Injury burden due to high temperature based on global burden of disease data from 1990 to 2021

Extreme heat is an emerging injury risk. We aimed to quantify the global burden of injuries attributable to high temperature from 1990 to 2021 using age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life-year rates (ASDR), and to examine regional and sex differences. We analyzed Global Burden of Disease (GBD) 2021 estimates for injuries attributable to high temperature. Outcomes were ASMR and ASDR per 100,000 with 95% uncertainty intervals (UIs). Temporal trends were summarized as estimated annual percentage change (EAPC) from log-linear models. Globally, ASMR declined from 1.26 (95% UI, 0.88–1.60) in 1990 to 0.90 (0.55–1.23) in 2021 (EAPC, − 28.4%; 95% CI − 37.3 to − 23.3). ASDR fell from 75.6 (54.8–94.0) to 48.7 (30.5–65.2) (EAPC, − 35.6%; 95% CI − 44.3 to − 30.6). Rates were consistently higher in males than females (2021 ASMR 1.32 vs. 0.49; ASDR 70.1 vs. 27.0). A clear socioeconomic gradient persisted: low and low-middle SDI groups had the highest burdens, whereas high SDI had the lowest (2021 ASMR 0.37; ASDR 19.3). Highest regional burdens clustered in South Asia, Sub-Saharan Africa, and the Middle East/North Africa; Western Europe and Australasia were lowest. Cause-specific patterns showed sharp declines for unintentional injuries, while transport-related injuries were broadly stable. Burden of injuries attributable to high temperature declined worldwide from 1990 to 2021, with reductions in ASMR and ASDR. Persistent disparities—higher rates in low and low-middle SDI settings and among males—highlight the need for targeted heat-health adaptation, injury prevention, and strengthened surveillance in vulnerable populations.