Health Impacts of Extreme Temperature Events in Cyprus: Insights from a Mediterranean Climate Change Hotspot

The Mediterranean region, recognized as a hotspot for climate change, is experiencing significant warming and drying, with the Eastern Mediterranean facing particularly severe impacts. This study focuses on Cyprus, a Mediterranean island, where extreme temperatures and prolonged heatwaves during summer months are becoming more common, resulting in increased thermal stress. While extreme coldwaves are less frequent and understudied in this region, they still pose considerable health risks.

Using ERA5-Land temperature data along with mortality and hospitalization records from 2004 to 2019, the study examines the effects of extreme high and low temperatures and the added synergistic impacts of heatwaves and coldwaves on mortality and hospitalizations. Advanced statistical and machine learning methods, including Distributed Lag Non Linear Models (DLNMs) and Generalized Additive Models (GAMs), were used to quantify season-specific and cause-specific risks, alongside attributable fractions for wave and non-wave days, and during significant heatwave and coldwave events. According to our findings, mortality risks increase significantly during very high temperatures in the warm season and very low temperatures in the cold season, with heatwaves posing greater risks than coldwaves. Hospitalization risks are notably higher during the cold season. While cold-related mortality exceeds heat-related mortality in absolute terms, the rate of increase in attributable deaths during heatwaves is nine times greater than on typical warm season days, compared to twice as high for coldwave days versus typical cold season days. This highlights the need for strategies addressing both the overall burden of cold-related mortality and the acute risks posed by extreme heat events.

By addressing these critical issues on a national level, this study reveals key insights into the broader health risks posed by climate extremes, offering valuable perspectives for enhancing urban resilience and public well-being in regions or cities with climates similar to Cyprus across the Mediterranean.