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2.
Glob Chang Biol ; 30(8): e17417, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39105285

ABSTRACT

Marine heatwaves (MHWs) are increasing in frequency, duration and intensity, disrupting global marine ecosystems. While most reported impacts have been in tropical areas, New Zealand experienced its strongest and longest MHW in 2022, profoundly affecting marine sponges. Sponges are vital to rocky benthic marine communities, with their abundance influencing ecosystem functioning. This study examines the impact of this MHW on the photosynthetic sponge Cymbastella lamellata in Fiordland, New Zealand. We describe the extent, physiological responses, mortality, microbial community changes and ecological impact of this MHW on C. lamellata. The Fiordland MHW reached a maximum temperature of 4.4°C above average, lasting for 259 days. Bleaching occurred in >90% of the C. lamellata Fiordland population. The population size exceeded 66 million from 5 to 25 m, making this the largest bleaching event of its kind ever recorded. We identified the photosynthetic symbiont as a diatom, and bleached sponges had reduced photosynthetic efficiency. Post-MHW surveys in 2023 found that over 50% of sponges at sampling sites had died but that the remaining sponges had mostly recovered from earlier bleaching. Using a simulated MHW experiment, we found that temperature stress was a driver of necrosis rather than bleaching, despite necrosis only rarely being observed in the field (<2% of sponges). This suggests that bleaching may not be the cause of the mortality directly. We also identified a microbial community shift in surviving sponges, which we propose represents a microbial-mediated adaptive response to MHWs. We also found that C. lamellata are key contributors of dissolved organic carbon to the water column, with their loss likely impacting ecosystem function. We demonstrate the potential for MHWs to disrupt key marine phyla in temperate regions, highlighting how susceptible temperate sponges globally might be to MHWs.


Subject(s)
Microbiota , Porifera , Porifera/microbiology , Porifera/physiology , Animals , New Zealand , Photosynthesis , Extreme Heat/adverse effects , Ecosystem , Symbiosis , Diatoms/physiology , Diatoms/growth & development
3.
Nat Commun ; 15(1): 6840, 2024 Aug 09.
Article in English | MEDLINE | ID: mdl-39122723

ABSTRACT

The world's oceans are under threat from the prevalence of heatwaves caused by climate change. Despite this, there is a lack of understanding regarding their impact on seawater oxygen levels - a crucial element in sustaining biological survival. Here, we find that heatwaves can trigger low-oxygen extreme events, thereby amplifying the signal of deoxygenation. By utilizing in situ observations and state-of-the-art climate model simulations, we provide a global assessment of the relationship between the two types of extreme events in the surface ocean (0-10 m). Our results show compelling evidence of a remarkable surge in the co-occurrence of marine heatwaves and low-oxygen extreme events. Hotspots of these concurrent stressors are identified in the study, indicating that this intensification is more pronounced in high-biomass regions than in those with relatively low biomass. The rise in the compound events is primarily attributable to long-term warming primarily induced by anthropogenic forcing, in tandem with natural internal variability modulating their spatial distribution. Our findings suggest the ocean is losing its breath under the influence of heatwaves, potentially experiencing more severe damage than previously anticipated.


Subject(s)
Climate Change , Oceans and Seas , Seawater , Seawater/chemistry , Oxygen , Climate Models , Hot Temperature , Extreme Heat/adverse effects , Biomass
5.
PLoS One ; 19(7): e0307417, 2024.
Article in English | MEDLINE | ID: mdl-39024254

ABSTRACT

OBJECTIVE: The objective of this study is to map the international evidence for extreme heat related adaptation strategies by health systems, with a particular focus on how heat-vulnerable populations and local situational awareness are considered in these strategies. INTRODUCTION: Since the Paris Climate Accords in 2015, awareness has increased of the health risks posed by extreme heat along with interest in adaptations which aim to reduce heat-health-risks for vulnerable populations. However, the extant literature on these adaptations suggest they are insufficient, and call for research to examine whether, how, and what adaptations for extreme heat are effective as public health interventions. INCLUSION CRITERIA: We will include English-language review articles describing and/or evaluating health system adaptations for extreme heat. Health systems will be defined broadly using the WHO Building Blocks model [1] and adaptations will range from the individual level to institutional, regional and national levels, with particular attention to localisation and the protection of vulnerable individuals. METHODS: A comprehensive literature search of the published literature will be conducted using MEDLINE, Embase, CINAHL, the Cochrane Library and Web of Science. Searches will be limited to reviews published since 2015 in the English language. Results will be exported to EndNote for screening (with a sample checked by two reviewers to ensure consistency). A complementary search for related reports by major international agencies (e.g. WHO; International Association of Emergency Managers), as well as local searches for current guidance and case studies, will be conducted in parallel. Data from included papers will be presented in tables with a narrative commentary.


