Percorrer por autor "Mistry, Malcolm"
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- The effectiveness of heat prevention plans in reducing heat-related mortality across EuropePublication . Urban, Aleš; Huber, Veronika; Henry, Salomé; Plaza, Nuria Pilar; Tušlová, Lucie; Dasgupta, Shouro; Masselot, Pierre; Cvijanovic, Ivana; Mistry, Malcolm; Pascal, Mathilde; de'Donato, Francesca; Di Napoli, Claudia; Gosling, Simon N.; Kohnová, Silvia; Kyselý, Jan; Lüthi, Samuel; Pau, Louis-François; Ragettli, Martina S.; Ruuhela, Reija; Ryti, Niilo; das Neves Pereira da Silva, Susana; Zemah-Shamir, Shiri; Thiery, Wim; Vicedo-Cabrera, Ana-Maria; Wieczorek, Joanna; Sera, Francesco; Armstrong, Ben; Gasparrini, AntonioHeat-health warning systems and action plans, referred to as heat prevention plans (HPPs), are key public health interventions aimed at reducing heat-related mortality. Despite their importance, prior assessments of their effectiveness have yielded inconsistent results. The objective of this study is to systematically assess the effectiveness of HPPs in reducing heat-related mortality risk across Europe. We analysed daily mortality and mean temperature data from 102 locations in 14 European countries between 1990 and 2019. Using data from national experts, we identified the year of HPP implementation and categorised their development class. A three-stage analysis was conducted: (1) quasi-Poisson time series models were used to estimate location-specific warm-season exposure-response functions in 3 year subperiods; (2) mixed-effect meta-regression models with multilevel longitudinal structures were employed to quantify changes in pooled exposure-response functions due to HPP implementation, adjusted for long-term trends in heat-related mortality risks; and (3) the heat-related excess mortality due to HPP was calculated by comparing factual (with HPP) and counterfactual (without HPP) scenarios. Estimates are reported by country, region, and HPP class. HPP implementation was associated with a 25.2% [95% CI: 19.8% to 31.9%] reduction in excess deaths attributable to extreme heat, corresponding to 1.8 [95% CI: 1.3-2.4] avoided deaths annually per 100 000 inhabitants. This equates to an estimated 14 551 [95% CI: 10 118-19 072] total deaths avoided across all study locations following HPP implementation. No significant differences in HPP effectiveness were observed by European region or HPP class. Our findings provide robust evidence that HPPs substantially reduce heat-related mortality across Europe, accounting for temporal changes and geographical differences in risks. These results emphasise the importance of monitoring and evaluating HPPs to enhance adaptation to a warming climate.
- Estimating the urban heat-related mortality burden due to greenness: a global modelling studyPublication . Wu, Yao; Wen, Bo; Ye, Tingting; Huang, Wenzhong; Liu, Yanming; Gasparrini, Antonio; Sera, Francesco; Tong, Shilu; Lavigne, Eric; Roye, Dominic; Achilleos, Souzana; Ryti, Niilo; Pascal, Mathilde; Zeka, Ariana; de'Donato, Francesca; das Neves Pereira da Silva, Susana; Madureira, Joana; Mistry, Malcolm; Armstrong, Ben; Bell, Michelle L; Schwartz, Joel; Guo, Yuming; Li, ShanshanBackground: Heat exposure poses a substantial public health threat. Increasing greenness has been suggested as a mitigation strategy due to its cooling effect and potential to modify the heat-mortality association. This study aimed to comprehensively estimate the effects of increased greenness on heat-related deaths. Methods: We applied a multistage meta-analytical approach to estimate the potential reduction in global heat-related deaths by increasing greenness in the warm season in 2000-19 in 11 534 urban areas. We used the enhanced vegetation index (EVI) to indicate greenness and a random forest model to predict daily temperatures in counterfactual EVI scenarios. In the factual EVI scenarios, daily mortality and weather variables from 830 locations in 53 countries were extracted from the Multi-Country Multi-City Collaborative Research Network and used to assess heat-mortality associations. These associations were then extrapolated to each urban area under both factual and counterfactual EVI scenarios based on meta-regression models. Findings: We estimated that EVI increased by 10% would decrease the global population-weighted warm-season mean temperature by 0·08°C, EVI increased by 20% would decrease temperature by 0·14°C, and EVI increased by 30% would decrease temperature by 0·19°C. In the factual scenario, 3 153 225 (2·48%) of 127 179 341 total deaths could be attributed to heat exposure. The attributable fraction of heat-related deaths (as a fraction of total deaths) in 2000-19 would decrease by 0·67 (95% empirical CI 0·53-0·82) percentage points in the 10% scenario, 0·80 (0·63-0·97) percentage points in the 20% scenario, and 0·91 (0·72-1·10) percentage points in the 30% scenario, compared with the factual scenario. South Europe was modelled to have the largest decrease in attributable fraction of heat-related mortality. Interpretation: This modelling study suggests that increased greenness could substantially reduce the heat-related mortality burden. Preserving and expanding greenness might be potential strategies to lower ambient temperature and reduce the health impacts of heat exposure.
