Projecting the health impacts of anthropogenic climate change -involving epidemiological models,  and data from climate change and demographic scenarios, can be a daunting task. Moreover, the interpretation of impact projections remains methodologically complex, highlighting the need for a structured guidance. A new study for conducting health impact projection studies published in Environmental Epidemiology addresses this requirement. Involving EHM Lab researchers Dr. Pierre Masselot and Prof. Antonio Gasparrini, the step-by-step tutorial provides a practical workflow for projecting climate-related health impacts that jointly incorporates climate and demographic scenarios, addressing a critical methodological gap in environmental epidemiology. By providing fully reproducible R code and open-access data, the tutorial allows researchers and policymakers to generate robust, transparent, and policy-relevant projections, supporting evidence-based adaptation and mitigation strategies in the context of climate change.

Extreme heat episodes are intensifying across several regions globally. Yet detangling the role of anthropogenic climate change in increasing the likelihood and intensity of such prolonged extreme heat events remains a challenging attribution exercise. Focusing on the impactful extreme heat across Asia in 2024, a new attribution study involving EHM Lab researcher Dr. Malcolm Mistry published in Weather and Climate Extremes, demonstrates the role of anthropogenic climate change in amplifying the 2024 Asian heat event, highlighting an urgent need to address escalating heat-related risks.

Dr Malcolm Mistry, Assistant Professor in Climate and Geo-spatial Modelling in the Environment and Health Modelling Lab at LSHTM recently contributed to an expert call for stronger heat safety measures ahead of the 2026 FIFA World Cup in the US, Canada and Mexico. Alongside leading scientists and medical experts, he warned that rising temperatures and humidity could pose serious risks to player health, particularly during high-intensity outdoor sport.

Highlighting the growing challenge of extreme heat in a warming climate, Malcolm said: “The science is clear: once heat stress exceeds certain thresholds, it cannot be mitigated by short breaks alone.” The experts are urging FIFA to align tournament protocols with the latest evidence on heat stress and athlete safety.

Read the full article

A new study involving EHM Lab researcher Prof. Antonio Gasparrini published in Environmental Epidemiology examines the associations between multiple environmental exposures and migraine events captured using a smartphone app in the province of Ontario, Canada. Using local daily weather and pollution estimates for 2017–2019, and the Migraine Buddy app, the authors utilised records from nearly 7,400 research-consenting participants. Associations between environmental exposures and migraine attack onsets were then examined with case-time series lagged multipollutant models, accounting for demographic and temporal covariates. The authors conclude that the onset of migraine was associated with key environmental determinants, namely, higher NO₂ and O₃, colder winter weather, and changes in the barometric pressure.

Climate change is intensifying exposures that may act as cardiovascular risk factors. Yet preventive cardiology has not systematically assessed how these exposures interact with established risks. A new viewpoint involving EHM Lab researcher Prof. Antonio Gasparrini published in the European Journal of Preventive Cardiology, pushes for a research agenda that moves beyond mortality to capture morbidity and early disease trajectories. Outlining three key challenges for preventive cardiology in the era of climate change, the authors propose pragmatic directions for clinical and public health action.

A new study co-authored by EHM Lab researcher Prof. Antonio Gasparrini in Environment International analysed heat-related preterm births (PTB) using harmonized individual-level data. The authors analysed ~36.5 million births occurring during the warm season across 250 locations in 13 countries to assess heat effects on PTB. Importantly, the analysis accounted for various individual characteristics that influence heat-related PTB. The study finds that an increased PTB risk is associated with heat, with variations across countries and climates. Additionally, vulnerability was found to be higher in younger, single, socioeconomically deprived mothers, and in female fetuses. The authors argue for better interventions required to reduce the heat-related burden on maternal health.

As part of its 15th anniversary, the prestigious journal of Nature Climate Change (NCC) has been looking back on some of the published studies that have made a lasting impact on Early Career Researchers (ECRs). As part of this, the journal reached out to ECRs, and asked them to share their opinions on one or more papers from NCC that impacted their careers or research. The 2021 global climate-health attribution study “The burden of heat-related mortality attributable to recent human-induced climate change” co-authored by EHM Lab researcher Prof. Antonio Gasparrini, was chosen by as one of the articles by the ECRs to write on.

Read the full 2021 study, and the reflection by ECRs.

A new study involving EHM Lab researcher Dr. Pierre Masselot published in the British Journal of General Practice evaluates the effectiveness of NHS Health Checks (NHS-HC) in reducing all-cause mortality. Using electronic primary care records and a Longitudinal cohort design for the borough of London, the authors analysed data for 158,645 eligible participants covering 2009–2023. The findings suggest significant long-term survival benefit associated with the NHS-HC, supporting continued investment in and optimisation of the programme to provide population health benefits.

Higher ambient temperature is thought to increase the odds of hypoglycemia developing in adults. A new study involving EHM Lab researchers Dr. Harriet Daultrey, Arturo De La Cruz Libardi and Prof. Antonio Gasparrini published in the American Diabetes Association journal Diabetes Care, explored the short-term association between ambient temperature and risk of hypoglycemia in adults with type 1 diabetes mellitus (T1DM). Adjusting for long-term trends, seasonality, day of the week, and public holidays, the study employed a quasi-binomial fixed-effect regression with distributed lag nonlinear models to estimate potentially nonlinear and lagged risks of non-optimal temperature on hypoglycemic episodes. Analysing a total of 32,966,282 glucose readings from 679 adults with T1DM attending two National Health Service clinics in Sussex, England, between 2017 and 2024, the study concluded that elevated ambient temperature significantly increases the short-term risk of hypoglycemia in adults with T1DM, though the authors caution that the findings are specific to the U.K. population and climate, which may limit generalizability.