Subject(s)
Extreme Heat , Humans , Adaptation, Physiological , Extreme Heat/adverse effects , Review Literature as Topic , Research Design
7.
Philos Trans R Soc Lond B Biol Sci ; 379(1909): 20230171, 2024 Sep 09.
Article in English | MEDLINE | ID: mdl-39034694

ABSTRACT

Marine heatwaves have caused massive mortality in coastal benthic ecosystems, altering community composition. Here, we aim to understand the effects of single and sequential sublethal heatwaves in a temperate benthic ecosystem, investigating their disturbance on various levels of ecological hierarchy, i.e. individual physiology, trophic groups' biomass and ecosystem carbon fluxes. To do so, we performed a near-natural experiment using outdoor benthic mesocosms along spring/summer, where communities were exposed to different thermal regimes: without heatwaves (0HW), with one heatwave (1HW) and with three heatwaves (3HWs). Gastropods were negatively impacted by one single heatwave treatment, but the exposure to three sequential heatwaves caused no response, indicating ecological stress memory. The magnitude of ecosystem carbon fluxes mostly decreased after 1HW, with a marked negative impact on mesograzers' feeding, while the overall intensity of carbon fluxes increased after 3HWs. Consumers' acclimation after the exposure to sequential heatwaves increased grazing activity, representing a threat for the macroalgae biomass. The evaluation of physiological responses and ecological interactions is crucial to interpret variations in community composition and to detect early signs of stress. Our results reveal the spread of heatwave effects along the ecological hierarchical levels, helping to predict the trajectories of ecosystem development.This article is part of the theme issue 'Connected interactions: enriching food web research by spatial and social interactions'.


Subject(s)
Acclimatization , Ecosystem , Animals , Acclimatization/physiology , Biomass , Extreme Heat/adverse effects , Carbon Cycle , Gastropoda/physiology , Food Chain , Hot Temperature/adverse effects
8.
J Environ Manage ; 366: 121665, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39032252

ABSTRACT

The escalating frequency, duration, and intensity of extreme heat events have posed a significant threat to human society in recent decades. Understanding the dynamic patterns of human mobility under extreme heat will contribute to accurately assessing the risk of extreme heat exposure. This study leverages an emerging geospatial data source, anonymous cell phone location data, to investigate how people in different communities adapt travel behaviors responding to extreme heat events. Taking the Greater Houston Metropolitan Area as an example, we develop two indices, the Mobility Disruption Index (MDI) and the Activity Time Shift Index (ATSI), to quantify diurnal mobility changes and activity time shift patterns at the city and intra-urban scales. The results reveal that human mobility decreases significantly in the daytime of extreme heat events in Houston while the proportion of activity after 8 p.m. is increased, accompanied with a delay in travel time in the evening. Moreover, these mobility-decreasing and activity-delaying effects exhibited substantial spatial heterogeneity across census block groups. Causality analysis using the Geographical Convergent Cross Mapping (GCCM) model combined with correlation analyses indicates that people in areas with a high proportion of minorities and poverty are less able to adopt heat adaptation strategies to avoid the risk of heat exposure. These findings highlight the fact that besides the physical aspect of environmental justice on heat exposure, the inequity lies in the population's capacity and knowledge to adapt to extreme heat. This research is the first of the kind that quantifies multi-level mobility for extreme heat responses, and sheds light on a new facade to plan and implement heat mitigations and adaptation strategies beyond the traditional approaches.


