Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.

Air Health Science Division Health Canada Ottawa Ontario Canada

Canadian Centre for Climate Modelling and Analysis Environment and Climate Change Canada Victoria British Colombia Canada

Center for Environmental and Respiratory Health Research University of Oulu Oulu Finland

Center for Global Health School of Public Health Nanjing Medical University Nanjing China

Centre for Statistical Methodology London School of Hygiene and Tropical Medicine London UK

Centre for Sustainability and Environmental Health National Institute for Public Health and the Environment Bilthoven the Netherlands

CIBER de Epidemiología y Salud Pública Madrid Spain

Department of Earth Sciences University of Torino Turin Italy

Department of Enviromental Health Instituto Nacional de Saúde Dr Ricardo Jorge Porto Portugal

Department of Environmental Engineering Graduate School of Engineering Kyoto University Kyoto Japan

Department of Environmental Health Faculty of Public Health University of Medicine and Pharmacy at Ho Chi Minh City Ho Chi Minh City Vietnam

Department of Environmental Health Harvard T H Chan School of Public Health Harvard University Boston MA USA

Department of Environmental Health National Institute of Public Health Cuernavaca Morelos Mexico

Department of Environmental Health University of São Paulo São Paulo Brazil

Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia

Department of Epidemiology Instituto Nacional de Saúde Dr Ricardo Jorge Lisbon Portugal

Department of Epidemiology Lazio Regional Health Service Rome Italy

Department of Geography University of Santiago de Compostela Santiago de Compostela Spain

Department of Global Health Policy School of International Health Graduate School of Medicine The University of Tokyo Tokyo Japan

Department of Hygiene Epidemiology and Medical Statistics School of Medicine National and Kapodistrian University of Athens Athens Greece

Department of Physical Chemical and Natural Systems Universidad Pablo de Olavide Seville Spain

Department of Preventive Medicine School of Medicine University of the Republic Montevideo Uruguay

Department of Public Health and Clinical Medicine Umeå University Umeå Sweden

Department of Public Health Environments and Society London School of Hygiene and Tropical Medicine London UK

Department of Public Health Universidad de los Andes Santiago Chile

Department of Statistics and Computational Research Universitat de Valencia Valencia Spain

Department of Statistics Computer Science and Applications 'G Parenti' University of Florence Florence Italy

Environmental and Occupational Medicine and Institute of Environmental and Occupational Health Sciences National Taiwan University and NTU Hospital Taipei Taiwan

EPIUnit Instituto de Saúde Pública Universidade do Porto Porto Portugal

European Centre for Medium Range Weather Forecast Reading UK

Facultad de Ciencias Sociales Instituto de Investigaciones Gino Germani Universidad de Buenos Aires Buenos Aires Argentina

Faculty of Environmental Sciences Czech University of Life Sciences Prague Czech Republic

Faculty of Geography and Environmental Sciences Hakim Sabzevari University Sabzevar Iran

Faculty of Geography Babes Bolay University Cluj Napoca Romania

Faculty of Health and Sport Sciences University of Tsukuba Tsukuba Japan

Faculty of Medicine ArqFuturo INSPER University of São Paulo São Paulo Brazil

Finnish Meteorological Institute Helsinki Finland

Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA

Graduate School of Public Health and Institute of Health and Environment Seoul National University Seoul Republic of Korea

Health Innovation Laboratory Institute of Tropical Medicine 'Alexander von Humboldt' Universidad Peruana Cayetano Heredia Lima Peru

Institute for Environment Health and Societies Brunel University London London UK

Institute of Atmospheric Physics of the Czech Academy of Sciences Prague Czech Republic

Institute of Environmental Assessment and Water Research Spanish Council for Scientific Research Barcelona Spain

Institute of Epidemiology Helmholtz Zentrum München German Research Center for Environmental Health Neuherberg Germany

Institute of Family Medicine and Public Health University of Tartu Tartu Estonia

Institute of Social and Preventive Medicine University of Bern Bern Switzerland

Laboratory of Management in Science and Public Health National Agency for Public Health of the Ministry of Health Chisinau Republic of Moldova

MRC PHE Centre for Environment and Health Environmental Research Group School of Public Health Imperial College London London UK

National Institute of Environmental Health Science National Health Research Institutes Zhunan Taiwan

Norwegian Institute of Public Health Oslo Norway

Oeschger Center for Climate Change Research University of Bern Bern Switzerland

Potsdam Institute for Climate Impact Research Potsdam Germany

Santé Publique France Department of Environmental Health French National Public Health Agency Saint Maurice France

School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada

School of Geographical Sciences and Urban Planning Arizona State University Tempe AZ USA

School of Physics Technological University Dublin Dublin Ireland

School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia

School of Public Health Fudan University Shanghai China

School of Public Health Institute of Environment and Population Health Anhui Medical University Hefei China

School of Tropical Medicine and Global Health Nagasaki University Nagasaki Japan

Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine Shanghai China

Swiss Tropical and Public Health Institute Basel Switzerland

The Centre on Climate Change and Planetary Health London School of Hygiene and Tropical Medicine London UK

University of Basel Basel Switzerland

Φ Lab European Space Agency Frascati Italy

Zobrazit více v PubMed

IPCCMasson-Delmotte V, et al., editors. Special Report on Global Warming of 1.5 °C. WMO; 2018.