Read the news article

A thought-provoking new commentary co-authored by EHM Lab researcher Prof. Antonio Gasparrini in the European Heart Journal highlights how rapid global expansion of Artificial Intelligence (AI) is driving a dangerous surge in fossil-fuel consumption, directly undermining efforts to mitigate the escalating cardiovascular health crisis across Europe. While Europe recorded a total of ~ 100,000 heat-related deaths in 2022 and 2023 alone, the authors highlight that the energy-hungry demands of AI data centers are forcing a structural dependence on coal and gas to maintain uninterrupted power. Further, the authors argue that current corporate "greenwashing" through financial carbon credits fails to address the physical reality of grid emissions, and they call for an urgent policy overhaul that integrates healthcare costs into energy and infrastructure planning to protect the continent's aging and vulnerable populations.

New research involving EHM Lab researchers Dr. Pierre Masselot and Prof. Antonio Gasparrini, published in The Lancet Public Health provides the first broad assessment of heatstroke mortality across 34 countries from 2000-2022.

The findings reveal stark geographical disparities. Japan reported the highest rate (5.81 per million), followed by Cyprus and China, while most of Europe, South America, and SE Asia recorded rates below one death per million.

Critically, the study highlights that formally reported heatstroke represent only a fraction of overall heat-attributable mortality, with the proportion ranging from less than 1% in many countries to nearly 24% in Japan. When focusing on extreme heat days, this share increased substantially. This variability likely reflects differences in diagnostic practices, reporting, and health system capacity rather than just climate exposure alone. As global temperatures rise, understanding these nuances in how we identify and record heat-related deaths becomes essential for effective public health policy.

A new study involving EHM Lab researchers Dr. Pierre Masselot and Prof. Antonio Gasparrini, published in NPJ Urban Sustainability offers evidence of the benefits of urban vegetation in reducing heat-related mortality. Analysing a decade of data across Paris districts, the study found that areas with more green areas have significantly lower heat-related mortality.

Crucially, trees outperform grass in protection, and the benefits extend beyond cooling—likely improving pollution and mental health. With some districts having just 1.4% of green space, the study emphasises the need to establish policies to increase presence and access to green areas. Modelling shows that if all areas matched the greenest (20%), a third of heat-related deaths could be prevented.

The study involving EHM Lab researchers Dr. Malcolm N. Mistry, Dr. Pierre Masselot and Prof. Antonio Gasparrini published in the Environment International explored the short-term effects of environmental stressors on coronavirus disease 2019 (COVID-19) transmission and severity. Motivated by the limited evidence on the interactive effects of meteorological conditions and air pollution, the study aimed to quantify the independent and interactive effects of short-term exposure to humidex, a composite index of temperature and relative humidity, and fine particulate matter ≤ 2.5 μm (PM2.5) on daily COVID-19 incidence across multiple cities and in multiple countries. Focusing on 439 cities in 22 countries during January 2020–August 2022, and employing state-of-the-art empirical methods, the study found short-term exposure to cold–dry conditions and elevated PM2.5 independently increased COVID-19 incidence, highlighting the need to consider both thermal environment and air quality when designing climate-resilient public health responses. These findings enhance understanding of how climate-related environmental stressors influence COVID-19 transmission.

A new study involving EHM Lab researcher Dr. Malcolm N. Mistry, published in Nature Scientific Reports examines the heat stress during key TdF stages dating back to 1973. While the riders have largely managed to avoid the peak heat episodes thanks to the stage dates and unfavourable heat stress conditions (fortunately) not coinciding in the recent 50 years of the iconic race, recent trends in heat stress are anything but alarming. The high intra-day heat stress across most frequently visited locations may require the race organisers to plan the annual event better.

A new study in Environment International led by Dr. Rebecca Cole and involving other members of the EHM Lab, used high-resolution environmental and health data to investigate how alder and birch pollen affect asthma-related hospital admissions across England. The authors linked national hospital records (2008–2022) with detailed pollen exposure data (10 km resolution) and found that moderate levels of tree pollen are associated with increased asthma admissions, especially in children. This association showed a non-linear pattern, with risks rising at lower pollen concentrations and attenuating at higher levels. The study was made possible by the availability of new, spatially complete, daily pollen data at an appropriate spatial resolution.

A new study published in Environmental Research Letters (ERL), involving EHM Lab researchers Dr. Pierre Masselot, Dr. Malcolm Mistry and Prof. Antonio Gasparrini highlights the importance of heat prevention plans (HPP) in saving lives across Europe. Analysing daily temperature and mortality data from 102 locations in 14 European countries over nearly three decades, the study finds that HPP significantly reduce deaths during extreme heat events across Europe. The research involving international collaboration with experts from Czech University of Life Sciences Prague (Czech Republic), Doñana Biological Station CSIC (Spain), and the MCC Collaborative Research Network coordinated by the LSHTM, assessed how heat-related mortality changed after the introduction of national and regional heat prevention plans, which typically include early warning systems, public communication, protection of vulnerable populations and adaptations in healthcare services. The results provide clear evidence that heat prevention plans are effective public health tools, with (on average) a reduction of more than 25% in excess mortality during extreme heat post-implementation. This reduction corresponds to approximately 1.8 avoided deaths per 100,000 inhabitants per year, amounting to over 14,000 lives saved across the analysed regions.

CarbonBrief; a UK-based website that provides clear, data-driven analysis, news, and fact-checks on climate science, energy policy, and climate change, has ranked the EHM Lab led study as the 7th most influential climate paper in global media for 2025. The study “Estimating future heat-related and cold-related mortality under climate change, demographic and adaptation scenarios in 854 European cities” involving EHM Lab researchers Dr. Pierre Masselot, Dr. Malcolm Mistry and Prof. Antonio Gasparrini, was published in the journal Nature Medicine.