Subject(s)
Cell Phone , Extreme Heat , Humans
9.
Front Public Health ; 12: 1409563, 2024.
Article in English | MEDLINE | ID: mdl-38962759

ABSTRACT

The increasingly frequent occurrence of urban heatwaves has become a significant threat to human health. To quantitatively analyze changes in heatwave characteristics and to investigate the return periods of future heatwaves in Wuhan City, China, this study extracted 9 heatwave definitions and divided them into 3 mortality risk levels to identify and analyze historical observations and future projections of heatwaves. The copula functions were employed to derive the joint distribution of heatwave severity and duration and to analyze the co-occurrence return periods. The results demonstrate the following. (1) As the concentration of greenhouse gas emissions increases, the severity of heatwaves intensifies, and the occurrence of heatwaves increases significantly; moreover, a longer duration of heatwaves correlated with higher risk levels in each emission scenario. (2) Increasing concentrations of greenhouse gas emissions result in significantly shorter heatwave co-occurrence return periods at each level of risk. (3) In the 3 risk levels under each emission scenario, the co-occurrence return periods for heatwaves become longer as heatwave severity intensifies and duration increases. Under the influence of climate change, regional-specific early warning systems for heatwaves are necessary and crucial for policymakers to reduce heat-related mortality risks in the population, especially among vulnerable groups.


Subject(s)
Climate Change , China/epidemiology , Humans , Risk Assessment/methods , Extreme Heat/adverse effects , Cities , Hot Temperature/adverse effects , Mortality/trends , Environmental Monitoring
10.
Article in English | MEDLINE | ID: mdl-39073887

ABSTRACT

BACKGROUND: Vulnerable populations across the United States are frequently exposed to extreme heat, which is becoming more intense due to a combination of climate change and urban-induced warming. Extreme heat can be particularly detrimental to the health and well-being of older citizens when it is combined with ozone. Although population-based studies have demonstrated associations between ozone, extreme heat, and human health, few studies focused on the role of social and behavioral factors that increase indoor risk and exposure among older adults. METHODS: We conducted a household survey that aimed to understand how older adults are affected by extreme heat and ozone pollution inside and outside of their homes across Houston, Phoenix, and Los Angeles. We examine contributing factors to the risk of self-reported health effects using a generalized linear mixed-effects regression model of telephone survey data of 909 older adults in 2017. RESULTS: We found an increased occurrence of self-reported symptoms for extreme heat with preexisting respiratory health conditions and a lack of air conditioning access; self-reported ozone symptoms were more likely with preexisting respiratory health conditions. The risk of heat-related symptoms was slightly higher in Los Angeles than Houston and Phoenix. We found several demographic, housing, and behavioral characteristics that influenced the risk of heat- and ozone-related symptoms. CONCLUSIONS: The increased risk among older adults based on specific social and behavioral factors identified in this study can inform public health policy and help cities tailor their heat and ozone response plans to the specific needs of this vulnerable population.


Subject(s)
Extreme Heat , Ozone , Humans , Ozone/analysis , Aged , Male , Female , Extreme Heat/adverse effects , Risk Factors , Environmental Exposure/adverse effects , Cities , Sociodemographic Factors , Self Report , Aged, 80 and over , Climate Change , Los Angeles/epidemiology , United States/epidemiology , Air Pollution, Indoor/adverse effects
11.
Sci Total Environ ; 947: 174345, 2024 Oct 15.
Article in English | MEDLINE | ID: mdl-38960174

ABSTRACT

Seaweed cultivation can inhibit the occurrence of red tides. However, how seaweed aquaculture interactions with harmful algal blooms will be affected by the increasing occurrence and intensity of marine heatwaves (MHWs) is unknown. In this study, we run both monoculture and coculture systems to investigate the effects of a simulated heatwave on the competition of the economically important macroalga Gracilariopsis lemaneiformis against the harmful bloom diatom Skeletonema costatum. Coculture with G. lemaneiformis led to a growth decrease in S. costatum. Growth and photosynthetic activity (Fv/Fm) of G. lemaneiformis was greatly reduced by the heatwave treatment, and did not recover even after one week. Growth and photosynthetic activity of S. costatum was also reduced by the heatwave in coculture, but returned to normal during the recovery period. S. costatum also responded to the stressful environment by forming aggregates. Metabolomic analysis suggests that the negative effects on S. costatum were related to an allelochemical release from G. lemaneiformis. These findings show that MHWs may enhance the competitive advantages of S. costatum against G. lemaneiformis, leading to more severe harmful algal blooms in future extreme weather scenarios.


