Rainfall events and daily mortality across 645 global locations: two stage time series analysis
Author(s)
Susanne Breitner-Busch
Veronika Huber
Kai Chen
Siqi Zhang
Antonio Gasparrini
Michelle L. Bell
Haidong Kan
Dominic Royé
Ben Armstrong
Joel Schwartz
Francesco Sera
Ana Maria Vicedo-Cabrera
Yasushi Honda
Jouni J K Jaakkola
Niilo Ryti
Jan Kyselý
Yuming Guo
Shilu Tong
Francesca de’Donato
Paola Michelozzi
Micheline de Sousa Zanotti Stagliorio Coêlho
Paulo Hilario Nascimento Saldiva
Eric Lavigne
Hans Orru
Ene Indermitte
Mathilde Pascal
Patrick Goodman
Ariana Zeka
Yoonhee Kim
Magali Hurtado‐Díaz
Eunice Elizabeth Félix Arellano
Ala Overcenco
Jochem O. Klompmaker
Shilpa Rao
Alfonso Diz-Lois Palomares
Gabriel Carrasco‐Escobar
Xerxes Seposo
Susana das Neves Pereira da Silva
Joana Madureira
Iulian‐Horia Holobâcă
Noah Scovronick
Fiorella Acquaotta
Ho Kim
Whanhee Lee
Masahiro Hashizume
Aurelio Tobı́as
Carmen Íñiguez
Bertil Forsberg
Martina S. Ragettli
Yue Leon Guo
Shih‐Chun Pan
Samuel Osorio
Shanshan Li
Antonella Zanobetti
Trần Ngọc Đăng
Do Van Dung
Alexandra Schneider
Date Issued
9 de octubre de 2024
Type
Article
Volume
387
Start Page
e080944
End Page
e080944
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.
Subjects