Read more on the CarbonBrief analysis.

Mortality from acute myocardial infarction (AMI) is known to exhibit a weekly pattern, with a peak occurring on Mondays. Although several hypotheses have been proposed, the effect of air pollution on this peak has not yet been investigated. Utilising 260,320 AMI death records in Spain from 2004 to 2018 from the Spanish National Institute of Statistics, the study in the Journal of the American College of Cardiology (JACC) Advances involving Prof. Antonio Gasparrini from the EHM Lab examined if the daily variation in major air pollutants modifies the risk of AMI mortality on Monday. The results from the study suggest that the excess AMI mortality observed on Mondays in the Spanish population is not explained by concurrent variations in major air pollutants.

Vulnerability to nonoptimal temperatures varies from one geographical location to another, but the contextual factors accounting for these spatial differences are still poorly understood. A new country-wide analysis involving EHM Lab researchers Dr. Pierre Masselot and Prof. Antonio Gasparrini  published in the journal Environmental Epidemiology, aimed to identify the community-level characteristics contributing to geographical disparities in heat-related and cold-related mortality risk in France. The findings from the study suggest that urban areas in France are more vulnerable to heat, compared to rural communities, and that this disparity is probably driven by air pollution (nitrogen dioxide -NO₂) and urban heat island. Reducing air pollution and mitigating urban heat island should be at the forefront of adaptation strategies to prevent heat-related health impacts as recommended by the authors.

Fine particulate matter with an aerodynamic diameter smaller than 2.5 μm (PM_2.5) and nitrogen dioxide (NO₂), are among the most hazardous pollutants that are known to contribute to substantial excess mortality in Europe. A new study involving EHM-Lab Lab researchers Dr. Pierre Masselot and Prof. Antonio Gasparrini published in the Journal of Atmospheric Pollution Research, analysed concentrations and associated long-term premature mortality across Great Britain. The data spanning 2008-2018 for the two pollutants were examined in relation to multiple AQ limits, as determined by WHO guidelines and international/national regulations. The study finds that the levels below the new, lower WHO guidelines for PM_2.5 and NO₂ were reached in only a handful of locations. Importantly, the study also reports that exposure to PM_2.5 in 2018 resulted in 36,403 (30,422–42,640) premature deaths, whereas NO₂ exposure contributed to 20,175 (7125–32,281) premature deaths.

A new study by Devon Nenon, Professor Antonio Gasparrini and Dr Pierre Masselot from the EHM Lab offers a nuanced perspective on ultrafine particles (UFP) and health. This major UK time-series study of over 850,000 deaths found that short-term exposure to UFP was not detectably associated with increased mortality in London and the West Midlands (2003-2018). These findings are crucial for public health and environmental policy, emphasising the need to refine our understanding of which particulate metrics are most harmful. This study underscores the complexity of air pollution toxicity and the need for continued, location-specific research.

Read the full study. The data and code for assembling the main dataset and analysing associations with non-accidental mortality are provided in a GitHub repository.

A new report by Public Health Scotland provides the first comprehensive analysis of heat impacts on health in Scotland. The report, building on contribution from EHM-Lab researcher Professor Antonio Gasparrini, highlights the estimated heat impacts on mortality in Scotland during the summer months (from June to September) over the last 20 years (2005-2024). A range of risk thresholds for heat attributable deaths are presented and an initial analysis of the differential impact of heat across demographic groups is also reported.

Read the report. 

A new rapid climate attribution analysis estimates nearly 24,400 heat-related deaths across 854 European cities in the 2025 summer. The assessment led jointly by Grantham Institute (Imperial College, London) and EHM-Lab researchers Dr. Pierre Masselot, Dr. Malcolm Mistry and Prof. Antonio Gasparrini  found anthropogenic climate change was responsible for around 16,500 (68%) of the 24,400 estimated heat-related deaths. 
The report highlights how even small increases in temperature can result in thousands of avoidable deaths – with older adults particularly vulnerable. The findings raise urgent questions about protecting Europe’s aging population, which is especially vulnerable to extreme heat.

Read the full report here and a further explanation by way of Q&A here.

New study co-authored by Prof. Antonio Gasparrini from the EHM Lab describes a theoretical and empirical assessment of confounding in cohort analysis of environmental factors using direct acyclic graphs (DAGs), extended Cox regression, and Distributed Lag Non-Linear Model (DLNM). The two key results include:

• Strong residual spatial confounding, with risk of mortality reversing when stratifying for assessment centre
• Importance of controlling for individual-level lifestyle factors, challenging established arguments about their (lack of) potential confounding effects

The analysis can be replicated step-by-step in full using a synthetic dataset and R code provided along with the study.

Read the full study here. 

A new study published in The Lancet Planetary Health, involving Prof. Antonio Gasparrini and Dr. Pierre Masselot from the EHM Lab evaluates the impact on mortality from these pollutants. Using a well-established methodological framework for multi-location studies in environmental epidemiology, the researchers found a robust association between exposure to BTEX and increased mortality levels. The study also shows unequal vulnerability to BTEX exposure between countries, with high risks of overmortality in Mexico, China, Thailand and the Philippines.

Read the full study here.

A new article co-authored by EHM-Lab researcher Dr Malcolm Mistry highlights how extreme heat warning systems, despite expanding globally, are often conceptually fragmented and operationally diverse. Published in Environmental Research Letters (ERL), the authors trace the roots of this fragmentation, in particular, the incompatible definitions and thresholds. They then propose a clear typology of heat indices aligned with the World Meteorological Organization (WMO) framework. The underlying recommendations are aimed to help national meteorological and health authorities to improve coordination for reducing health and societal impacts, as well as accelerate progress under global frameworks such as the UN’s Early Warnings for All initiative.

Read the publication. 

