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. 2016 May 16:16:407.
doi: 10.1186/s12889-016-3077-y.

Projected heat-related mortality under climate change in the metropolitan area of Skopje

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Projected heat-related mortality under climate change in the metropolitan area of Skopje

Gerardo Sanchez Martinez et al. BMC Public Health. .

Abstract

Background: Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period.

Methods: After ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5) and the evolution of the city population in two future time periods: 2026-2045 and 2081-2100, and in a past time period (1986-2005) to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact.

Results: Our estimates suggest that, compared to the baseline period (1986-2005), heat-related mortality in Skopje would more than double in 2026-2045, and more than quadruple in 2081-2100. When considering the impact in 2081-2100, sampling variability around the heat-mortality relationship and climate model explained 40.3 and 46.6 % of total variability.

Conclusion: These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.

Keywords: Climate change; Heat waves; Heat-related mortality; Skopje.

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Figures

Fig. 1
Fig. 1
Adjusted relationship between lag 0–3 mean temperature and mortality for the period 2007–2011 during the warm season (1 May–30 September). Cubic regression spline (pointwise 95 % confidence bands) describing the relationship on a logarithmic scale
Fig. 2
Fig. 2
Projected population size for the city of Skopje from 2002 to 2100. Projections under exponential model and under logistic models with different values of the carrying capacity parameter (K). Vertical lines indicate the years 2002 and 2012
Fig. 3
Fig. 3
Attributable deaths predictions under the median, the minimal and the maximal climate models. An exponential model for population growth is assumed. Red lines indicate the average number of attributable deaths per year during each time period

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