Seasonal variation in mortality in The Netherlands.

Abstract

Study objective-The aim was to describe the pattern of seasonal variation in all cause mortality in The Netherlands, and to analyse the contribution of specific causes of death to the winter excess of all cause mortality.Design-Daily numbers of deaths in The Netherlands, by cause, were obtained for the period [1979][1980][1981][1982][1983][1984][1985][1986][1987]. Patterns ofvariation were analysed using Poisson regression. The model related the observed number of deaths to (1) the number expected for that day on the basis of person-days at risk by age and sex, (2) secular trend, and (3) first and higher order cosine terms where appropriate.Main results-All cause mortality has a bimodal peak in the first months of the year. After that it declines to reach a plateau in late spring. Mortality is lowest at the end of August, after which it rises steeply again. The winter excess of all cause mortality is primarily due to cardiovascular diseases (66%) and respiratory conditions (13%). Cardiovascular mortality peaks before respiratory mortality, suggesting different lag times in the effects of winter. There was an episode of exceptionally high mortality (above the normal winter excess) in early 1986, which was primarily due to cardiovascular diseases (39%) and respiratory conditions (25%). This episode was probably caused by a severe influenza epidemic, and was not followed by a compensatory lowering of mortality.Conclusions-The pattern of variation of mortality within the year suggests that it is not based on a simple relationship with climatological circumstances, because the latter fluctuate according to a less complex pattern. Cause specific data suggest an instantaneous effect of "winter" on the cardiovascular system, and a delayed effect mediated by respiratory infections.

Visualizing Mortality Dynamics in the Lexis Diagram

“…Primarily, those are circulatory diseases (e.g., heart diseases, cerebrovascular diseases)-as shown in the first row of Fig. 9.1-and respiratory diseases such as chronic obstructive pulmonary disease ("COPD"), pneumonia or influenza (Eurowinter Group 1997Mackenbach et al 1992;Kunst et al 1990;Rau 2007;Yen et al 2000;Seretakis et al 1997), which are displayed in three horizontal panels in the middle of Fig. 9.1.…”

The health benefits of a targeted cash transfer: The UK Winter Fuel Payment

“…In 2014/2015, the number of excess winter deaths in England and Wales was estimated at 43,900, the highest level since 1999. EWM has also been documented in Europe (Eng & Mercer, 1998; Keatinge & Donaldson, 1995; Kunst, Looman, & Mackenbach, 1993; Mackenbach, Kunst, & Looman, 1992; Rose, 1966), the USA (Kloner, Poole, & Perritt, 1999; Lanska & Hoffmann, 1999), and Asia (Chen, 1993; Ornato, Siegel, Craren, & Nelson, 1990). Most EWM occurs among the elderly and is due to respiratory and circulatory diseases (Donaldson, 2010; Lloyd, 2013; ONS Statistical Bulletin 2014/2015).…”

Impacto de la ola de calor de 2003 en el Hospital de Riveira (A Coruña)

“…Diversos estudios epidemiológicos describen la relación entre la temperatura ambiental y la mortalidad, y así se conoce que los periodos de tiempo prolongados con temperaturas altas se asocian a mayores impactos en la mortalidad de lo que cabría esperarse de una relación lineal, probablemente por la persistencia del estrés térmico que se extiende a las temperaturas nocturnas (12). En Holanda, se demuestran cifras de mortalidad menores en días en los que la temperatura máxima se encuentra en torno a los 20-25 ºC (13). Se considera que en el Reino Unido la mortalidad es menor cuando la temperatura media diaria está en torno a los 17-18 ºC (14).…”