A recent study led by EHM-Lab researcher Dr Rebecca Cole projects increases in heat-related mortality under UK-specific climate, population and socioeconomic scenarios. The study found that annual deaths could rise sixfold even with strong mitigation (RCP2.6–SSP1) due to population ageing and locked in climate warming. Whilst low mitigation and high population growth scenarios  could see heat-related mortality rise by approximately 50 times in England and Wales.

Dr Rebecca Cole, lead author of the study from the EHM-Lab at LSHTM, said: “Increases in heat-related deaths are not just a consequence of rising temperatures – they’re also driven by how we build our cities, care for vulnerable populations and address social inequality. Concerted adaptation strategies are required, well in excess of those over recent years.”

A rapid heat-mortality attribution analysis led jointly by the EHM-Lab and the World Weather Attribution group (WWA, Imperial Grantham Institute) estimated that climate change may have tripled the number of expected heat-related deaths during the June 23 – July 02, 2025 European heatwave. The researchers examined the influence of anthropogenic climate change in intensifying the heatwaves and the subsequent burden on mortality over 12 major cities across Europe. Read more here on the first rapid analysis to estimate number of heatwave deaths linked to climate change. The analysis builds on the earlier epidemiological framework led by EHM-Lab researchers -Dr. Pierre Masselot, Dr. Malcolm N. Mistry and Prof. Antonio Gasparrini.

Following an earlier study published in 2024 by EHM-Lab researchers Dr Malcolm Mistry and Professor Antonio Gasparrini, the tool developed to predict temperature-related mortality at small geographic scales over England & Wales, was implemented in real-time for the first time in 2025. Using the ECMWF temperature forecast for 19-22 June 2025, the modelling framework was used to forecast the expected heat-related excess-deaths to complement the existing amber heat-alerts issued by the UKHSA-UKMO. The results of the analysis described in a joint report with Imperial College Grantham Institute - Climate Change and the Environment, London, highlights the contrast in expected heat-related excess-deaths across various age categories, and importantly, at smaller local administrative units in the two countries. Read more in the following LSHTM news article. 

A recent study co-authored by Dr Malcolm Mistry and Professor Antonio Gasparrini, researchers from the EHM-Lab at the London School of Hygiene & Tropical Medicine (LSHTM), highlights the important role of greenness in reducing heat-related mortality.  The research, published in The Lancet Planetary Health estimates that increasing vegetation cover by 10-30% could reduce the global population-weighted mean temperature during the warm season by 0.08-0.19°C, which in turn could prevent approximately 0.86-1.16 million deaths—corresponding to nearly 27.2-36.7% of all heat-related deaths during the study period of 2000-2019.

Dr Malcolm Mistry, co-author of the study from the EHM-Lab at LSHTM, said: “Greenness, such as trees are known to be a highly effective strategy for mitigating the health impacts of warm temperatures. However, previous studies have likely underestimated its protective effects. Our modelling results show the reduction in excess deaths from heat under different scenarios of incremental change in greenness. Enhancing and maintaining green spaces can be effective strategies for lowering ambient temperatures and mitigating the health risks associated with heat exposure”.

Read the publication.

We have just updated our recent work from the EHMLab, first-authored by Jacopo Vanoli, published in the Journal of Exposure Science & Environmental Epidemiology. This contribution presents a linkage framework which can be used to assign individual-level environmental exposures to population-based cohorts using high-resolution spatio-temporal exposure. We have now added a simple tutorial demonstrating how to reconstruct individual-level exposure profiles using residential data. The tutorial includes simple synthetic data and R scripts in a GitHub repository, making the process completely reproducible. The example is straightforward but leverages computationally optimised packages, making it easy to adapt for large-scale analyses.

Access the GitHub repo

On Monday 7 April, the UK Government announced the creation of a new system for the access and analysis of data collected through the National Health Service (NHS). The system, currently known as the Health Data Research Service, will look to provide researchers with a single location and route to access health data, simplifying access to a range of datasets such as primary care, hospital and mortality data. Prof Antonio Gasparrini, lead of the EHM-Lab, offers an expert view on the new system, hailing it as a game-changer for health research, allowing access to a whole range of linked data on health conditions, medications, as well as socio-economic and lifestyle characteristics.

Read the expert comment.

A new study in Statistical Methods in Medical Research presents innovative modelling techniques tailored to analysing environmental epidemiology across multiple locations. Traditional models often struggle to account for differences in environmental exposures, climate conditions, and population characteristics between regions, leading to inconsistencies in risk assessments. The new framework, proposed by Dr Pierre Masselot and Professor Antonio Gasparrini from the EHM-Lab at LSHTM, improves how spatial variations are handled, allowing for better estimates of the health impacts of factors like air pollution, extreme temperatures, and other environmental hazards. By improving the way location-specific factors are incorporated into analysis, these methods can provide more accurate and reliable insights, ultimately strengthening public health research and informing more targeted policies.

Read the publication.

A new commentary in the Scandinavian Journal of Public Health highlights the urgent need for climate adaptation policies in Northern Europe that prioritise health equity. While the region benefits from strong public services, socioeconomic disparities still drive unequal health outcomes, particularly among migrants and disadvantaged groups. The authors, including Professor Antonio Gasparrini and Dr Pierre Masselot from the EHM-Lab at LSHTM, emphasise that both heat and cold-related mortality disproportionately affect these populations. Key recommendations include integrating health into climate adaptation plans, building climate-resilient communities, and developing inclusive surveillance and health systems. These steps are crucial for ensuring vulnerable groups are not left behind in climate adaptation efforts. The study also calls for greater research into the intersection of climate change, migration, and health to better safeguard at-risk communities.

Read the publication.

