Periodic Reporting for period 1 - MORDIC (Mortality Risk Attributable to Thermal Discomfort Indicators with Implications of Climate Change)
Periodo di rendicontazione: 2022-09-01 al 2024-08-31
Environmental epidemiologists and physiologists continue to disagree on the importance of humidity when assessing heat-related impacts on human mortality. The former community has favoured ambient air temperature (Tair) as the preferred environmental exposure variable. Their argument is deep rooted in studies, wherein humidity when included in empirical models, did not substantially improve its predictive power compared to those using only Tair as a exposure variable. On the contrary, using laboratory-based settings, the latter community have demonstrated that humidity, in addition to Tair, often expressed as different standalone heat stress indices (HSIs), plays an important role to explain how human physiology regulates the core body temperature when exposed to elevated levels of heat stress. Nonetheless, scientific evidence has remained elusive with no single HSI considered as universally applicable in different climate regimes and population settings.
The MSCA project MORDIC systematically examined whether: (i) commonly used HSIs (e.g. wet bulb temperature, heat index) perform better than Tair in explaining heat-related health impacts at city-level; (ii) the association of HSIs and mortality varies geographically, and if so, which factors are instrumental for this variance; and (iii) the subsequent excess-deaths attributable to non-optimal heat stress differ when estimated using HSIs instead of Tair.
The above research objectives (ROs) and the subsequent findings published in numerous peer-reviewed studies, have enabled not only the scientific community, but also the public health authorities and decision makers to gain valuable insights in cross-disciplinary subjects. Whether or not the regional-scale health-impact assessments should utilise HSI (in lieu of Tair) is a direct outcome of the above ROs addressed by MORDIC. In addition, a parallel and important goal of the MSCA Fellowship was to foster the development of the individual researcher and contribute to the host institute’s outreach in epidemiological and public health research areas.
The MSCA project MORDIC systematically examined whether: (i) commonly used HSIs (e.g. wet bulb temperature, heat index) perform better than Tair in explaining heat-related health impacts at city-level; (ii) the association of HSIs and mortality varies geographically, and if so, which factors are instrumental for this variance; and (iii) the subsequent excess-deaths attributable to non-optimal heat stress differ when estimated using HSIs instead of Tair.
The above research objectives (ROs) and the subsequent findings published in numerous peer-reviewed studies, have enabled not only the scientific community, but also the public health authorities and decision makers to gain valuable insights in cross-disciplinary subjects. Whether or not the regional-scale health-impact assessments should utilise HSI (in lieu of Tair) is a direct outcome of the above ROs addressed by MORDIC. In addition, a parallel and important goal of the MSCA Fellowship was to foster the development of the individual researcher and contribute to the host institute’s outreach in epidemiological and public health research areas.
Work was planned in five work packages (WPs) as elaborated below. In brief, the WPs can be categorised broadly into two components: (i) Data gathering and assembly (linkage) of health outcome with environmental exposure, and (ii) Assessment of health impacts in historical and future climate. As far as possible, the WPs were structured to enable the work to be carried out in parallel, thus enabling continuity should for example, accessing health records from new locations not previously explored in literature be delayed for any unforeseen circumstances.
The five WPs in MORDIC addressed the following key components of the project: (i) data gathering and assembly (linkage) of health data with relevant environmental exposures (WPs I, IV); (ii) examine the relationship of daily all cause or non-external cause mortality with Tair and individual HSIs using multivariate regression approaches (WP II); (iii) assessment of the derived HSI-mortality relationship; (iv) identification of geographic patterns, such as regional-scale variation in importance of humidity in health-impact assessment (WPs II-III); and (iv) assessment of heat-related mortality in a future warming climate (WP V).
With regards to research outcomes, several studies were published in high impact factor journals during the 24-month fellowship. Notably, the findings were not only highlighted by various media channels but were also cited heavily in literature, as well as presented in international scientific conferences fostering further research collaboration. Not all ROs envisaged initially at the time of proposal submission could be addressed during the fellowship. Several reasons were responsible for this minor departure. For instance, a specific research question or a dataset proposed in the original submission of MORDIC proposal was found published while the same was being investigated during the fellowship. Similarly, a RO that was conditional on an original research hypothesis, could not be pursued as the findings from preliminary analyses did not support the same. To overcome these challenges required revisiting and restructuring a few of the original (proposed) ROs, which in turn resulted in additional published studies addressing other novel research questions.
Public engagement was another important component during the fellowship period. The fellow actively engaged with several social and print media outlets to disseminate the important research findings in a lucid and interpretable manner. Similarly, as part of training and transfer-of-knowledge (TOF), the fellow attended various in-house and external training sessions enabling him to gain knowledge in cutting-edge tools and methodology in environmental epidemiology used for carrying out research in MORDIC. Likewise, the fellow’s own prior expertise in the field climatology and earth observation data, were instrumental in TOF to the host institute and the project collaborators.
