Issues in health risk assessment of current and future heat extremes

BACKGROUND: In assessing health risks relating to current and future heat extremes, it is important to include developing countries, because these countries are considered to be vulnerable to the impact of climate change due to inadequate public health infrastructure, nutritional status and so forth. However, it is usually difficult to obtain relevant information from these countries, also because of insufficient public health infrastructure. OBJECTIVES: We invented a method that can be used for developing countries to assess the health risks of current and future extremes, but there still are some issues. We introduce and discuss these issues. DESIGN: We analysed time-series data with non-parametric regression models including generalised additive models, which controlled for time trends. RESULTS: When we controlled for year, the temperature–mortality relation was V-shaped, but when we controlled for season as well as year, the left side of the V-shape disappeared. Our month-specific analysis also revealed that winter months had higher mortality rates than other months, but there was no relation between mortality rate and temperature within each month during winter. CONCLUSIONS: This suggests that, unlike heat effects, risks due to cold effects may not be ameliorated even if global warming occurs. We need to investigate the mechanism behind high mortality during winter months.