BACKGROUND: Exposure to cold spells is associated with mortality. However, little is known about the global mortality burden of cold spells. METHODS: A three-stage meta-analytical method was used to estimate the global mortality burden associated with cold spells by means of a time series dataset of 1960 locations across 59 countries (or regions). First, we fitted the location-specific, cold spell-related mortality associations using a quasi-Poisson regression with a distributed lag non-linear model with a lag period of up to 21 days. Second, we built a multivariate meta-regression model between location-specific associations and seven predictors. Finally, we predicted the global grid-specific cold spell-related mortality associations during 2000-19 using the fitted meta-regression model and the yearly grid-specific meta-predictors. We calculated the annual excess deaths, excess death ratio (excess deaths per 1000 deaths), and excess death rate (excess deaths per 100 000 population) due to cold spells for each grid across the world. FINDINGS: Globally, 205 932 (95% empirical CI [eCI] 162 692-250 337) excess deaths, representing 3·81 (95% eCI 2·93-4·71) excess deaths per 1000 deaths (excess death ratio), and 3·03 (2·33-3·75) excess deaths per 100 000 population (excess death rate) were associated with cold spells per year between 2000 and 2019. The annual average global excess death ratio in 2016-19 increased by 0·12 percentage points and the excess death rate in 2016-19 increased by 0·18 percentage points, compared with those in 2000-03. The mortality burden varied geographically. The excess death ratio and rate were highest in Europe, whereas these indicators were lowest in Africa. Temperate climates had higher excess death ratio and rate associated with cold spells than other climate zones. INTERPRETATION: Cold spells are associated with substantial mortality burden around the world with geographically varying patterns. Although the number of cold spells has on average been decreasing since year 2000, the public health threat of cold spells remains substantial. The findings indicate an urgency of taking local and regional measures to protect the public from the mortality burdens of cold spells. FUNDING: Australian Research Council, Australian National Health and Medical Research Council, EU's Horizon 2020 Project Exhaustion.

Center for Environmental and Respiratory Health Research University of Oulu Oulu Finland; Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland; Department of Public Health University of Helsinki Helsinki Finland

Climate Air Quality Research Unit School of Public Health and Preventive Medicine Monash University Melbourne Australia

Climate Air Quality Research Unit School of Public Health and Preventive Medicine Monash University Melbourne Australia; Department of Epidemiology School of Public Health Cheeloo College of Medicine Shandong University Jinan China

Department of Geography University of Santiago de Compostela Santiago de Compostela Spain; EPIUnit Instituto de Saude Publica Universidade do Porto Porto Portugal

Department of Public Health and Clinical Medicine Umeå University Sweden

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

Department of Public Health Environments and Society London School of Hygiene and Tropical Medicine London UK; Centre for Statistical Methodology London School of Hygiene and Tropical Medicine London UK; Centre on Climate Change and Planetary Health London School of Hygiene and Tropical Medicine London UK

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

Faculty of Environmental Sciences Czech University of Life Sciences Prague Czech Republic; Institute of Atmospheric Physics Czech Academy of Sciences Prague Czech Republic

Institute for the Environment Brunel University London London UK

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

School of Epidemiology and Public Health Faculty of Medicine University of Ottawa Ottawa ONT Canada; Air Health Science Division Health Canada Ottawa ONT Canada

School of Public Health and Social Work Queensland University of Technology Brisbane Australia; School of Public Health and Institute of Environment and Human Health Anhui Medical University Hefei China; Shanghai Children's Medical Centre Shanghai Jiao Tong University Shanghai China

Technological University Dublin Dublin Ireland

The Institute for Medical Information Processing Biometry and Epidemiology Ludwig Maximilians University Munich Munich Germany

Citace poskytuje Crossref.org

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