Participation and presentation of project’s outcomes in international scientific conferences, including co-convening a session, was yet another important component in the TOF and communication. The fellow also earned a teaching qualification in the UK Associate Fellowship of the Higher Education Academy (AFHEA).
While the underlying data sharing agreements with the local health authorities prevented the fellow from making the health data publicly available, a comprehensive set of tutorials (as replication codes and sample data including secondary data directly emanating from the scientific findings) were made available to the research community in the spirit of Open Data/Science.
The five WPs in MORDIC addressed the following key components of the project: (i) data gathering and assembly (linkage) of health data with relevant environmental exposures (WPs I, IV); (ii) examine the relationship of daily all cause or non-external cause mortality with Tair and individual HSIs using multivariate regression approaches (WP II); (iii) assessment of the derived HSI-mortality relationship; (iv) identification of geographic patterns, such as regional-scale variation in importance of humidity in health-impact assessment (WPs II-III); and (iv) assessment of heat-related mortality in a future warming climate (WP V).
With regards to research outcomes, several studies were published in high impact factor journals during the 24-month fellowship. Notably, the findings were not only highlighted by various media channels but were also cited heavily in literature, as well as presented in international scientific conferences fostering further research collaboration. Not all ROs envisaged initially at the time of proposal submission could be addressed during the fellowship. Several reasons were responsible for this minor departure. For instance, a specific research question or a dataset proposed in the original submission of MORDIC proposal was found published while the same was being investigated during the fellowship. Similarly, a RO that was conditional on an original research hypothesis, could not be pursued as the findings from preliminary analyses did not support the same. To overcome these challenges required revisiting and restructuring a few of the original (proposed) ROs, which in turn resulted in additional published studies addressing other novel research questions.
Public engagement was another important component during the fellowship period. The fellow actively engaged with several social and print media outlets to disseminate the important research findings in a lucid and interpretable manner. Similarly, as part of training and transfer-of-knowledge (TOF), the fellow attended various in-house and external training sessions enabling him to gain knowledge in cutting-edge tools and methodology in environmental epidemiology used for carrying out research in MORDIC. Likewise, the fellow’s own prior expertise in the field climatology and earth observation data, were instrumental in TOF to the host institute and the project collaborators.
Participation and presentation of project’s outcomes in international scientific conferences, including co-convening a session, was yet another important component in the TOF and communication. The fellow also earned a teaching qualification in the UK Associate Fellowship of the Higher Education Academy (AFHEA).
While the underlying data sharing agreements with the local health authorities prevented the fellow from making the health data publicly available, a comprehensive set of tutorials (as replication codes and sample data including secondary data directly emanating from the scientific findings) were made available to the research community in the spirit of Open Data/Science.
The MSCA funded project MORDIC has pushed the frontiers of heat-health impact assessments in a warming climate in numerous ways.
First, the new research focus on LULCC-associated health impacts in a future climate that the fellow spearheaded have shed new light on how the climate and health community as well as the policy makers, need to look beyond the traditional climate change scenarios for an understanding of the future burden on heat-related mortality.
Second, the complex feedback loop linking climate, health and economy (via labour productivity and GDP), remains ambiguous. This can result in incorrect assessment of climate-induced health impacts, a point identified and emphasised in an important perspective article.
Third, for the first time ever in scientific literature, the importance of humidity when assessing health impacts at regional-scales was established using global-scale climate and health data. In fact, a direct outcome of these findings have resulted in another study (currently in review) examining how evolving heat stress during outdoor summer sports events in Europe (such as the Tour De France) are at risk in a warming climate.
And last but not the least, a new novel framework for real-time heat-health warning was proposed, enabling prediction of expected excess-deaths on short time scales (1-14 days); a framework has gained immense attention from local public health authorities.
First, the new research focus on LULCC-associated health impacts in a future climate that the fellow spearheaded have shed new light on how the climate and health community as well as the policy makers, need to look beyond the traditional climate change scenarios for an understanding of the future burden on heat-related mortality.
Second, the complex feedback loop linking climate, health and economy (via labour productivity and GDP), remains ambiguous. This can result in incorrect assessment of climate-induced health impacts, a point identified and emphasised in an important perspective article.
Third, for the first time ever in scientific literature, the importance of humidity when assessing health impacts at regional-scales was established using global-scale climate and health data. In fact, a direct outcome of these findings have resulted in another study (currently in review) examining how evolving heat stress during outdoor summer sports events in Europe (such as the Tour De France) are at risk in a warming climate.
And last but not the least, a new novel framework for real-time heat-health warning was proposed, enabling prediction of expected excess-deaths on short time scales (1-14 days); a framework has gained immense attention from local public health authorities.