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Title: Development of the Adjusted Wind Chill Equivalent Temperature (AWCET) for cold mortality assessment across a subtropical city : validation and comparison with a spatially-controlled time-stratified approach
Authors: Ho, HC
Wong, MS 
Abbas, S 
Zhu, R
Keywords: Biometeorological index
Cold stress
Mortality assessment
Wind chill
Issue Date: 2019
Publisher: BioMed Central
Source: BMC public health, 2019, v. 19, no. 1, 1290 How to cite?
Journal: International journal of environmental research and public health 
Abstract: Background: Global warming has reduced the adaptability of the people living in subtropical regions to cope up with cold stress due to lengthening of hot days and shortening of transition period from hot to cold weather. However, existing studies on measuring cold stress are based on biometeorological indices designed for temperate regions. This may overestimate the impact of wind chill on mortality risk in subtropical cities.
Methods: This study developed an Adjusted Wind Chill Equivalent Temperature (AWCET) index. A spatially-controlled time-stratified approach was applied to evaluate the ability of AWCET for estimating cold mortality in subtropical cities, based on a mortality dataset (2008-2012) in Hong Kong.
Results: The use of AWCET could indicate increase in all-cause, cardiovascular, respiratory, and cancer-related mortality risk during the days with average temperature < = 1st [11.0 °C], <= 3rd [12.6 °C] and < = 5th [13.4 °C] percentiles. The results were stable and consistent based on both log-linear and curve-linear relationships between AWCET and mortality risk. AWCET was also compared with the New Wind Chill Equivalent Temperature (NWCET) designed for temperate regions, and has found that higher magnitude of mortality risk would be found when using AWCET for assessing all-cause and cause-specific mortality in Hong Kong, for days with average temperature < = 1st, <= 3rd and < = 5th percentiles.
Conclusions: AWCET is validated to be effective to access cold mortality in the context of subtropical cities. The use of AWCET may enhance the cold weather warning system in subtropical cities, as a supplementary tool to help demonstrating small administrative-level perceived temperature with volunteered geographic information.
ISSN: 1471-2458
EISSN: 1471-2458
DOI: 10.1186/s12889-019-7612-5
Rights: © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
The following publication Ho, H. C., Wong, M. S., Abbas, S., & Zhu, R. (2019). Development of the Adjusted Wind Chill Equivalent Temperature (AWCET) for cold mortality assessment across a subtropical city: validation and comparison with a spatially-controlled time-stratified approach. BMC public health, 19(1), 1290 is available at
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