Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study

Abstract BackgroundWith global warming, the number of days with extreme heat is expected to increase and may cause more acute heat illnesses. While decreasing emissions may mitigate the climate impacts, its effectiveness in reducing acute heat illnesses remains uncertain. Taiw...

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Main Authors: Hsiao-Yu Yang, Chang-Fu Wu, Kun-Hsien Tsai
Format: Article
Language:English
Published: JMIR Publications 2024-10-01
Series:JMIR Public Health and Surveillance
Online Access:https://publichealth.jmir.org/2024/1/e57948
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author Hsiao-Yu Yang
Chang-Fu Wu
Kun-Hsien Tsai
author_facet Hsiao-Yu Yang
Chang-Fu Wu
Kun-Hsien Tsai
author_sort Hsiao-Yu Yang
collection DOAJ
description Abstract BackgroundWith global warming, the number of days with extreme heat is expected to increase and may cause more acute heat illnesses. While decreasing emissions may mitigate the climate impacts, its effectiveness in reducing acute heat illnesses remains uncertain. Taiwan has established a real-time epidemic surveillance and early warning system to monitor acute heat illnesses since January 1, 2011. Predicting the number of acute heat illnesses requires forecasting temperature changes that are influenced by adaptation policies. ObjectiveThe aim of this study was to estimate the changes in the number of acute heat illnesses under different adaptation policies. MethodsWe obtained the numbers of acute heat illnesses in Taiwan from January 2011 to July 2023 using emergency department visit data from the real-time epidemic surveillance and early warning system. We used segmented linear regression to identify the join point as a nonoptimal temperature threshold. We projected the temperature distribution and excess acute heat illnesses through the end of the century when Taiwan adopts the “Sustainability (shared socioeconomic pathways 1‐2.6 [SSP1-2.6]),” “Middle of the road (SSP2-4.5),” “Regional rivalry (SSP3-7.0),” and “Fossil-fueled development (SSP5-8.5)” scenarios. Distributed lag nonlinear models were used to analyze the attributable number (AN) and attributable fraction (AF) of acute heat illnesses caused by nonoptimal temperature. ResultsWe enrolled a total of 28,661 patients with a mean age of 44.5 (SD 15.3) years up to July 2023, of whom 21,619 (75.4%) were male patients. The nonoptimal temperature was 27 °C. The relative risk of acute heat illnesses with a 1-degree increase in mean temperature was 1.71 (95% CI 1.63-1.79). In the SSP5-8.5 worst-case scenario, the mean temperature was projected to rise by +5.8 °C (SD 0.26), with the AN and AF of acute heat illnesses above nonoptimal temperature being 19,021 (95% CI 2249‐35,792) and 89.9% (95% CI 89.3%‐90.5%) by 2090‐2099. However, if Taiwan adopts the Sustainability SSP1-2.6 scenario, the AN and AF of acute heat illnesses due to nonoptimal temperature will be reduced to 12,468 (95% CI 3233‐21,704) and 62.1% (95% CI 61.2‐63.1). ConclusionsAdopting sustainable development policies can help mitigate the risk of acute heat illnesses caused by global warming.
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spelling doaj-art-3366d3078ad14f3bb480f11bbe9a3e9a2024-12-05T05:09:23ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602024-10-0110e57948e5794810.2196/57948Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover StudyHsiao-Yu Yanghttp://orcid.org/0000-0001-5298-2462Chang-Fu Wuhttp://orcid.org/0000-0003-2244-1934Kun-Hsien Tsaihttp://orcid.org/0000-0002-6154-113X Abstract BackgroundWith global warming, the number of days with extreme heat is expected to increase and may cause more acute heat illnesses. While decreasing emissions may mitigate the climate impacts, its effectiveness in reducing acute heat illnesses remains uncertain. Taiwan has established a real-time epidemic surveillance and early warning system to monitor acute heat illnesses since January 1, 2011. Predicting the number of acute heat illnesses requires forecasting temperature changes that are influenced by adaptation policies. ObjectiveThe aim of this study was to estimate the changes in the number of acute heat illnesses under different adaptation policies. MethodsWe obtained the numbers of acute heat illnesses in Taiwan from January 2011 to July 2023 using emergency department visit data from the real-time epidemic surveillance and early warning system. We used segmented linear regression to identify the join point as a nonoptimal temperature threshold. We projected the temperature distribution and excess acute heat illnesses through the end of the century when Taiwan adopts the “Sustainability (shared socioeconomic pathways 1‐2.6 [SSP1-2.6]),” “Middle of the road (SSP2-4.5),” “Regional rivalry (SSP3-7.0),” and “Fossil-fueled development (SSP5-8.5)” scenarios. Distributed lag nonlinear models were used to analyze the attributable number (AN) and attributable fraction (AF) of acute heat illnesses caused by nonoptimal temperature. ResultsWe enrolled a total of 28,661 patients with a mean age of 44.5 (SD 15.3) years up to July 2023, of whom 21,619 (75.4%) were male patients. The nonoptimal temperature was 27 °C. The relative risk of acute heat illnesses with a 1-degree increase in mean temperature was 1.71 (95% CI 1.63-1.79). In the SSP5-8.5 worst-case scenario, the mean temperature was projected to rise by +5.8 °C (SD 0.26), with the AN and AF of acute heat illnesses above nonoptimal temperature being 19,021 (95% CI 2249‐35,792) and 89.9% (95% CI 89.3%‐90.5%) by 2090‐2099. However, if Taiwan adopts the Sustainability SSP1-2.6 scenario, the AN and AF of acute heat illnesses due to nonoptimal temperature will be reduced to 12,468 (95% CI 3233‐21,704) and 62.1% (95% CI 61.2‐63.1). ConclusionsAdopting sustainable development policies can help mitigate the risk of acute heat illnesses caused by global warming.https://publichealth.jmir.org/2024/1/e57948
spellingShingle Hsiao-Yu Yang
Chang-Fu Wu
Kun-Hsien Tsai
Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study
JMIR Public Health and Surveillance
title Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study
title_full Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study
title_fullStr Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study
title_full_unstemmed Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study
title_short Projections of Climate Change Impact on Acute Heat Illnesses in Taiwan: Case-Crossover Study
title_sort projections of climate change impact on acute heat illnesses in taiwan case crossover study
url https://publichealth.jmir.org/2024/1/e57948
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AT changfuwu projectionsofclimatechangeimpactonacuteheatillnessesintaiwancasecrossoverstudy
AT kunhsientsai projectionsofclimatechangeimpactonacuteheatillnessesintaiwancasecrossoverstudy