Susceptibility to mortality related to temperature and heat and cold wave duration in the population of Stockholm County, Sweden

Abstract

BackgroundAmbient temperatures can cause an increase in mortality. A better understanding is needed of how health status and other factors modify the risk associated with high and low temperatures, to improve the basis of preventive measures. Differences in susceptibility to temperature and to heat and cold wave duration are relatively unexplored.ObjectivesWe studied the associations between mortality and temperature and heat and cold wave duration, stratified by age and individual and medical factors.MethodsDeaths among all residents of Stockholm County between 1990 and 2002 were linked to discharge diagnosis data from hospital admissions, and associations were examined using the time stratified case-crossover design. Analyses were stratified by gender, age, pre-existing disease, country of origin, and municipality level wealth, and adjusted for potential confounding factors.ResultsThe effect on mortality by heat wave duration was higher for lower ages, in areas with lower wealth, for hospitalized patients younger than age 65. Odds were elevated among females younger than age 65, in groups with a previous hospital admission for mental disorders, and in persons with previous cardiovascular disease. Gradual increases in summer temperatures were associated with mortality in people older than 80 years, and with mortality in groups with a previous myocardial infarction and with chronic obstructive pulmonary disease (COPD) in the population younger than 65 years. During winter, mortality was associated with a decrease in temperature particularly in men and with the duration of cold spells for the population older than 80. A history of hospitalization for myocardial infarction increased the odds associated with cold temperatures among the population older than 65. Previous mental disease or substance abuse increased the odds of death among the population younger than 65.ConclusionTo increase effectiveness, we suggest preventive efforts should not assume susceptible groups are the same for warm and cold days and heat and cold waves, respectively.

What is the effect of the weather on trauma workload? A systematic review of the literature

“…Hospital admission rates for a number of conditions, most notably in respiratory and cardiovascular disease [3][4][5], have been linked to variations in the weather, and it is well established that trauma workload displays significant seasonal variation [6,7]. Weather forecasts are used to good effect in the commercial sector to predict consumer demand; a reliable predictive model in healthcare might enable targeting of high risk groups for intervention and effective planning of hospital staff levels [8][9][10].…”

Estimating and projecting the effect of cold waves on mortality in 209 US cities

“…To obtain the overall cold-related deaths, we need to estimate both the immediate and lingering effects. However, the epidemiologic estimates for the immediate effect of cold waves differed substantially across studies and there are fewer estimates for the lingering effects (Barnett and others 2012; Gasparrini and others 2015; Medina-Ramon and Schwartz 2007; Rocklov and others 2014; Ryti and others 2016). Second, evidence on what factors modify the association between cold waves and mortality is limited.…”

Heat and cardiovascular diseases: A review of epidemiological surveys

“…По данным различных авторов, в Европе и США наиболее выраженное негативное вли-яние оказывает первая волна в сезоне [18,22], однако в соответ-ствии с результатами шведского исследования по оценке смерт-ности от различных причин в 1990-2002 гг. эффекты продолжи-тельных периодов экстремальных температурных режимов не ослабевают и к концу лета [23,24]. Следует отметить, что во вре-мя длительной жары риск смерти от ССЗ повышается также у более молодых людей, в том числе трудоспособного возраста (в возрасте 45-64 лет), что может быть обусловлено в том числе ис-тощением механизмов адаптации [15,23,24].…”

“…эффекты продолжи-тельных периодов экстремальных температурных режимов не ослабевают и к концу лета [23,24]. Следует отметить, что во вре-мя длительной жары риск смерти от ССЗ повышается также у более молодых людей, в том числе трудоспособного возраста (в возрасте 45-64 лет), что может быть обусловлено в том числе ис-тощением механизмов адаптации [15,23,24]. При единичных аномально жарких днях в группе риска оказываются люди стар-шего возраста (старше 80 лет) [24].…”