LNSLNS

We thank Mr. Loß for his interest in our recent publication (1). However, we do not agree with his interpretation of our findings and the comment that health professionals should not play a leading role in tackling climate change. Although the estimates of net changes in future temperature-related myocardial infarction (MI) events are insignificant, estimates for heat-related MI are statistically significant, with increases by 54 [95% confidence interval: 1 to 124] and 109 (4 to 313) cases per decade under global warming of 2 °C and 3 °C, respectively (Table 2 in [1]). The insignificant estimates in net changes are mainly due to the large uncertainty in the cold-related burden estimates.

As the number of myocardial infarctions in the KORA study population is relatively small, the confidence intervals in the cold effects (eFigure in [1]) lead to large uncertainties in the cold-related estimates. The increased burden of heat-related MI under global warming of 2 °C and 3 °C compared with that of 1.5 °C, is consistent with the conclusion of a special report by the Intergovernmental Panel on Climate Change (IPCC) that “lower risks are projected at 1.5°C than at 2°C for heat-related morbidity and mortality” (2). Therefore, our findings, as well as multiple lines of evidence (3), suggest that limiting global warming to 1.5 °C is essential to protect public health due to climate change. We firmly believe that health professionals should participate in addressing climate change, as supported by many health professionals in Germany (https://healthforfuture.de).

DOI: 10.3238/arztebl.2019.0736b

On behalf of the authors

Kai Chen, Ph.D.

Department of Environmental Health Sciences

Yale School of Public Health;
Yale Climate Change and Health Initiative, USA
kai.chen@yale.edu

Conflict of interest statement

The authors of each contribution declare that no conflict of interest exists.

1.
Chen K, Breitner S, Wolf K, et al.: Projection of temperature-related myocardial infarction in Augsburg, Germany moving on from the Paris Agreement on Climate Change. Dtsch Arztebl Int 2019; 116: 521–7 VOLLTEXT
2.
Hoegh-Guldberg O, Jacob D, Taylor M, et al.: Impacts of 1.5°C global warming on natural and human systems. In: Masson-Delmotte V et al. (eds.): Global warming of 15°C. Geneva, Switzerland: World Meteorological Organization 2018.
3.
Haines A, Ebi K: The imperative for climate action to protect health. N Eng J Med 2019; 380: 263–73 CrossRef MEDLINE
1.Chen K, Breitner S, Wolf K, et al.: Projection of temperature-related myocardial infarction in Augsburg, Germany moving on from the Paris Agreement on Climate Change. Dtsch Arztebl Int 2019; 116: 521–7 VOLLTEXT
2. Hoegh-Guldberg O, Jacob D, Taylor M, et al.: Impacts of 1.5°C global warming on natural and human systems. In: Masson-Delmotte V et al. (eds.): Global warming of 15°C. Geneva, Switzerland: World Meteorological Organization 2018.
3.Haines A, Ebi K: The imperative for climate action to protect health. N Eng J Med 2019; 380: 263–73 CrossRef MEDLINE

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