A recent study, led by researchers from the EHM-Lab at LSHTM including Dr Pierre Masselot, Dr Malcolm Mistry and Professor Antonio Gasparrini, finds that climate change is likely to cause a significant increase in heat-related deaths across Europe, substantially surpassing any decrease in cold-related deaths. The research, published in Nature Medicine estimates that changes to the climate could directly result in over 2.3 million additional temperature-related deaths in 854 European cities by 2099 if urgent action is not taken to cut carbon emissions. However, up to 70% of these deaths could be prevented if rapid action is taken.

Dr Pierre Masselot, lead author at the EHM-Lab at the London School of Hygiene & Tropical Medicine (LSHTM), said: “Our results stress the urgent need to aggressively pursue both climate change mitigation and adaptation to increased heat. This is especially critical in the Mediterranean area where, if nothing is done, consequences could be dire. But, by following a more sustainable pathway, we could avoid millions of deaths before the end of the century.”

Read the full article from LSTHM, or the publication.

This seminar series, delivered by the Centre for Data & Statistical Science for Health (DASH) and co-organised by Dr Pierre Masselot from the EHM-Lab at LSHTM, will use real-world examples and critical discussions to explore challenges in assessing causality in environmental epidemiology, and highlight innovative approaches to improve public health insights.

The series includes three virtual seminars given by speakers from Harvard Medical School, Harvard T.H. Chan School of Public Health and North Carolina State University, followed by a fourth internal LSHTM panel discussion event. These seminars are open to anyone within and beyond LSHTM interested in the topic, and we hope that you can join us for some insightful discussions.

Please find more information about the individual events below:

• 22 January from 15.00-16.00 GMT (external): Causal inference in environmental health: Dr Marie-Abèle Bind, Assistant of Investigation at the MGH Biostatistics Center and an Assistant Professor at the Harvard Medical School, will discuss how causal inference is essential for understanding how environmental exposures impact health.
• 29 January from 15.00-16.00 GMT (external): Innovative methods for studying the health effects of air pollution: Dr Heejun Shin and Michael Cork from Harvard T.H. Chan School of Public Health will explore some essential methods for researching health problems associated with air pollution.
• 12 February from 15.00-16.00 GMT (external): Mitigating spatial confounding in observational studies (more details TBA on the DASH website)
• 18 February from 12.45-13.50 (internal): Causal inference in environmental epidemiology panel session (only LSHTM members – more details TBA on the LSHTM Intranet)

The health impacts of climate change are often underestimated or thought of as a future problem, in contrast to the recent COVID-19 pandemic which was an unprecedented public health catastrophe causing substantial global mortality. A new study, published in Scientific Reports, shows that climate change poses an imminent health threat, with heat-related deaths in major global cities potentially surpassing COVID-19 deaths within a decade at +3°C of global warming. Using projections across 38 cities, the analysis co-authored by Professor Ben Armstrong, Professor Antonio Gasparrini and Dr Pierre Masselot from the EHM-Lab at LSHTM, indicates that current vulnerabilities could result in significant heat-related mortality burdens, particularly in Europe and North America. For 7 cities (Sydney, Tokyo, New York, Bangkok, Ho Chi Minh City, Manila, and Seoul), heat-related deaths could exceed COVID-19 deaths in less than five years. These findings highlight that every year of global warming is significant for human lives, and underscore the urgency of addressing climate change through ambitious climate action to safeguard human health globally. 

Read the publication.

The impacts of short-term exposure to heat are well documented, but longer-term effects of heat exposure have only recently received attention in the context of a changing climate. Recent research, co-authored by Professor Antonio Gasparrini and Dr Pierre Masselot from the EHM-Lab at LSHTM, examined the independent effects of long-term exposure to increased temperatures on all-cause mortality during warm periods in regions of the UK, Norway, Italy and Greece, from 1996-2018. The findings, published in Environmental Pollution, indicate an impact on mortality from longer-term heat exposure, but the relationship varies between countries and the specific temperature metrics used. The authors of the study recommend further research is needed, and should use non-ecological study designs and span several geographical areas in order to capture the impact of area-specific differences, and understand these associations better. 

Read the publication.

Fine particulate matter (PM2.5) is one of the most harmful environmental risk factors, worsened by ever-increasing global emissions. Yet, PM2.5 does not occur in isolation - it is part of a cocktail of pollutant gases with which it interacts, including ozone, nitrogen dioxide and sulfur dioxide, and its toxicity in a location is affected by the overall mixture in which it occurs. A recent study, concluding the MCC Special Collection in Environmental Epidemiology, explores how the complexity of air pollution mixtures (using the pollutant mixture complexity index, or PMCI) influences PM2.5-related mortality, i.e. toxicity. 

The research, led by Dr Pierre Masselot, and co-authored by Professor Antonio Gasparrini from the EHM-Lab at LSHTM, analysed data from 264 cities across the Northern Hemisphere, using the extensive Multi-Country Multi-City (MCC) database. The analysis revealed that a higher PMCI was associated with an increased risk of PM2.5-related mortality, highlighting that the local pollutant mix significantly influences PM2.5 toxicity. The PMCI also explained substantial within-country variations in health risks, and compared to alternative models, the PMCI emerged as a robust predictor of mortality risks, underscoring its potential for air quality monitoring. Authors emphasise the importance of considering air pollution as a complex mixture, rather than focusing on individual pollutants, and find that PMCI offers a promising tool for tracking and addressing air quality impacts globally, especially with advances in remote sensing.

Read the publication.

The complete MCC Special Collection is now published in Environmental Epidemiology, and includes 8 articles on the latest contributions from the MCC Network related to environmental health, highlighting the impact of this collaborative research approach on global health risks in the face of climate change.

