ArticleInternational journal of environmental research and public health2021
Selecting Thresholds of Heat-Warning Systems with Substantial Enhancement of Essential Population Health Outcomes for Facilitating Implementation.
Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review and meta-analysis on heat thresholds for maternal health and birth outcomes.Nature communications · 2026Pooled it
- A Systematic Review of Heat Health Warning Systems: Enhancing the Framework Towards Effective Health Outcomes.Current environmental health reports · 2025Pooled it
- An innovative method of evaluating the association of heat exposure and heart rate variability in a panel of agricultural workers with small and lightweight personal sensors.Journal of exposure science & environmental epidemiology · 2026Article
- Evaluation of heat warning thresholds with multiple lagged and cumulative health impacts based on a 20-year population database.Scientific reports · 2026Article
- Determining Location-Specific Thresholds for Heat Warning Systems to Mitigate Heatstroke Mortality in Japan.Environment & health (Washington, D.C.) · 2026Article
- Opposite Association Between Wet-Bulb Globe Temperature With Central Obesity in Different Geographic Regions in Taiwan.International journal of endocrinology · 2026Article
- Effects of heat exposure on self-reported heat strain symptoms among pregnant and postpartum women in South Africa.npj digital public health · 2026Article
- Association between wet-bulb globe temperature with peptic ulcer disease in different geographic regions in a large Taiwanese population study.BMC gastroenterology · 2025Article
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most heat-health studies identified thresholds just outside human comfort zones, which are often too low to be used in heat-warning systems for reducing climate-related health risks. We refined a generalized additive model for selecting thresholds with substantial health risk enhancement, based on Taiwan population records of 2000-2017, considering lag effects and different spatial scales. Reference-adjusted risk ratio (RaRR) is proposed, defined as the ratio between the relative risk of an essential health outcome for a threshold candidate against that for a reference; the threshold with the highest RaRR is potentially the optimal one. It was found that the wet-bulb globe temperature (WBGT) is a more sensitive heat-health indicator than temperature. At lag 0, the highest RaRR (1.66) with WBGT occurred in emergency visits of children, while that in hospital visits occurred for the working-age group (1.19), presumably due to high exposure while engaging in outdoor activities. For most sex, age, and sub-region categories, the RaRRs of emergency visits were higher than those of hospital visits and all-cause mortality; thus, emergency visits should be employed (if available) to select heat-warning thresholds. This work demonstrates the applicability of this method to facilitate the establishment of heat-warning systems at city or country scales by authorities worldwide.
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