Subject(s)
Diatoms , Harmful Algal Bloom , Seaweed , Diatoms/physiology , Seaweed/physiology , Extreme Heat , Aquaculture , Gracilaria/physiology , Photosynthesis
12.
Sci Rep ; 14(1): 17058, 2024 07 24.
Article in English | MEDLINE | ID: mdl-39048637

ABSTRACT

Previous research on social disparities in heat exposure has not examined heatwave frequency or economic damage at the local or neighborhood level. Additionally, most US studies have focused on specific cities or regions, and few national-scale studies encompassing both urban and rural areas have been conducted. These gaps are addressed here by analyzing racial/ethnic disparities in the distribution of annual heatwave frequency and expected economic losses from heatwave occurrence in the contiguous US. Census tract-level data on annualized heatwave frequency and expected loss from the FEMA's National Risk Index are linked to relevant variables from the American Community Survey. Results indicate that all racial/ethnic minority groups except non-Hispanic Black are significantly overrepresented in neighborhoods with greater annual heatwave frequency (top 10% nationally), and all minority groups are overrepresented in neighborhoods with greater total expected annual loss from heatwaves, compared to non-Hispanic Whites. Multivariable models that control for spatial clustering, climate zone, and relevant socio-demographic factors reveal similar racial/ethnic disparities, and suggest significantly greater heatwave frequency and economic losses in neighborhoods with higher percentages of Hispanics and American Indians. These findings represent an important starting point for more detailed investigations on the adverse impacts of heatwaves for US minority populations and formulating appropriate policy interventions.


Subject(s)
Ethnicity , Extreme Heat , Racial Groups , Humans , Extreme Heat/adverse effects , Residence Characteristics/statistics & numerical data , United States/epidemiology
13.
Ecotoxicol Environ Saf ; 282: 116687, 2024 Sep 01.
Article in English | MEDLINE | ID: mdl-38981395

ABSTRACT

The changing climate poses a growing challenge to the population health. The objective of this study was to assess the association between ambient temperature and cause-specific mortality in Suzhou. Based on the non-accidental mortality data collected during 2008-2022 in Suzhou, China, this study utilized an individual-level case-crossover design to evaluate the associations of temperature with cause-specific mortality. We applied a distributed lag nonlinear model with a maximum lag of 14 days to account for lag effects. Mortality risk due to extreme cold (<2.5th percentile) and extreme heat (>97.5th percentile) was analyzed. A total of 634,530 non-accidental deaths were analyzed in this study. An inverse J-shaped exposure-response relationship was observed between ambient temperature and non-accidental mortality, with the minimum mortality temperature (MMT) at 29.1℃. The relative risk (RR) of mortality associated with extreme cold (2.5th percentile) was 1.37 [95 % confidence interval (CI): 1.30, 1.44], higher than estimate of 1.09 (95 %CI: 1.07, 1.11) for extreme heat (97.5th percentile) relative to the MMT. Heat effect lasted for 2-3 days, while cold effect could persist for almost 14 days. Higher mortality risk estimates were observed for cardiorespiratory deaths compared to total deaths, with statistically significant between-group differences. Consequently, this study provides first-hand evidence on the associations between ambient temperatures and mortality risks from various causes, which could help local government and policy-makers in designing targeted strategies and public health measures against the menace of climate change.


Subject(s)
Cross-Over Studies , China/epidemiology , Humans , Female , Male , Mortality/trends , Middle Aged , Climate Change , Adult , Temperature , Environmental Exposure/statistics & numerical data , Environmental Exposure/adverse effects , Aged , Cause of Death , Young Adult , Extreme Heat/adverse effects
15.
JAMA ; 332(4): 333-335, 2024 07 23.
Article in English | MEDLINE | ID: mdl-38913388

ABSTRACT

This study investigates the effects of extreme heat exposure on kidney function using plasma-based biomarkers in young and older adults.


Subject(s)
Biomarkers , Humans , Biomarkers/blood , Aged , Male , Adult , Female , Extreme Heat/adverse effects , Kidney/physiology , Kidney/physiopathology , Middle Aged , Young Adult , Glomerular Filtration Rate , Creatinine/blood , Age Factors
16.
Nat Ecol Evol ; 8(7): 1285-1297, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38831017

ABSTRACT

Long-term, large-scale experimental studies provide critical information about how global change influences communities. When environmental changes are severe, they can trigger abrupt transitions from one community type to another leading to a regime shift. From 2014 to 2016, rocky intertidal habitats in the northeast Pacific Ocean experienced extreme temperatures during a multi-year marine heatwave (MHW) and sharp population declines of the keystone predator Pisaster ochraceus due to sea star wasting disease (SSWD). Here we measured the community structure before, during and after the MHW onset and SSWD outbreak in a 15-year succession experiment conducted in a rocky intertidal meta-ecosystem spanning 13 sites on four capes in Oregon and northern California, United States. Kelp abundance declined during the MHW due to extreme temperatures, while gooseneck barnacle and mussel abundances increased due to reduced predation pressure after the loss of Pisaster from SSWD. Using several methods, we detected regime shifts from substrate- or algae-dominated to invertebrate-dominated alternative states at two capes. After water temperatures cooled and Pisaster population densities recovered, community structure differed from pre-disturbance conditions, suggesting low resilience. Consequently, thermal stress and predator loss can result in regime shifts that fundamentally alter community structure even after restoration of baseline conditions.


