@article{3219186,
    title = "Fluctuating temperature modifies heat-mortality association around the globe",
    author = "Wu, Y. and Wen, B. and Li, S. and Gasparrini, A. and Tong, S. and Overcenco, A. and Urban, A. and Schneider, A. and Entezari, A. and Vicedo-Cabrera, A.M. and Zanobetti, A. and Analitis, A. and Zeka, A. and Tobias, A. and Alahmad, B. and Armstrong, B. and Forsberg, B. and Íñiguez, C. and Ameling, C. and De la Cruz Valencia, C. and Åström, C. and Houthuijs, D. and Van Dung, D. and Royé, D. and Indermitte, E. and Lavigne, E. and Mayvaneh, F. and Acquaotta, F. and de'Donato, F. and Sera, F. and Carrasco-Escobar, G. and Kan, H. and Orru, H. and Kim, H. and Holobaca, I.-H. and Kyselý, J. and Madureira, J. and Schwartz, J. and Katsouyanni, K. and Hurtado-Diaz, M. and Ragettli, M.S. and Hashizume, M. and Pascal, M. and de Sousa Zanotti Stagliorio Coélho, M. and Scovronick, N. and Michelozzi, P. and Goodman, P. and Nascimento Saldiva, P.H. and Abrutzky, R. and Osorio, S. and Dang, T.N. and Colistro, V. and Huber, V. and Lee, W. and Seposo, X. and Honda, Y. and Bell, M.L. and Guo, Y.",
    journal = "Innovation: The European Journal of Social Science Research",
    year = "2022",
    volume = "3",
    number = "2",
    publisher = "Cell Press",
    issn = "1351-1610, 1469-8412",
    doi = "10.1016/j.xinn.2022.100225",
    abstract = "Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: −0.33 to 1.69), 1.34% (95% CI: −0.14 to 2.73), 1.99% (95% CI: 0.29–3.57), and 2.73% (95% CI: 0.76–4.50) of total deaths for Q1–Q4 (first quartile–fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25–9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: −0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health. © 2022 The Author(s)"
}