The impact of heat waves on mortality and years of life lost in a dry region of Iran (Kerman) during 2005-2017.

The present study was conducted to compare the impact of heat waves on mortality and years of life lost (YLL) in Kerman, Iran during the years 2005-2017. Daily mean temperature in a combination of intensity and duration were used in order to define heat waves (90, 95, and 98th percentile and ≥ 2, 3, and 4 consecutive days). YLL was calculated according to Iran's life table and by considering the discount rate. In order to investigate the impact of heat waves in different lags and its cumulative effect on mortality and YLL, Poisson and linear models within distributed lag nonlinear models were used respectively. A maximum lag of 14 days was considered. The best model was selected based on AIC (Akaike Information Criteria). The model was adjusted for air pollutants, public holidays, days of the week, and humidity. The average daily mortality and YLL were 10.54 ± 4.31 deaths and 175.58 ± 91.39 years respectively. They were higher in men and in heat waves matching a definition of above the 98th temperature percentile and ≥ 3 days, than others. Except heat waves defined as the 98th percentile and ≥ 4 days, the impact of heat waves on mortality and YLL were the highest at lag 0. The cumulative relative risk of total mortality was significantly higher in heat waves above the 95 and 98th percentiles. The cumulative effect of heat waves on total YLL was significantly higher only above the 98th percentile. Men over 65 years old were the most vulnerable and had the highest mortality and YLL. Heat waves with temperatures above the 98th percentile that lasted at least 2 or 3 consecutive days had a significant effect in increasing both total YLL and mortality in Kerman, Iran.