Association of heat and cold waves with cause-specific mortality in Iran: a systematic review and meta-analysis

Despite the frequent occurrence of heat waves in the Middle East, there is a lack of evidence regarding the overall estimates for the effect of heat waves on mortality in this region. This study aimed to review the effect of exposure to heat and cold waves and daily cause-specific mortality. Four electronic databases were searched. The titles, abstracts, and full-texts of the articles were carefully reviewed by two researchers. Once eligible studies were identified, the required data were extracted. Separate meta-analyses were conducted based on gender, age group, and health endpoint combinations. According to the meta-analysis, heat waves had a statistically significant effect on all-cause mortality with an RR of 1.23 (CI 95%: 1.08, 1.39). Cardiovascular mortality significantly increased in heat waves with an RR of 1.08 (CI 95%: 1.05, 1.10). However, the increase in respiratory mortality was not statistically significant. Compared to young people (age < 65 years old) and women, elderly and men were more vulnerable to heat waves with RRs of 1.31 (95% CI: 1.05, 1.57) and 1.33 (95% CI: 1.08, 1.58), respectively. This study can be beneficial in developing response or adaptation plans for heat waves. Future studies should focus on other specific health endpoints like ischemic heart disease, chronic obstructive pulmonary diseases, etc., and other outcomes such as hospitalization and emergency visits.