Subject(s)
Starfish , Animals , Starfish/physiology , Oregon , California , Pacific Ocean , Thoracica/physiology , Ecosystem , Bivalvia/physiology , Climate Change , Population Dynamics , Extreme Heat/adverse effects , Kelp
17.
Proc Biol Sci ; 291(2025): 20240714, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38889783

ABSTRACT

Extreme heat poses a major threat to plants and pollinators, yet the indirect consequences of heat stress are not well understood, particularly for native solitary bees. To determine how brief exposure of extreme heat to flowering plants affects bee behaviour, fecundity, development and survival we conducted a no-choice field cage experiment in which Osmia lignaria were provided blueberry (Vaccinium corymbosum), phacelia (Phacelia tanacetifolia) and white clover (Trifolium repens) that had been previously exposed to either extreme heat (37.5°C) or normal temperatures (25°C) for 4 h during early bloom. Despite a similar number of open flowers and floral visitation frequency between the two treatments, female bees provided with heat-stressed plants laid approximately 70% fewer eggs than females provided with non-stressed plants. Their progeny received similar quantities of pollen provisions between the two treatments, yet larvae consuming pollen from heat-stressed plants had significantly lower survival as larvae and adults. We also observed trends for delayed emergence and reduced adult longevity when larvae consumed heat-stressed pollen. This study is the first to document how short, field-realistic bursts of extreme heat exposure to flowering host plants can indirectly affect bee pollinators and their offspring, with important implications for crop pollination and native bee populations.


Subject(s)
Fertility , Pollination , Animals , Bees/physiology , Female , Extreme Heat/adverse effects , Hot Temperature , Longevity , Pollen
18.
Sci Total Environ ; 946: 174209, 2024 Oct 10.
Article in English | MEDLINE | ID: mdl-38914322

ABSTRACT

The coming decades are likely to see of extreme weather events becoming more intense and frequent across Europe as a whole and around the Mediterranean in particular. The reproduction rate of some microorganisms, including the bacteria that cause foodborne diseases, will also be affected by these events. The aim of this study was thus to ascertain whether there might be a statistically significant relationship between emergency hospital admissions due to the principal bacterial foodborne diseases (BFDs) and the various meteorological variables, including heatwaves. We conducted a time-series study, with daily observations of both the dependent variable (emergency hospital admissions due to BFDs) and the independent variables (meteorological variables and control variables of chemical air pollution) across the period 2013-2018 in the Madrid Region (Spain), using Generalised Linear Models with Poisson regression, in which control and lag variables were included for the purpose of fitting the models. We calculated the threshold value of the maximum daily temperature above which such admissions increased statistically significantly, analysed data for the whole year and for the summer months alone, and estimated the relative and attributable risks. The estimated attributable risk was 3.6 % for every one-degree rise in the maximum daily temperature above 12 °C throughout the year, and 12.21 % for every one degree rise in temperature above the threshold heatwave definition temperature (34 °C) in summer. Furthermore, different meteorological variables displayed a statistically significant association. Whereas hours of sunlight and mean wind speed proved significant in the analyses of both the whole year and summer, the variables "rain" and "relative humidity", only showed a significant relationship in the analysis for the whole year. High ambient temperature is a risk factor that favours the increase in emergency hospitalisations attributable to the principal BFDs, with a greater impact being observed on days coinciding with heatwave periods. The results yielded by this study could serve as a basis for implementing BFD prevention strategies, especially on heatwave days.


