TY - JOUR
T1 - Comparison of health risks by heat wave definition
T2 - Applicability of wet-bulb globe temperature for heat wave criteria
AU - Heo, Seulkee
AU - Bell, Michelle L.
AU - Lee, Jong Tae
N1 - Funding Information:
This work was supported by the U.S. Environmental Protection Agency (Grant no. RD835871 ) and the Korea Government (The Ministry of Science, ICT and Future Planning, MSIP) (Grant no. 2014R1A2A1A11052556 ).
Funding Information:
This publication was developed under Assistance Agreement No. RD835871 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Acquisition of hospitalization data for this study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2014R1A2A1A11052556 ). The authors of this study express thanks to the National Meteorological Satellite Center in South Korea and the Korea Meteorological Administration for providing data.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/1
Y1 - 2019/1
N2 - Despite the active applications of thermal comfort indices for heat wave definitions, there is lack of evaluation for the impact of extended days of high temperature on health outcomes using many of the indices. This study compared the impact of heat waves on health outcomes among different heat wave definitions based on thermal comfort and air temperature. We compared heat waves in South Korea (cities and provinces) for the warm season for 2011–2014, using air temperature, heat index (HI), and web-bulb globe temperature (WBGT). Heat waves were defined as days with daily maximum values of each index at a specified threshold (literature-based, the 90th and 95th percentiles) or above. Distributed lag non-linear models and meta-analysis were used to estimate risk of mortality and hospitalization for all-causes, cardiovascular causes, respiratory causes and heat disorders during heat wave days compared to non-heat wave days. WBGT identified 1.15 times longer maximum heat wave duration for the study periods than air temperature when the thresholds were based on 90th and 95th percentiles. Over the study period, for heat waves defined by WBGT and HI, the Southwestern region showed the highest total number of heat wave days, whereas for air temperature the longest heat wave days were identified in the southeastern region. The highest and most significant impact of heat waves were found by WBGT for hospitalization from heat disorders (Relative risk = 2.959, 95% CI: 1.566–5.594). In sensitivity analyses using different structure of lags and temperature metrics (e.g., daily mean and minimum), the impacts of heat waves on most health outcomes substantially increased by using WBGT for heat wave definitions. As a result, WBGT and its thresholds can be used to relate heat waves and heat-related diseases to improve the prevention effectiveness of heat wave warnings and give informative health guidelines according to the range of WBGT thresholds.
AB - Despite the active applications of thermal comfort indices for heat wave definitions, there is lack of evaluation for the impact of extended days of high temperature on health outcomes using many of the indices. This study compared the impact of heat waves on health outcomes among different heat wave definitions based on thermal comfort and air temperature. We compared heat waves in South Korea (cities and provinces) for the warm season for 2011–2014, using air temperature, heat index (HI), and web-bulb globe temperature (WBGT). Heat waves were defined as days with daily maximum values of each index at a specified threshold (literature-based, the 90th and 95th percentiles) or above. Distributed lag non-linear models and meta-analysis were used to estimate risk of mortality and hospitalization for all-causes, cardiovascular causes, respiratory causes and heat disorders during heat wave days compared to non-heat wave days. WBGT identified 1.15 times longer maximum heat wave duration for the study periods than air temperature when the thresholds were based on 90th and 95th percentiles. Over the study period, for heat waves defined by WBGT and HI, the Southwestern region showed the highest total number of heat wave days, whereas for air temperature the longest heat wave days were identified in the southeastern region. The highest and most significant impact of heat waves were found by WBGT for hospitalization from heat disorders (Relative risk = 2.959, 95% CI: 1.566–5.594). In sensitivity analyses using different structure of lags and temperature metrics (e.g., daily mean and minimum), the impacts of heat waves on most health outcomes substantially increased by using WBGT for heat wave definitions. As a result, WBGT and its thresholds can be used to relate heat waves and heat-related diseases to improve the prevention effectiveness of heat wave warnings and give informative health guidelines according to the range of WBGT thresholds.
KW - Climate change
KW - Heat wave
KW - Morbidity
KW - Mortality
KW - Temperature
UR - http://www.scopus.com/inward/record.url?scp=85054467476&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2018.09.032
DO - 10.1016/j.envres.2018.09.032
M3 - Article
C2 - 30316101
AN - SCOPUS:85054467476
VL - 168
SP - 158
EP - 170
JO - Environmental Research
JF - Environmental Research
SN - 0013-9351
ER -
