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Rainfall events and daily mortality across 645 global locations: two stage time series analysis
Author(s)
Helmholtz Munich
Susanne Breitner-Busch
Helmholtz Munich
Veronika Huber
Helmholtz Munich
Kai Chen
Yale University
Siqi Zhang
Yale University
Antonio Gasparrini
London School of Hygiene & Tropical Medicine
Michelle L. Bell
Korea University
Haidong Kan
Fudan University
Dominic Royé
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Ben Armstrong
London School of Hygiene & Tropical Medicine
Joel Schwartz
Harvard University
Francesco Sera
University of Florence
Ana Maria Vicedo-Cabrera
University of Bern
Yasushi Honda
National Institute for Environmental Studies
Jouni J K Jaakkola
Finnish Meteorological Institute
Niilo Ryti
University of Oulu
Jan Kyselý
Czech Academy of Sciences
Yuming Guo
National Health Research Institutes
Shilu Tong
Queensland University of Technology
Francesca de’Donato
ASL Roma
Paola Michelozzi
ASL Roma
Micheline de Sousa Zanotti Stagliorio Coêlho
Universidade de São Paulo
Paulo Hilario Nascimento Saldiva
Insper
Eric Lavigne
Health Canada
Hans Orru
University of Tartu
Ene Indermitte
University of Tartu
Mathilde Pascal
Santé Publique France
Patrick Goodman
Technological University Dublin
Ariana Zeka
University College London
Yoonhee Kim
The University of Tokyo
Magali Hurtado‐Díaz
Instituto Nacional de Salud Pública
Eunice Elizabeth Félix Arellano
Instituto Nacional de Salud Pública
Ala Overcenco
Ministry of Health, Labour and Social Protection
Jochem O. Klompmaker
National Institute for Public Health and the Environment
Shilpa Rao
Norwegian Institute of Public Health
Alfonso Diz-Lois Palomares
Norwegian Institute of Public Health
Gabriel Carrasco‐Escobar
Universidad Peruana Cayetano Heredia
Xerxes Seposo
Nagasaki University
Susana das Neves Pereira da Silva
National Institute of Health Dr. Ricardo Jorge
Joana Madureira
Universidade do Porto
Iulian‐Horia Holobâcă
Babeș-Bolyai University
Noah Scovronick
Emory University
Fiorella Acquaotta
University of Turin
Ho Kim
Seoul National University
Whanhee Lee
Pusan National University
Masahiro Hashizume
The University of Tokyo
Aurelio Tobı́as
Institute of Environmental Assessment and Water Research
Carmen Íñiguez
Universitat de València
Bertil Forsberg
Umeå University
Martina S. Ragettli
Swiss Tropical and Public Health Institute
Yue Leon Guo
National Health Research Institutes
Shih‐Chun Pan
National Health Research Institutes
Samuel Osorio
Universidade de São Paulo
Shanshan Li
Monash University
Antonella Zanobetti
Harvard University
Trần Ngọc Đăng
Duy Tan University
Do Van Dung
University of Medicine and Pharmacy at Ho Chi Minh City
Alexandra Schneider
Helmholtz Munich
Date Issued
9 de octubre de 2024
Type
Article
Volume
387
Series/Report No.
BMJ
Start Page
e080944
End Page
e080944
ISSN
1756-1833
Abstract
OBJECTIVE: To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. DESIGN: Two stage time series analysis. SETTING: 645 locations across 34 countries or regions. POPULATION: Daily mortality data, comprising a total of 109 954 744 all cause, 31 164 161 cardiovascular, and 11 817 278 respiratory deaths from 1980 to 2020. MAIN OUTCOME MEASURE: Association between daily mortality and rainfall events with return periods (the expected average time between occurrences of an extreme event of a certain magnitude) of one year, two years, and five years, with a 14 day lag period. A continuous relative intensity index was used to generate intensity-response curves to estimate mortality risks at a global scale. RESULTS: During the study period, a total of 50 913 rainfall events with a one year return period, 8362 events with a two year return period, and 3301 events with a five year return period were identified. A day of extreme rainfall with a five year return period was significantly associated with increased daily all cause, cardiovascular, and respiratory mortality, with cumulative relative risks across 0-14 lag days of 1.08 (95% confidence interval 1.05 to 1.11), 1.05 (1.02 to 1.08), and 1.29 (1.19 to 1.39), respectively. Rainfall events with a two year return period were associated with respiratory mortality only, whereas no significant associations were found for events with a one year return period. Non-linear analysis revealed protective effects (relative risk <1) with moderate-heavy rainfall events, shifting to adverse effects (relative risk >1) with extreme intensities. Additionally, mortality risks from extreme rainfall events appeared to be modified by climate type, baseline variability in rainfall, and vegetation coverage, whereas the moderating effects of population density and income level were not significant. Locations with lower variability of baseline rainfall or scarce vegetation coverage showed higher risks. CONCLUSION: Daily rainfall intensity is associated with varying health effects, with extreme events linked to an increasing relative risk for all cause, cardiovascular, and respiratory mortality. The observed associations varied with local climate and urban infrastructure.
Keywords