{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:45:38Z","timestamp":1792889138551,"version":"4.5.0"},"reference-count":77,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Bavarian State Ministry of the Environment and Consumer Protection","award":["K3-8503-PN 18-18-D14187\/2018"],"award-info":[{"award-number":["K3-8503-PN 18-18-D14187\/2018"]}]},{"name":"The Bavarian State Ministry of Health and Care","award":["K3-8503-PN 18-18-D14187\/2018"],"award-info":[{"award-number":["K3-8503-PN 18-18-D14187\/2018"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>When meteorological conditions deviate from the optimal range for human well-being, the risks of illness, injury, and death increase, and such impacts are feared in particular with more frequent and intense extreme weather conditions resulting from climate change. Thermal indices, such as the universal thermal climate index (UTCI), can better assess human weather-related stresses by integrating multiple weather components. This paper quantifies and compares the seasonal and spatial association of UTCI with mortality, morbidity, and road accidents in the federal state of Bavaria, Germany. Linear regression was applied to seasonally associate daily 56 million hospital admissions and 2.5 million death counts (1995\u20132015) as well as approximately 930,000 road accidents and 1.7 million people injured (2002\u20132015) with spatially interpolated same day- and lagged- (up to 14 days) average UTCI values. Additional linear regressions were performed stratifying by age, gender, region, and district. UTCI effects were clear in all three health outcomes studied: Increased UTCI resulted in immediate (1\u20132 days) rises in morbidity and even more strongly in mortality in summer, and lagged (up to 14 days) decreases in fall, winter, and spring. The strongest UTCI effects were found for road accidents where increasing UTCI led to immediate decreases in daily road accidents in winter but pronounced increases in all other seasons. Differences in UTCI effects were observed e.g. between in warmer north-western regions (Franconia, more districts with heat stress-related mortality, but hospital admissions for lung, heart and external reasons decreasing with summer heat stress), the touristic alpine regions in the south (immediate effect of increasing UTCI on road accidents in summer), and the colder south-eastern regions (increasing hospital admissions for lung, heart and external reasons in winter with UTCI). Districts with high percentages of elderly suffered from higher morbidity and mortality, particularly in winter. The influences of UTCI as well as the spatial and temporal patterns of this influence call for improved infrastructure planning and resource allocation in the health sector.<\/jats:p>","DOI":"10.1371\/journal.pone.0259086","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T18:24:26Z","timestamp":1637173466000},"page":"e0259086","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Universal thermal climate index associations with mortality, hospital admissions, and road accidents in Bavaria"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3184-9683","authenticated-orcid":true,"given":"Wael","family":"Ghada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Estrella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna P.","family":"Ankerst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Menzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,17]]},"reference":[{"key":"pone.0259086.ref001","first-page":"109","author":"S Seneviratne","year":"2012","journal-title":"Changes in climate extremes and their impacts on the natural physical environment"},{"key":"pone.0259086.ref002","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.annemergmed.2020.03.010","article-title":"Clinical Implications of Climate Change on US Emergency Medicine: Challenges and Opportunities","volume":"76","author":"CJ Sorensen","year":"2020","journal-title":"Ann Emerg Med"},{"key":"pone.0259086.ref003","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.envint.2018.05.014","article-title":"Escalating heat-stress mortality risk due to global warming in the Middle East and North Africa (MENA)","volume":"117","author":"A Ahmadalipour","year":"2018","journal-title":"Environment International"},{"key":"pone.0259086.ref004","first-page":"143772","article-title":"Effects of weather, air pollution and Oktoberfest on ambulance-transported emergency department admissions in Munich, Germany","volume":"2020","author":"W Ghada","journal-title":"Sci Total Environ"},{"key":"pone.0259086.ref005","article-title":"Regional Temperature-Sensitive Diseases and Attributable Fractions in China","volume":"17","author":"X Su","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0259086.ref006","doi-asserted-by":"crossref","first-page":"104","DOI":"10.2151\/sola.2020-018","article-title":"Quantitative Assessment of the Contribution of Meteorological Variables to the Prediction of the Number of Heat Stroke Patients for Tokyo","volume":"16","author":"T Sato","year":"2020","journal-title":"SOLA"},{"key":"pone.0259086.ref007","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.injury.2015.03.016","article-title":"What is the effect of the weather on trauma workload? 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