@article{ref1,
title="The burden of heat-related stroke mortality under climate change scenarios in 22 East Asian cities",
journal="Environment international",
year="2022",
author="Zhou, Lu and He, Cheng and Kim, Ho and Honda, Yasushi and Lee, Whanhee and Hashizume, Masahiro and Chen, Renjie and Kan, Haidong",
volume="170",
number="",
pages="e107602-e107602",
abstract="BACKGROUND: Stroke is a leading cause of death and disability in East Asia. Owing to the aging population and high prevalence of stroke, East Asia might suffer a disproportionately heavy burden of stroke under the changing climate. However, the evidence relevant is still limited in this area. <br><br>OBJECTIVE: To evaluate the stroke mortality risk due to heat exposure in East Asia and predict its burden under various future climate change scenarios. <br><br>METHODS: We conducted a multi-center observational study and collected data from 22 representative cities in three main East Asian countries (i.e., China, Japan, and South Korea) from 1972 to 2015. The two-stage time-series analyses were applied to estimate the effects of heat on stroke mortality at the regional and country level. We further projected the burden of heat-related stroke mortality using 10 global climate models (GCMs) under four shared socioeconomic pathway and representative concentration pathway (SSP-RCP) scenarios, including SSP1-RCP1.9, SSP1-RCP2.6, SSP2-RCP4.5, and SSP5-RCP8.5 scenarios. <br><br>RESULTS: In the present study, a total of 287,579 stroke deaths were collected during the warm season. Heat was significantly associated with an increased risk of stroke mortality. Overall, compared with the 2010 s, the heat-related attributable fraction (AF) was projected to increase in the 2090 s, with increments ranging from 0.8 % to 7.5 % across various climate change scenarios. The heat-related AF was projected to reach 11.9 % (95 % empirical confidence interval [eCI]: 6.1 %, 17.5 %) in the 2090 s under the SSP5-RCP8.5 scenario in China, while the corresponding estimates were 6.6 % (95 % eCI: 2.5 %, 11.0 %) and 5.1 % (95 % eCI: 1.2 %, 9.1 %) for Japan and South Korea, respectively. <br><br>CONCLUSIONS: Climate change will exacerbate the burden of heat-related stroke mortality but with considerable geographical heterogeneity in East Asia.<p /> <p>Language: en</p>",
language="en",
issn="0160-4120",
doi="10.1016/j.envint.2022.107602",
url="http://dx.doi.org/10.1016/j.envint.2022.107602"
}