Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change
Abstract Heatwaves are commonly simplified as binary variables in epidemiological studies, limiting the understanding of heatwave-mortality associations. Here we conduct a multi-country study across 28 East Asian cities that employed the Cumulative Excess Heatwave Index (CEHWI), which represents exc...
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Nature Portfolio
2025-01-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-025-56067-7 |
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| author | Jiangdong Liu Ho Kim Masahiro Hashizume Whanhee Lee Yasushi Honda Satbyul Estella Kim Cheng He Haidong Kan Renjie Chen |
| author_facet | Jiangdong Liu Ho Kim Masahiro Hashizume Whanhee Lee Yasushi Honda Satbyul Estella Kim Cheng He Haidong Kan Renjie Chen |
| author_sort | Jiangdong Liu |
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| description | Abstract Heatwaves are commonly simplified as binary variables in epidemiological studies, limiting the understanding of heatwave-mortality associations. Here we conduct a multi-country study across 28 East Asian cities that employed the Cumulative Excess Heatwave Index (CEHWI), which represents excess heat accumulation during heatwaves, to explore the potentially nonlinear associations of daytime-only, nighttime-only, and day-night compound heatwaves with mortality from 1981 to 2010. Populations exhibited high adaptability to daytime-only and nighttime-only heatwaves, with non-accidental mortality risks increasing only at higher CEHWI levels (75th–90th percentiles). In contrast, compound heatwaves posed a super-linear increase in mortality risks after the 25th percentile of CEHWI. Associations of heatwaves with cardiovascular mortality mirrored those with non-accidental mortality but were more pronounced at higher CEHWI levels, while significant associations with respiratory mortality emerged at low-to-moderate CEHWI levels. These results highlight the necessity of considering the nonlinear health responses to heatwaves of different types in disease burden assessments and heatwave-health warning systems amid climate change. |
| format | Article |
| id | doaj-art-bfb0419b8a394c0faa7fb667f884149b |
| institution | Kabale University |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Nature Communications |
| spelling | doaj-art-bfb0419b8a394c0faa7fb667f884149b2025-01-19T12:31:57ZengNature PortfolioNature Communications2041-17232025-01-0116111210.1038/s41467-025-56067-7Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate changeJiangdong Liu0Ho Kim1Masahiro Hashizume2Whanhee Lee3Yasushi Honda4Satbyul Estella Kim5Cheng He6Haidong Kan7Renjie Chen8School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan UniversityDepartment of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National UniversityDepartment of Global Health Policy, Graduate School of Medicine, The University of TokyoSchool of Biomedical Convergence Engineering, Pusan National UniversityCenter for Climate Change Adaptation, National Institute for Environmental StudiesCenter for Climate Change Adaptation, National Institute for Environmental StudiesInstitute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental HealthSchool of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan UniversitySchool of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan UniversityAbstract Heatwaves are commonly simplified as binary variables in epidemiological studies, limiting the understanding of heatwave-mortality associations. Here we conduct a multi-country study across 28 East Asian cities that employed the Cumulative Excess Heatwave Index (CEHWI), which represents excess heat accumulation during heatwaves, to explore the potentially nonlinear associations of daytime-only, nighttime-only, and day-night compound heatwaves with mortality from 1981 to 2010. Populations exhibited high adaptability to daytime-only and nighttime-only heatwaves, with non-accidental mortality risks increasing only at higher CEHWI levels (75th–90th percentiles). In contrast, compound heatwaves posed a super-linear increase in mortality risks after the 25th percentile of CEHWI. Associations of heatwaves with cardiovascular mortality mirrored those with non-accidental mortality but were more pronounced at higher CEHWI levels, while significant associations with respiratory mortality emerged at low-to-moderate CEHWI levels. These results highlight the necessity of considering the nonlinear health responses to heatwaves of different types in disease burden assessments and heatwave-health warning systems amid climate change.https://doi.org/10.1038/s41467-025-56067-7 |
| spellingShingle | Jiangdong Liu Ho Kim Masahiro Hashizume Whanhee Lee Yasushi Honda Satbyul Estella Kim Cheng He Haidong Kan Renjie Chen Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change Nature Communications |
| title | Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change |
| title_full | Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change |
| title_fullStr | Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change |
| title_full_unstemmed | Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change |
| title_short | Nonlinear exposure-response associations of daytime, nighttime, and day-night compound heatwaves with mortality amid climate change |
| title_sort | nonlinear exposure response associations of daytime nighttime and day night compound heatwaves with mortality amid climate change |
| url | https://doi.org/10.1038/s41467-025-56067-7 |
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