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BMC Public Health

, 16:407

Environmental Health


BackgroundExcessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period.

MethodsAfter ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario RCP8.5 and the evolution of the city population in two future time periods: 2026–2045 and 2081–2100, and in a past time period 1986–2005 to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact.

ResultsOur estimates suggest that, compared to the baseline period 1986–2005, heat-related mortality in Skopje would more than double in 2026–2045, and more than quadruple in 2081–2100. When considering the impact in 2081–2100, sampling variability around the heat–mortality relationship and climate model explained 40.3 and 46.6 % of total variability.

ConclusionThese results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.

KeywordsHeat waves Skopje Heat-related mortality Climate change AbbreviationsADattributable deaths

AFattributable fraction

AR5fifth assessment report of the Intergovernmental Panel on Climate Change

CIconfidence interval

CIRCEClimate Change and Impact Research: the Mediterranean Environment

CMIP5Coupled Model Intercomparison Project 5

DiSIADepartment of Statistics, Informatics and Applications, University of Florence

ECMWFEuropean Centre for Medium-Range Weather Forecasts

EUEuropean Union

GCMsglobal climate models

GEEgeneralized estimating equations

HHAPheat-health action plan

IPCCintergovernmental panel on climate change

ISPOCancer Prevention and Research Institute

NACLIMNorth Atlantic Climate Collaborative Project

NCDCUnited States National Climatic Data Center

NDVINormalized Difference Vegetation Index

PHEWEassessment and Prevention of acute Health Effects of Weather conditions in Europe

PM10particulate matter less than 10 micrometers in diameter

RAMSESReconciling Adaptation, Mitigation and Sustainable Development for Cities

RCPRepresentative Concentration Pathway scenario

UHIurban heat island effect

VITOFlemish Institute for Technological Research

WHOWorld Health Organization

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-016-3077-y contains supplementary material, which is available to authorized users.

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Autor: Gerardo Sanchez Martinez - Michela Baccini - Koen De Ridder - Hans Hooyberghs - Wouter Lefebvre - Vladimir Kendrovski - Kri


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