389673. Fax: 61 731383130. E-mail: huangcunrui@
            Environ Health Perspect
            Environmental Health Perspectives
            National Institute of Environmental Health Sciences
            04 August 2011
            December 2011
            : 119
            : 12
            : 1681-1690

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


            Public health

            heat wave, public health, projection, scenario, climate change, mortality


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