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Variation in reporting of heatstroke mortality: evidence from a multi-country study

2026-03-24Artigo científico Acesso aberto
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dc.contributor.authorTobias, Aurelio
dc.contributor.authorHonda, Yasushi
dc.contributor.authorMadaniyazi, Lina
dc.contributor.authorAlhamad, Barrak
dc.contributor.authorLavigne, Erik
dc.contributor.authorRoye, Dominic
dc.contributor.authorTong, Shilu
dc.contributor.authorde Sousa Zanotti Stagliorio Coelho, Micheline
dc.contributor.authorHuber, Veronica
dc.contributor.authorUrban, Ales
dc.contributor.authordas Neves Pereira da Silva, Susana
dc.contributor.authorAchilleos, Souzana
dc.contributor.authorParks, Robbie M.
dc.contributor.authorIñiguez, Carmen
dc.contributor.authorMasselot, Pierre
dc.contributor.authorVicedo-Cabrera, Ana M.
dc.contributor.authorArmstrong, Ben
dc.contributor.authorGasparrini, Antonio
dc.contributor.authorHashizume, Masahiro
dc.contributor.authorMulti-City Multi-Country Collaborative Research Network
dc.date.accessioned2026-10-07T09:59:52Z
dc.date.available2026-10-07T09:59:52Z
dc.date.issued2026-03-24
dc.descriptionErratum in: Lancet Public Health. 2026 Apr;11(4):e211. doi: 10.1016/S2468-2667(26)00058-7.
dc.description.abstractBackground: Heatstroke represents the most severe manifestation of heat exposure. Heatstroke is rare and under-reported, resulting in limited empirical data on its global incidence and burden. This study aimed to examine geographical variations and temporal trends in reported heatstroke mortality across multiple countries. Methods: We collected annual heatstroke mortality data from 34 countries participating in the Multi-Country Multi-City Collaborative Research Network between 2000 and 2022, using the ICD-10 code X30. Country-specific mortality rates were estimated using Poisson regression, alongside analyses of annual trends and associations with mean warm-season temperature. We also assessed the proportion of heatstroke deaths relative to both overall heat and extreme heat-attributable all-cause mortality. Findings: Heatstroke mortality rates varied widely across countries, with Japan reporting the highest rate (5·81 per 1 million population; 95% CI 4·43-7·62), followed by Cyprus (2·51; 1·36-4·61), and China (2·42; 1·21-4·85). By contrast, most countries in Europe, South America, and southeast Asia reported rates of less than one death per 1 million population. Heatstroke mortality increased over time in several countries and was associated with warm-season temperatures in most regions. The proportion of heatstroke deaths relative to overall heat-attributable mortality ranged from less than 1% in many countries to as close to 24% in Japan. When analyses were restricted to deaths attributable to extreme heat, the proportion of heatstroke deaths increased substantially. Interpretation: Our broad international assessment of heatstroke mortality highlights its distinct patterns compared with overall heat-attributable mortality. The observed variability likely reflects differences in recognition, reporting, and diagnostic practices, while climate exposure and health system capacity influence whether heat-related deaths are identified and recorded as heatstroke.eng
dc.description.sponsorshipThe Japan Society for the Promotion of Science and the Environment Research and Technology Development Fund of the Environmental Restoration and Conservation Agency provided by the Japanese Ministry of the Environment. Support from the Japan Society for the Promotion of Science through the Grants in Aid for Scientific Research (KAKENHI) programme (grant number 24K13527). MH was supported by the Environment Research and Technology Development Fund (JPMEERF23S21120, JPMEERF20231007, and JPMEERF25S12433) of the Environmental Restoration and Conservation Agency provided by the Japanese Ministry of the Environment. DR was supported by a Ramón y Cajal fellowship programme of the Spanish Ministry of Science and Innovation (RYC2023 042824 I). AG was supported by Wellcome Trust (308914/Z/23/Z).
dc.identifier.citationLancet Public Health . 2026 Mar;11(3):e156-e163. doi: 10.1016/S2468-2667(25)00322-6
dc.identifier.doi10.1016/S2468-2667(25)00322-6
dc.identifier.eissn2468-2667
dc.identifier.pmid41748235
dc.identifier.urihttp://hdl.handle.net/10400.18/11380
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.hasversionhttps://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00322-6/fulltext
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectMortality
dc.subjectHeatstroke
dc.subjectMCC
dc.subjectMulti-Country Multi-City
dc.subjectDeterminantes da Saúde e da Doença
dc.subjectAvaliação do Risco
dc.titleVariation in reporting of heatstroke mortality: evidence from a multi-country studyeng
dc.typejournal article
dcterms.referenceshttps://www.thelancet.com/cms/10.1016/S2468-2667(25)00322-6/attachment/c398bdf0-742a-4e48-a565-efa7ff11d238/mmc1.pdf
dspace.entity.typePublication
oaire.citation.endPagee163
oaire.citation.issue3
oaire.citation.startPagee156
oaire.citation.titleThe Lancet Public Health
oaire.citation.volume11
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNamedas Neves Pereira da Silva
person.givenNameSusana
person.identifier.ciencia-idB718-8EF6-EBD8
person.identifier.orcid0000-0003-2524-0548
relation.isAuthorOfPublication49b180bc-3e03-4347-9e32-5725fd7142f8
relation.isAuthorOfPublication.latestForDiscovery49b180bc-3e03-4347-9e32-5725fd7142f8

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