Long-term exposure to air pollution is widely recognised as a major risk factor for human health, even at very low concentrations, yet much of the evidence of long-term mortality risks from fine particulate matter (PM2.5) exposure comes from large administrative studies with incomplete information and limitations. Recent research, led by Jacopo Vanoli, and co-authored by Arturo de la Cruz Libardi, Dr Francesco Sera, Dr Pierre Masselot, Dr Malcolm Mistry and Professor Antonio Gasparrini from the EHM-Lab at LSHTM assessed long-term associations between time-varying PM2.5 exposure and mortality in the UK Biobank cohort. The analysis, published in Epidemiology, revealed an association between long-term PM2.5 exposure with all-cause, non-accidental, respiratory and lung cancer mortality, but not cardiovascular mortality. The study identifies how pollution and lifestyle factors interact, highlighting the value of detailed, long-term analyses and stressing the need for better pollution control to improve public health. 

Read the publication.

The impacts of climate change-related extreme weather events are increasingly recognised as a threat to mental health in the UK, yet this risk is not fully reflected in relevant policy and regulatory frameworks. A recent study, published in The British Journal of Psychiatry, provides an overview of the integration of mental health within current climate policies and regulations in the UK, highlighting particular gaps and opportunities. The research, co-authored by Professor Antonio Gasparrini from the EHM-Lab at LSHTM, found almost no reference to the impacts of extreme weather on mental health, and authors call for mental health, climate and policy experts to work together to improve understanding and develop practical interventions that bring mental health within climate policy frameworks.

Read the publication. 

Despite increasing awareness and concern of the public health impacts of air pollution caused by landscape fires (fires in any natural and cultural landscape, including wildfires and human-planned fires), little is known about the global, regional and national mortality burden caused by them.

A recent study, co-authored by Dr Malcolm Mistry and Professor Antonio Gasparrini from the EHM-Lab at LSHTM (on behalf of the Multi-Country Multi-City (MCC) Collaborative Research Network), aimed to address these research gaps by providing a comprehensive estimation of global mortality burdens caused by landscape fire-sourced (LFS) air pollution (PM_2·5 and O₃) from 2000-2019. The analysis, published in The Lancet, revealed that LFS air pollution caused 1.53 million deaths per year globally - 90% of which were in low- and middle-income countries, particularly in sub-Saharan Africa, southeast Asia and east Asia. The countries with the largest mortality burdens from LFS air pollution included China, the Democratic Republic of the Congo, India, Indonesia and Nigeria, and countries around the Mediterranean and North and Central America all showed increasing mortality trends from 2000-2019. By the end of 2019, the mortality rates caused by LFS air pollution in low-income countries remained four times those in high-income countries.

These findings demonstrate a significant global mortality burden from landscape fires, and highlight severe geographical and socioeconomic disparities. As wildfires increase in frequency and intensity as a result of worsening climate change, authors of the study urgently call for action to address the impact on climate-related mortality and related environmental injustice. 

Read the publication. 

New research published in Environmental Epidemiology aimed to further the understanding around environmental predictors of the spread of COVID-19 to reduce impact and burden on health systems, which has continued years after the pandemic began. The study, co-authored by Professor Ben Armstrong, Dr Malcolm Mistry, Dr Pierre Masselot and Professor Antonio Gasparrini from the EHM-Lab at LSHTM, analysed how meteorological factors, including temperature and humidity, alongside population immunity, influence COVID-19 incidence across 439 cities in 22 countries from 2020-2022. Findings suggest some weather conditions can affect transmission rates, for example at temperatures of 5°C, the risk of COVID-19 incidence was 1.22 times higher compared with a reference level of 17 °C, but no modifiying effect of vaccination rates and strains on the weather-COVID-19 association. This study strengthens previous evidence of a relationship between temperature, humidity and COVID-19 incidence, and could be used to more accurately estimate COVID-19 impacts under various environmental factors.

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A recent study published as part of the MCC Special Collection in Environmental Epidemiology estimated the future impact of land-use and land-cover change (LULCC) on temperature related mortality. The authors used Multi-Country Multi-City (MCC) mortality data from 823 locations in 52 countries worldwide to model two contrasting future scenarios of LULCC: one with globally sustainable land use and socioeconomic development (sustainability); and one where sustainability is unequally distributed, and only implemented in the Organisation for Economic Cooperation and Development countries (inequality). The analysis, co-authored by Dr Pierre Masselot, Professor Antonio Gasparrini and Dr Malcolm Mistry from the EHM-Lab at LSHTM, revealed that unequal socioeconomic development and unsustainable land use could increase the burden of heat-related mortality in most regions, and globally sustainable land has the potential to reduce it in some locations, although the total impact on mortality is dependent on the underlying climate change scenario in each location.

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Although climate change is a global concern, most of the evidence for the impact of non-optimal temperatures on mortality risk comes from studies conducted in high-income countries, and does not include consideration of the economic burden that comes with increased health risks. A recent paper, co-authored by Professor Antonio Gasparrini from the EHM-Lab at LSHTM, analysed the mortality and economic impact of extreme temperatures in 13 Central and South American countries in the Multi-City Multi-Country (MCC) Collaborative Research Network. The study, published in Environmental Epidemiology, revealed that both heat and cold significantly contribute to mortality and economic losses across the region, with mortality burden generating a considerable annual total economic loss of $2.1 billion associated with cold and $290.7 million associated with heat. The results by climatic zones showed a higher mortality impact from cold temperatures in arid and temperate regions, and higher impact from heat in tropical climates. The research underscores the need for climate-resilience health strategies and interventions tailored to address regional vulnerabilities to extreme temperature and projections under future climate change. 

