The Mortality Effect of Apparent Temperature: A Multi-City Study in Asia

(1) Background: The health effect of temperature has become a rising public health topic. The objective of this study is to assess the association between apparent temperature and non-accidental deaths, and the mortality burden attributed to cold and heat temperature; (2) Methods: The daily data on temperature and deaths were collected from 10 cities in Thailand, Korea and China. We fitted a time-series regression with a distributed lag nonlinear model (DLNM) to derive the health risk of temperature for each city and then pooled them to get the overall cumulative risk by multivariate meta-analysis. Additionally, we calculated the attributable fraction of deaths for heat and cold, which was defined as temperatures above and below minimum-mortality temperature (MMT); (3) Results: There are regional heterogeneities in the minimum mortality percentiles (MMP) and attributable fractions for different countries. The MMP varied from about the 5-10th percentile in Thailand to 63-93rd percentile in China and Korea. The attributable fractions of the total deaths due to short-term exposure to temperature in Asia is 7.62%, of which the cold effect (6.44%) is much higher than the heat effect (1.18%); (4) Conclusions: Our study suggested that apparent temperature was associated with an increase in non-accidental mortality. Most of the temperature-related mortality burden was attributable to cold, except for Thailand.