Heat, humidity and health impacts: how causal diagrams can help tell the complex story

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Sidharth Sivaraj - , University of Bern (Author)
  • Jakob Zscheischler - , Chair of Data Analytics in Hydro Sciences, Helmholtz Centre for Environmental Research, TUD Dresden University of Technology (Author)
  • Jonathan R. Buzan - , University of Bern (Author)
  • Olivia Martius - , University of Bern (Author)
  • Stefan Brönnimann - , University of Bern (Author)
  • Ana M. Vicedo-Cabrera - , University of Bern (Author)

Abstract

The global health burden associated with exposure to heat is a grave concern and is projected to further increase under climate change. While physiological studies have demonstrated the role of humidity alongside temperature in exacerbating heat stress for humans, epidemiological findings remain conflicted. Understanding the intricate relationships between heat, humidity, and health outcomes is crucial to inform adaptation and drive increased global climate change mitigation efforts. This article introduces ‘directed acyclic graphs’ (DAGs) as causal models to elucidate the analytical complexity in observational epidemiological studies that focus on humid-heat-related health impacts. DAGs are employed to delineate implicit assumptions often overlooked in such studies, depicting humidity as a confounder, mediator, or an effect modifier. We also discuss complexities arising from using composite indices, such as wet-bulb temperature. DAGs representing the health impacts associated with wet-bulb temperature help to understand the limitations in separating the individual effect of humidity from the perceived effect of wet-bulb temperature on health. General examples for regression models corresponding to each of the causal assumptions are also discussed. Our goal is not to prioritize one causal model but to discuss the causal models suitable for representing humid-heat health impacts and highlight the implications of selecting one model over another. We anticipate that the article will pave the way for future quantitative studies on the topic and motivate researchers to explicitly characterize the assumptions underlying their models with DAGs, facilitating accurate interpretations of the findings. This methodology is applicable to similarly complex compound events.

Details

Original languageEnglish
Article number074069
JournalEnvironmental research letters
Volume19
Issue number7
Publication statusPublished - 1 Jul 2024
Peer-reviewedYes

Keywords

Keywords

  • compound events, directed acyclic graphs, environmental epidemiology, wet bulb temperature