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The overlooked health impacts of extreme rainfall exposure in 30 East Asian cities

Nature Sustainability volume 7, pages 423–431 (2024)Cite this article

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Abstract

Extreme rainfall, intensified by climate change, elevates the risk of infectious diseases. The connection between extreme rainfall and common respiratory diseases remains unclear. Here we used a probabilistic approach to detect extreme rainfall events with different return periods for 30 cities across four East Asian countries and regions, including mainland China, Taiwan, South Korea and Japan, from 1980 to 2020. Significant associations were found between respiratory deaths and extreme rainfall events with 5 or 10 year return periods, but not for the events with a 1 or 2 year return period. The cumulative relative risks of respiratory mortality were found to be 1.29 (95% confidence interval: 1.09–1.51) and 1.33 (95% confidence interval: 1.02–1.65) for extreme rainfall events with 5 and 10 year return periods, respectively. The associations were strongest for asthma, followed by chronic obstructive pulmonary disease, but not significant for pneumonia. In cities across South Korea and Japan, no significant differences in the relative risks were detected before 2010. This multi-city study presents compelling evidence that extreme rainfall events could elevate mortality risks for respiratory diseases, especially for asthma and chronic obstructive pulmonary disease, emphasizing the multiple and complex consequences of extreme natural phenomena.

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Fig. 1: Spatial locations of the cities experiencing extreme rainfall events with three different return periods (2, 5 and 10 years) during the study period.
Fig. 2: Overall lag structure in effects of extreme rainfall days on daily respiratory mortality in the selected East Asian cities, by three different return periods (2, 5 and 10 years).
Fig. 3: Cumulative effects of extreme rainfall days with a 5 year return period on daily respiratory mortality over 14 lag days, classified by specific respiratory disease, age groups and two different periods.

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Data availability

The time-series rainfall data for each city in this study were extracted from three databases: ERA5-Land, MSWEP and IMERG. These databases are publicly accessible and can be downloaded from their respective websites. Specifically, data from ERA5-Land are available at https://cds.climate.copernicus.eu, those from MSWEP at https://www.gloh2o.org/mswep/, and those from IMERG at https://disc.gsfc.nasa.gov/datasets/GPM_3IMERGHHL_06/summary. In addition, the Dartmouth Flood Observatory database can be accessed at https://floodlist.com/. Due to restrictions imposed by the data owners, the daily mortality data for each city of this study cannot be publicly released. They are only available upon request from the corresponding author and other relevant authors. Source data are provided with this paper.

Code availability

The primary code used in this study, including the Python code for calculating the threshold values for extreme rainfall events across different return periods and the R code for estimating the impact of extreme rainfall events on respiratory mortality, can be found in GitHub (https://github.com/chenghe1130/Extreme-rainfall-East-Asia/tree/main).

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (82030103), the National Key Research and Development Program of China (2022YFC3702701), the Shanghai International Science and Technology Partnership Project (21230780200), the Shanghai Committee of Science and Technology (21TQ015) and the Alexander von Humboldt Foundation for the Humboldt Research Fellowship.

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Authors and Affiliations

  1. School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China

    Cheng He, Yixiang Zhu, Lu Zhou, Renjie Chen & Haidong Kan

  2. Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany

    Cheng He & Alexandra Schneider

  3. Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea

    Ho Kim

  4. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Masahiro Hashizume

  5. School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea

    Whanhee Lee

  6. Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Japan

    Yasushi Honda & Satbyul Estella Kim

  7. Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan

    Yasushi Honda & Satbyul Estella Kim

  8. Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan

    Yue Leon Guo

  9. Children’s Hospital of Fudan University, National Center for Children’s Health, Shanghai, China

    Haidong Kan

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  1. Cheng He
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Contributions

C.H., R.C. and H. Kan contributed to study conceptualization. C.H., R.C. and H. Kan contributed to the study methods. C.H., Y.Z. and L.Z. did the formal analysis. R.C., H. Kan, H. Kim, M.H., W.L., Y.H., S.E.K. and Y.L.G. contributed to data curation and collection of the mortality database. C.H., Y.Z. and L.Z. contributed to the making of all the figures and tables. C.H., R.C. and H. Kan contributed to the study draft preparation. C.H., R.C., H. Kan, H. Kim, M.H., W.L., Y.H., S.E.K., Y.L.G. and A.S. contributed to the study revision preparation. R.C. and H. Kan supervised all the data analysis and paper writing. All authors reviewed and edited the paper and approved its submission.

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Correspondence to Renjie Chen or Haidong Kan.

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He, C., Kim, H., Hashizume, M. et al. The overlooked health impacts of extreme rainfall exposure in 30 East Asian cities. Nat Sustain 7, 423–431 (2024). https://doi.org/10.1038/s41893-024-01294-x

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