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Climate change is increasing the frequency, intensity and unpredictability of extreme weather events, including rainfall, which can result in harmful impacts on human health. Recent research, published in The BMJ, explored the association between rainfall events and mortality (all cause, cardiovascular and respiratory) in 645 locations across 34 countries globally from 1980 to 2020. The study, co-authored by Professor Antonio Gasparrini and Professor Ben Armstrong from the EHM-Lab at LSHTM, found that a day of extreme rainfall with a five year return period (the time between occurences of an extreme event of a certain magnitude) was significantly associated with mortality rates, and higher mortality risks were noted in regions with low baseline rainfall variability or sparse vegetation. This research highlights that local factors such as climate, urban infrastructure and vegetation coverage have an influence on rainfall-related health risks, and can be used to enhance understanding of the broad and complex health impacts of climate change and improve localised adaptation measures. 

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Professor Ben Armstrong and Professor Antonio Gasparrini from the EHM-Lab at LSHTM recently co-authored the largest epidemiological study to date on the links between ambient temperature and mortality by age and cause in 532 cities across 33 countries. The study found that both high and low temperatures increased mortality risks, with older adults, especially those 85 and above, being the most vulnerable. The findings, which highlight heightened risks for cardiovascular and respiratory causes at temperature extremes, can be used to improve the accuracy and scope of disease burden projections and offer critical insights for public health strategies in the context of climate change. 

This article was published in Environmental Epidemiology as part of the MCC Special Collection.

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A new study, published in Environmental International, investigated the long-term associations between low concentrations of particulate matter (PM_2.5) and cardiovascular hospital admissions. Previous research has linked exposure to air pollution and cardiovascular risks, yet few studies have assessed the impacts of low-level exposure, and identified the most important window of exposure. This research, led by Jacopo Vanoli and co-authored by Dr Malcolm Mistry, Dr Pierre Masselot, Arturo de la Cruz Libardi and Professor Antonio Gasparrini from the EHM-Lab at LSHTM, using data from the UK Biobank cohort, revealed positive associations between long-term exposure to PM_2.5 and multiple cardiovascular outcomes for different exposure windows. The results highlighted that despite recent decreases in air pollution levels, air pollution still causes adverse effects even at verylow concentrations, and therefore new mitigation strategies are needed to account for the public health burden that cannot be avoided by solely reducing air pollution levels. 

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A recent commentary co-authored by Professor Antonio Gasparrini and Dr Pierre Masselot from the EHM-Lab at LSHTM, outlines a framework for integrating advanced data analytics into urban planning. The paper, published in Cities, highlights the potential for big data and specialised mapping tools in tackling urban environmental health challenges, and calls for stronger collaboration across fields. The authors emphasise that future research must focus on making data more accessible, addressing equity issues, and supporting new approaches to healthier and more sustainable urban environments.

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The health impacts of climate change and environmental degradation vary across regions and populations as a result of differences in levels of exposure and vulnerability. Accurate assessments of these impacts need epidemiological studies that can provide both global comparisons and reliable estimates at a local scale. This paper, led by Professor Antonio Gasparrini from the EHM-Lab at LSHTM, is the first contribution to present The Multi-Country Multi-City Collaborative (MCC) Research Network, an international collaboration working on a global research programme on the association between environmental stressors, climate, and health in a multi-centre setting. The article demonstrates the protocol used by the MCC Network, and the power of collaboration that promotes data sharing and collective participation. As well as providing an overview of MCC publications on different research areas, this study also acts as an introduction to a special collection to be published over the next few months in Environmental Epidemiology. The collection will feature the latest contributions from the MCC Network on topical environmental research issues, and will highlight the potential for this collaborative approach to enable comprehensive, large-scale analyses that provide crucial insights into global health risks under changing climate conditions, and support evidence-based policymaking.

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In a comment published alongside this study, Professor Bert Brunekreef, the Editor in Chief of Environmental Epidemiology, states that, "For almost 10 years now, this unique collaboration has raised the science of the short-term effects of weather and air pollution on population health to new levels. It is based on the voluntary contributions of many scientists all over the world, who contribute their data and time to make the analyses of huge datasets possible. Perhaps the most unique feature of the MCC enterprise is that it is almost completely unfunded. It survives, no, flourishes, because of the trust and companionship among the many authors and collaborating centers, and because of the gentle and continuous leadership of the coordinating investigators."

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A new publication, co-authored by Professor Antonio Gasparrini from the EHM-Lab at LSHTM, provides the first structured expert judgement of how weather and climate directly impact mortality, using the UK as a case study. The lack of a comprehensive synthesis of hazard-specific mortality causes uncertainty in estimating country-level health burdens - uncertainty that can be reduced by leveraging collective expert knowledge in this way to assess a broader range of mortality risks beyond those explicitly quantified. The study, published in The Lancet Planetary Health, asked 30 experts from environmental health disciplines to estimate the health impacts of heatwaves, cold spells, and other climate hazards under different future scenarios. While current weather-related mortality is dominated by short-term exposure to hot and cold temperatures, the expert judgement revealed additional underappreciated health outcomes, especially related to long-exposure hazards, and show a potential future worsening of cause-specific mortality in the UK. Authors suggest that this framework could be used to create an expert-based understanding of climate-related health burdens in other countries, and ultimately build a more complete global picture.

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A new study published in The Lancet Planetary Health, investigates how the short-term effects of ambient air pollution on cardiovascular and respiratory mortality have changed over time across different urban areas. This comprehensive analysis, co-authored by Dr Pierre Masselot, Professor Ben Armstrong and Professor Antonio Gasparrini from the EHM-Lab at LSHTM, is the first of this kind to use a large multi-country dataset covering 380 urban areas worldwide from 1995 to 2016, to assess the health impacts of common air pollutants such as particulate matter (PM_2.5 and PM₁₀), and nitrogen dioxide (NO₂) over time. The findings revealed no significant temporal variations in the mortality effects of NO₂ and PM_10, although exposure concentrations have decreased over the past decades. A borderline significant change was seen in the effect estimate for PM_2·5 and cardiovascular mortality over time. The results suggest that reductions in air pollution concentrations during the study period does not necessarily lead to a change in the association between air pollution and mortality, and warrants further research into the impact of influencing factors, such as the sources and composition of pollutants, social and economic determinants, human behaviour, and changes in population distribution. The study calls for enhanced air quality management and tailored public health interventions to address the dynamic nature of pollution effects on health.