- Excess mortality attributed to heat and cold: a health impact assessment study in 854 cities in EuropePublication . Masselot, Pierre; Mistry, Malcolm; Vanoli, Jacopo; Schneider, Rochelle; Iungman, Tamara; Garcia-Leon, David; Ciscar, Juan-Carlos; Feyen, Luc; Orru, Hans; Urban, Aleš; Breitner, Susanne; Huber, Veronika; Schneider, Alexandra; Samoli, Evangelia; Stafoggia, Massimo; de’Donato, Francesca; Rao, Shilpa; Armstrong, Ben; Nieuwenhuijsen, Mark; Vicedo-Cabrera, Ana Maria; Gasparrini, Antonio; Achilleos, Souzana; Kyselý, Jan; Indermitte, Ene; Jaakkola, Jouni J.K.; Ryti, Niilo; Pascal, Mathilde; Katsouyanni, Klea; Analitis, Antonis; Goodman, Patrick; Zeka, Ariana; Michelozzi, Paola; Houthuijs, Danny; Ameling, Caroline; Silva, Susana; Madureira, Joana; Holobaca, Iulian-Horia; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Åström, Christofer; Ragettli, Martina S.; Surname, First name; Zafeiratou, Sofia; Vazquez Fernandez, Liliana; Monteiro, Ana; Rai, Masna; Zhang, Siqi; Aunan, KristinBackground: Heat and cold are established environmental risk factors for human health. However, mapping the related health burden is a difficult task due to the complexity of the associations and the differences in vulnerability and demographic distributions. In this study, we did a comprehensive mortality impact assessment due to heat and cold in European urban areas, considering geographical differences and age-specific risks. Methods: We included urban areas across Europe between Jan 1, 2000, and Dec 12, 2019, using the Urban Audit dataset of Eurostat and adults aged 20 years and older living in these areas. Data were extracted from Eurostat, the Multi-country Multi-city Collaborative Research Network, Moderate Resolution Imaging Spectroradiometer, and Copernicus. We applied a three-stage method to estimate risks of temperature continuously across the age and space dimensions, identifying patterns of vulnerability on the basis of city-specific characteristics and demographic structures. These risks were used to derive minimum mortality temperatures and related percentiles and raw and standardised excess mortality rates for heat and cold aggregated at various geographical levels. Findings: Across the 854 urban areas in Europe, we estimated an annual excess of 203 620 (empirical 95% CI 180 882-224 613) deaths attributed to cold and 20 173 (17 261-22 934) attributed to heat. These corresponded to age-standardised rates of 129 (empirical 95% CI 114-142) and 13 (11-14) deaths per 100 000 person-years. Results differed across Europe and age groups, with the highest effects in eastern European cities for both cold and heat. Interpretation: Maps of mortality risks and excess deaths indicate geographical differences, such as a north-south gradient and increased vulnerability in eastern Europe, as well as local variations due to urban characteristics. The modelling framework and results are crucial for the design of national and local health and climate policies and for projecting the effects of cold and heat under future climatic and socioeconomic scenarios.
