A study released this Wednesday (17) estimates that approximately 120,000 deaths in Brazil between 2000 and 2019 were associated with heat waves. This is equivalent to 0.6% of the total mortality recorded in the period, excluding deaths from external causes (accidents and violence). There was also an increased risk of hospitalizations for respiratory, kidney and gastrointestinal diseases during periods of extreme temperatures.  Related news: Most cities in Brazil do not have an action plan for extreme heat. El Niño: UN asks the world to prepare for the risk of extreme heat. The study Health and heat waves in Brazil: evidence on mortality, hospital morbidity and implications for the SUS was prepared by researchers from the Oswaldo Cruz Foundation (Fiocruz) and the Federal University of Bahia (UFBA). The technical coordination of the projects is from Ciência&Clima, technical cooperation between the Ministry of Science, Technology and Innovation (MCTI) and the United Nations Development Program (UNDP), and ProAdapta, a partnership between the Ministry of Environment and Climate Change of Brazil (MMA) and the Federal Ministry of the Environment, Climate Action, Nature Conservation and Nuclear Safety (BMUKN) of Germany. >> Follow the Agência Brasil channel on WhatsApp The data covers 5,566 Brazilian municipalities, almost all of them. Only four were excluded due to technical and administrative incompatibilities, according to the researchers: Itaparica (BA), Madre de Deus (BA), Fernando de Noronha (PE) and Bombinhas (SC). Analyzes indicate a consistent association between exposure to extreme heat and increased mortality, especially among the elderly, people with respiratory diseases, women and individuals with less education. Fiocruz researcher Beatriz Oliveira highlights the relevance of the study due to its ability to make a more comprehensive diagnosis of the country. “The innovation of this study is in integrating, on a national scale, the characterization of heat waves considering frequency, intensity and duration with a detailed analysis of their impacts on hospital admissions and mortality”, explains the researcher. "We realize that the effects are observed throughout the territory. When we look at the results, we are able to get a better understanding of the problem and guide more effective public policies", he adds. UFBA researcher Ismael Silveira says that the results warn of the seriousness of the problem. "An important implication is the recognition of heat waves as an important risk to public health. With this, we can draw attention to specific contingency plans, in addition to strengthening the SUS' capacity to anticipate and respond", he says. In the population over 60 years of age, the survey identified high sensitivity to respiratory, kidney and metabolic diseases. Photo: Tomaz Silva/Agência Brasil Hospitalizations According to the study, heat waves consistently increase the risk of hospitalizations for respiratory diseases, especially pneumonia, and genitourinary diseases, such as kidney failure, in practically all regions of the country. Among children under 10 years of age, gastroenteritis appeared as the cause of hospitalization most strongly associated with episodes of extreme heat. According to researchers, greater vulnerability to dehydration and environmental changes that affect water quality and food conservation contribute to this scenario. In the population over 60 years of age, the survey identified high sensitivity to respiratory, kidney and metabolic diseases, including diabetes. The study also suggests that cardiovascular events during heat waves can quickly progress to serious conditions, with the possibility of death before hospitalization. For the supervisor of Impacts, Vulnerabilities and Adaptation of the Ciência&Clima project, Sávio Raeder, the results highlight social inequalities in the effects of extreme heat. "In hospital morbidity, we explored different health outcomes, a topic still little studied in the country. In mortality, we identified a social gradient of risk, with a greater percentage increase in the risk of death among people with less education. These results reinforce the need to direct adaptation and protection actions to the most vulnerable groups", said Raeder. More frequent heat According to the research, most Brazilian municipalities recorded an increase in the frequency and intensity of heat waves between 2000 and 2019. The most frequent and long-lasting events occurred in the North and Central-West regions, while episodes with greater intensity in relation to historical averages were observed in the South and Southeast. The authors defend the strengthening of monitoring and early warning systems for heat waves, in addition to the incorporation of climate information into the epidemiological and environmental surveillance actions of the Unified Health System (SUS). According to the director of Urban Environment at the Ministry of Environment and Climate Change and member of the ProAdapta project, Maurício Guerra, the results demonstrate that extreme heat already produces relevant impacts on the health of the Brazilian population. "The research brings an unequivocal message: extreme heat is already costing lives in Brazil. The more than 120,000 deaths associated with heat waves reveal that adaptation to climate change needs to advance urgently, expanding the construction of green and resilient cities", said Guerra.