The heatwave in France during August 2003 was associated with a large increase in the number of deaths. The impact estimated using a time-series design was consistent with crude previous estimates of the impact of the heatwave. This finding suggests that neither air pollution nor long-term and seasonal trends confounded previous estimates. There was no evidence to suggest that the extras deaths associated with the heatwave were simply brought forward in time.

BackgroundDuring August 2003, record high temperatures were observed across Europe, and France was the country most affected. During this period, elevated ozone concentrations were measured all over the country. Questions were raised concerning the contribution of O3 to the health impact of the summer 2003 heat wave.MethodsWe used a time-series design to analyze short-term effects of temperature and O3 pollution on mortality. Counts of deaths were regressed on temperatures and O3 levels, controlling for possible confounders: long-term trends, season, influenza outbreaks, day of the week, and bank holiday effects. For comparison with previous results of the nine cities, we calculated pooled excess risk using a random effect approach and an empirical Bayes approach.FindingsFor the nine cities, the excess risk of death is significant (1.01%; 95% confidence interval, 0.58–1.44) for an increase of 10 μg/m3 in O3 level. For the 3–17 August 2003 period, the excess risk of deaths linked to O3 and temperatures together ranged from 10.6% in Le Havre to 174.7% in Paris. When we compared the relative contributions of O3 and temperature to this joint excess risk, the contribution of O3 varied according to the city, ranging from 2.5% in Bordeaux to 85.3% in Toulouse.InterpretationWe observed heterogeneity among the nine cities not only for the joint effect of O3 and temperatures, but also for the relative contribution of each factor. These results confirmed that in urban areas O3 levels have a non-negligible impact in terms of public health.

In accordance with other studies, our results indicate that the coarse fraction may have a stronger effect than the fine fraction on some morbidity endpoints, especially respiratory diseases.

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Long-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.

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Cup- or sometimes slit-shaped nectary glands on the rachis are a widespread trait in the legume subfamily Mimosoideae, especially in derived tribes. Their spotty occurrence in genera that appear to be basal has led to uncertainty about when in the mimosoid radiation this character evolved. Until now, specialized rachis glands were unknown in caesalpinioids thought to be related to ancestral mimosoids. We report here the occurrence of rachis glands in seven of the ten species of the Paleotropical genus Erythrophleum, a member of the Dimorphandra group of caesalpinioids thought to include the sister group(s) of mimosoids. The histological structure and location of Erythrophleum glands suggest homology with those of mimosoids; these glands are simpler structurally than rachis glands of any known mimosoid. The Erythrophleum glands differ from those of most mimosoids in the following respects: (1) they are smaller than glands of mimosoids; (2) the secretory surface is sunken in a pit capped by a small round pore rather than exposed on a broad concave or flat surface; (3) a smaller number of cells are involved in production and secretion of nectar; (4) vascular supply to the nectary is less extensive; and (5) mechanical support tissue (sclerenchyma) is less extensive and less organized. Rachis glands appear to be absent in the nine other genera included in the Dimorphandra group. We also report the occurrence of other secretory structures (patches of glandular trichomes) on the rachis of some Caesalpinieae and Mimoseae that lack specialized nectary glands and suggest that these patches of trichomes are primitive homologues of more organized glands. We discuss the significance of these glands and of the patches of trichomes for understanding relationships among primitive mimosoids and related caesalpinioids, and for understanding the origin of ant-guard defenses typical of many mimosoids.