Subject(s)
Foodborne Diseases , Foodborne Diseases/epidemiology , Humans , Spain/epidemiology , Hospitalization/statistics & numerical data , Extreme Heat/adverse effects , Emergency Service, Hospital/statistics & numerical data , Seasons
19.
Environ Res ; 257: 119347, 2024 Sep 15.
Article in English | MEDLINE | ID: mdl-38844034

ABSTRACT

BACKGROUND: As climate change increases the frequency and intensity of extreme heat events, there is an urgent need to quantify the heat-related health burden. However, most past studies have focussed on a single health outcome (mainly mortality) or on specific heatwaves, thus providing limited knowledge of the total pressure heat exerts on health services. OBJECTIVES: This study aims to quantify the heat-related mortality and morbidity burden for five different health outcomes including all-cause mortality, hospitalizations, emergency department (ED) visits, ambulance transports and calls to a health hotline, using the province of Quebec (Canada) as a case study. METHODS: A two-step statistical analysis was employed to estimate regional heat-health relationships using Distributed Lag Non-Linear Models (DLNM) and pooled estimates using a multivariate meta-regression. Heat burden was quantified by attributable fraction (AF) and attributable number (AN) for two temperature ranges: all heat (above the minimum mortality/morbidity temperature) and extreme heat (above the 95th percentile of temperature). RESULTS: Higher temperatures were associated with greater risk ratios for all health outcomes studied, but at different levels. Significant AF ranging from 2 to 3% for the all heat effect and 0.4-1.0% for extreme heat were found for all health outcomes, except for hospitalizations that had an AF of 0.1% for both heat exposures. The estimated burden of all heat (and extreme heat) every summer across the province was 470 (200) deaths, 225 (170) hospitalizations, 36 000 (6 200) ED visits, 7 200 (1 500) ambulance transports and 15 000 (3 300) calls to a health hotline, all figures significant. DISCUSSION: This new knowledge on the total heat load will help public health authorities to target appropriate actions to reduce its burden now and in the future. The proposed state-of-the-art framework can easily be applied to other regions also experiencing the adverse effects of extreme heat.


Subject(s)
Hospitalization , Hot Temperature , Quebec/epidemiology , Humans , Hospitalization/statistics & numerical data , Hot Temperature/adverse effects , Emergency Service, Hospital/statistics & numerical data , Heat Stress Disorders/mortality , Heat Stress Disorders/epidemiology , Morbidity , Extreme Heat/adverse effects , Mortality/trends , Aged
20.
Health Rep ; 35(6): 3-15, 2024 Jun 19.
Article in English | MEDLINE | ID: mdl-38896416

ABSTRACT

Background: Extreme heat has significant impacts on mortality. In Canada, past research has analyzed the degree to which non-accidental mortality increases during single extreme heat events; however, few studies have considered multiple causes of death and the impacts of extreme heat events on mortality over longer time periods. Data and methods: Daily death counts attributable to non-accidental, cardiovascular, and respiratory causes were retrieved for the 12 most populous cities in Canada from 2000 to 2020. Generalized additive models were applied to quantify daily mortality risks for people aged younger than 65 years and for those aged 65 years and older in each city and for each cause of death. Model results were used to calculate the change in mortality risks and the number of excess deaths attributable to extreme heat during extreme heat events. Results: Elevated mortality risks were observed during extreme heat events in most cities for non-accidental and respiratory causes. The impacts of extreme heat on non-accidental mortality were typically greater for people aged 65 and older than for those aged younger than 65. Significantly higher non-accidental mortality risks were observed during extreme heat events for people aged 65 and older in Montréal, the city of Québec, Surrey, and Toronto. For cardiovascular and respiratory causes, people aged 65 and older had significantly higher mortality risks during extreme heat events in Montréal, and both Montréal and Toronto, respectively. In the 12 cities, approximately 670 excess non-accidental deaths, 115 excess cardiovascular deaths, and 115 excess respiratory deaths were attributable to extreme heat events during the study period. Mortality risks during extreme heat events were generally higher in cities with larger proportions of renter households and fewer extreme heat events. Interpretation: This study estimates the longer-term impacts of extreme heat events on three mortality outcomes in a set of large Canadian cities. As climate change causes more frequent and intense extreme heat events, and as policy makers aim to reduce the health impacts of heat, it is important to understand how and where extreme heat affects health.


Subject(s)
Cardiovascular Diseases , Cause of Death , Cities , Extreme Heat , Respiratory Tract Diseases , Humans , Cardiovascular Diseases/mortality , Canada/epidemiology , Aged , Cities/epidemiology , Respiratory Tract Diseases/mortality , Extreme Heat/adverse effects , Middle Aged , Male , Female , Adult , Child, Preschool , Infant , Adolescent , Young Adult , Child
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