Gasparrini A, et al. Mortality risk attributable to high and low ambient temperature: a multicountry observational study. Lancet. 2015;386:369–375. PubMed PMC

Hsiang S, et al. Estimating economic damage from climate change in the United States. Science. 2017;356:1362–1369. PubMed

Ye X, et al. Ambient temperature and morbidity: a review of epidemiological evidence. Environ Health Perspect. 2012;120:19–28. PubMed PMC

Pachauri RK, Meyer LA, IPCC Core Writing Team . Climate Change 2014: Synthesis Report. IPCC; 2014.

Ebi KL, et al. Health risks of warming of 1.5 °C, 2 °C, and higher, above pre-industrial temperatures. Environ Res Lett. 2018;13:063007

Bindoff NL, et al. In: Climate Change 2013: The Physical Science Basis. Stocker TF, et al., editors. Cambridge Univ.Press; 2013. pp. 867–952.

Cramer W, et al. In: IPCC Climate Change 2014: Impacts, Adaptation, and Vulnerability. Field CB, et al., editors. Cambridge Univ. Press; 2014. pp. 979–1037.

Ebi KL, Ogden NH, Semenza JC, Woodward A. Detecting and attributing health burdens to climate change. Environ Health Perspect. 2017;125:085004. PubMed PMC

Mitchell D, et al. Attributing human mortality during extreme heat waves to anthropogenic climate change. Environ Res Lett. 2016;11:074006

Christidis N, Mitchell D, Stott PA. Anthropogenic climate change and heat effects on health. Int J Climatol. 2019;39:4751–4768.

Gasparrini A. Modeling exposure-lag-response associations with distributed lag non-linear models. Stat Med. 2014;33:881–899. PubMed PMC

Gasparrini A, Armstrong B. Reducing and meta-analysing estimates from distributed lag non-linear models. BMC Med Res Methodol. 2013;13:1. PubMed PMC

Sera F, Armstrong B, Blangiardo M, Gasparrini A. An extended mixed-effects framework for meta-analysis. Stat Med. 2019;38:5429–5444. PubMed

Vicedo-Cabrera AM, Sera F, Gasparrini A. Hands-on tutorial on a modeling framework for projections of climate change impacts on health. Epidemiology. 2019;30:321–329. PubMed PMC

Gasparrini A, Leone M. Attributable risk from distributed lag models. BMC Med Res Methodol. 2014;14:55. PubMed PMC

Gillett NP, et al. The detection and attribution model intercomparison project (DAMIP v1.0) contribution to CMIP6. GeoSci Model Dev. 2016;9:3685–3697. PubMed PMC

Gillett NP, et al. Constraining human contributions to observed warming since preindustrial. Nat Clim Change. 2021;11:207–212.

Hempel S, Frieler K, Warszawski L, Schewe J, Piontek F. A trend-preserving bias correction—the ISI-MIP approach. Earth Syst Dynam. 2013;4:219–236.

Gasparrini A, et al. Changes in susceptibility to heat during the summer: a multicountry analysis. Am J Epidemiol. 2016;183:1027–1036. PubMed PMC

Åström DO, Forsberg B, Ebi KL, Rocklöv J. Attributing mortality from extreme temperatures to climate change in Stockholm, Sweden. Nat Clim Change. 2013;3:1050–1054.

Basu R. High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008. Environ Health. 2009;8:40. PubMed PMC

Benmarhnia T, Deguen S, Kaufman JS, Smargiassi A. Vulnerability to heat-related mortality: a systematic review. Epidemiology. 2015;26:781–793. PubMed

Gasparrini A, et al. Temporal variation in heat-mortality associations: a multicountry study. Environ Health Perspect. 2015;123:1200–1207. PubMed PMC

Vicedo-Cabrera AM, et al. A multi-country analysis on potential adaptive mechanisms to cold and heat in a changing climate. Environ Int. 2017;111:239–246. PubMed

Rogelj J, et al. Paris Agreement climate proposals need a boost to keep warming well below 2 °C. Nature. 2016;534:631–639. PubMed

Gasparrini A, et al. Projections of temperature-related excess mortality under climate change scenarios. Lancet Planet Health. 2017;1:e360–e367. PubMed PMC

Vicedo-Cabrera AM, et al. Temperature-related mortality impacts under and beyond Paris Agreement climate change scenarios. Climatic Change. 2018;150:391–402. PubMed PMC

Kottek M, Grieser J, Beck C, Rudolf B, Rubel F. World Map of the Köppen-Geiger climate classification updated. Meteorol Z. 2006;15:259–263.

Gasparrini A, Armstrong B, Kenward MG. Multivariate meta-analysis for non-linear and other multi-parameter associations. Stat Med. 2012;31:3821–3839. PubMed PMC

Gasparrini A. Distributed lag linear and non-linear models in R: the package dlnm. J Stat Softw. 2011;43:1–20. PubMed PMC

Short-term effect of temperature on cause-specific, sex-specific, and age-specific ambulance dispatches in Czechia: a nationwide time-series analysis

Rapid climate action is needed: comparing heat vs. COVID-19-related mortality

Rainfall events and daily mortality across 645 global locations: two stage time series analysis

Regional variation in the role of humidity on city-level heat-related mortality

Joint effect of heat and air pollution on mortality in 620 cities of 36 countries

Rapid increase in the risk of heat-related mortality

Optimal heat stress metric for modelling heat-related mortality varies from country to country

Fluctuating temperature modifies heat-mortality association around the globe

Comparison of weather station and climate reanalysis data for modelling temperature-related mortality