The significance of the thermo-physiological determinants of heat-related deaths has been recognized since antiquity. Still, the impact of heat on human health in the modern era is repeatedly assessed in the epidemiological literature based solely on the environmental drivers of heat stress, primarily using aggregated daily metrics of air temperature. Going beyond this simplified approach, here we showcase a prototype heat-health modelling method that incorporates thermo-physiological principles and accounts for variability across different regions and populations, using the advanced human-biometeorological mPET (modified Physiologically Equivalent Temperature) index. This novel approach is based on a hierarchical general additive modelling framework. By applying the framework in the vulnerable to heat stress Athens urban area in Greece, we demonstrate, for the first time in epidemiological terms, that fatal heat-related risk is strongly associated with daylong (> 6 h) strong heat stress exposure. We also show that atmospherically and thermo-physiologically driven location- and population-specific variations in exposure, as well as short-term acclimatization, contribute to heat-effect occurrence and modification. These novel outcomes assist in establishing links between environmental epidemiological and thermo-physiological research. This is of great importance for supporting robust and effective public health interventions, especially in cities, which are particularly heat stress susceptible.

中文翻译：

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使用分层广义加法建模研究热-健康关系的热生理学一致方法：在雅典市区（希腊）的应用


自古以来，人们就认识到热相关死亡的热生理决定因素的重要性。尽管如此，在流行病学文献中，仅根据热应激的环境驱动因素，主要使用每日气温的汇总指标，反复评估了现代高温对人类健康的影响。除了这种简化的方法之外，我们在这里展示了一种原型热健康建模方法，该方法结合了热生理原理，并使用先进的人类生物气象 mPET（改良生理等效温度）指数来解释不同地区和人群的变异性。这种新颖的方法基于分层的通用加法建模框架。通过在希腊雅典市区易受热应激影响的地区应用该框架，我们首次从流行病学角度证明了致命的高温相关风险与全天 （x3E 6 h） 强热应激暴露密切相关。我们还表明，大气和热生理驱动的暴露位置和人群特异性变化，以及短期驯化，有助于热效应的发生和改变。这些新结果有助于建立环境流行病学和热生理学研究之间的联系。这对于支持稳健有效的公共卫生干预措施非常重要，尤其是在特别容易受到热应激影响的城市。