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Cause specific mortality risks associated with tropical cyclones in multiple countries and territories: two stage, time series study

Authors

Huang,  Wenzhong
External Organizations;

Xu,  Rongbin
External Organizations;

Yang,  Zhengyu
External Organizations;

/persons/resource/christian.otto

Otto,  Christian       
Potsdam Institute for Climate Impact Research;

Hales,  Simon
External Organizations;

Hundessa,  Samuel
External Organizations;

Ye,  Tingting
External Organizations;

Chua,  Paul L. C.
External Organizations;

Ritchie,  Elizabeth A.
External Organizations;

Coelho,  Micheline S. Z. S.
External Organizations;

Yu,  Pei
External Organizations;

Tantrakarnapa,  Kraichat
External Organizations;

Saldiva,  Paulo H. N.
External Organizations;

Zhang,  Yiwen
External Organizations;

Xu,  Zhihu
External Organizations;

Zhou,  Shuang
External Organizations;

Lavigne,  Eric
External Organizations;

Seposo,  Xerxes Tesoro
External Organizations;

Kliengchuay,  Wissanupong
External Organizations;

Guo,  Yue Leon
External Organizations;

Kim,  Ho
External Organizations;

Yu,  Wenhua
External Organizations;

Liu,  Yanming
External Organizations;

Ju,  Ke
External Organizations;

Wu,  Yao
External Organizations;

Wen,  Bo
External Organizations;

Li,  Shanshan
External Organizations;

Guo,  Yuming
External Organizations;

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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. (2025): Cause specific mortality risks associated with tropical cyclones in multiple countries and territories: two stage, time series study. - BMJ: British Medical Journal, 391, e084906.
https://doi.org/10.1136/bmj-2025-084906


Cite as: https://publications.pik-potsdam.de/pubman/item/item_33257
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.