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Air pollution, including particulate matter (PM₁₀ and PM_2.5) and nitrogen dioxide (NO₂₎, is linked to increased health risks, making accurate exposure measurement crucial for epidemiological studies. A recent study, published in Atmospheric Pollution Research, used advanced machine learning methods to reconstruct daily pollution levels of NO₂, PM₁₀, and PM₂.₅ across Great Britain from 2003 to 2021, offering high-resolution data to enhance understanding of pollution patterns and their health impacts. By combining data from multiple sources such as ground monitoring stations, satellite images, and traffic patterns, the researchers, including Arturo de la Cruz Libardi, Dr Pierre Masselot, Jacopo Vanoli, Dr Malcolm Mistry and Professor Antonio Gasparrini from the EHM-Lab at LSHTM, were able to accurately predict pollution levels at a 1km² scale. Findings revealed distinct patterns in changes of pollution over time and space, and a significant improvement in PM_2.5 prediction as well as new data on PM₁₀ and NO₂ in Great Britain. With a high resolution and performance, this framework has the potential to provide reliable data over a large geographic areas and timescales, and contribute to future research on the long- and short-term health impacts of air pollution.

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Recent research co-authored by Dr Pierre Masselot, Dr Malcolm Mistry and Professor Antonio Gasparrini from the EHM-Lab at LSHTM warns that deaths from extreme heat could triple in Europe by 2100 under current climate policies, mostly among people living in southern Europe. The study, published in The Lancet Public Health, in collaboration with the Joint Research Centre (JRC) at the European Commission, provides the first indepth analysis of the current and future health risks from hot and cold temperatures between 1,368 regions within 30 countries across Europe. The analysis revealed that under 3°C global warming – an upper estimate based on current climate policies – the number of heat-related deaths in Europe could increase from 43,729 to 128,809 by the end of the century, particularly affecting elderly populations in Spain, Italy, Greece and parts of France. Dr Pierre Masselot, co-author of the study, said, "It is clear that the Mediterranean area is particularly vulnerable and that, in a world that is now reaching a global warming of 1.5°C, radical climate mitigation policies that the EU can lead on are more urgent than ever, to reduce the burden on public health systems and protect populations at risk."

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While the impacts of climate-change induced heatwaves is well documented and expected to worsen in the future, there reamins a gap in understanding how to effectivley integrate humid heat into heat-health alert systems. A recent study, published in PNAS Nexus, is the first to examine the association between daily mortality and multiple heat stress indicators (HSIs), including ambient humidity, at a global scale. Using MCC historical epidemiological and climatological datasets, the analysis revealed that regional factors such as distance from the coast, latitude, and importantly, a weak or positive correlation between air temperature and humidity make multiple HSIs a better predictor variable for heat-related mortality, than relying solely on air temperature. This research, co-authored by Dr Malcolm Mistry, Dr Pierre Masselot & Professor Antonio Gasparrini from the EHM-Lab, offers crucial insights for enhancing heat-health alert systems, and takes the first step in aligning different communities of thought on the impact of humidity in heat-related health risks. 

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In The Telegraph, Dr Malcolm Mistry, Assistant Professor in the EHM-Lab Lab at LSHTM comments on the effects of the phenomenon La Niña on weather patterns in the UK. Dr Mistry explains that effects of La Niña are less pronounced and often take a while to emerge, suggesting that summer 2025 is likely to be wetter and milder, similar to this year, but this remains an active area of research in climate science.

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A recent study by Dr Malcolm Mistry & Professor Antonio Gasparrini from the EHM-Lab at LSHTM describes a new framework which can, for the first time, enable real-time forecasting of temperature related excess mortality at a small-area scale. The innovative design addresses the limitations of current real-time temperature health alerts, providing an additional layer of understanding by forecasting heat-related risk by age categories and at smaller geographical scales. The study demonstrates an application of the framework using the UK heatwave of July 2022, mimicking real-time prediction of heat-related excess-deaths as if made prior to the heatwave. Dr Malcolm Mistry, Assistant Professor in Climate and Geospatial Modelling in the EHM-Lab and lead author said, “We believe this comprehensive framework has the potential to become a gold standard method for forecasting temperature-related excess mortality at a small-area level, enabling local authorities to implement more targeted preventive measures and potentially reduce the health burden during extreme weather events”.

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Dr Malcolm Mistry, Assistant Professor in Climate and Geospatial Modelling in LSHTM’s EHM-Lab provides commentary on recent heatwaves in parts of the UK, following a joint heat-health warning issued by the UK Health Security Agency and Met Office. Dr Mistry explains how heatwaves and extreme weather events are measured, and that “the consensus within the climate modelling community is that the frequency, magnitude and duration of most extreme weather events are expected to increase globally in a warming climate”. He concludes that “from a long-term perspective, society and policy makers need to take measures to increase our resilience to extreme temperature and other weather events, and we need to have plans in place to support our most vulnerable when we see precautionary warnings being issued”.

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The EHM-Lab is looking for a highly motivated research assistant to conduct environmental epidemiology analyses using novel epidemiological methods. The role will focus on analyses for the Constrained estimation project, although the successful candidate will also have the opportunity to be involved in other projects from the EHM Lab members. The successful candidate should be willing to familiarise themselves with the state-of-the-art methods in environmental epidemiology and engage in rigorous scientific practice.

Read the full job description and apply here. Closing date for applications is Tuesday 25 June 2024.