Cause specific mortality risks associated with tropical cyclones in multiple countries and territories: two stage, time series study
Issued Date
2025-11-05
Resource Type
eISSN
17561833
Scopus ID
2-s2.0-105020992698
Pubmed ID
41193239
Journal Title
BMJ Clinical Research Ed
Volume
391
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Clinical Research Ed Vol.391 (2025) , e084906
Suggested Citation
Huang W., Xu R., Yang Z., Otto C., Hales S., Hundessa S., Ye T., Chua P.L.C., Ritchie E.A., Coelho M.S.Z.S., Yu P., Tantrakarnapa K., Saldiva P.H.N., Zhang Y., Xu Z., Zhou S., Lavigne E., Seposo X.T., Kliengchuay W., Guo Y.L., Kim H., Yu W., Liu Y., Ju K., Wu Y., Wen B., Li S., Guo Y. Cause specific mortality risks associated with tropical cyclones in multiple countries and territories: two stage, time series study. BMJ Clinical Research Ed Vol.391 (2025) , e084906. doi:10.1136/bmj-2025-084906 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113064
Title
Cause specific mortality risks associated with tropical cyclones in multiple countries and territories: two stage, time series study
Author's Affiliation
The University of Tokyo
Universidade de São Paulo
Monash University
Seoul National University
National Taiwan University
University of Ottawa
University of Otago
National Taiwan University Hospital
Nagasaki University
Graduate School of Medicine
National Health Research Institutes Taiwan
Health Canada
Faculty of Tropical Medicine, Mahidol University
Potsdam Institut fur Klimafolgenforschung
Chongqing Emergency Medical Center
Universidade de São Paulo
Monash University
Seoul National University
National Taiwan University
University of Ottawa
University of Otago
National Taiwan University Hospital
Nagasaki University
Graduate School of Medicine
National Health Research Institutes Taiwan
Health Canada
Faculty of Tropical Medicine, Mahidol University
Potsdam Institut fur Klimafolgenforschung
Chongqing Emergency Medical Center
Corresponding Author(s)
Other Contributor(s)
Abstract
OBJECTIVE: To characterise and quantify the mortality risks for a range of causes after tropical cyclones in nine countries and territories. DESIGN: Two stage, time series study. SETTING: Nine countries or territories (Australia, Brazil, Canada, South Korea, Mexico, New Zealand, the Philippines, Taiwan, and Thailand), covering tropical, subtropical, and extra-tropical regions. PARTICIPANTS: General populations living in regions with tropical cyclones in the nine countries or territories, 2000-19. MAIN OUTCOMES MEASURES: Excess mortality risk of cardiovascular diseases, respiratory diseases, infectious diseases, injuries, neuropsychiatric disorders, renal diseases, digestive diseases, diabetes, and neoplasms as the leading cause of death. Wind speed and rainfall profiles were quantified with a physics based tropical cyclone field model. RESULTS: 14.8 million deaths and 217 tropical cyclone events in communities from the nine countries or territories were included in the analysis. Mortality risks from various causes consistently increased after tropical cyclones, with peaks occurring within the first two weeks after the cyclone, followed by a rapid decline. During the first two weeks after a tropical cyclone, the highest increases were seen in mortality from renal diseases and injuries, with a cumulative relative risk of 1.92 (95% confidence interval (CI) 1.63 to 2.26) and 1.21 (1.12 to 1.30), respectively, for each additional tropical cyclone day. Relatively more modest risks were found for mortality from diabetes (cumulative relative risk 1.15, 95% CI 1.08 to 1.21), neuropsychiatric disorders (1.12, 1.05 to 1.19), infectious diseases (1.11, 1.05 to 1.17), digestive diseases (1.06, 1.02 to 1.09), respiratory diseases (1.04, 1.00 to 1.08), cardiovascular diseases (1.02, 1.01 to 1.04), and neoplasms (1.02, 1.00 to 1.04). Mortality risks were substantially higher in communities with greater levels of deprivation and in those with historically fewer tropical cyclones, especially for renal, infectious, and digestive diseases, as well as for diabetes. Rainfall related to tropical cyclones had a more consistent increasing exposure-response relation with mortality risks, particularly for deaths related to respiratory, cardiovascular, and infectious diseases. CONCLUSIONS: After tropical cyclones, mortality risk increased variably for different causes, populations, and regions. Integrating epidemiological evidence into the development of management systems for climate extremes is urgently needed, particularly in regions with higher levels of deprivation and in those with historically fewer tropical cyclones. These measures are necessary to improve the adaptive capacity in responding to the growing risks and shifting activity of tropical cyclones in a warming climate.