- Global excess deaths associated with heatwaves in 2023 and the contribution of human-induced climate changePublication . Hundessa, Samuel; Huang, Wenzhong; Xu, Rongbin; Yang, Zhengyu; Zhao, Qi; Gasparrini, Antonio; Armstrong, Ben; Bell, Michelle L.; Huber, Veronika; Urban, Aleš; Coelho, Micheline; Sera, Francesco; Tong, Shilu; Royé, Dominic; Kyselý, Jan; de'Donato, Francesca; Mistry, Malcolm; Tobias, Aurelio; Íñiguez, Carmen; Ragettli, Martina S.; Hales, Simon; Achilleos, Souzana; Klompmaker, Jochem; Li, Shanshan; Guo, Yuming; Multi-Country Multi-City Collaborative Research NetworkAbstract: An unprecedented heatwave swept the globe in 2023, marking it one of the hottest years on record and raising concerns about its health impacts. However, a comprehensive assessment of the heatwave-related mortality and its attribution to human-induced climate change remains lacking. We aim to address this gap by analyzing high-resolution climate and mortality data from 2,013 locations across 67 countries/territories using a three-stage modeling approach. First, we estimated historical heatwave-mortality associations using a quasi-Poisson regression model with distributed lag structures, considering lag effects, seasonality, and within-week variations. Second, we pooled the estimates in meta-regression, accounting for spatial heterogeneity and potential changes in heatwave-mortality associations over time. Third, we predicted grid-specific (0.5 0.5) association in 2023 and calculated the heatwave-related excess deaths, death ratio, and death rate per million people. Attribution analysis was conducted by comparing heatwave-related mortality under factual and counterfactual climate scenarios. We estimated 178,486 excess deaths (95% empirical confidence interval [eCI], 159,892≥204,147) related to the 2023 heatwave, accounting for 0.73% of global deaths, corresponding to 23 deaths per million people. The highest mortality rates occurred in Southern (120, 95% eCI, 116≥126), Eastern (107, 95% eCI, 100≥114), and Western Europe (66, 95% eCI, 62≥70), where the excess death ratio was also higher. Notably, 54.29% (95% eCI, 45.71%≥61.36%) of the global heatwave-related deaths were attributable to human-induced climate change. These results underscore the urgent need for adaptive public health interventions and climate mitigation strategies to reduce future mortality burdens in the context of increasing global warming.
- Global, regional, and national burden of mortality associated with cold spells during 2000–19: a three-stage modelling studyPublication . Gao, Yuan; Huang, Wenzhong; Zhao, Qi; Ryti, Niilo; Armstrong, Ben; Gasparrini, Antonio; Tong, Shilu; Pascal, Mathilde; Urban, Aleš; Zeka, Ariana; Lavigne, Eric; Madureira, Joana; Goodman, Patrick; Huber, Veronika; Forsberg, Bertil; Kyselý, Jan; Sera, Francesco; Guo, Yuming; Li, Shanshan; Gao, Yuan; Huang, Wenzhong; Zhao, Qi; Ryti, Niilo; Armstrong, Ben; Gasparrini, Antonio; Tong, Shilu; Pascal, Mathilde; Urban, Aleš; Zeka, Ariana; Lavigne, Eric; Madureira, Joana; Goodman, Patrick; Huber, Veronika; Forsberg, Bertil; Kyselý, Jan; Sera, Francesco; Bell, Michelle; Simon Hales; Honda, Yasushi; Jaakkola, Jouni J.K.; Tobias, Aurelio; Vicedo-Cabrera, Ana Maria; Abrutzky, Rosana; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Correa, Patricia Matus; Ortega, Nicolás Valdés; Kan, Haidong; Osorio, Samuel; Roye, Dominic; Orru, Hans; Indermitte, Ene; Schneider, Alexandra; Katsouyanni, Klea; Analitis, Antonis; Carlsen, Hanne Krage; Mayvaneh, Fatemeh; Roradeh, Hematollah; Raz, Raanan; Michelozzi, Paola; de'Donato, Francesca; Hashizume, Masahiro; Kim, Yoonhee; Alahmad, Barrak; Cauchy, John Paul; Diaz, Magali Hurtado; Arellano, Eunice Elizabeth Félix; Valencia, César De la Cruz; Overcenco, Ala; Houthuijs, Danny; Ameling, Caroline; Rao, Shilpa; Carrasco, Gabriel; Seposo, Xerxes; Chua, Paul Lester Carlos; Silva, Susana das Neves Pereira da; Nunes, Baltazar; Holobaca, Iulian-Horia; Cvijanovic, Ivana; Mistry, Malcolm; Scovronick, Noah; Acquaotta, Fiorella; Kim, Ho; Lee, Whanhee; Íñiguez, Carmen; Åström, Christofer; Ragettli, Martina S.; Guo, Yue Leon; Pan, Shih-Chun; Colistro, Valentina; Zanobetti, Antonella; Schwartz, Joel; Dang, Tran Ngoc; Dung, Do Van; Guo, Yuming; Li, ShanshanBackground: 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.